Beneficial carry-over effects of chronic at-home genital nerve stimulation on incontinence in individuals with spinal cord injury: A pragmatic trial

BACKGROUND

Genital nerve stimulation (GNS) is a promising, but under-researched, alternative treatment for neurogenic detrusor overactivity (NDO) in those with spinal cord injury (SCI).

OBJECTIVES

To investigate the urodynamic, quality-of-life (QOL) and carry-over effects of GNS when applied at home for 2 weeks by participants with incomplete SCI and NDO during activities of daily living.

METHODS

Seven men and 1 woman participated in this 1-month protocol study. Urodynamic and QOL data were gathered during week 1 (baseline measurements), followed by 2 weeks of daily GNS at home using a portable device. GNS was applied either on-demand or thrice daily, depending on the individual's sensation. At week 4, post-stimulation tests were repeated to record any carry-over effect from the GNS. Participants maintained voiding diaries throughout the study. Assessments were carried out at the end of each protocol period in a randomized order. Clinical procedures were conducted at Taipei Medical University Hospital (Taipei, Taiwan).

RESULTS

Everyone completed the study but only 7 of the 8 participants completed their voiding diary. Two weeks after GNS, average cystometric bladder capacity was increased by 30 % compared to baseline (P< 0.05). A 1-week carry-over effect was demonstrated as this capacity remained, on average, 35 % greater than baseline in week 4 after GNS was stopped (P< 0.05). Incontinence frequency significantly decreased by the end of week 3 (P< 0.05) but no significant improvements were recorded for either detrusor pressure or bladder compliance.

CONCLUSIONS

Chronic at-home GNS improved cystometric bladder capacity and reduced urinary incontinence for individuals with incomplete SCI and NDO. A carry-over effect of 1 week was observed following GNS treatment. The use of portable GNS treatment that can be applied by the individual at home merits further investigation as alternative treatment for NDO in those with SCI.

NMR-based metabolomics for the environmental assessment of Kaohsiung Harbor sediments exemplified by a marine amphipod (Hyalella azteca)

Inflow of wastewater from upstream causes a large flux of pollutants to enter Kaohsiung Harbor in Taiwan daily. To reveal the ecological risk posed by Kaohsiung Harbor sediments, an ecological metabolomic approach was employed to investigate environmental factors pertinent to the physiological regulation of the marine amphipod Hyalella azteca. The amphipods were exposed to sediments collected from different stream inlets of the Love River (LR), Canon River (CR), Jen-Gen River (JR), and Salt River (SR). Harbor entrance 1 (E1) was selected as a reference site. After 10-day exposure, metabolomic analysis of the Hyalella azteca revealed differences between two groups: {E1, LR, CR} and {JR, SR}. The metabolic pathways identified in the two groups of amphipods were significantly different. The results demonstrated that NMR-based metabolomics can be effectively used to characterize metabolic response related to sediment from polluted areas.

Transparent Memory For Harsh Electronics

As a new class of non-volatile memory, resistive random access memory (RRAM) offers not only superior electronic characteristics, but also advanced functionalities, such as transparency and radiation hardness. However, the environmental tolerance of RRAM is material-dependent, and therefore the materials used must be chosen carefully in order to avoid instabilities and performance degradation caused by the detrimental effects arising from environmental gases and ionizing radiation. In this work, we demonstrate that AlN-based RRAM displays excellent performance and environmental stability, with no significant degradation to the resistance ratio over a 100-cycle endurance test. Moreover, transparent RRAM (TRRAM) based on AlN also performs reliably under four different harsh environmental conditions and 2 MeV proton irradiation fluences, ranging from 10¹¹ to 10¹⁵ cm^-2. These findings not only provide a guideline for TRRAM design, but also demonstrate the promising applicability of AlN TRRAM for future transparent harsh electronics.

Abstract P5-16-21: The association of higher tumor HER2 load with treatment response to neoadjuvant therapy in HER2 positive breast cancer patients

Background: Neoadjuvant therapy for HER2 positive invasive breast cancer is used to downstage tumor prior to surgery, objectively measure response, and evaluate novel therapies in clinical trials. Residual Cancer Burden (RCB) established by pathologic evaluation of post-treatment surgical specimens is a marker of tumor response to chemotherapy as well as predictor of recurrence-free survival in HER2 positive breast cancer. The relationship between the HER2 tumor load and the response to chemotherapy in not known.

Specific Aims: To evaluate RCB after neoadjuvant chemotherapy and HER2-targeted treatment for HER2-positive breast cancer, and to determine clinicopathologic factors associated with treatment response as represented by RCB.

Methods: This retrospective chart review included all HER2-positive breast cancer patients, stage I – III, receiving neoadjuvant chemotherapy and HER2-targeted therapy with post-treatment surgical resection at an Allina Health hospital from 2013-2016. Review of clinicopathologic variables included HER2/CEP17 ratio, HER2 absolute copies, ER/PgR status (using the H score calculation), patient age, baseline tumor size, and gross and microscopic pathology review of breast tissue specimens with RCB evaluation completed by breast pathologists. To compare factors related to response, chi-square with Monte-Carlo simulation was used to analyze dichotomous variables, and Mann Whitney U-tests were used for continuous variables.

Findings: The study included 97 patients. Upon surgical resection, complete pathologic response (RCB-0) was found in 47% (46/97 patients), and partial pathologic response (RCB-I) in 15% (15/97 patients). As compared to non-responders (RCB-2 and RCB-3) the complete and partial responders (RCB-0 and RCB-1) were associated with greater HER2/CEP17 ratios (10.2 vs. 6.5; p=0.003), and greater HER2 absolute copies (25 vs. 15.8; p &lt;0.001). Complete responders were associated with lower ER expression (H scores of 89.2 vs. 171.8; p=0.005) than non-responders, with RCB-1 responders associated with ER H-scores between RCB-0 and non-responders (H score=145.9). No significant differences were noted between responders and non-responders on age at diagnosis, pre-treatment tumor size, PgR expression, or the percentage of tumor infiltrating lymphocytes.

Conclusions: The majority of patients with HER2 positive tumors show considerable benefit with neoadjuvant chemotherapy and HER2-targeted treatment (63% in our study) based on RCB assessment. Predictors of response as measured by RCB include high HER2/CEP17 ratios, high absolute copies of HER2 signals by FISH, and lower ER expression.

Citation Format: Lillemoe TJ, Susnik B, Grimm E, Kang S-HL, Swenson KK, Krueger JL, Finkelstein MJ, Tsai ML. The association of higher tumor HER2 load with treatment response to neoadjuvant therapy in HER2 positive breast cancer patients [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-16-21.

Abstract P3-02-02: Predictive value of breast MRI in detecting mammographically occult contralateral breast cancer: Can we target women more likely to have contralateral breast cancer based on primary tumor clinicopathologic factors?

Background: Use of preoperative magnetic resonance imaging (MRI) staging in newly diagnosed breast cancer increases detection of synchronous contralateral breast cancer (CBC) over other screening modalities; however, it is associated with a high false positive rate, additional biopsies, extensive surgical procedures, and possibly increased psychological morbidity.

Specific Aims: To determine predictors of synchronous, mammographically-occult but MRI-detected CBC in women newly diagnosed with breast cancer.

Methods: We performed a retrospective review of patients at Allina Health, Abbott Northwestern Hospital who had preoperative breast MRI prior to surgical resection of their breast cancer from 2010–2014. We collected patient demographic and clinicopathologic data. To determine the association between MRI-detected CBC versus benign findings based on clinicopathologic data, we performed univariate analysis (p&lt;0.05). Multivariate Logistic Regression was used to adjust for covariates and factors predictive of CBC. Area under the Receiver Operating Characteristic Curve provided a measure of model accuracy.

Findings: 1894 patients had pre-operative MRI during the study period. Of those, 201 had suspicious findings on contralateral breast MRI requiring biopsy (table 1). Overall 3% (60/1894) had synchronous CBC (invasive carcinoma or DCIS) detected on MRI. The majority of CBCs (n=60) were stage 0 or IA (85%), ER/PgR+ (98%), HER2- (89%), and low/intermediate grade (80%). Women more likely to have mammographically-occult CBC were older (p&lt;0.001), had lobular versus ductal index cancer (p=0.03), and had ER positive (p=0.027) or PgR positive (p=0.002) tumors. On multivariate logistic regression analysis (ROC area=0.75), PgR positive status (p=0.022), and older age (p=0.004) were predictive of CBC. With each year of additional age, odds of CBC increased by 5%. No CBC was identified in women &lt; age 45 with high risk index cancers (ER- or HER2 +). CBC was 11 times more likely when PgR status was positive versus negative. CBCs were diagnosed significantly more frequently in patients with index cancers that were hormone receptor positive and HER2 negative compared to HER2 positive or triple negative invasive index cancers (Fisher's exact test; p=0.041).

Risk of CBC by Index Cancer TypeIndex CancerCBC n (%)DCIS (n=51)15 (29)Invasive carcinoma (n=150)45 (30)ER+/HER2- (n=121)41 (34)HER2 positive (n=18)3 (17)Triple Negative (n=11)1 (9)Total (n=201)60 (30)

Conclusions: Preoperative MRI is effective in detecting mammographically-occult early stage, hormone receptor positive CBC in older women. MRI-detected CBC is more common in patients originally presenting with hormone receptor positive and HER2 negative index cancers. Our results suggest that it may be possible to determine a subset of patients who are less likely to benefit from a preoperative breast MRI, an important implication in an era of increasing healthcare cost utilization awareness.

Citation Format: Susnik B, Lillemoe TJ, Swenson KK, Tsai ML, Finkelstein MJ, Schneider L, Braatz CM, Krueger JL, Rueth N. Predictive value of breast MRI in detecting mammographically occult contralateral breast cancer: Can we target women more likely to have contralateral breast cancer based on primary tumor clinicopathologic factors? [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-02-02.

Salivary proteomics in bisphosphonate-related osteonecrosis of the jaw

OBJECTIVE

The objective of this study was to identify differentially expressed salivary proteins in bisphosphonate-related osteonecrosis of the jaw (BRONJ) patients that could serve as biomarkers for BRONJ diagnosis.

SUBJECTS AND METHODS

Whole saliva obtained from 20 BRONJ patients and 20 controls were pooled within groups. The samples were analyzed using iTRAQ-labeled two-dimensional liquid chromatography-tandem mass spectrometry.

RESULTS

Overall, 1340 proteins were identified. Of these, biomarker candidates were selected based on P-value (<0.001), changes in protein expression (≥1.5-fold increase or decrease), and unique peptides identified (≥2). Three comparisons made between BRONJ and control patients identified 200 proteins to be differentially expressed in BRONJ patients. A majority of these proteins were predicted to have a role in drug metabolism and immunological and dermatological diseases. Of all the differentially expressed proteins, we selected metalloproteinase-9 and desmoplakin for further validation. Immunoassays confirmed increased expression of metalloproteinase-9 in individual saliva (P = 0.048) and serum samples (P = 0.05) of BRONJ patients. Desmoplakin was undetectable in saliva. However, desmoplakin levels tended to be lower in BRONJ serum than controls (P = 0.157).

CONCLUSIONS

Multiple pathological reactions are involved in BRONJ development. One or more proteins identified by this study may prove to be useful biomarkers for BRONJ diagnosis. The role of metalloproteinase-9 and desmoplakin in BRONJ requires further investigation.

High-voltage thin-film GaN LEDs fabricated on ceramic substrates: the alleviated droop effect at 670 W/cm(2)

High-voltage thin-film GaN LEDs with the emission wavelength of 455 nm were fabricated on ceramic substrates (230 W/m · K). The high-voltage operation was achieved by three cascaded sub-LEDs with dielectric passivation and metal bridges conformally deposited on the side walls. Under the driving power of 670 W/cm(2), the high-voltage LEDs exhibit much alleviated efficiency droop and the operative temperature below 80 °C. The excellent performances were attributed to the improved current spreading within each sub-LED and the superior heat sinking of the ceramic substrate.

Automatic microfluidic platform for cell separation and nucleus collection

This study reports a new biochip capable of cell separation and nucleus collection utilizing dielectrophoresis (DEP) forces in a microfluidic system comprising of micropumps and microvalves, operating in an automatic format. DEP forces operated at a low voltage (15 Vp-p) and at a specific frequency (16 MHz) can be used to separate cells in a continuous flow, which can be subsequently collected. In order to transport the cell samples continuously, a serpentine-shape (S-shape) pneumatic micropump device was constructed onto the chip device to drive the samples flow through the microchannel, which was activated by the pressurized air injection. The mixed cell samples were first injected into an inlet reservoir and driven through the DEP electrodes to separate specific samples. Finally, separated cell samples were collected individually in two outlet reservoirs controlled by microvalves. With the same operation principle, the nucleus of the specific cells can be collected after the cell lysis procedure. The pumping rate of the micropump was measured to be 39.8 microl/min at a pressure of 25 psi and a driving frequency of 28 Hz. For the cell separation process, the initial flow rate was 3 microl/min provided by the micropump. A throughput of 240 cells/min can be obtained by using the developed device. The DEP electrode array, microchannels, micropumps and microvalves are integrated on a microfluidic chip using micro-electro-mechanical-systems (MEMS) technology to perform several crucial procedures including cell transportation, separation and collection. The dimensions of the integrated chip device were measured to be 6x7 cm. By integrating an S-shape pump and pneumatic microvalves, different cells are automatically transported in the microchannel, separated by the DEP forces, and finally sorted to specific chambers. Experimental data show that viable and non-viable cells (human lung cancer cell, A549-luc-C8) can be successfully separated and collected using the developed microfluidic platform. The separation accuracy, depending on the DEP operating mode used, of the viable and non-viable cells are measured to be 84 and 81%, respectively. In addition, after cell lysis, the nucleus can be also collected using a similar scheme. The developed automatic microfluidic platform is useful for extracting nuclear proteins from living cells. The extracted nuclear proteins are ready for nuclear binding assays or the study of nuclear proteins.

The differential effects of tamoxifen and ICI 182,780 on the reduction of Na+/K+ ATPase activity and spontaneous oscillations by 17beta-estradiol

A prolonged treatment with 17beta-estradiol reduces the frequency of spontaneous oscillations and the Na+/K+ ATPase activity in rat uteri. Acute inhibition of Na+/K+ ATPase activity by a Na+/K+ ATPase inhibitor, ouabain, decreases the frequency of oxytocin-induced oscillations in uteri. Therefore, the purpose of this study was to examine whether the prolonged inhibition of Na+/K+ ATPase activity by 17beta-estradiol was estrogen receptor (ER)-dependent. The uterine explants from ovariectomized rats were cultured in vitro as our experimental model to compare the effect of two antiestrogenic compounds (ICI 182,780 and tamoxifen) on the Na+/K+ ATPase activity and the frequency of spontaneous oscillations. ATPase assay and a standard muscle bath apparatus were to measure the activity and the contraction. When compared with the control, a 2-day treatment with 17beta-estradiol in vivo or in vitro decreased the activity and the frequency. ICI 182,780 lowered the activity but tamoxifen did not. ICI 182,780 did not decrease the frequency but tamoxifen did. Even the reversal effects of these antiestrogenic compounds on the reduced activity and the frequency by 17beta-estradiol were different. Tamoxifen elicited a greater reversal effect on the reduced activity but ICI 182,780 did not. In contrast, ICI 182,780 elicited a greater reversal effect on the reduced frequency but tamoxifen did not. Prolonged inhibition of Na+/K+ ATPase activity by K+-free solution suppressed the frequency with the elevation of basal tension. Addition of KCl at lower concentrations (0.3-1.2 mM) induced oscillatory contraction after reducing the basal tension. As our data suggest, the prolonged effect of 17beta-estradiol may decrease uterine the activity through ER dependent and independent pathways. The reduction of uterine Na+/K+ ATPase activity by estrogens may increase the basal tension after each oscillatory cycle, which, in part, contributes to the reduced frequency of spontaneous oscillations.

Potent cytotoxic lignans from Justicia procumbens and their effects on nitric oxide and tumor necrosis factor-alpha production in mouse macrophages

A new lignan glycoside, 4-O-alpha-L-arabinopyranosyl-(1' "-->2' ')-beta-D-apiofuranosyldiphyllin (2), named procumbenoside A, and 11 known compounds were isolated from the whole plant of Justicia procumbens. The structure of 2 was established by spectral analysis and chemical methods. The known compounds justicidin A (1), diphyllin (3), and tuberculatin (4) showed potent cytotoxic effects against a number of cancer cells in vitro. Compounds 1 and 4 also strongly enhanced tumor-necrosis factor-alpha (TNF-alpha) generation from mouse macrophage-like RAW 264.7 cells stimulated with lipopolysaccharide (LPS).

Clinical and electroencephalographic findings in early and late onset benign childhood epilepsy with occipital paroxysms

Twenty-six patients were studied who had the clinical and electroencephalographic features of benign childhood epilepsy with occipital paroxysms (BCEOP) as defined by the Commission of the International League Against Epilepsy (ILAE). Twelve patients were characterized as having early-onset benign childhood occipital seizures (EBOS) susceptible syndrome, as described by Panayiotopoulos, and 14 patients had late onset childhood idiopathic occipital seizures (LOS). Patients with symptomatic epilepsy and whose EEGs exhibited occipital spikes were excluded. The age of onset of the EBOS group ranged from 2.6 to 9.4 years (mean: 4.9+/-1.7 years), which was significantly younger than the LOS group (range: 4-12 years, mean:8.4+/-2.5 years). Both sexes were equally affected. The patients in the EBOS group had less frequent and longer seizures, ictal vomiting, more frequent deviation of the eyes, adversive seizures and more frequent nocturnal and secondary generalized seizures (P<0.05). By comparison, patients in the LOS group had a higher incidence of seizures, shorter duration of seizures and more frequent diurnal onset (P<0.01); also, although not statistically significant, the LOS group had more frequent visual hallucinations and headaches. The EEG topography in both groups showed at either side of occipital area typical paroxysms that were unilateral or bilaterally synchronous. Neither group had dipoles according to scalp voltage mapping. The clinical prognoses were favorable for both groups. To distinguish EBOS from LOS, detailed description of the age of onset, motor symptoms, visual symptoms, presence of eye deviation and diurnal or nocturnal occurrence are essential.

Effect of antenatal dexamethasone on the expression of endothelial nitric oxide synthase in the lungs of postnatal pups

Activities of endothelial nitric oxide synthase (eNOS) are developmentally regulated and its presence at birth may play a role in the transition of cardiopulmonary circulation. Antenatal dexamethasone (Dex) therapy accelerates fetal lung maturation. We speculate that Dex therapy may enhance pulmonary eNOS protein expression in the newborn. This article examines whether antenatal Dex therapy affected the expression of eNOS in the lungs of rat pups in the postnatal period. Time-dated pregnant Wistar rats were subjected to 2 doses of Dex (0.8 mg/kg, intramuscularly, daily) or equivalent volume of normal saline at the 18th and 19th gestational day and delivered naturally. The newborn pups were randomly assigned to 4 groups by age: days 1, 3, 5, and 7. After homogenization, abundance of eNOS protein in lungs was determined by Western blot analysis. There were 7 dams in each group. Mean body weights of the pups in the Dex group were lighter than those in the control at birth and remained stunted up to day 7 (5.68+/-0.47 g v 6.34+/-0.47 g, P <.01). However, there were no differences in wet lung weights and lung/body weight ratios between both groups in the study period. Abundance of eNOS protein expression decreased in both the control and Dex groups (P < .01). Pups that received antenatal Dex had 39% more in abundance of eNOS protein expression in lungs when compared to the control on day 1 (P < .05) but there were no differences between both groups from day 3 to 7. We conclude that antenatal Dex therapy enhances the abundance of eNOS protein expression in the lung at birth and could be a factor in improving respiratory functions in infants who received antenatal steroid therapy.

The spectrum of postinfectious encephalomyelitis

The medical records of 52 consecutive patients diagnosed with postinfectious encephalitis/encephalomyelitis during the period from 1980 to 1998, including 29 males and 23 females, were reviewed. These patients were divided into three groups according to their clinical and neurodiagnostic characteristics: (1) group I: postinfectious encephalitis, 38 patients; (2) group II: acute disseminated encephalomyelitis (ADEM), 13 patients; (3) group III: multiphasic disseminated encephalomyelitis (MDEM), one patient. Fever, headache/vomiting, seizure and disturbance of consciousness were common clinical features in all patients, while pictures of pyramidal, extrapyramidal, brainstem, and spinal cord lesions were more often found in the group II and group III patients than in the group I patients. Magnetic resonance imaging (MRI) revealed abnormal lesions in six (60%) of ten group I patients, but all group II (n=7) and group III (n=1) patients who received MRI study showed abnormal signals in various regions of the brain including the cerebral hemisphere, basal ganglia, brainstem and cerebellum. Patients with ADEM and MDEM had a longer clinical course and more neurological sequelae than group I patients. This study demonstrates the breadth of the clinical spectrum of postinfectious encephalomyelitis. Thorough clinical observations and appropriate neurodiagnostic studies such as MRI are crucial for the diagnosis.

The inhibitory effects of lead on steroidogenesis in MA-10 mouse Leydig tumor cells

Lead is an environmental and occupational pollutant. It has been reported that lead affects the male reproductive system in humans and animals. However, the cellular mechanism of the adverse effect of lead on Leydig cell steroidogenesis remains unknown. To clarify whether lead has a direct effect on Leydig cells and how lead affects Leydig cells, MA-10 cells, a mouse Leydig tumor cell line, were exploited in this study. Lead acetate significantly inhibited hCG- and dbcAMP-stimulated progesterone production in MA-10 cells at 2 h. Steroid production stimulated by hCG or dbcAMP were reduced by lead. The mechanism of lead in reducing MA-10 cell steroidogenesis was further investigated. The expression of Steroidogenic Acute Regulatory (StAR) protein and the activities of P450 side-chain cleavage (P450scc) and 3beta-hydroxysteroid dehydrogenase (3beta-HSD) enzymes were detected. Cells were treated with dbcAMP, 22R-hydroxycholesterol or pregnenolone alone or in combination with lead acetate ranging from 10(-8) to 10(-5) M for 2 h. The expression of StAR protein stimulated by dbcAMP was suppressed by lead at about 50%. Progesterone productions treated with 22R-hydroxycholesterol or pregnenolone were reduced 30-40% in lead-treated MA-10 cells. These data suggest that lead directly inhibited steroidogenesis by decreasing StAR protein expression and the activities of P450scc and 3beta-HSD enzymes with a dose-response trend in MA-10 cells. Moreover, cadmium, a calcium channel blocker, abolished inhibitory effect of lead on MA-10 cell steroid production. This indicates that lead might act on calcium channel to regulate MA-10 cell steroidogenesis.

Postinfectious encephalomyelitis: etiologic and diagnostic trends

Fifty cases of postinfectious encephalomyelitis admitted to our Pediatric Department during the period 1980 to 1997 were consecutively collected and reviewed. There were 28 males and 22 females. The age of onset ranged from 9 months to 14 years. The antecedent infections included measles (6 cases), rubella (5 cases), mumps (4 cases), chicken pox (4 cases), Epstein-Barr virus infection (11 cases), mycoplasma infection (6 cases), and unknown etiology (14 cases). The cessation of measles, rubella, and mumps as causes for encephalomyelitis in our patients corresponds with the introduction of a measles-mumps-rubella nationwide vaccination program in Taiwan commencing in 1992. The main clinical symptoms were fever, headache, and/or vomiting, seizure, and motor weakness. The presenting signs included altered consciousness, meningeal signs, cranial nerve palsy, brainstem signs, involuntary movement, and cerebellar signs. Computed tomography scans were abnormal for 14 (56%) of 25 patients studied, whereas magnetic resonance imaging (MRI) disclosed lesions in 14 (82%) of 17 patients, with abnormal signals in various parts of the cerebral hemisphere, as well as in the basal ganglion, diencephalon, midbrain, brain stem, and cerebellum. Of the three patients with negative MRI findings, an abnormal finding on somatosensory evoked potential was noted for one patient, and a focal decrease in tracer uptake on single photon emission computed tomography (SPECT) was found for the other two patients. This study demonstrates that the causative agents of postinfectious encephalomyelitis in Taiwan have changed from those of traditional exanthematous diseases to nonspecific respiratory infections and suggests that this may also be the case in other parts of the world. MRI remains the imaging method of choice, whereas other neurofunctional studies such as evoked potentials and SPECT are complementary for the diagnosis.

Epstein-Barr virus encephalitis in children

Fourteen children with Epstein-Barr virus (EBV) encephalitis admitted to our pediatric department during the period 1988 to 1998 were collected and reviewed to characterize the clinical, laboratory and neuroradiological findings. There were 7 boys and 7 girls. The age of onset ranged from 10 months to 14 years. Among them, 5 patients belonged to Alice in Wonderland syndrome, 5 were diagnosed as acute viral encephalitis, 1 presented with acute meningoencephalitis followed by cerebellitis, the remaining 3 cases attributed to acute disseminated encephalomyelitis. The main symptoms were fever (43%), seizure (36%), bizarre behavior (31%), headache (21%) and metamorphopsia (36%). The presenting signs included altered consciousness (50%), meningeal sign (14%), bulbar sign (14%), cerebellar sign (7%), and cranial nerve palsy (7%). Classic findings of infectious mononucleosis were obscure. The laboratory data showed the existence of atypical lymphocyte in only one case but positive serology for EBV infection in all patients. Pleocytosis was found in 3 (30%) of 10 patients examined. Eight (67%) of 12 patients had nonspecific electroencephalographic changes in the acute stage. Computed tomography (CT) scans were abnormal in 2 (40%) of 5 patients tested; while magnetic resonance image (MRI) disclosed lesions in 5 (56%) of 9 patients, with abnormal signals in various parts of the brain. Single photon emission computed tomography (SPECT) brain scan showed abnormal perfusion lesions in 3 (75%) of 4 patients studied. The results demonstrate the diversity of neurological manifestations of EBV encephalitis. EBV should be considered in any acute neurological illness of uncertain etiology in the pediatric population. While MRI remains the image of choice in EBV encephalitis, SPECT detects the abnormal perfusion more precisely in a substantial number of patients.

Preferential reduction of Na+/K+ ATPase alpha3 by 17beta-estradiol influences contraction frequency in rat uteri

One beta1 and two alpha (alpha1 and alpha3) isoforms of Na+/K+-ATPase exist in rat uteri. Previous immunocytochemistry studies have suggested that the alpha3 isoform may be involved in calcium regulation indirectly. Estrogens are known to both modulate Na+/K+-ATPase activities in non-uterine tissues and suppress spontaneous uterine contractions in rats. Thus the purpose of this study was to examine the correlation between estrogens-modulated uterine contraction and the expression of Na+/K+-ATPase alpha3 isoform in rats. After 1-, 2-, and 4- day treatments with 17beta-estradiol (E2, 5 microg/ml/kg, s.c., daily), the diameter of uterine horn was measured. The contraction force of uterine strips was measured by standard muscle bath apparatus. The protein abundance and enzyme activity of Na+/K+-ATPase in rat uteri were measured by Western blot analysis and ATPase assay, respectively. One day of E2 decreased both contraction frequency and alpha3-protein expression without the change in uterine diameter, enzyme activity or other isoforms. Two days of E2 reduced contraction frequency, the enzyme activity, as well as alpha3- and beta1- protein abundance but increased alpha1-protein and uterine diameter. Four days of E2 elicited similar effects as two days of E2, but did not affect alpha1-protein abundance. In conclusion, E2 elicits differential effects on isoform expression. After 1-day treatment with 17beta-estradiol, the decrease in the expression of alpha3 and beta1 without a change in Na+/K+-ATPase activity suggests that some isoform other than beta1 exist in rat uteri. The positive correlation between the reduction of alpha3-and the decrease of contraction frequency suggests the involvement of alpha3 isoform in uterine oscillation.

In vivo exposure to carbon disulfide increases the contraction frequency of pregnant rat uteri through an indirect pathway

Exposure to CS2, an organic solvent, is associated with an increased rate of abnormal labor or dysmenorrhea. Contraction of quiescent uteri during pregnancy can cause preterm labor. We wish to know the effects of in vivo and in vitro exposures to CS2 on uterine contractions of mid-gestation rats. After 10-d exposure to 300 or 600 mg/kg CS2, uteri of pregnant rats were measured for contractile responses to various stimuli, such as KCl, oxytocin, carbachol or A23187, a calcium ionophore, using standard muscle bath apparatus. CS2 treatment significantly increased the contractile response to KCl, carbachol, and A23187. The increase to A23187 was the greatest. In contrast, in vitro exposure to CS2 immediately suppressed carbachol-induced contraction but did not affect spontaneous and KCl-induced contractions. Results showed the pregnant uterus of the rat is susceptible to CS2. The influence of in vivo exposure to CS2 on uterine contraction was opposite to that in vitro. The increased response of CS2-treated uteri to A23187 suggests that in vivo exposure to CS2 may sensitize contraction machinery to calcium through indirect pathways.

Effects of Fructus schizandrae on cycloheximide-induced amnesia in rats

The effects of Fructus Schisandrae (Schizandra Chinensis, (FS) on cycloheximide (CXM)-induced amnesia by using a passive avoidance task were studied in rats. FS at 0.25 and 0.75 g/kg administered for 1 week significantly prolonged the CXM-shortened step-through latency (STL). Of the fractions (n-hexane, chloroform and water), only the water fraction at 25 mg/kg administered for 1 week prolonged the CXM-shortened STL. These results suggest that the water fraction is the main active fraction of FS.

Effects of Fructus schizandrae on cycloheximide-induced amnesia in rats

The effects of Fructus Schisandrae (Schizandra Chinensis, (FS) on cycloheximide (CXM)-induced amnesia by using a passive avoidance task were studied in rats. FS at 0.25 and 0.75 g/kg administered for 1 week significantly prolonged the CXM-shortened step-through latency (STL). Of the fractions (n-hexane, chloroform and water), only the water fraction at 25 mg/kg administered for 1 week prolonged the CXM-shortened STL. These results suggest that the water fraction is the main active fraction of FS.

Quantitative relationship between fluctuations of blood pressure and sympathetic nerve activity in pentobarbital anesthetized rats

Transfer function analysis was used to examine the coupling between the sympathetic nerve activity (SNA) and the blood pressure (BP) fluctuations. In pentobarbital anesthetized Wistar rats, linear regression of the relationship between frequency (X-axis) and the logarithmic transfer magnitude, i.e. log (BP power density/renal SNA power density) (Y-axis), in the low frequency range (0.016-0.85 Hz) revealed an excellent fit (r = 0.97-0.98). Comparing the regression lines, rats under large dose of pentobarbital anesthesia (40 mg/kg, i.v. single dose) had significantly smaller intercept and slope values compared to rats under small dose of pentobarbital anesthesia (12.5 mg/kg). When intercept and slope values were compared between intact and acutely sinoaortic denervated rats, no significant difference were found. The results suggest that sympathetic modulation of vasomotor tone may be a major factor in generating BP fluctuations between 0.016 and 0.85 Hz in rats. Furthermore, these results support the possibility of using low frequency spectral power of BP to quantitatively estimate the fluctuations of SNA for rats under pentobarbital anesthesia if anesthetic depth is controlled.

Effect of U-995, a potent shark cartilage-derived angiogenesis inhibitor, on anti-angiogenesis and anti-tumor activities

BACKGROUND

A potent angiogenesis inhibitor, U-995, has been purified from the cartilage of the blue shark (Prionace glauca). U-995 is composed of two single peptides with molecular mass of 10 and 14 kDa, respectively.

MATERIALS AND METHODS

U-995 was designed to study human umbilical vein endothelial cell (HUVEC) migration and proliferation in vitro and angiogenesis induced by TNF alpha in chicken chorioallantoic membrane (CAM). Furthermore, we determined the ability of U-995 to inhibiting tumor cell growth and metastasis.

RESULTS

U-995 (15 and 30 micrograms/ml) markedly inhibited HUVEC migration and, at 15-50 micrograms/ml produced a dose-dependent decline in [3H]-thymidine incorporation. 30 and 50 micrograms/ml of U-995, when added to TNF alpha-induced angiogenesis caused discontinuous and disrupted blood vessels. Moreover, U-995 (30 micrograms/ml) markedly prevented collagenase-induced collagenolysis. In addition, when 200 micrograms U-995 was injected i.p. into mice it suppressed sarcoma-180 cell growth and B16-F10 mouse melanoma cell metastasis in vivo.

CONCLUSIONS

These results suggest that the anti-angiogenic effects of U-995 may be be due to interference with the proliferation and migration of HUVECs as well as inhibition of collagenolysis, thereby leading to inhibition of both angiogenesis and tumor cell growth.

Acute inhibition of spontaneous uterine contractions by an estrogenic polychlorinated biphenyl is associated with disruption of gap junctional communication

An estrogenic polychlorinated biphenyl, 4-hydroxy-2',4', 6'-trichlorobiphenyl (4-OH-TCB), inhibits oscillatory uterine contractions immediately. Because increased gap junction formation is associated with the development of synchronized uterine contractions at term, we examined whether the inhibitory effect of 4-OH-TCB on spontaneous oscillatory contractions was due to the disruption of gap junctional communication. The effect of 4-OH-TCB on gap junctional communication was determined by intercellular Lucifer yellow dye transfer in primary cultures of myometrial myocytes isolated from midgestation rats. Intercellular dye transfer was inhibited by 4-OH-TCB or 17beta-estradiol in a concentration-dependent manner. The inhibitory effect of 4-OH-TCB on intercellular dye transfer was reversed by tetraethylammonium (TEA). To examine effects on uterine contraction, longitudinal uterine strips were excised from midgestation rats and placed in muscle baths for isometric force measurement. Spontaneous uterine oscillation was suppressed by 4-OH-TCB or 17beta-estradiol. The inhibitory effects of 4-OH-TCB and 17beta-estradiol on spontaneous oscillations were counteracted by TEA but were not affected by a calcium ionophore (A23187) or a calcium-dependent potassium channel blocker (apamin). These results suggest that the acute inhibition of spontaneous oscillatory contractions by an estrogenic polychlorinated biphenyl may result from the disruption of intercellular communication.

Attenuation of cardiac but not vascular component in baroreflex of spontaneously hypertensive rats

The cardiac and vascular components of the baroreceptor reflex in spontaneously hypertensive rat (SHR) and stroke-prone spontaneously hypertensive rat (SHRSP) were compared against their counterparts in normotensive Wistar Kyoto rat (WKY). SHR, SHRSP and WKY of 12-16 weeks old were chronically instrumented for intra-arterial recording of blood pressure. Intravenous injections of phenylephrine and nitroprusside were used to challenge their baroreflex. The products of blood pressure change and the half time required for the pressure to return to the control value were used as the quantitative estimation of the blood pressure stabilizing capability. The cardiac component of the baroreflex was obtained from the change in the blood pressure stabilizing capability after blockade of beta and muscarinic receptors by atenolol and atropine, respectively. The vascular component was obtained by subtracting the cardiac component from the total stabilizing capability which was the difference after blockade with a ganglionic transmission blocker, hexamethonium. We found the cardiac component of the baroreflex of the hypertensive rats was significantly less sensitive than that of the WKY. In contrast, the vascular component of the baroreflex of the three strains did not differ significantly. Therefore, we concluded that the 12-16 week old SHRs were able to maintain a stable blood pressure due to the intact vascular component of the baroreflex.

Evidence of independent origin of multiple tumors from patients with prostate cancer

BACKGROUND

In men with prostate cancer, the gland usually contains two or more widely separate tumors. A critical issue of prostatic carcinogenesis is whether these multiple tumors are independent in origin. Molecular analysis of microsatellite (i.e., highly repeated, short nucleotide sequences) alterations in the DNA from separate tumors in the same prostate can be used to determine whether or not these separate tumors arise independently.

METHODS

Four microsatellite polymorphic markers (D8S133, D8S136, and D8S137, for a putative tumor suppressor gene on chromosome 8p, and D17S855, for the BRCA1 gene on chromosome 17q) were used to examine the pattern of allelic loss in prostate cancer from 19 patients who had two or more distantly separate tumors (i.e., located on contralateral sides or separated by at least half the anterior-posterior diameter of the prostate). Forty distantly separate tumors were microdissected, DNA samples were prepared from formalin-fixed, paraffin-embedded wholemount prostate tissue section, and the overall frequencies of loss of heterozygosity at the four loci were determined.

RESULTS

The pattern of allelic loss was compatible with independent tumor origin in 15 of 18 informative cases. A random discordant pattern of allelic deletion was observed in distantly separate tumors, whereas the same allele was consistently lost in cells from different regions of the same tumor. For three patients, the results were compatible with either intraglandular dissemination or independent origin of prostate cancer.

CONCLUSIONS

Our data suggest that multiple tumors in some patients with prostate cancer have independent origin.

Topographic mapping and clinical analysis of benign childhood epilepsy with centrotemporal spikes

We studied the topographic mapping of the electroencephalography (EEG) of 47 children whose clinical history and course were compatible with typical benign childhood epilepsy with centrotemporal spikes (BCECT). Twenty-nine (62%) patients showed typical dipole fields, with a negative potential field in the centrotemporal region and a positive field in the frontal region. Eighteen children did not demonstrate the typical dipole field. Their non-dipole rolandic discharges were localized in small fields of centrotemporal region. The patients with dipole fields in BCECT had significantly less frequent seizures than patients without dipole fields. Twelve of the 47 patients with BCECT (26%) had more than one EEG focus. The clinical courses of patients with multiple foci were not worse than those of patients with a single focus. We conclude that EEG topographic mapping is helpful in identifying typical or atypical EEG topographic patterns in patients with clinically diagnosed BCECT. We also conclude that the presence of dipole field usually indicates a better clinical course of epilepsy and multiple foci do not mean a poor clinical course.

Desiccation resistance of two semiterrestrial isopods, Ligia exotica and Ligia taiwanensis (Crustacea) in Taiwan

The ability to resist desiccation stress was examined in two semiterrestrial Ligia species, Ligia exotica Roux and L. taiwanensis Lee, in Taiwan, under a certain desiccation condition. L. exotica exhibited the longer survival time, lower weight-specific rates of water loss, and the slightly higher ability of tolerance to water loss, compared to L. taiwanensis. In each species, the animal size displays a positive correlation to the survival time and total ability to resist desiccation, yet this size effects on the weight-specific water loss rate is negative. Neither water content nor maximum tolerance to water loss shows the association with the animal size in both species. The path ways and magnitudes of the interactions between these traits of desiccation resistance are analyzed and diagrammed using a stepwise regression model. In this model, the body sizes of animal can explain the most part of the variations in the survival time. The body size has a direct effect and an indirect effect, through the effect on water loss rate, on the time that the experimental animals can survival under this desiccated condition. These results suggest that L. exotica attains larger size than does L. taiwanensis, a lower transpiration rate and, consequently, a greater ability in desiccation resistance. The performances of these interactions in the desiccated resistance are more advantageous for L. exotica to migrate and colonize in variable land habitats within a certain limit, and as a result that L. exotica shows a broader distribution pattern than did L. taiwanensis in Taiwan.

A simple method for the construction of a recording-injection microelectrode with glass-insulated microwire

A rapid method for the production of a glass-insulated microwire electrode is described. A microwire was threaded into a glass capillary which was then pulled on a vertical pipette puller. A conical tip of the microwire was formed when the strongly heated glass capillary broke together with the wire in it. A tight seal of the glass-insulated microwire electrode between the glass and the metal was accomplished with silicone glue. The manufactured electrode performed consistently at different immersion depths, and yielded stable recordings of single units in the cerebral cortex and the medulla of rats. The strength and low impedance characteristics of the glass-insulated microwire electrode may make it useful for the recording of single units in deep brain structures. Furthermore, the electrode can be easily combined with another glass micropipette to form a dual recording-injection microelectrode unit.

Increase of oxytocin-induced oscillatory contractions by 4-hydroxy-2',4',6'-trichlorobiphenyl is estrogen receptor mediated

Polychlorinated biphenyls (PCBs) are ubiquitous environmental contaminants that are associated with decreased gestation length in women as well as other mammals. Many lightly chlorinated PCBs are hydroxylated in vivo. The PCB congener 4-hydroxy-2',4',6'-trichlorobiphenyl (4-OH-TCB) has a high affinity for estrogen receptors and exerts a uterotropic effect in vivo. This study tested the hypothesis that 4-OH-TCB increases the contractile response of midgestation uteri to oxytocin by an estrogen receptor-mediated mechanism. After in vitro treatments with 4-OH-TCB or estradiol-17beta for 20 h or 42 h, uterine explants from midgestation rats were mounted in standard muscle baths for measurement of isometric contractions. A 20-h exposure to either 4-OH-TCB (0.1, 1, or 10 microM) or estradiol-17beta (10 nM) failed to alter the contractile response to cumulative additions of oxytocin (10(-10) to 10(-7) M). However, a 42-h exposure to either 1 microM 4-OH-TCB or 10 nM estradiol-17beta significantly elevated the contractile response to oxytocin, which was abolished by cotreatment with the estrogen receptor antagonist tamoxifen (30 nM). These data support the hypothesis that the stimulatory actions of estradiol-17beta and 4-OH-TCB on oxytocin-induced oscillatory contractions are mediated by estrogen receptors. Under the conditions of this experiment, more than 20 h of treatment is required to elicit the estrogen-dependent responses.

Frequency dependent sympathetic modulation of vasomotor tone in the anesthetized rat

The hypothesis that sympathetic nerve system modulates a specific frequency range of blood pressure fluctuation was tested by electrical stimulation of the medullary sympathetic excitatory sites in anesthetized, paralyzed, vagotomized, cardiac sympathetic blocked, baroreceptor transected and angiotensin II converting enzyme inhibited rats. The frequency tested ranged from 0.02 to 1.7 Hz. For blood pressure fluctuation within this range there was no specific sympathetic reactive zone. Instead, low frequency fluctuation of sympathetic flow produced blood pressure fluctuation of the same frequency. Transfer magnitude of renal sympathetic activity to blood pressure decrease logarithmically with the increase of stimulation frequency. The relationship between the sympathetic spectral power (P(SND), (microV.s)2/Hz) and the blood pressure spectral power (P(BP), mmHg2/Hz) was found as P(BP)=10(1.3) x P(SND) x 10(-4.7x(frequency)). This transfer function demonstrates that when blood pressure fluctuation is used to estimate the sympathetic activity, it should be frequency weighted.

Effect of dietary fish oil on plasma lipoprotein cholesterol in rats fed a diet enriched in cholesterol and sucrose

The aim of this study was to examine the effect of dietary fish oil on plasma lipoprotein cholesterol levels in rats fed different carbohydrate sources. Male Wistar rats fed a soy bean oil diet or a fish oil diet containing 0.5% cholesterol were studied for 7 weeks. Corn starch or sucrose were used as carbohydrate sources in the experimental diet. Fish oil supplementation significantly (p < 0.05) decreased plasma VLDL (very low density lipoprotein) cholesterol in rats fed a diet containing corn starch. However, there was no significant difference in plasma total cholesterol and LDL (low density lipoprotein) cholesterol in rats fed a corn starch diet with fish oil treatment. In the experiment with sucrose, significantly (p < 0.05) decreased plasma total cholesterol, LDL cholesterol and VLDL cholesterol were observed in rats fed a fish oil diet. Although higher plasma total and VLDL cholesterol levels were found in rats fed the sucrose diet when compared with those fed the corn starch diet, no significant difference between the corn starch group and the sucrose group was observed in rats after fish oil treatment. Results from the present study suggest that the carbohydrate source might play an important role in the regulation of plasma lipoprotein metabolism in rats fed fish oil.

The association of periventricular echodensity with cerebral palsy in preterm infants

The purpose of this study was to investigate the risk factors of development of cerebral palsy (CP) in preterm infants who had periventricular echogenic abnormalities with or without cyst formation. During a period of 66 months, 332 newborns of 34 weeks gestation or less born at our hospital received serial brain ultrasound scans. Sixty-six of the 332 infants, 36 males and 30 females, were detected increased periventricular echodensity (PVE) during admission period. Subsequently, serial brain ultrasound scans were done for the 66 preterm infants at our follow-up clinic. Their neurodevelopment outcomes were then followed up for 10-48 months. The degree of periventricular echodensity (PVE) was graded as mild; or moderate to severe, according to the extent of the echodensity. Periventricular echodensity with cyst formation was classified by the size of the cyst at its widest diameter as either large (3 mm or multiple) or small (< 3 mm) in the parasagittal image. Eighteen of 66 (27.3%) infants developed cerebral palsy (CP). Infants with PVE with large cystic formation were at significantly higher risk for development of cerebral palsy (P < 0.005). Nine of 16 (56.3%) patients in the CP group had a longer duration of PVE than the non-CP group (8 of 46 patients: 17.4%) (p < 0.005). It is concluded that large cystic periventricular echodensity and long duration of PVE are associated with later development of cerebral palsy.

Multiphasic disseminated encephalomyelitis mimicking multiple sclerosis

We report a case of multiphasic disseminated encephalomyelitis (MDEM) following viral illness presenting as multiple sclerosis (MS) in a 7-year-old boy. The patients had two episodes of alternating hemiparesis and other neurologic symptoms following viral infection, which were separated by 3 years. Neuroimaging studies demonstrated multiple, discrete, small nodules and large globular lesions in the cerebral white matter, basal ganglia, brainstem and cerebellar areas. Based on typical appearance of magnetic resonance imaging (MRI) and clinical manifestations including systemic symptoms such as fever, nausea, vomiting, headache and seizures followed by consciousness disturbance and other multifocal neurologic signs, the diagnosis of MDEM rather than that of MS was made. Because it is difficult to differentiate between MDEM and MS on the basis of the clinical history, the cerebrospinal fluid examination and evoked potential studies, this report emphasizes that the MRI study of the brain may provide an important clue for the diagnosis.

Cerebrospinal fluid interleukin-6, interleukin-8, and tumor necrosis factor-alpha in children with central nervous system infections

Concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor-alpha (TNF-alpha) in cerebrospinal (CSF) samples were determined from 11 control and 42 children with central nervous system infections including 11 patients with bacterial meningitis, 20 patients with aseptic meningitis, 11 patients with encephalitis. The CSF IL-6, IL-8 and TNF-alpha concentrations in patients with bacterial meningitis were significantly higher than those with aseptic meningitis, encephalitis and the control groups. CSF IL-6, IL-8 and TNF-alpha levels in patients with aseptic meningitis were also significantly higher than those in the control group. There was no significant increase of CSF IL-6, IL-8 and TNF-alpha concentrations in patients with encephalitis compared to the control group. CSF IL-6 and TNF-alpha concentrations were decreased in patients with bacterial meningitis after treatment. CSF IL-8 levels were significantly decreased in both bacterial and aseptic meningitis groups at recovery period. There were no correlation between CSF IL-6, IL-8 and TNF-alpha levels and other parameters including CSF leukocytes, protein, sugar, IgG levels and IgG indexes in patients with bacterial meningitis. These results suggest that IL-6, IL-8 and TNF-alpha are important mediators in the meningeal inflammatory process in patients with meningitis. The levels of these mediators are good indicators for the extent of the meningeal inflammation.

Congener-specific effects of PCBs on contractions of pregnant rat uteri

Both increased and decreased gestation lengths have been reported following exposures to polychlorinated biphenyl (PCB) mixtures and congeners. Because oscillatory uterine contractions are essential for parturition, we hypothesized that the disparate findings on gestation length may be the result of distinct PCB congener-specific actions on oscillatory uterine contractions. This study examined the acute effects of PCB congeners on isometric contractions of isolated pregnant uteri and the structure-activity relationship for individual congeners. After cumulative exposure to individual PCB congeners (0.5 microM to 150 microM), oscillatory contractions were: 1) not altered by 2,4,5,2',4',5'-hexachlorobiphenyl, 3,4,5,3',4'-pentachlorobiphenyl, or 3,4,3',4'-tetrachlorobiphenyl; 2) significantly inhibited by 4-hydroxy-2',4',6'-trichlorobiphenyl; and 3) markedly increased by 2,4,6-trichlorobiphenyl and 2,4,2',4'-tetrachlorobiphenyl, when compared to solvent controls. The uteri were more sensitive to PCB congeners with ortho-substituted light chlorination than those highly chlorinated, or those interacting with the Ah-receptor.

The role of gap junctional communication in contractile oscillations in arteries from normotensive and hypertensive rats

OBJECTIVES

To test the hypotheses that vascular supersensitivity correlates with the appearance of contractile oscillations; vascular oscillations are mediated by gap junctions; and gap junctional communication is altered in the vasculature in stroke-prone spontaneously hypertensive (SHRSP) compared with Wistar-Kyoto (WKY) rats.

DESIGN AND METHODS

Helical strips of mesenteric and tail arteries from SHRSP and WKY rats were mounted in tissue baths for measurement of isometric force. Cultures of mesenteric arterial cells were used for measurement of Lucifer yellow dye transfer and abundance of connexin43 mRNA, a monomer of gap junctions.

RESULTS

Mesenteric arteries from SHRSP that displayed spontaneous oscillations were more sensitive to the contractile agonist 5-hydroxytryptamine than those from SHRSP and WKY rats that displayed no oscillations. In addition, SHRSP tail arteries displayed norepinephrine-induced oscillations. The putative gap junction up-regulator tetraethylammonium (10(-3)-10(-1) mol/l) induced oscillations (1-5 cycle/min) in arteries from both rat strains. These oscillations were not altered by endothelium removal or phentolamine and were blocked by heptanol (10(-3) mol/l). Although tetraethylammonium and heptanol caused similar effects in both arteries, heptanol-sensitive agonist-induced oscillations persisted only in the tail artery of SHRSP. Tetraethylammonium increased dye transfer between contiguous cells approximately 35% above basal levels both for SHRSP and WKY cells. In both cell lines, heptanol reduced basal- and tetraethylammonium-stimulated dye transfer. Total RNA from WKY rat and SHRSP cultured cells hybridized strongly and to a similar magnitude with a complementary DNA probe for messenger RNA for connexin43.

CONCLUSIONS

Gap junctional communication is important in vascular reactivity and might play a part in the development of oscillations. Altered gap junctional communication could not be demonstrated in cell cultures nor in some contractile experiments. It is possible that the culture conditions failed to mimic conditions in vivo that differentially regulate gap junctions in the hypertensive state, but it is also possible that gap junctional activity is not abnormal in hypertension.

Involvement of NAD-poly(ADP-ribose) metabolism in p53 regulation and its consequences

We have used two different approaches to study the consequences of NAD/poly(ADP-ribose) deficiency on p53 expression and its activity in V79-derived cell lines. In the first approach, we have used two cell lines that are deficient in poly(ADP-ribose) (pADPR) synthesis because of deficiency in the enzyme poly(ADP-ribose) polymerase (PARP). In a second approach, we have used a cell line that is deficient in NAD/pADPR metabolism due to unavailability of NAD, the substrate for PARP. These NAD/PARP-deficient cell lines exhibit a significant reduction in both baseline p53 expression and its activity compared to their parental V79 cells. Furthermore, etoposide, a topoisomerase II inhibitor that was shown to cause an increase in p53 expression and subsequent apoptosis in V79 cells, failed to produce any significant increase in p53 expression or apoptotic DNA fragmentation in NAD/PARP-deficient cell lines. Thus, our studies suggest that NAD/pADPR synthesis may be involved in the regulation of p53 and its dependent pathways.

Blood-brain barrier damage in children with central nervous system infections

The blood-brain barrier (BBB) function in childhood central nervous system (CNS) infections was evaluated, using cerebrospinal fluid (CSF) and paired serum samples from 30 controls and 74 patients aged from 1 to 15 years with various CNS infections. The 74 patients included 34 cases of aseptic meningitis, 24 of encephalitis and 16 of purulent meningitis. The degree of BBB damage was graded by CSF/serum albumin ratio, and IgG production by IgG index (IgG ratio/albumin ratio of CSF to serum). In the acute stage, patients with purulent meningitis had greater elevation of the albumin ratio than other study groups. The patients with encephalitis, especially chronic encephalitis, had a selectively elevated IgG index compared to other groups. Most patients with aseptic meningitis showed little or no elevation of albumin ratio and IgG index. This study demonstrated the nature of various degrees of BBB damage and intra-BBB IgG production in different infectious CNS diseases in children. BBB damage is most severe in cases of purulent meningitis, while the intrathecal IgG production is greatest in chronic encephalitis. These abnormalities disappear as the inflammatory processes subside.

Risk factors for subsequent epilepsy after febrile convulsions

To evaluate the risk of subsequent epilepsy after febrile convulsions and the long-term prognosis of such patients, the risk factors for afebrile seizures following initial febrile convulsions were studied in 154 hospitalized children: 122 with simple febrile convulsions and 32 with complex features of febrile convulsions. The mean follow-up period was 7 years 2 months (range, 4 yr - 11 yr 2 mo). Nineteen patients (12.3%) developed subsequent epilepsy in the follow-up period. The seizure types in patients with subsequent epilepsy following febrile convulsions included generalized seizures in seven patients, complex partial seizures in five patients, partial seizures evolving to secondary generalized seizures in six patients and benign childhood epilepsy with centrotemporal spike in one patient. The occurrence of epilepsy was strongly associated with complex features of febrile convulsions, pre-existing neurodevelopmental abnormalities, family history of epilepsy, and abnormal electroencephalographic findings. However, the number of recurrences of febrile convulsions, sex, family history of febrile convulsions, age of onset and long-term prophylactic use of anticonvulsants for febrile convulsions were not significant factors for subsequent epilepsy. This study demonstrates the importance of identifying the risk factors for subsequent afebrile seizures after febrile convulsions.

Gap junctional communication and vascular smooth muscle reactivity: use of tetraethylammonium chloride

Oscillatory contractions in uterine smooth muscle are mechanistically related to gap junction complex formation. We have tested the hypothesis that agonist-induced oscillations in vascular smooth muscle are also mediated by gap junctions and that gap junctions are important for vascular smooth muscle cell communication. Total RNA from cultured Wistar-Kyoto rat (WKY) mesenteric arterial cells hybridized strongly with a cDNA probe for the message for connexin43, a monomer of the gap junction. In these same cells, the quaternary ion tetraethylammonium (TEA) (10 mM) increased Lucifer yellow dye transfer between contiguous cells, a measure of cell-to-cell communication via gap junctions, approximately 35% above basal levels. Heptanol, an established inhibitor of gap junction communication, completely blocked both basal- and TEA-stimulated dye transfer between neighboring cells. In other experiments, helical strips of superior mesenteric and tail arteries from WKY rats were mounted in tissue baths for measurement of isometric contractile force. TEA (10(-3)-10(-1) M) induced oscillatory contractions (1-5 cycle/min) in both mesenteric and tail arteries. Removal of endothelium did not affect the pattern of TEA-stimulated oscillations. Oscillations to TEA were blocked in a concentration-dependent manner in both arteries by heptanol (10(-7)-10(-3) M). Heptanol (10(-3) M) also significantly reduced (40%) acetylcholine-induced relaxation in the mesenteric artery (contracted with phenylephrine).(ABSTRACT TRUNCATED AT 250 WORDS)

DIDS-sensitive pHi regulation in single rat cardiac myocytes in nominally HCO3-free conditions

The fluorescent dye 2',7'-bis(carboxyethyl)-5,6-carboxyfluorescein (BCECF) was used to measure pHi in the spontaneously hypertensive rat (SHR) and in normal rat cardiac myocytes under nominally HCO3-free (20 mmol/L HEPES-buffered) conditions. When only the Na-H exchanger was blocked, the intrinsic buffering power (beta i) in SHR myocytes was significantly higher than when both the Na-H exchanger and 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid (DIDS)-sensitive pHi regulators (the Na-HCO3 cotransporter and the Cl-HCO3 exchanger) were blocked. Similar low values for beta i were also found for normal rat myocytes in Na(+)-free conditions. In Cl(-)-free solution under nominally HCO3-free conditions, in both normal and SHR myocytes, the pHi slowly alkalinized (by 0.16 +/- 0.02 and 0.11 +/- 0.02 pH units, respectively); this alkalinization was also DIDS sensitive. The reacidification during NH4+ perfusion was inhibited 30.2 +/- 7.4% by DIDS. In addition, in the nominal absence of HCO3-, 100 mumol/L ATP acidified the pHi in both normal and SHR myocytes (by 0.21 +/- 0.03 and 0.33 +/- 0.03 pH units, respectively); this acidification was totally inhibited by 0.1 mmol/L DIDS. It has been shown, in rat cardiac myocytes, that ATP acidifies the pHi by 0.35 pH unit via stimulation of a DIDS-sensitive Cl-HCO3 exchanger in HCO3-containing solutions. Finally, we have shown, in normal cardiac myocytes, that two potent Na-H exchanger blockers, N-5-ethylisopropyl amiloride (EIPA) and N-5-methyl-N-isobutyl amiloride (MIA), only partially inhibited the pHi recovery from internal acidosis under nominally bicarbonate-free conditions. When DIDS was added at the same time as EIPA, pHi recovery from an internal acid loading was completely inhibited. Our results clearly demonstrate that in both normal and SHR cardiac myocytes, bicarbonate-dependent pHi regulators can be significantly activated under resting or acidified pHi in HEPES-buffered medium, probably because of the cellular production of CO2. The contribution of these bicarbonate-dependent pHi regulators, ie, the Na-HCO3 cotransporter and the Cl-HCO3 exchanger, cannot therefore be ignored even under nominally HCO3-free conditions.

Electrocorticography in patients with medically intractable temporal lobe seizures. I. Quantification of epileptiform discharges prior to resective surgery

We studied retrospectively the intraoperative preresection electrocorticograms (ECoGs) of 72 patients undergoing surgery for medically intractable, mostly complex partial, temporal lobe seizures (TLS). Quantification of interictal epileptiform discharges (EDs) detected visually at each electrode location in 2 min recording epochs included computations of ED rates (EDs/min) and cumulative voltages (CuVs) (microV/min). Of 6388 EDs, 81% involved the infratemporal surface, 18% the lateral temporal surface and 1% the orbital frontal area. Forty-eight patients (67%) demonstrated multiple (up to 5 or more), temporally independent foci. Dominant foci in medial and lateral infratemporal locations were about equally common and were significantly more frequent than in lateral temporal locations. Rankings of ED CuVs and rates at individual cortical locations defined 4 areas of "relative interictal cortical epileptogenicity." These were arranged in an orderly pattern with the anterior parahippocampal gyrus and the inferomedial surface of the temporal tip displaying the highest and the lateral temporal and posterior infratemporal cortices showing the lowest propensity to the interictal epileptiform discharge. Individual areas were not characterized by distinct clinical seizure manifestations. Preresection ECoGs provide information on the epileptogenic dysfunction that involves most of the temporal lobe of patients with medically intractable TLS.

Electrocorticography in patients with medically intractable temporal lobe seizures. II. Quantification of epileptiform discharges following successive stages of resective surgery

We quantified retrospectively the interictal epileptiform discharges (EDs) detected visually in the electrocorticograms (ECoGs) of 42 patients undergoing successive stages of anterior temporal lobectomy for medically intractable temporal lobe seizures (TLS). Following first resection sparing the hippocampus (H) and the parahippocampal gyrus (PHG), EDs were recorded on both structures in all patients and by far exceeded in amount those on residual lateral infratemporal and lateral temporal cortices. Frequently, EDs occurred apparently simultaneously but with opposite polarities on the H and the PHG, but more complex relationships were also evident in most individuals. These features likely reflected abnormal post-synaptic activity generated at different locations and cortical depths within the H, PHG, or both. Quantification of epileptiform activity and the effects of selective anterior hippocampectomy or parahippocampectomy suggested that both the H and PHG had remarkable epileptogenic potential. Levels of epileptiform activity were not significantly different in the H and PHG and in the H of subjects with and without H sclerosis. After final resection, including the amygdaloid nucleus (AN), anterior H and PHG, interictal EDs were present, although markedly diminished, in 35 patients. Postresection foci were significantly less numerous and extensive, and attained smaller maximal voltages, than did foci before and after first resection.

Study on the concentrations of cerebrospinal fluid immunoglobulin G and albumin in children

Concentrations of immunoglobulin G (IgG) and albumin in cerebrospinal fluid (CSF) and serum were measured in 118 "normal" Chinese children from birth to 15 years old to obtain the reference values for the evaluation of the blood-brain barrier (BBB) function. The values of the CSF/serum IgG ratio, CSF/serum albumin ratio and IgG index (IgG ratio/albumin ratio) were then calculated for each subject. A relation was found between the content of IgG in CSF and serum depending on age. The gradual decrease of CSF IgG and IgG ratio during the first 6 months indicated a postnatal impediment of the diffusion of IgG from the blood to the CSF. In the meanwhile the CSF/serum albumin ratio continued to drop until the age of one year. The slower slope of the decrement of the latter ratio further demonstrated the differential permeability of the BBB in favor of the shift of small molecular protein. The change of the protein permeability within the first year of life shows a characteristic of the maturational process of the BBB. Nevertheless, IgG index has no age-dependent variation throughout the childhood period. It remains constant in the absence of inflammation within the central nervous system.

Growth hormone induces c-fos and c-jun expression in cells with varying requirements for differentiation

GH is one of the major factors required for the differentiation of 3T3-F442A preadipocyte fibroblasts into adipocytes. An early event following the addition of GH to 3T3-F442A preadipocytes is induction of the expression of c-fos and c-jun. Although c-fos and c-jun expression has been observed in conjunction with growth factor-stimulated differentiation in several cell types, it is not clear whether protooncogene expression and differentiation are necessarily related. In this study the relationship between the induction of these protooncogenes and differentiation was evaluated by taking advantage of several cell lines that are related to 3T3-F442A cells but have varying GH requirements for differentiation. Adipose differentiation in the adipogenic cell lines 3T3-L1 and 3T3-GI-16 is known to be GH independent, requiring insulin or insulin-like growth factor-I. In both 3T3-L1 and 3T3-GI-16 preadipocytes, GH, nevertheless, induced the expression of mRNA for both protooncogenes. GH (2.2 nM) was more effective than insulin (1 microM) in inducing c-fos expression in these two adipogenic cell lines, suggesting that induction of the protooncogenes is not sufficient to induce adipogenesis. 3T3-C2 fibroblasts do not differentiate in response to any of the stimuli that convert 3T3-F442A fibroblasts to adipocytes. However, GH (2.2 nM) as well as calf serum induced the expression of c-fos and c-jun in 3T3-C2 cells. NIH-3T3 fibroblasts, which do not undergo differentiation, also showed induction of c-fos by GH. Thus, GH-induced expression of c-fos and c-jun occurs in nondifferentiating cells. Furthermore, in differentiated 3T3-F442A adipocytes, GH stimulated the expression of c-fos and c-jun as it does in the preadipocytes. Since GH elicits a variety of metabolic responses in 3T3-F442A adipocytes, the present findings raise the possibility that induction of c-fos and c-jun expression might be associated with multiple events in GH-stimulated 3T3-F442A adipocytes. The lack of requirement for GH in GH-independent and nondifferentiating cells compared to 3T3-F442A cells does not appear to reflect the lack of GH receptors, since expression of mRNA for the GH receptor was evident in all of the cell types tested and, thus, corresponds with the ability of GH to induce protooncogene expression. Although GH-induced c-fos expression was relatively invariant, since it was evident in all of the cell types studied, this response could clearly be regulated, since it was attenuated by prior exposure to GH or serum in 3T3-F442A preadipocytes.(ABSTRACT TRUNCATED AT 400 WORDS)