The association of aldosterone with papillophlebitis and retinal artery occlusion: A case report

PURPOSE

To explore the association between elevated blood aldosterone levels and papillophlebitis and retinal artery occlusion in a young, healthy woman.

CASE DESCRIPTION

A 19-year-old woman with an unremarkable medical history presented with sudden-onset visual loss in the right eye, which lasted for 10 hours. Fundus examination revealed retinal whitening, splinter hemorrhages, disc swelling, and tortuous vessels in the right eye. Optical coherence tomography revealed inner retinal thickening. Fluorescein angiography demonstrated a delayed arteriovenous transit time and delayed filling of the cilioretinal artery circulation. Further workup showed a high aldosterone level and aldosterone-to-renin ratio. The patient was treated with steroid pulse therapy and combined intravitreal injection of dexamethasone implant and aflibercept. Visual acuity was recovered from count finger at initial presentation to 6/15 on the fifth day. For over 2 months, the fundal manifestations gradually subsided. Three months after the episode, her visual acuity further improved to 6/6.7.

CONCLUSION

This report emphasizes the potential role aldosterone plays in the complex disease mechanism of retinal vasculopathy. In addition, steroid pulse therapy is more effective when applied in conjunction with combined intravitreal injection therapy for rescuing impaired vision caused by retinal vascular occlusion.

Progressive macular ischemia in retinal vasculopathy with cerebral leukodystrophy

PURPOSE

We present a case of retinal vasculopathy with cerebral leukodystrophy and review the usefulness of optical coherence tomography angiography (OCT-A) in the assessment of long-term outcomes.

CASE DESCRIPTION

A 31-year-old woman developed sudden-onset scotoma in her right eye. Fundus examination and fluorescein angiography showed a patch of soft exudate and capillary nonperfusion in the posterior pole and outside the vascular arcades. OCT-A revealed that the initial vessel density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) of the right eye were 32% and 49.2%, respectively. Interestingly, over time, the VD of the SCP and DCP gradually decreased to 23.1% and 26.2%, respectively. In contrast, the initial VD of the SCP and DCP of the left eye were both stable at 44.3% and 56.2%, respectively, and only decreased slightly to 39.3% and 45.7%, respectively, over time. The average VD loss of the SCP and DCP, assessed over 1 year, was 8% and 13%, respectively, in the right eye, and 3% and 6%, respectively, in the left eye.

CONCLUSION

Based on this case report, in which we demonstrated a long-term decline in VD of the macula in a young woman with mild retinal vasculopathy with cerebral leukodystrophy, we suggest that there is a potential and valuable role for OCT-A in this rare disease.

PADAr: physician-oriented artificial intelligence-facilitating diagnosis aid for retinal diseases

Purpose: Retinopathy screening via digital imaging is promising for early detection and timely treatment, and tracking retinopathic abnormality over time can help to reveal the risk of disease progression. We developed an innovative physician-oriented artificial intelligence-facilitating diagnosis aid system for retinal diseases for screening multiple retinopathies and monitoring the regions of potential abnormality over time. Approach: Our dataset contains 4908 fundus images from 304 eyes with image-level annotations, including diabetic retinopathy, age-related macular degeneration, cellophane maculopathy, pathological myopia, and healthy control (HC). The screening model utilized a VGG-based feature extractor and multiple-binary convolutional neural network-based classifiers. Images in time series were aligned via affine transforms estimated through speeded-up robust features. Heatmaps of retinopathy were generated from the feature extractor using gradient-weighted class activation mapping++, and individual candidate retinopathy sites were identified from the heatmaps using clustering algorithm. Nested cross-validation with a train-to-test split of 80% to 20% was used to evaluate the performance of the screening model. Results: Our screening model achieved 99% accuracy, 93% sensitivity, and 97% specificity in discriminating between patients with retinopathy and HCs. For discriminating between types of retinopathy, our model achieved an averaged performance of 80% accuracy, 78% sensitivity, 94% specificity, 79% F1-score, and Cohen's kappa coefficient of 0.70. Moreover, visualization results were also shown to provide reasonable candidate sites of retinopathy. Conclusions: Our results demonstrated the capability of the proposed model for extracting diagnostic information of the abnormality and lesion locations, which allows clinicians to focus on patient-centered treatment and untangles the pathological plausibility hidden in deep learning models.

Defined cell adhesion for silicon-based implant materials by using vapor-deposited functional coatings

The field of implantable electronics relies on using silicon materials due to the merits of a well-established fabrication process and favorable properties; of particular interest is the surface modification of such materials. In the present study, we introduce a surface modification technique based on coatings of functionalized Parylene on silicon substrates, where the modified layers provide a defined cell adhesion capability for the resultant silicon materials/devices. Functionalization of Parylene was achieved during a one-step chemical vapor deposition (CVD) polymerization process, forming NHS ester-functionalized Parylene, and subsequent RGD attachment was enabled via a conjugation reaction between the NHS ester and amine groups. The modification procedures additionally provided a clean and gentle approach to avoid thermal excursions, intense irradiation, chemicals, or solvents that might damage delicate structures or sensitive molecules on the devices. The modification layers exhibited excellent mechanical strength on the substrate, meeting the high standards of the American Society for Testing and Materials (ASTM), and the resultant cell adherence property was verified by a centrifugation assay and the analysis of attached cell morphologies; the results collectively demonstrated robust and sustainable modification layers of the NHS ester-functionalized Parylene and confirmed that the cell-adherence property imparted by using this facile modification technique was effective. The modification technology is expected to benefit the design of prospective interface properties for silicon-based devices and related industrial products.

Homocysteine Facilitates Prominent Polygonal Angiogenetic Networks of a Choroidal Capillary Sprouting Model

Purpose

To investigate the effects of homocysteine on choroidal angiogenesis, we established an ex vivo choroidal sprouting explant model and examined the potential growth factors for angiogenesis.

Methods

Choroid fragments with retinal pigment epithelium were isolated from mouse and embedded in Matrigel. Homocysteine at different concentrations were added to the culture mediums. The choroidal explants were observed at different time points, and the total area of choroidal sprouting was measured and analyzed.

Results

Homocysteine evoked choroidal capillary sprouting by inducing capillary endothelial cell proliferation with pericyte formation and by facilitating polygonal angiogenetic networks. In some cases, vascular lumens were observed in the newly forming capillaries facilitated by homocysteine. The choroidal sprouting effect of homocysteine can only be observed at a certain range of homocysteine concentration, with 1-mM homocysteine exhibiting the most significantly increased choroidal sprouting areas. Isolectin overexpression was noted in the homocysteine-treated group. Possible growth factors for angiogenesis were detected through immunofluorescent staining, which demonstrated the overexpression of platelet-derived growth factor C and angiopoietin 1 in the homocysteine-treated preparations only. In these preparations, platelet-derived growth factor C was highly expressed in the tip cells of sprouting capillaries.

Conclusions

We therefore conclude that platelet-derived growth factor C and angiopoietin 1 may play key roles in the choroid angiogenesis evoked by homocysteine.

Efficacy of intravitreal injection of anti-vascular endothelial growth factor agents for stage 4 retinopathy of prematurity

PURPOSE

To investigate the efficacy of intravitreal injection of anti-vascular endothelial growth factor agents for Stage 4 retinopathy of prematurity.

METHODS

Retrospective case series study. The medical records of patients receiving intravitreal injection of anti-vascular endothelial growth factor agents for Stage 4 retinopathy of prematurity from January 2007 to May 2012 in Taipei Veterans General Hospital were reviewed.

RESULTS

A total of 13 eyes of 7 patients (3 boys and 4 girls) with Stage 4 retinopathy of prematurity were included. The mean gestational age and birth weight were 27.6 ± 2.6 weeks (range, 24.5-30.5 weeks) and 893.1 ± 293.2 g (range, 550-1422 g), respectively. The mean age at the time of injection was 38.2 ± 1.9 weeks (range, 36.0-41.5 weeks) postmenstrual age, and the mean follow-up period was 37.8 ± 19.5 months (range, 11.0-67.5 months). The active neovascularization regressed rapidly, and the anatomical outcomes were favorable in all patients. One eye developed recurrent retinal hemorrhage with localized retinal detachment 21 weeks after initial treatment, which resolved after a second injection. There were no ocular or systemic complications in these patients.

CONCLUSION

Intravitreal injection of anti-vascular endothelial growth factor agents may be effective as monotherapy or as supplement to failed laser treatment for patients with Stage 4 retinopathy of prematurity without additional surgical intervention. Further randomized controlled trials are necessary to compare the clinical efficacy and safety with other conventional interventions.

Large gene deletion and changes in corneal endothelial cells in a family with choroideremia

PURPOSE

We provided the first report of an association between changes in corneal endothelial cells, retina, and choriocapillaris in a choroideremia family.

METHODS

Four members of an Asian choroideremia family, comprising two affected patients and two carriers, were evaluated. All participants underwent complete eye examinations, including visual acuity (VA), slit-lamp examination, ophthalmoscopy, perimetry, and electrophysiology tests. In addition, images of corneal endothelium were captured with a noncontact specular microscope. Genomic DNA amplification and whole-genome cytogenic array analysis were used to confirm the diagnosis of choroideremia and determine the molecular basis of the phenotype.

RESULTS

In the affected patients, funduscopy revealed characteristic features of RPE and chorioretinal atrophy. The slit-lamp biomicroscopy disclosed unexpected pigmented punctate lesions in the corneal endothelium in one of them. Surprisingly, specular microscopy detected decreased endothelial cell density (ECD) with features of pleomorphism and polymegethism. Genomic DNA analysis revealed large deletion (~4.5 mega base pairs) of the entire CHM gene and encompassed region. In carriers, funduscopy revealed stippling pigmentary change despite normal electrophysiological results. Specular microscopy also disclosed reduced ECD with features of pleomorphism and polymegethism.

CONCLUSIONS

To our knowledge, this is the first description of corneal changes in choroideremia patients. The loss of corneal ECD is conspicuous and is accompanied by pleomorphism and polymegethism in this family. The observed changes in corneal endothelium may be associated with larger encompassed regions of the CHM gene defect or dysfunction in the blood-aqueous barrier. It warrants further investigation and clarification of the pathophysiology and associations between retinal and corneal changes in choroideremia.

Sub-internal limiting membrane hemorrhage treated with intravitreal tissue plasminogen activator followed by octafluoropropane gas injection

Sub-internal limiting membrane (sub-ILM) hemorrhage is a relatively rare disease which is associated with different etiologies and often leads to loss of visual acuity. We report two cases of sub-ILM hemorrhage, both confirmed by optical coherence tomography (OCT) and treated with an intravitreal injection of tissue plasminogen activator (tPA) followed by an octafluoropropane (C₃F₈) pneumopexy and a strict postoperative prone positioning. The hemorrhage was totally resolved and complete visual recovery was achieved in both cases. We found tPA hemolysis with C₃F₈ pneumopexy to be a safe and effective method for treating sub-ILM hemorrhage.

Hyperhomocysteinemia in patients with polypoidal choroidal vasculopathy: a case control study

Purpose

To determine whether elevated plasma homocysteine and serum high sensitivity C-reactive protein (hsCRP) levels, two established risk factors of vascular diseases, are associated with polypoidal choroidal vasculopathy (PCV).

Design

Retrospective case-control study.

Methods

One hundred and nineteen consecutive patients with PCV and 119 matched controls were enrolled in a tertiary hospital from September 2008 to June 2013. Plasma homocysteine and serum hsCRP levels were measured. Associations among plasma homocysteine, serum hsCRP levels and PCV were further evaluated using multivariable logistic regression analysis.

Results

The median plasma homocysteine level was significantly higher in patients with PCV than in the controls (12.20 µmol/L vs. 9.80 µmol/L, p<0.001). The median serum hsCRP level was slightly higher in the PCV group (0.16 mg/dl vs. 0.11 mg/dl in control group, p = 0.07). After multivariable logistic regression analysis, each 1 µmol/L increase of plasma homocysteine was associated with a 1.5-fold increase in likelihood of having PCV (OR, 1.54; 95% confidence interval (CI), 1.33–1.79, p<0.001).

Conclusions

Hyperhomocysteinemia was associated with PCV and might play a role in the pathogenesis of PCV.

Short-term external buckling with pneumatic retinopexy for retinal detachment with inferior retinal breaks

PURPOSE

To introduce a new approach for short-term external scleral buckling with pneumatic retinopexy for the management of rhegmatogenous retinal detachment with inferior retinal breaks.

DESIGN

Retrospective, noncomparative, interventional case series.

METHODS

A review of 33 consecutive eyes of 31 patients who underwent external buckling with pneumatic retinopexy for uncomplicated rhegmatogenous retinal detachment with inferior retinal breaks from December 2006 through December 2010. An external buckle was made of a 505 sponge sutured along the blunt side of a 279 tyre (MIRA Inc). The buckle was inserted deeply into the inferior fornix without suture after pneumatic retinopexy and was kept in place for 3 days. Primary and final anatomic outcomes, visual acuity, and adverse events were recorded.

RESULTS

All patients tolerated the procedure. The mean follow-up period was 24.0 months (range, 9 to 61 months). Primary success, defined as successful retinal reattachment within 6 months without further treatment, was achieved in 29 (87.9%) eyes. All patients attained final retinal reattachment (100%). Overall, the mean best-corrected visual acuity improved significantly at the end of follow-up (0.30 logarithm of the minimal angle of resolution units; Snellen equivalent, 6/12), compared with the preoperative best-corrected visual acuity (0.82 logarithm of the minimal angle of resolution units; Snellen equivalent, 6/38; P < .001).

CONCLUSIONS

Short-term external buckling with pneumatic retinopexy is a novel and effective treatment for rhegmatogenous retinal detachment with inferior retinal breaks, with a comparable success rate with other treatment methods. This approach also can avoid complications of long-term buckle implantation. Further comparative cohort studies may be necessary to compare the clinical efficacy with other conventional operations.

High-altitude retinopathy after climbing Mount Aconcagua in a group of experienced climbers

BACKGROUND

Visual disturbances after high-altitude exposure were first reported in 1969. Manifestations may include retinal hemorrhage, papilledema, and vitreous hemorrhage.

METHODS

We observed a group of 6 experienced climbers who ascended Mt Aconcagua to an altitude of 6,962 m in February 2007. Visual acuity study, intraocular pressure study, visual field study, nerve fiber layer analysis, eye Doppler, laboratory studies, fundus photography, and intravenous fluorescein angiography were performed on the climbers before and after their exposures to high altitude.

RESULTS

In all six study subjects, retinal vascular engorgement and tortuosity were present in varying degrees in both eyes. One of the climbers had both retinal hemorrhage and pulmonary edema. Of the two subjects who had visual field defects, one had severe nerve fiber layer defects of both eyes. Furthermore, laboratory studies of this climber showed a high level of antiphospholipid antibody. Significant reduction of the left ocular blood flow was also noted on this subject's eye Doppler examination after the Mt Aconcagua expedition.

CONCLUSION

Various high-altitude retinopathies were observed in the experienced climbers of this study. As high-altitude pursuits become more popular, attention should be paid to the increasing prevalence of high-altitude retinopathy.

Enzyme assay and clinical assessment in subjects with a Chinese hotspot late-onset Fabry mutation (IVS4 + 919G→A)

Newborn screening for Fabry disease in Taiwan Chinese has revealed a high incidence of the late-onset GLA mutation IVS4 + 919G→A (∼1 in 1,500-1,600 males). We studied 94 adults with this mutation [22 men, 72 women; mean age: men 57.8 ± 6.0 (range 42-68), women 39.1 ± 14.1 years (range 19-82)]. Plasma α-galactosidase A activity assay was 10.4 ± 11.2% of normal in the men and 48.6 ± 19.5% of normal in the women. Echocardiography in 90 of the adults revealed left ventricular hypertrophy (LVH) in 19 (21%), including 14 of 21 men (67%) and 5 of 69 women (7%). Microalbuminuria, based on the urine albumin-to-creatinine ratio measured on at least two occasions, was present in 17 of 86 subjects (20%) (men: 5/20, 25%; women 12/66, 18%). At least one ocular manifestation consistent with Fabry disease was present in 41 of 52 subjects (79%) who underwent ophthalmologic examination, including 8 (15%) with conjunctival vessel tortuosity, 15 (29%) with cornea verticillata, 10 (19%) with Fabry cataract, and 34 (65%) with retinal vessel tortuosity. Among subjects over 40 years of age, men were more likely than women to have LVH [14/21 (67%) vs 5/25 (20%), p < 0.001]. Cardiovascular, renal and ocular abnormalities are highly prevalent in adult Taiwan Chinese subjects with the Fabry mutation IVS4 + 919G→A. Our findings contribute to the limited understanding of the course of this late-onset disease variant and underscore the need for close follow up in such patients.

White-centered retinal hemorrhage in ocular ischemic syndrome resolved after carotid artery stenting

Ocular ischemic syndrome (OIS) is characterized by ocular symptoms and signs that are secondary to severe carotid artery obstruction. We report a 69-year-old man who suffered from progressively blurred vision in both eyes. Fundus examination showed scattered areas of retinal hemorrhage, some with a white center, in both eyes. Fluorescence angiography revealed multiple microaneurysm-like hyperfluorescent spots over the retina mimicking diabetic retinopathy. Carotid Doppler ultrasonography revealed 90-95% stenosis of bilateral internal carotid arteries, and OIS was diagnosed. Thus, bilateral internal carotid artery stenting was performed. After treatment, the patients visual acuity recovered within 1 month and the areas of white-centered retinal hemorrhage completely resolved within 6 months.

Intraocular gene transfer of ciliary neurotrophic factor rescues photoreceptor degeneration in RCS rats

Ciliary neurotrophic factor (CNTF) is known as an important factor in the regulation of retinal cell growth. We used both recombinant CNTF and an adenovirus carrying the CNTF gene to regulate retinal photoreceptor expression in a retinal degenerative animal, Royal College of Surgeons (RCS) rats. Cells in the outer nuclear layer of the retinae from recombinant-CNTF-treated, adenoviral-CNTF-treated, saline-operated, and contralateral untreated preparations were examined for those exhibiting CNTF photoreceptor protective effects. Cell apoptosis in the outer nuclear layer of the retinae was also detected. It was found that CNTF had a potent effect on delaying the photoreceptor degeneration process in RCS rats. Furthermore, adenovirus CNTF gene transfer was proven to be better at rescuing photoreceptors than that when using recombinant CNTF, since adenoviral CNTF prolonged the photoreceptor protection effect. The function of the photoreceptors was also examined by taking electroretinograms of different animals. Adenoviral-CNTF-treated eyes showed better retinal function than did the contralateral control eyes. This study indicates that adenoviral CNTF effectively rescues degenerating photoreceptors in RCS rats.

The long-term results of one time treatment by continuously fractionated transpupillary thermotherapy for occult choroid neovascularization membrane of age-related macular degeneration

BACKGROUND

This study was to assess the long-term results of a novel continuously fractionated transpupillary thermotherapy (cfTTT) in treating occult choroid neovascularization membrane (CNV) of age-related macular degeneration (ARMD).

METHODS

After informed consent was obtained, 19 patients were treated with cfTTT in 21 eyes. The diode laser (810 nm) was applied with 6 continuous 9-second sessions to the neovascular membrane. Each session lasted 9 seconds. Every spot (1 mm on retina) was in close contact with each other to entirely cover the CNV.

RESULTS

The average age was 75.9 years (from 61 to 86 years). The mean follow-up time was 19.6 months (from 15 to 24 months). Five eyes (23.8%) had improved visual acuity by 2 or more lines, 6 eyes (28.5%) by 1 line, and 10 eyes (47.6%) had no change in visual acuity. None had decreased vision. In final fluorescein angiography, all eyes treated revealed decreased fluorescein leakage.

CONCLUSIONS

cfTTT shows no deleterious side effects in treating subfoveal or juxtafoveal CNV of ARMD at long-term follow-up and is at least as effective as long-pulse TTT.

Ipsilateral globe penetration and transient contralateral amaurosis following retrobulbar anesthesia

PURPOSE

To report a rare complication of retrobulbar anesthesia with ipsilateral globe penetration and transient contralateral amaurosis.

DESIGN

Interventional case report.

METHODS

A 63-year-old woman complained of vision loss in the right eye immediately following cataract surgery on the left eye.

RESULTS

Right eye vision decreased to no light perception with clear media and normal fundus. The vision recovered to baseline in 12 hours. Left eye vision was checked and demonstrated only light perception. Fundus examination disclosed preretinal and vitreous hemorrhage. During vitrectomy of the left eye, a penetrating wound below the optic disk with retinal detachment was found.

CONCLUSION

The ipsilateral globe penetration wound depicts the mechanism of contralateral amaurosis following retrobulbar anesthesia of the case.

Absorbable sandwich-like membrane for retinal-sheet transplantation

Neural retinal transplantation has great potential for the alleviation of different degenerative and hereditary retinal disorders. However, because of the fragile and soft nature of retina, retinal-sheet transplantation is relatively difficult to achieve. To overcome this difficulty, we developed a technique for lamellar tissue transplantation. Biodegradable gelatin membranes were fabricated into a sandwich and encapsulated retinal grafts for transplantation. Before transplantation, we characterized the in vivo and in vitro properties of such membranes to determine the optimal sterilization procedure, that is, a sterile membrane with suitable degradability and good mechanical properties and without cytotoxicity. Three sterilization methods were conducted, with hydrogen peroxide gas plasma (HPGP), ethylene oxide (EO), and gamma-ray irradiation (gamma). The results were compared with those of a control (no disinfection). Initial studies revealed that the gelatin membranes sterilized with HPGP or EO exhibited retinal pigment epithelium (RPE) cytotoxicity, whereas the membrane sterilized by 16.6-kGy gamma ray irradiation had no RPE cytotoxicity and had enhanced mechanical properties. In the in vivo rabbit study, implanted gelatin membranes demonstrated satisfactory biocompatibility without any inflammation. Transplanted retinal sheets survived well and developed laminar structures. Such a method using gelatin membranes for tissue transportation has great potential for future routine retinal-sheet transplantation.

The synthesis and in vitro cytotoxic studies of novel bis-naphthalimidopropyl polyamine derivatives

Bis-naphthalimidopropyl putrescine (BNIPPut), spermidine (BNIPSpd), spermine (BNIPSpm) and oxa-putrescine (BNIPOPut) were synthesised and their growth-inhibitory properties characterised. All these compounds except for BNIPOPut, showed high in vitro cytotoxic activity (with mean GI50 values between 0.5 and 8.45 microM) and selectivity against cancer cells derived from nine different human tumours. The increased content of nitrogen atoms in the linker chain of BNIPSpd and BNIPSpm significantly improved their aqueous dissolution properties with a marginal decrease in their cytotoxic activity.

The synthesis and in vitro cytotoxic studies of novel oxa-spermidine derivatives and homologues

A series of oxa-spermidine derivatives and homologues were prepared and their anticancer properties were evaluated. All these compounds showed an average GI50 value in the range of 3.9-28.9 microM. SAR studies showed that the presence of a sulphonamido functionality and the length of the alkyl chain are important factors for an enhanced activity.

Noninvasive glucose monitoring with optical heterodyne technique

A novel optical polarimeter to sense the glucose level in vivo and noninvasively has been developed in the Institute of Radiological Science, National Yang Ming University. A 30-minute delay between the aqueous glucose and the blood glucose was observed in rabbit's eyeball. Currently, aqueous glucose in low concentration is being tested and discussed.

Tolerance of human fetal retinal pigment epithelium xenografts in monkey retina

BACKGROUND

RPE transplantation offers the possibility of treating certain forms of retinal degeneration. Understanding how to optimize the surgical technique for performing RPE transplantation, especially in primates, is therefore of considerable interest.

METHODS

Fifteen patch RPE transplants were performed in six monkeys. The transplant sites were examined at follow-up by ophthalmoscopy, biomicroscopy, fluorescein angiography and histology. Foveal and peripheral retinal transplants were compared.

RESULTS

Human fetal RPE xenografts can survive without rejection for at least 6 months after transplantation in monkey retina. Such grafts form a basal lamina and make intimate contacts with the outer segments of the host. Both rods and cones retain a normal appearance when in contact with unrejected transplants. Rejection occurred in only 30% (3/10) of the peripheral but in 60% (3/5) of the foveal transplants.

CONCLUSIONS

Cultured human fetal RPE patch transplants can survive and maintain local photoreceptor integrity for relatively long periods of time in monkey subretinal space without immunosuppression. Rejection, when it occurs, is more frequent near the fovea.

Effect of three novel polyamine oxa-analogues (MTR-OSPD, DIP-SPN and APPO-TFA) on the growth and proliferation of Swiss 3T3 cells

In order to investigate their biological function on cellular polyamine content, cell growth and proliferation, three novel polyamine oxa-analogues, 5-(4-methoxy-2,3,6-trimethylbenzenesulfonyl)-6-oxa-spermidine (MTR-OSPD); 6,9-dioxa-5,10-di-(2,2,5,7,8-pentamethylchroman-6-sulfonyl) spermine (DIP-SPN) and 3-aminopropyl N-(3-phthalimidopropyloxy) trifluoroacetimidate (APPO-TFA) were tested for their ability to stop or slow down the growth of Swiss 3T3 cells. Cells at 50-60% confluency were grown for 24 or 48 hr in the presence of a wide range of polyamine oxa-analogue concentrations and the number of cells counted. To determine whether the drugs were cytotoxic or cytostatic, the analogue-containing medium in some vials was replaced with fresh culture medium after 48 hr and the cells incubated for a further 24 hr. Cellular protein, RNA, DNA, polyamine contents and the activities of ornithine decarboxylase, S-adenosyl-L-methionine decarboxylase and spermidine/spermine N1-acetyltransferase were also determined at the lowest effective analogue concentration. All three inhibitors stopped cell proliferation at concentrations over 100 microM. Both MTR-OSPD and DIP-SPN were cytotoxic, since the cells could not be revived by removing the inhibitor from the medium, whereas APPO-TFA was only cytostatic. At the lowest effective concentration the analogues had little effect on protein, RNA and DNA content of the cells, but had varying effects on polyamine metabolism. The most interesting analogue was APPO-TFA. This drug showed concentration-dependent growth inhibition between concentrations of 5 nM and 5 microM. These novel analogues may be of value in elucidating the precise functions of polyamines in cellular metabolism. Their exact mode of action is now under investigation.

Direct observation of two base-pairing modes of a cytosine-thymine analogue with guanine in a DNA Z-form duplex: significance for base analogue mutagenesis

The pyrimidine nucleobase analogue 6H,8H-3,4-dihydropyrimido[4,5-c]- [1,2]oxazin-7-one (P) is a mimic both of cytosine and thymine, since it can form stable hydrogen-bonded base-pairs with either guanine or adenine. To investigate the geometric properties of pairing with guanine in a DNA double helix, the structure of d(CGCGPG)2 has been determined by single crystal X-ray analysis. The oligonucleotide crystallised as a left-handed Z-DNA duplex in the orthorhombic space group P2(1)2(1)2(1) with cell dimensions a = 18.23 A, b = 30.63 A, c = 43.78 A. Refinement using NUCLSQ with 51 water molecules included in the final model converged at R = 0.179 (Rw = 0.159) for 2798 reflections (F > 2 sigma (F)) in the range 8 A to 1.7 A. Remarkably, the two P.G pairs in the hexamer duplex are different: Watson-Crick and wobble types separately illustrate both cytosine-like and thymine-like behaviour. The result suggests that mutagenesis experiments involving P and other analogues which display pronounced base-pairing ambivalence can be used to examine the structural basis of substrate discrimination by polymerases that is essential to accurate genetic replication.

An intracranial aneurysm associated with a recurrent meningioma--a case report

A patient presented with late onset seizure due to sphenoid ridge meningioma excision, during a craniotomy. Nine years after craniotomy, sphenoid ridge meningioma recurred in this patient along with middle cerebral artery (MCA) aneurysm. Peripheral intracranial aneurysm has been shown to be caused by many etiologies. But a direct relationship to an intracranial neoplasm is extremely rare. A causal relationship between the growth of the tumor and the development of the aneurysm is postulated.

Estimation of body composition changes during weight cycling by bioelectrical impedance analysis in rats

The effects of body weight cycling (WC) in rats on body composition (BC) and feeding efficiency were studied. The usefulness of estimating BC by bioelectrical impedance analysis (BIA) was also examined. Female Sprague-Dawley rats were divided into high-fat ad libitum feeding, either noncycling or cycling, or restricted feeding (75% of control feed) cycling groups. Control rats were fed a regular laboratory ad libitum diet and did not cycle. All rats were killed at the end of week 61. A BIA unit was used at each stage of WC to obtain resistance and reactance readings. Final BC was determined by chemical analysis. On the basis of the final chemical analysis and BIA measurements, an equation was established and applied to estimate BC at each stage of WC: fat-free mass (g) = 0.38 x body wt (g) + 13.8 x [length (cm)2/resistance] + 70.9 (r = 0.95, P < 0.001). High-fat ad libitum feeding induced rapid body weight and fat gains as well as an elevated feeding efficiency and an internal fat-to-subcutaneous fat ratio, regardless of whether the rats cycled. This change in fat mass was clearly detected by the BIA. Although rats fed restricted diets had similar body weights as did control rats, they had a significantly higher internal fat-to-subcutaneous fat ratio. Thus, not only the amount of food but also the composition of the diet is important for proper weight management. The BIA method is capable of detecting the body fat mass change during WC.

Molecular basis for methoxyamine-initiated mutagenesis: 1H nuclear magnetic resonance studies of oligonucleotide duplexes containing base-modified cytosine residues

Methoxyamine, N4-methoxycytidine and its 2'-deoxyribo analogue are transition mutagens. The mechanism by which the latter acts after incorporation into or generation within DNA has been ascribed to the ability of the base analogue to pair effectively with both adenine and guanine. To obtain a detailed understanding of these interactions, the solution structures of the self-complementary octanucleotide d(CGGATCCG) and its analogues d(CGGATTCG), d(CGGATMCG) and d(CGGATPCG) (designated 8mer-GC, -GT, -GM and -GP, respectively) were investigated by 1H nuclear magnetic resonance spectroscopy; M is N4-methoxycytosine (mo4C) and P is an analogue, the bicyclic dihydropyrimido[4,5-c][1,2] oxazin-7-one. A variable temperature study showed the order of stability as 8mer GC > GP > GT > GM. Nuclear Overhauser spectroscopy permitted the assignment of the base, anomeric and H2'/H2" protons in these 8mers. All had spectra consistent with regular B-DNA duplex structures. Imino proton spectra showed that the 8mers GC, GP and GM involved Watson-Crick base-pairing but that the G.P and to a greater extent G.M base-pairs were in slow exchange on the nuclear magnetic resonance time-scale with the wobble configuration. Indeed, the G.M pair showed an additional exchange process interpreted in terms of the presence of syn and anti conformers of the methoxy group in the wobble pair. This accounts for the destabilization of M compared with the P-containing duplex. The observations are compared with those made earlier on the corresponding AT, AP and AM octamers. It is evident that M and P can form stable base-pairs with both A and G with essentially Watson-Crick geometry. This confirms the earlier, although unsubstantiated explanation for the transition mutational propenstty of methoxyamine which, in turn, was based on the fact that methoxycytosine bases have tautomeric constants (KT) much nearer to unity than the normal bases. The same general explanation for hydroxylamine and hydrazine-induced mutations is correspondingly rendered more certain.

Synthesis of oligodeoxyribonucleotides containing degenerate bases and their use as primers in the polymerase chain reaction

Heptadecaoligodeoxyribonucleotides containing one or more of the bases, 6H,8H-3,4-dihydropyrimido[4,5-c][1,2]oxazin-7-one (P), 2-amino-6-methoxyaminopurine (K), and hypoxanthine (I) and combinations of P with K and I have been synthesised on a DNA synthesiser. The stability of duplexes containing these basemodified oligomers with P/A, P/G, K/C and K/T; P/A, P/G, I/C, I/T and I/A, I/G, I/C, I/T base pairs were compared by measuring their melting transition (Tm) values. Oligomers containing both P and K and P and I were more stable than those with I alone or with mismatches. These oligomers together with one with a P base at the 3'-end were used as primers in polymerase chain reaction (PCR) experiments. They were all effective primers except one with I alone and a triple mismatch. Thus the use of the degenerate bases P and K in primer design is established.

Long-term exercise training and retirement in genetically obese rats: effects on food intake, feeding efficiency and carcass composition

Short-term physical exercise (EX) can reduce body weight and fat gain in obese humans and animals. However, the beneficial effects of physical exercise are not long-lasting. In this study, the effects of long-term physical exercise and retirement from exercise (R) on body weight, body composition and fat distribution were examined in genetically obese (OB) and lean (LE) female rats. Fifty OB and 45 LE rats, four weeks old, were divided into EX (swimming, 2h/day, 5 days/week) or sedentary (SD) groups. At the end of the 28th week of treatment, EX groups were further divided into continued EX or R groups for another 11-12 weeks. It was found that at the end of the 28th week EX had reduced the rate of weight gain in OB and LE rats. Percentage body fat was only reduced in OBEX rats and this was achieved by a significant reduction of subcutaneous fat mass. At the end of the 40th week, EX had further reduced the weight gain, fat mass and body fat percentage in OBEX rats while only body fat percentage was reduced in the LEEX group. Retirement from exercise reversed these phenomena. Thus there were no differences between OBSD and OBEX-R rats in body weight, fat mass and percentage body fat. However, the OBEX-R group had a significantly higher amount of internal fat than the other two OB groups. Therefore, exercise, even long-term to cover the entire fat cell proliferation period, still only exerted temporary beneficial effects in OB rats. After retirement, the beneficial effects all disappeared rapidly.(ABSTRACT TRUNCATED AT 250 WORDS)

Molecular basis for methoxyamine initiated mutagenesis. 1H nuclear magnetic resonance studies of base-modified oligodeoxynucleotides

In order to reach a more detailed understanding of the mechanism of the mutagenic action of methoxyamine and of N4-methoxycytidine and its 2'-deoxyribo-analogue, the solution structures of the self-complementary octanucleotide, d(CGAATTCG) and its analogues, d(CGAATCCG), d(CGAATMCG) and d(CGAATPCG) (designated 8mer-AT, 8mer-AC, 8mer-AM, and 8mer-AP, respectively), were investigated by 1H nuclear magnetic resonance spectroscopy; M is N4-methoxycytosine (mo4C) and P is an analogue, the bicyclic dihydropyrimido[4,5-c][1,2]oxazin-7-one, in which the N-O bond is held in the anti configuration with respect to N3 of the cytosine ring. Correlated spectroscopy and nuclear Overhauser spectroscopy allowed assignment of the base, anomeric and H2'/H2" protons in 8mers-AT, -AM and -AP, and showed that all three had features consistent with a regular B-DNA duplex structure. Duplex-to-coil transition temperatures were determined to be 52(+/- 2) degrees C (8mer-AT), 51(+/- 2) degrees C (8mer-AP), 32(+/- 2) degrees C (8mer-AM); on the chemical shift timescale, the melting transition was fast for 8mer-AT and 8mer-AP, but slow for 8mer-AM. Imino proton spectra were indicative of Watson-Crick base-pairing in 8mers-AT, -AP and -AM. The 8mer-AP duplex had a structure and melting characteristics virtually identical with those of the 8mer-AT duplex. The preferred syn configuration of the methoxyl group in M had a destabilising effect on the 8mer-AM duplex. At low temperatures, the A.M base-pair was in fast equilibrium between Watson-Crick and wobble configurations, with the methoxyl function anti-oriented, but the melting transition was accompanied by isomerization of the methoxyl group to the syn conformation. This syn-anti isomerization was the rate-determining step in the duplex-to-coil transition. The 8mer-AC oligomer did not form a stable duplex.

Synthesis and duplex stability of oligonucleotides containing adenine-guanine analogues

The nucleosides N6-methoxy-2'-deoxyadenosine (dZ) and 2-amino-9-(2-deoxy-beta-ribofuranosyl)-6-methoxyaminopurine (dK) have been synthesised and converted into 5'-O-dimethoxytrityl 3'-(2-cyanoethyl N,N-diisopropylphosphoramidites). These monomers have been used in machine DNA synthesis to give a set of heptadecanucleotides containing up to three analogue nucleotides. The melting transitions (Tm) show that the 17-mer duplexes containing Z.T and Z.C base-pairs have closely similar stabilities, as have those containing K.T and K.C pairs. They are less stable than the corresponding fully complementary duplexes, but more stable than those containing mismatched pairs. This, in the case of dZ, is in accord with the amino-imino tautomeric ratio of approximately 1:4 observed for the nucleoside in methyl sulfoxide. The application of oligomers containing such "degenerate" bases in oligonucleotide probes and primers is discussed.

Molecular and crystal structure of d(CGCGmo4CG): N4-methoxycytosine.guanine base-pairs in Z-DNA

The base analogue N4-methoxycytosine (mo4C) is ambivalent in its hydrogen-bonding potential, since it forms stable base-pairs with both adenine and guanine in oligomer duplexes. To investigate the base-pair geometry, the structure of d(CGCGmo4CG) has been determined by single-crystal X-ray diffraction techniques. The d(CGCGmo4CG)2 crystallized in a left-handed double helical structure (Z-type). Refinement using 2559 reflections between 10 and 1.7 A converged with a final R = 0.181 (Rw = 0.130) including 68 solvent molecules. The orthorhombic crystals are in the space group P2(1)2(1)2(1), with cell dimensions a = 18.17 A, b = 30.36 A, c = 43.93 A. The mo4C.G base-pair is of the wobble type, with mo4C in the imino form, and the methoxy group in the syn configuration.

Repeated pregnancy without lactation: effects on maternal glycemic control, pregnancy outcome, carcass composition, and fat distribution in rats

Repeated pregnancy without lactation in rats has been reported to produce permanently elevated carcass fat mass and hyperplasia in subcutaneous fat depot. In the present study, the pregnancy outcome, intravenous glucose tolerance ability (IVGTT), and carcass composition were further examined in Osborne-Mendel rats. Female rats were divided into pregnancy-lactation (PL), pregnancy-no lactation (PNL), and control (CON) groups. Half of the rats were killed after three pregnancy/lactation cycles, whereas the rest were given a 12-week rest period before killing. It was found that rats in PNL group had fasting hyperglycemia and insulin insensitivity during the third pregnancy (P less than or equal to .05), elevated spontaneous abortion rate (P less than or equal to .05), and elevated subcutaneous fat content (P less than or equal to .01) relative to that of PL rats or CON rats. After a 12-week rest period, a significant increase in subcutaneous fat cell number was also observed in PNL rats. PL rats, on the other hand, have significantly elevated internal/subcutaneous fat ratios (P less than or equal to .05), both immediately after weaning and after the 12-week rest period. The significance of this change is not yet known.

Synthesis and duplex stability of oligonucleotides containing cytosine-thymine analogues

The synthesis of the deoxynucleoside derived from the base P, 6H,8H-3,4-dihydro-pyrimido[4,5-c] [4,5-c] [1,2]oxazin-7-one, 2, and its introduction by established phosphoramidite and H-phosphonate chemistry into oligonucleotides is described. The melting transition temperatures (Tm) of a range of heptadecamer duplexes containing P/A and P/G base-pairs are compared with corresponding ones having N4-methoxycytosine (M) 1 and mismatched normal bases. P/A and P/G pairs allow closely similar duplex stabilities and have the potential to reduce the multiplicity of probes and primers based on amino acid sequences by removing the T/C degeneracy.

Repeated pregnancy without lactation: effects on carcass composition and adipose tissue cellularity in rats

Four groups of Sprague-Dawley rats, 200-225 g, were mated. Two groups of rats were killed after 3 wk of nursing eight pups (PL-1) or no lactation (PNL-1). The remaining two groups went through three cycles of pregnancy/lactation (PL-3) or pregnancy/no lactation (PNL-3) and were then killed for carcass composition analysis. Two virgin groups (CON-1, CON-3) served as age controls and were killed at the appropriate time. There was a gradual reduction in food intake from cycle 1 to cycle 3 for all groups. PL-3 rats ingested significantly more food than PNL-3 rats in pregnancies of cycle 2 and cycle 3. At the end of cycle 1, there was no difference in body weight, carcass weight, fat content and fat cell cellularity in parametrial and subcutaneous fat pads between three groups of rats. However, after three cycles, the PL-3 group had significantly reduced carcass fat content because of a significant reduction in fat cell number. Repeated pregnancy followed by no lactation resulted in greater carcass fat content and fat cell number in the subcutaneous pad than observed in lactating rats, although these increases failed to reach significance when compared with virgin controls. Thus lactation may not only be beneficial to the offspring but also enhances maternal weight loss and prevents obesity in multiparous individuals.