Apelin as a new therapeutic target for COVID-19 treatment

BACKGROUND

Apelin is an endogenous neuropeptide that binds to the G-protein-coupled receptor (APJ) and participates in a variety of physiological processes in the heart, lungs and other peripheral organs. Intriguingly, [Pyr1]-Apelin-13, a highly potent pyroglutamic form of apelin, has the potential to bind to and be degraded by angiotensin-converting enzyme 2 (ACE2). ACE2 is known to operate as a viral receptor in the early stages of severe acute respiratory coronavirus (SARS-CoV-2) infection.

AIM

This study aimed to determine if apelin protects against SARS-CoV-2 infection by inhibiting ACE2 binding to SARS-CoV-2 spike protein.

DESIGN AND METHODS

To determine whether [Pyr1]-Apelin-13 inhibits ACE2 binding to the SARS-CoV-2 spike protein (S protein), we performed a cell-to-cell fusion assay using ACE2-expressing cells and S protein-expressing cells and a pseudovirus-based inhibition assay. We then analyzed publicly available transcriptome data while focusing on the beneficial effects of apelin on the lungs.

RESULTS

We found that [Pyr1]-Apelin-13 inhibits cell-to-cell fusion mediated by ACE2 binding to the S protein. In this experiment, [Pyr1]-Apelin-13 protected human bronchial epithelial cells, infected with pseudo-typed lentivirus-producing S protein, against viral infection. In the presence of [Pyr1]-Apelin-13, the level of viral spike protein expression was also reduced in a concentration-dependent manner. Transcriptome analysis revealed that apelin may control inflammatory responses to viral infection by inhibiting the nuclear factor kappa B pathway.

CONCLUSION

Apelin is a potential therapeutic candidate against SARS-CoV-2 infection.

Differences in the Cytotoxic Effects of Multi-Walled Carbon Nanotubes on Two- and Three-Dimensionally Cultured Human Neural Precursor Cells and Rat Brain Slices

Carbon nanotubes (CNTs) are used in batteries, nano-electronic devices, fuel cells, and biosensors as they can be used to make these devices more biocompatible; moreover, various compounds can be attached to these CNTs. Although multi-walled carbon nanotubes (MWCNTs) have been used in biosensors for the detection of specific proteins and neurotransmitters, they are not well understood. The present study addressed the difference between the cytotoxic effects of different types of MWCNTs by testing them on two dimensional (2D) and 3D-cultivated human neural precursor cells (hNPCs). We also evaluated the apoptotic damage caused by these MWCNTs using rat brain slices. Our results confirmed that there was significant cytotoxic effect of MWCNT, as shown by the damage caused to the 2D cultured cells. However, the cell death seen in the 3D cultured cells treated with MWCNT was significantly lower than that of the 2D cultivated cells. Furthermore, the 3D cell cytotoxicity assay showed similar results after MWCNT 1/2 treatment and decreased slightly after MWCNT 3/4 treatment, except when treated with 10 ng/ml of MWCNT 3 and 1 g/ml of MWCNT 4. Western blot results using brain slices treated with MWCNTs showed that the expressions of SAPK/JNK, Caspase 3, and Caspase 8 were not significantly different compared to those in the control. In conclusion, MWCNTs had a stable effect on the 3D cultured cells or brain slices, consistent with the results seen in the in vivo system, but caused remarkable damage to the 2D cultured cells that were observed as a flat structure

Assessing Concordance With Watson for Oncology, a Cognitive Computing Decision Support System for Colon Cancer Treatment in Korea

PURPOSE

IBM Watson for Oncology (WFO) is a clinical decision-support computing system that provides oncologists with evidence-based treatment recommendations for a variety of cancer diagnoses. The evidence-based supported treatment recommendations are presented in three categories: Recommended, representing the Memorial Sloan Kettering Cancer Center (MSKCC) preferred approach; For Consideration, evidence-based alternative treatments; and Not Recommended, alternative therapies that may be unacceptable. We examined the absolute concordance of treatment options with that of the recommendations of a multidisciplinary team of oncologists from Gachon University, Gil Medical Centre, Incheon, South Korea.

METHODS

We enrolled 656 patients with stage II, III, and IV colon cancer between 2009 and 2016. Cases were processed using WFO and, using retrospective clinical data, outputs were compared with the actual treatment the patient received. Absolute concordance was defined as an alignment of recommendation in the Recommended MSKCC preferred-approach category. Treatment recommendations that were represented in the For Consideration category were not the focus of this study.

RESULTS

The absolute concordance between the WFO-derived MSKCC preferred approach and Gil Medical Centre treatment recommendations was 48.9%. The percentage of cases found to be acceptable was 65.8% (432 of 656) and the stage-specific concordance rate was 32.5% for patients with stage II disease who had risk factors and 58.8% for patients with stage III disease. Patients 70 years of age and older had a concordance rate of only 20.2%, whereas younger patients had a concordance rate of 63.8% ( P = .0001).

CONCLUSION

The main reasons attributed to the low concordance rate were age, reimbursement plan, omitting chemotherapy after liver resection, and not recommending biologic agents (ie, cetuximab and bevacizumab).

Dose-Dependent Cytotoxicity of Gold Nanoparticles on Human Neural Progenitor Cells and Rat Brain

Gold nanoparticles (GNPs) are utilized as diagnostic and therapeutic tools to detect and treat human disease. Researchers in the field of nanotoxicity are working to determine the physicochemical properties of nanoparticles that lead to toxicity in an effort to establish safe design rules. In this study, we performed the MTT and terminal transferase dUTP nick end labeling (TUNEL) assays to verify the cytotoxicity of GNPs on rat brain tissue and human neural progenitor cells (NPCs). As results, we observed that GNPs induced apoptosis in NPCs. NPCs were markedly damaged following the administration of 200 μM and 2 mM GNPs, whereas 2 μM GNPs showed slightly increased damage relative to that of the control. In addition, TUNEL-positive cells were densely distributed at regions surrounding the GNP injection site in the brain 7 days after the GNPs injection. During long-term GNPs exposure, TUNEL-positive cells were rarely observed in the cerebral cortex. In this study, we observed that apoptosis increased in proportion to GNP concentrations in the brain and in cultivated NPCs. These result suggest that large GNPs (<100 nm) are toxic and that the cytotoxicity increased as the concentration of GNPs increased in NPCs or in the brain.

Five-year outcomes and predictive factors of transforaminal full-endoscopic lumbar discectomy

Although several studies have reported the effectiveness of transforaminal full-endoscopic lumbar discectomy (TELD), no cohort study on the long-term outcomes of TELD has been conducted. Thus, this study aimed to evaluate the long-term clinical outcomes of TELD and to determine the factors predicting favorable outcome.Five-year longitudinal data of 204 consecutive patients who underwent TELD were collected. Outcomes were assessed using the visual analog scale (VAS) pain score, Oswestry disability index (ODI), patient satisfaction rating, and the modified Macnab criteria.The mean VAS score for leg pain improved from 7.64 at the baseline to 1.71, 0.81, 0.90, and 0.99 at postoperative 6 weeks, 1 year, 2 years, and 5 years, respectively (P <.001). The mean ODI improved from 67.2% at the baseline to 15.7%, 8.5%, 9.4%, and 10.1% at postoperative 6 weeks, 1 year, 2 years, and 5 years, respectively (P <.001). The overall patient satisfaction rate was 94.1%. Based on the modified Macnab criteria, 83.8% of patients had excellent or good results. In this study, younger patients with intracanal disc herniation tended to have better outcomes than elderly patients with foraminal/far-lateral disc herniation (P <.05).Transforaminal endoscopic lumbar discectomy offers favorable long-term outcomes with minimal tissue damage. Postoperative pain and functional status may change over time. Proper patient selection remains essential for the success of this minimally invasive procedure.

Laser-Assisted Microdiscectomy for Far Lateral Lumbar Disc Herniation at the L5-S1 Level

OBJECTIVE

Laser-assisted paraspinal microdiscectomy for far lateral lumbar disc herniation (LDH) enables direct access to the foraminal or far lateral zone with minimal tissue injury and preserves facet joints, thereby preventing postoperative segmental instability. We demonstrated the clinical outcomes of this technique and discussed the pros and cons of laser use in lumbar disc surgery.

BACKGROUND

The microdiscectomy technique for L5-S1 far lateral zone may be difficult due to the limited surgical field with narrowed disc space, hypertrophied facet, and sacral ala. Thus, we used carbon dioxide (CO₂) laser for sophisticated decompression.

METHODS

Eighty-four patients who were treated with microdiscectomy for far lateral LDH at the L5-S1 level were evaluated. Among them, 40 patients were treated using CO₂ laser-assisted microdiscectomy, and the remaining 44 patients using conventional microdiscectomy. Perioperative and postoperative data were compared between the two groups with 2 years of follow-up. Clinical outcomes were assessed using the visual analog scale (VAS), Oswestry disability index (ODI), and modified Macnab criteria.

RESULTS

VAS and ODI significantly improved in both groups. An excellent or good outcome was rated in 80% and 77.3% of the laser and conventional group, respectively. There was no significant difference in global outcomes. However, hospital stay and time to return to work were significantly shorter in the laser group (p < 0.05).

CONCLUSIONS

CO₂ laser-assisted paraspinal microdiscectomy is effective for treating far lateral LDH. The pinpoint laser scalpel enables delicate and complete decompression in a limited surgical field with minimal tissue trauma.

Use of a cognitive computing system for treatment of colon and gastric cancer in South Korea

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Background: IBM Watson for Oncology (WFO) is a Memorial Sloan Kettering-trained cognitive computing system that provides oncologists with evidence-based treatment options for cancer. Treatments are presented in three categories: “Recommended”, “For Consideration” and “Not Recommended”. We examined the concordance of treatment options between WFO and the tumor board from Gachon University Gil Medical Centre (GMC), Incheon, South Korea. GMC is an urban center that cares for 50,000 cancer patients annually. Methods: We enrolled 340 patients with stage II, III and IV colon cancer and 185 with chemotherapy-naïve advanced gastric cancer, all treated between 2012 and 2016. Cases were processed using WFO, and the output was compared to blinded tumor board recommendations. Treatment options were considered concordant when the GMC recommendation was included in the “Recommended” or “For Consideration” categories. Results: Treatment recommendations were concordant in 248 (73%) of the 340 evaluated colon cancer cases. Of 250 patients treated in the adjuvant setting, 212 (85%) were concordant. Of 90 patients with metastatic disease, 36 (40%) were concordant. Treatment recommendations were concordant in 90 (49%) of 185 chemotherapy-naïve gastric cancer patients. Low concordance rates in gastric cancer were explained by two observations: (1) The trastzumab/FOLFOX regimen is not covered by the Korean National Health Insurance System, and (2) A regimen known as S-1 (tegafur, gimeracil, and oteracil) plus cisplatin is routinely used in Korea and is not used in the U.S. Conclusions: Treatment options suggested by WFO were concordant with the therapeutic decisions of GMC in the large majority of colon cancer patients treated in the adjuvant setting. Lower degrees of concordance were seen in patients with metastatic colon and gastric cancer, reflecting differences in practice patterns between the United States, where WFO was trained, and GMC, in Korea. Geography-specific customization is available in WFO and should enable physicians and patients to benefit from WFO worldwide. WFO's ability to learn from gastric cancer cases in a part of the world with increased incidence may reveal insights that are applicable elsewhere.

Cytotoxicity of gold nanoparticles in human neural precursor cells and rat cerebral cortex

Nanoparticles are promising tools for the advancement of drug delivery, medical imaging, and as diagnostic sensor. Medical nanodevices should develop miniaturization, because it would be injected into a human body. Gold nanoparticles (GNPs) with different sizes and shapes have therapeutic potential as a result of their small size, robust nature, excellent biocompatibility and optical properties. However, the application of GNPs as medical nanodevices it is necessary to know the biodegradation, biocompatibility, and development of surface coating which avoid the accumulation of nanoparticles. In this study, we carry out an in vitro toxicity and in vivo gene expression study using two kinds of GNPs. We found that GNPs toxicity is dependent on the dose or size administrated after the injected GNPs into the brain, and small particle size GNPs appeared more nestin expression compared to large particle size at short term implantation. These findings of toxicity of GNPs may play an important role in development of in vivo tools for the safety of GNPs.

Cytotoxicity of Gold Nanorods and Nanowires on Cultivated Neural Precursor Cells

Given the emergence of nanotherapeutics and nanodiagnostics as key tools in today's medicine, it has become of critical importance to define the interactions of nanomaterials with biological systems. The biomedical applications of nanoparticles (NPs) in chemical sensing, biological imaging, drug delivery, photothermal therapy and cancer treatment have been demonstrated. Gold NPs as new biomedical tools are the focus of research due to their ease of synthesis, chemical stability and unique optical properties. Therefore, there is a need to establish the toxicity, side effects and safety of gold NPs for human applications. To study the in vitro cytotoxicity of gold NPs, we performed MTT assay using two types of gold NPs such as gold nanorods (GNRs) and gold nanowires (GNWs). The percentage cytotoxicity of damaged neural precursor cells (NPCs) that were treated with 100 mg GNRs was 97.5±3.9%; and proportion of damaged NPCs following the administration of the same dose of GNWs was 98.8±0.3%. The cytotoxicity of 10 mg GNRs in NPCs was 54.4±8.3%, whereas it was 98.7±0.6% for the same dose of GNWs. Then, to verify that gold NPs induced apoptotic cell death in NPCs, the LIVE/DEAD Viability/Cytotoxicity assay was performed. We observed that cell death of NPCs increased with an increase in quantity of both types of gold NPs. Cell viability assessed the overall dose-dependent toxicity of NPs in cultured cells. As the results suggest, this study demonstrated that treatment with gold NPs resulted in cellular toxicity in a dose-dependent manner in cultured NPCs.

An Evaluation of the Government's Current Guideline on the Hospitalization of Minor Head Trauma Patients

OBJECTIVE

In June 28, 2012, a 'Hospitalization guideline for car accident patients' was announced to mediate the clash of opinions about the hospitalization of minor head trauma patients among doctors, patients and insurance companies. The guideline was issued to describe the patients' symptoms and emotions in detail after the injury. In this paper, evaluation for the guideline and suggestions for modifications was done.

METHODS

Thirty-two doctors, 96 patients and 60 employees were each given surveys about the hospitalization guidelines, related personnels' attitude and evaluation of patients' emotional problems. The frequency, ratio and chi-square test were performed.

RESULTS

Sixty-eight point eight percent of doctors, 79.8% patients and 91.6% insurance company employees agreed to the need for a guideline. Among the 68.8% doctors that supported the need for a guideline, 18.8% knew that the guideline actually existed. Sixty-nine point two percent of doctors said that they would apply the guideline once they were introduced to it. Among the announced guideline provisions, 'Glasgow coma score less than 15' and 'socially not suitable for discharge' required reevaluation since 40.6% all surveyors consented that these two criteria were not suitable. The consensus supporting the need for emotional evaluation came out to be 78.1%, 58.5%, 50.9% in doctors, patients and insurance employees respectively.

CONCLUSION

Although a guideline for hospitalization of minor head injury patients is necessary, some part of it seems to be reevaluated and improved, especially for clauses related to the patient's emotional problems. These changes and revisions to the guideline require further speculation and research.

Resorption of Autogenous Bone Graft in Cranioplasty: Resorption and Reintegration Failure

Objective

Re-implantation of autologous skull bone has been known to be difficult because of its propensity for resorption. Moreover, the structural characteristics of the area of the defect cannot tolerate physiologic loading, which is an important factor for graft healing. This paper describes our experiences and results with cranioplasty following decompressive craniectomy using autologous bone flaps.

Methods

In an institutional review, the authors identified 18 patients (11 male and 7 female) in whom autologous cranioplasty was performed after decompressive craniectomy from January 2008 to December 2011. We examined the age, reasons for craniectomy, size of the skull defect, presence of bony resorption, and postoperative complications.

Results

Postoperative bone resorption occurred in eight cases (44.4%). Among them, two experienced symptomatic breakdown of the autologous bone graft that required a second operation to reconstruct the skull contour using porous polyethylene implant (Medpor®). The incidence of bone resorption was more common in the pediatric group and in those with large cranial defects (>120 cm²). No significant correlation was found with sex, reasons for craniectomy, and cryopreservation period.

Conclusion

The use of autologous bone flap for reconstruction of a skull defect after decompressive craniectomy is a quick and cost-effective method. But, the resorption rate was greater in children and in patients with large skull defects. As a result, we suggest compressive force of the tightened scalp, young age, large skull defect, the gap between bone flap and bone edge and heat sterilization of autologous bone as risk factors for bone resorption.

Association of hypomagnesemia with inferior survival in a phase III, randomized study of cetuximab plus best supportive care versus best supportive care alone: NCIC CTG/AGITG CO.17

BACKGROUND

Cetuximab-induced hypomagnesemia has been associated with improved clinical outcomes in advanced colorectal cancer (CRC). We explored this relationship from a randomized clinical trial of cetuximab plus best supportive care (BSC) versus BSC alone in patients with pretreated advanced CRC.

PATIENTS AND METHODS

Day 28 hypomagnesemia grade (0 versus ≥1) and percent reduction (<20% versus ≥20%) of Mg from baseline was correlated with outcome.

RESULTS

The median percentage Mg reduction at day 28 was 10% (-42.4% to 63.0%) for cetuximab (N = 260) versus 0% (-21.1% to 25%) for BSC (N = 251) [P < 0.0001]. Grade ≥1 hypomagnesemia and ≥20% reduction from baseline at day 28 were associated with worse overall survival (OS) [hazard ratio, HR 1.61 (95% CI 1.12-2.33), P = 0.01 and 2.08 (95% CI 1.32-3.29), P = 0.002, respectively] in multivariate analysis including grade of rash (0-1 versus 2+). Dyspnea (grade ≥3) was more common in patients with ≥20% versus < 20% Mg reduction (68% versus 45%; P = 0.02) and grade 3/4 anorexia were higher in patients with grade ≥1 hypomagnesemia (81% versus 63%; P = 0.02).

CONCLUSIONS

In contrast to prior reports, cetuximab-induced hypomagnesemia was associated with poor OS, even after adjustment for grade of rash.

ε-Acetamidocaproic acid pharmacokinetics in rats with gastric ulcer or small bowel inflammation

The pharmacokinetics of ϵ-acetamidocaproic acid (AACA) were evaluated after the intravenous and oral administration of an antiulcer agent, zinc acexamate (ZAC) at a dose of 20 mg kg⁻¹ (ion pairing between zinc and AACA) in rats with indomethacin-induced acute gastric ulcer (IAGU) or indomethacin-induced small bowel inflammation (ISBI). In IAGU rats, the area under the curves (AUCs) of AACA were significantly smaller after both the intravenous (551 versus 1270 μg min ml⁻¹) and oral (397 versus 562 μg min ml⁻¹) administration of ZAC than controls, possible due to the significantly faster CL(R) of AACA. In ISBI rats, however, the AUCs of AACA were comparable with controls after both the intravenous and oral administration of ZAC. In IAGU rats, the significantly smaller AUCs of AACA were due to the significantly faster CL(R) (due to the decreased urinary pH by indomethacin treatment) than controls. AACA has a basic secondary amine group. On the other hand, the comparable AUCs of AACA in ISBI rats were due to the comparable CL(R)s between ISBI and control rats. AACA was excreted in the urine via active renal tubular secretion in all rats studied.

Pharmacokinetic interaction between itraconazole and metformin in rats: competitive inhibition of metabolism of each drug by each other via hepatic and intestinal CYP3A1/2

BACKGROUND AND PURPOSE

Fungal infection is prevalent in patients with diabetes mellitus. Thus, we investigated whether a pharmacokinetic interaction occurs between the anti-fungal agent itraconazole and the anti-glycaemic drug metformin, as both drugs are commonly administered together to diabetic patients and are metabolized via hepatic CYP3A subfamily in rats.

EXPERIMENTAL APPROACH

Itraconazole (20 mg·kg(-1)) and metformin (100 mg·kg(-1)) were simultaneously administered i.v. and p.o. to rats. Concentrations (I) of each drug in the liver and intestine, maximum velocity (V(max)), Michaelis-Menten constant (K(m)) and intrinsic clearance (CL(int) ) for the disappearance of each drug, apparent inhibition constant (K(i) ) and [I]/K(i) ratios of each drug in the liver and intestine were determined. Also the metabolism of each drug in rat and human CYPs was measured in vitro.

KEY RESULTS

After simultaneous administration of both drugs, either i.v. or p.o., the total area under the plasma concentration-time curve from time zero to infinity (AUC)s of itraconazole and metformin were significantly greater than that of either drug administered alone. The metabolism of itraconazole and metformin was significantly inhibited by each other via CYP3A1 and 3A2 in rat and 3A4 in human microsomes.

CONCLUSIONS AND IMPLICATIONS

The significantly greater AUCs of itraconazole and metformin after i.v. administration of both drugs are probably due to competitive inhibition of the metabolism of each drug by each other via hepatic CYP3A1/2. Whereas after oral administration of both drugs, the significantly greater AUCs of each drug administered together than that of either drug alone is mainly due to competitive inhibition of intestinal metabolism of each drug by each other via intestinal CYP3A1/2.

A phase II study of sunitinib in patients with recurrent epithelial ovarian and primary peritoneal carcinoma: an NCIC Clinical Trials Group Study

PURPOSE

Sunitinib is a multitargeted receptor tyrosine kinase inhibitor. We conducted a two-stage phase II study to evaluate the objective response rate of oral sunitinib in recurrent epithelial ovarian cancer.

PATIENTS AND METHODS

Eligibility required measurable disease and one or two prior chemotherapies, at least one platinum based. Platinum-sensitive or -resistant disease was allowed. Initial dose schedule was sunitinib 50 mg daily, 4 of 6 weeks. Observation of fluid accumulations during off-treatment periods resulted in adoption of continuous 37.5 mg daily dosing in the second stage of accrual.

RESULTS

Of 30 eligible patients, most had serous histology (67%), were platinum sensitive (73%) and had two prior chemotherapies (60%). One partial response (3.3%) and three CA125 responses (10%) were observed, all in platinum-sensitive patients using intermittent dosing. Sixteen (53%) had stable disease. Five had >30% decrease in measurable disease. Overall median progression-free survival was 4.1 months. Common adverse events included fatigue, gastrointestinal symptoms, hand-foot syndrome and hypertension. No gastrointestinal perforation occurred.

CONCLUSIONS

Single-agent sunitinib has modest activity in recurrent platinum-sensitive ovarian cancer, but only at the 50 mg intermittent dose schedule, suggesting that dose and schedule may be vital considerations in further evaluation of sunitinib in this cancer setting.

Perspective in Nanoneural Electronic Implants With Wireless Power-Feed and Sensory Control

New medical device technology is essential for diagnosing, monitoring, and curing wide spectrum of diseases, anomalies, and inflictions. For neural applications, currently available devices are generally limited to either a curing or a probing function. In this paper, we review the technology requirements for a new neural probe and cure device technology currently under development. The concept of the probe-pin device that integrates the probes for neurochemistry, neuroelectricity, temperature, and pressure into a single embodiment with a wireless power transmission was designed for the purpose of deep brain feedback stimulation (DBFS) with in situ neural monitoring. The probe considered for monitoring neurochemistry is a microspectrometer. The feature and size of the microspectrometer are defined for the DBFS device. Two types of wireless power transmission technology were studied for the DBFS device operation. The test results of pig skin showed that both power transmission technologies demonstrated the feasibility of power feed through human tissue.

Mitochondrial DNA in patients with essential tremor

Essential tremor (ET) is one of the most common of the movement disorders. However, there has been little agreement in the neurological literature regarding diagnostic criteria for ET. It is not clear to what extent ET is associated with defects of mitochondrial DNA. In this study, we analyzed mitochondrial DNA (mtDNA) from the blood cells of the normal and ET patients using the long and accurate polymerase chain reaction (LA-PCR) and PCR. The large deletions were detected within several regions of mtDNA, but were not detected in the D-loop or CO I regions in ET patients. From our study, it is suggested that ET is a disorder showing a deficiency of mtDNA multicomplexes, and it also appears that mitochondrial dysfunction could be one of the causative factors of ET.

Neuroprotection of adenoviral-vector-mediated GDNF expression against kainic-acid-induced excitotoxicity in the rat hippocampus

Glial-cell-line-derived neurotrophic factor (GDNF) is a potent survival factor for several types of neurons. In the present study, we examined the protective roles of adenoviral-vector-delivered GDNF (Ad-GDNF) in the hippocampus damaged by kainic-acid (KA)-induced excitotoxicity using GAD-67 immunoreactivity, immunoblot analysis, behavioral test, 5-bromo-2-deoxyuridine (BrdU) and TUNEL assay. Ad-GDNF was pre-inoculated into the KA-treated rat hippocampus 7 days before KA injection. Ad-GDNF resulted in the suppression of KA-induced tonic-clonic convulsions. In situ apoptosis assay demonstrated a significant reduction in apoptotic cells in the CA3 and dentate hilus regions of the Ad-GDNF-pre-inoculated rats (Ad-GDNF-KA), compared to the KA rats. Striking reductions in the density of GAD-67 neurons were also observed in the CA3 and dentate hilus regions of the KA rats. On the other hand, the number of GAD-67-positive cells was recovered to the control levels in the Ad-GDNF-KA rats. Immunoblot analysis further confirmed that GAD-67 and Bcl-2 expression increased in the Ad-GDNF-KA rats compared to KA rats. Taken together, these results suggest that Ad-GDNF may serve to control KA-induced hippocampal cell loss and behavioral seizure.

The change of the neuron–glia differentiation rate in human neural precursor cells (HPCs) and Ad-BDNF-/-GDNF-infected HPCs following the administration of a neurotoxin

Neurotrophic factors promote the survival of various neurons, including peripheral autonomic and sensory neurons, as well as central motor and dopamine neurons, and it is expected that they could function as therapeutic agents for neurodegenerative disease. We examined the changes in the neuron-glia differentiation rate in normal human neural precursor cells (HPCs), Ad-BDNF- and Ad-GDNF-infected HPCs following their treatment with 6-OHDA. We isolated the precursor cells from the human fetal midbrain. To investigate the expression of differentiated cell markers within neurons and glia after 6-OHDA-induced toxicity in HPCs, immunocytochemistry was performed. Our results showed that the treatment with 6-OHDA (100, 200, 300, 400 and 500 microM) for 24 h decreased the viability of the HPCs in vitro. Among the growth factors tested, BDNF and GDNF protected the HPCs against 6-OHDA-induced toxicity. Approximately, 5.8+/-2.2% and 0.5+/-0.1% of the HPCs treated with 6-OHDA were positive for the neuron marker, MAP2, and the oligodendrocyte marker, GalC, respectively, while 13.8+/-3.2% and 1.1+/-0.36% of the Ad-BDNF- or Ad-GDNF-infected HPCs treated with 6-OHDA stained positive for MAP2 and GalC, respectively. These results suggest that cocktail therapy using human precursor cells (HPCs) and certain neurotrophic factors (BDNF, GDNF) provide direct protection against 6-OHDA-induced toxicity and has an effect on the differentiation rate.

Phase II multicenter open-label study of carboplatin and pegylated liposomal doxorubicin in uterine and cervical malignancies

The results of a multicenter phase II study investigating carboplatin and pegylated liposomal doxorubicin (PLD) in patients with recurrent/metastatic uterine and cervical malignancies (UCM) are presented here. Fifty-three subjects with measurable, untreated, advanced UCM were enrolled. Fifty-one were evaluable for response. Prior combined-modality treatment was permitted if a component of primary therapy. Patients received carboplatin AUC = 5 with PLD 35 mg/m(2) intravenously once every 4 weeks. Overall response rate was 33% (35% stable disease). Overall survival (OS) at six months was 86% (95% CI 76%-96%). Six-month progression-free survival (PFS) was 43% (95% CI 30%-57%). Median PFS was 22.9 weeks (range 16.0-35.3) and median OS was 49.1 weeks (range 41.4-75.1). The most frequent grade 3-4 nonhematological adverse events were: abdominal pain (n = 7), fatigue (4), vomiting (4), nausea (3), and shortness of breath (3). There was 1 report of grade 3 hand-foot syndrome and none of grade 4. Twelve patients had first infusion reactions with only 1 discontinuing treatment. Grade 3-4 neutropenia occurred in 26/230 cycles (11.3%). There were no treatment-related deaths. The combination of carboplatin and PLD is well tolerated with sufficient activity to justify additional evaluation in clinical trials and might be suited to the addition of a taxane.

Apoptosis and nestin expression in the cortex and cultured astrocytes following 6-OHDA administration

We used the dopaminergic neurotoxicant, 6-hydroxydopamine (6-OHDA), as a tool to characterize the origins of the astrocytic response to injury. Reactive astrocytes were examined by immunocyto- and histo-chemical visualization of nestin protein in the brain and cultivated cells. Following 6-OHDA (dose-dependent) treatment, the expression of nestin-like immunoreactive cells in the corpus callosum and cerebral cortex was increased compared with that of the control animals, indicating that a significant up-regulation of nestin protein occurred in these regions. In the corpus callosum and cerebral cortex, the majority of the nestin-like immunoreactive cells showed a distribution and pattern similar to those of the glial fibrillary acid protein (GFAP)-immunoreactive cells. Double immunofluorescence measurements showed that 100% of the nestin-like immunoreactive cells expressed GFAP-immunoreactive cells, indicating that these nestin-like immunoreactive cells belong to a reactive population of the astrocytes. In this study, we observed the morphological changes in the astrocytes following 6-OHDA administration, demonstrating that 6-OHDA induced injury leads to a rapid and transient up-regulation of nestin-like immunoreactivity in activated astrocytes.

Tamoxifen-induced cell death and expression of neurotrophic factors in cultured C6 glioma cells

The effects of ( Z)-2[ p -(1,2-diphenyl-1-butenyl)phenoxy]-N ,N -dimethylamine citrate (tamoxifen) on cell survival and the expression of neurotrophic factors (NTF) were investigated in rat C6 glioma cells (C6). C6 cells do not express the estrogen receptor. Cytotoxic effect was detected from 24 h after the treatment with 10 microM tamoxifen and increased with time in a dose-dependent manner. C6 cells treated with tamoxifen also displayed various morphological types such as elliptical, round and aggregated form. As the treatment time increased, the proliferation of C6 cells was reduced remarkably and most of them became the round or aggregated form. To examine the relationship of the expression of NTF and the cytotoxicity of tamoxifen, the mRNA level of brain-derived neurotrophic factor (BDNF), glial-derived neurotrophic factor (GDNF), and basic fibroblast growth factor (bFGF) was measured after 24 h treatment with tamoxifen by RT-PCR. The expression of mRNA of BDNF or GDNF in C6 cells treated with various concentrations of tamoxifen was comparable to controls. The expression of bFGF mRNA was significantly reduced in C6 cells treated with 10 or 15 microM tamoxifen. The results suggest that tamoxifen exerts cytotoxic effect on estrogen receptor-negative C6 cells through the inhibition of the transcription of bFGF.

Neurotrophic factor in the treatment of Parkinson disease

Object

Parkinson disease (PD) is a well-known degenerative disease resulting in the depletion of dopamine-producing neurons in the pars compacta of the substantia nigra. Adenoviral vector delivery of neurotrophic factors may provide a potential therapy for PD. The authors examined whether glial cell line–derived neurotrophic factor (GDNF) delivered via adenoviral vector (Ad-GDNF) could promote functional recovery in a rat model of PD. Additionally, they examined whether neural precursor cells (NPCs) provide the therapeutic potential of cultured neural cells for cell regeneration and replacement in PD.

Methods

All animals underwent stereotactic injection of 6-hydroxydopamine into the right substantia nigra. Eight weeks later, the rats were tested for apomorphine-induced rotational asymmetry and evaluation of explanted grafts infected with the complementary DNA for GDNF containing NPCs and NPCs alone. In the NPC cultures of embryonic rat striata, the authors found that basic fibroblast growth factor induced the proliferation of stem cells, which give rise to spheres of undifferentiated cells that generate neurons and glia.

Conclusions

In this study the authors found that the reduction of apomorphine-induced rotation was more prominent in parkinsonian rats that received Ad-GDNF-treated grafts containing NPCs (61%) than in those that received grafts of NPCs alone (16%).

Growth of human squamous cell carcinoma xenografts in mice is inhibited by local angiostatin gene therapy

The possibility of inhibiting tumor growth by blocking the formation of new tumor vessels has recently received attention. Antiangiogenic tumor therapies have recently attracted intense interest because of their direct endothelial targeting and the absence of drug resistance. Local antiangiogenic gene therapy for cancer offers a potential way to achieve sustained therapeutic release of antiangiogenic substances. As a step toward this goal, we used liposomes complexed to angiostatin cDNA and targeted to human squamous cell carcinoma cell lines in vivo. Tumor cells expressing angiostatin after local gene transfer showed markedly reduced vascularity and contained many apoptotic tumor cells. These results demonstrate the potential utility of liposome-derived angiostatin for adjuvant therapy of oral cancer in humans.

Broad bean wilt virus Causes Necrotic Symptoms and Generates Defective RNAs in Capsicum annuum

ABSTRACT A virus was isolated from hot pepper (Capsicum annuum cv. Hyang Chon) growing in Korea and displaying necrotic spots or streaks on leaves and stems followed by stunting and death of plants. Morphological and host range analyses of extracts from infected plants suggested that the causal agent of disease was a Broad bean wilt virus (BBWV), and the virus was tentatively named a Korean isolate of BBWV (BBWV-K). When the isolate was back-inoculated onto hot pepper plants, it induced symptoms similar to those of naturally infected hot pepper in the field. Two coat proteins (CPs) of 44 and 22 kDa, corresponding to a large CP and a small CP, respectively, were identified from the virus, and both reacted specifically with polyclonal antibody to BBWV 2. The complete nucleotide sequences of RNA 1 and RNA 2 of the isolate were determined from cDNA clones. The deduced amino acid sequence data from the putative proteins encoded by RNA 1 and 2 of the BBWV-K indicated a closer relationship with the isolates of BBWV 2 than BBWV 1. However, sequence comparison of the 5' noncoding regions of the viruses differentiates BBWV-K from other BBWV 2 isolates. Another distinctive feature of the BBWV-K is that it generates defective RNAs in hot pepper exhibiting necrotic symptoms, which is the first report of defective RNAs in the Fabavirus genera of BBWVs.

Adhesion mediated by LFA-1 is required for efficient IL-12-induced NK and NKT cell cytotoxicity

Interleukin 12 (IL-12)-activated NK1.1+TCRalpha beta+ (NKT2) and NK1.1+TCRalpha beta- (NK) cells exhibit cytotoxic activity against a wide variety of tumor cells in the absence of prior sensitization. Here we demonstrate that the integrin adhesion receptor LFA-1 (CD11a/CD18) regulates the cytotoxic activity of IL-12-activated NKT and NK cells against YAC-1 and EL-4 tumor cells. Differentiation in vivo and the expression of the cytolytic effector molecules perforin and Fas-L were comparable in both IL-12-activated NKT and NK cells from LFA-1-/ - and LFA-1+/+ mice. However, LFA-1-/-IL-12-activated NKT and NK cells showed impaired conjugate formation with target cells. These results provide the first genetic evidence for a role for an adhesion receptor in killing by IL-12-activated NK cells.

Topographic analysis of the gyral patterns of the central area

Great advances in imaging technology allows the surgeon to visualize the entire brain surface during surgery. However, the cerebral convolutions are extremely complex, so that it is often difficult to define the central area precisely. Using the curvilinear reconstruction technique (Gyroview) and MRI, we have analyzed the gyral anatomy of the central area in 20 normal brans and have recognized several patterns of topographic organization and have classified them into several categories. We divided the central area into anterior and posterior subregions with the central sulcus as the main landmark. More specifically, we studied how the pre- and postcentral gyri merge into the frontal and parietal lobe proper by anatomical bridges (roots). We describe three anterior and two main posterior roots which originate from the precentral and the postcentral gyrus, respectively. We found four different types of pattern for the anterior roots and as many as 10 different patterns for the posterior roots. The arterior roots are relatively constant, compared to the posterior ones. The most frequent pattern (type 1) was found in 33 hemispheres among the 40 analyzed (82.5%). Four main posterior root patterns were recognized in 32 hemispheres of the 40 analyzed (80%). Thus, although gyral variability was encountered for the posterior roots, a very constant global pattern was seen for the central area. One of the most important steps of frameless stereotactic-guided epilepsy surgery is the precise localization of the central area. Therefore, a knowledge of gyral patterns of the central area is essential not only for the resective epilepsy surgery, but also for the successful removal of a variety of lesions in the central area.

Sterilization of elastic ligatures for intraoperative mandibulomaxillary immobilization

Sterilization can influence the mechanical properties of elastic ligatures used for mandibulomaxillary immobilization. The aim of this study was to compare different sterilization protocols (ethylene oxide, autoclave, irradiation, plasma sterilization, povidone-iodine for 24 hours and 70% isopropyl alcohol for 24 hours) of three elastomers (natural rubber, silicone rubber, and polyurethane). Three mechanical variables were assessed in a testing machine: breaking strength, tensile strength and tensile strength after a 24-hour load (material fatigue). Natural rubber was most susceptible to mechanical alteration by sterilization and lost 46% of its breaking strength and 43% of its tensile strength after autoclaving. Polyurethane was more resistant (multiple comparison, Tukey-Kramer), but polyurethane ligatures stuck together after autoclaving. The protocols for low-temperature sterilization, ethylene oxide, irradiation, and plasma were superior to autoclaving and the disinfecting solutions. These data suggest that polyurethane sterilized with ethylene oxide is the material of choice.

Proposed mechanism for the stabilization of nuclear receptor DNA binding via protein dimerization

Hepatocyte nuclear factor 4 (HNF-4) defines a new subgroup of nuclear receptors that exist in solution and bind DNA exclusively as homodimers. We recently showed that the putative ligand binding domain (LBD) of HNF-4 is responsible for dimerization in solution and prevents heterodimerization with other receptors. In this report, the role of the LBD in DNA binding by HNF-4 is further investigated by using electrophoretic mobility shift analysis. A comparison of constructs containing either the DNA binding domain (DBD) alone or the DBD plus the LBD of HNF-4 showed that dimerization via the DBD was sufficient to provide nearly the full DNA binding affinity of the full-length HNF-4. In contrast, dimerization via the DBD was not sufficient to produce a stable protein-DNA complex, whereas dimerization via the LBD increased the half-life of the complex by at least 100-fold. Circular permutation analysis showed that full-length HNF-4 bent DNA by approximately 80 degrees while the DBD bent DNA by only 24 degrees. Nonetheless, analysis of other constructs indicated that the increase in stability afforded by the LBD could be explained only partially by an increased ability to bend DNA. Coimmunoprecipitation studies, on the other hand, showed that dimerization via the LBD produced a protein-protein complex that was much more stable than the corresponding protein-DNA complex. These results led us to propose a model in which dimerization via the LBD stabilizes the receptor on DNA by converting an energetically favorable two-step dissociation event into an energetically unfavorable single-step event. Implications of this one-step model for other nuclear receptors are discussed.

Resistance to tobamoviruses in transgenic tobacco plants expressing the coat protein gene of pepper mild mottle virus (Korean isolate)

Red pepper, one of the most important vegetable crops in Korea, is severely affected by viral diseases causing 20-50% reduction in product yield. A pepper strain of tobacco mosaic virus (TMV-p) is the most common virus in red pepper. To study the molecular structure of the TMV-p virus, we generated cDNA clones of the viral genome. Partial sequencing of a few cDNA clones revealed that TMV-p shares a 98% identity at the nucleotide level with the Spanish isolate of pepper mild mottle virus (PMMV-s). This suggests that TMV-p should be reclassified as the Korean isolate of PMMV (PMMV-k). The coat protein (CP) gene together with the 3' untranslated region of the PMMV-k virus was obtained by reverse transcriptase-polymerase chain reaction (RT-PCR) using oligomers deduced from the sequence of PMMV-s. The sequence analysis of the CP gene and the 3' untranslated region further confirmed that PMMV-k is highly related to PMMV-s. The CP gene and the 3' untranslated region of PMMV-k were cloned into a plant expression vector and the construct was introduced into tobacco plants. The transgenic plants expressing the PMMV-k CP gene were delayed in developing systemic disease or failed to develop symptoms at all after inoculation with PMMV-k. Delay of symptoms was also observed when the plants were inoculated with TMV-OM which shares a 74% homology with PMMV-k in the amino acid sequence of the CP region. In a local lesion host, the CP expressing plants exhibited a greatly reduced number of necrotic lesions as compared to control plants after inoculation with TMV-OM. Our results show that CP-mediated viral resistance is readily applicable in the case of PMMV-k and can provide resistance to other viruses in the tobamovirus group.

Fibrous histiocytoma of the lacrimal sac

BACKGROUND

Fibrous histiocytoma is a slow-growing tumor that most commonly occurs in the superficial and deep soft tissue, with an occasional occurrence in the orbit. However, fibrous histiocytoma of the lacrimal sac is very rare.

METHODS

A case report of a 33-year-old man with a palpable mass in the right lacrimal sac and epiphora is presented, with a review of the literature pertaining to this unusual case.

RESULTS

The patient was found to have a 3 x 2-cm-sized mass in the right lacrimal sac. Under the impression of benign tumor, the tumor was excised. Histopathological diagnosis of fibrous histiocytoma was made on the surgical specimen. Following surgical treatment, the patient has remained free of symptoms.

CONCLUSIONS

Fibrous histiocytoma of the lacrimal sac is a rare disease. This case report and a review of the literature demonstrated that surgical excision appears to control the tumor.