SGN nerve filaments develop synapses with IHCs earlier than with OHCs in C57BL/6 mouse inner ear

OBJECTIVE

To explore the connections between hair cells and spiral ganglion neurons (SGNs) during the development of the C57BL/6 mouse inner ear.

MATERIALS AND METHODS

The specimens of C57BL/6 mouse inner ear, from E15 (embryo day 15) to adult mouse, were collected; immunohistochemistry was employed to explore the frozen sections of specimens.

RESULTS

The development of cochlea starts sequentially from the basal turn to the apex turn. Morphological development of SGNs occurs mainly from E16 to P12 (postnatal day 12). Hair cells appear from E18 to P12, and inner hair cells (IHCs) develop earlier than outer hair cells (OHCs). The connections between hair cells and SGNs begin to develop during E18-P1, morphologically resemble mature synapses during P8-P12, and completely mature in adult mice.

CONCLUSIONS

The genesis of auditory ribbon synapse occurs from E18 to P1. Synchronized with the development of SGNs and hair cells, the functional filaments remain connected to hair cells, while the spare ones get disconnected from the surface of hair cells. Connections between SGN nerve filaments and IHCs occur earlier than those between SGN nerve filaments and OHCs.

Influences of surgical decompression on the dorsal horn after chronic constriction injury: changes in peptidergic and delta-opioid receptor (+) nerve terminals

To understand plastic changes in the dorsal horn related to neuropathic pain, we developed a model of decompression in rats with chronic constriction injury (CCI) and investigated corresponding changes in the dorsal horn. At postoperative week 4 (POW 4) of CCI, rats were divided into a decompression group, in which ligatures were removed, and a CCI group, in which ligatures remained. Spinal cords were immunostained for substance P (SP), the delta-opioid receptor (DOR), and calcitonin gene-related peptide (CGRP). Areas of immunoreactive nerve terminals in the dorsal horn were quantified and expressed as the dorsal horn index (immunoreactive areas of the operated side compared with those of the contralateral side). At POW 4, dorsal horn indexes of all of these molecules were significantly reduced in both groups to similar degrees (0.36-0.43). At POW 8, neuropathic pain behaviors had completely disappeared in the decompression group with significant reversal of the dorsal horn indexes compared with the CCI group (0.81+/-0.02 vs. 0.58+/-0.09, P < 0.001 for SP and 0.75+/-0.04 vs. 0.55+/-0.03, P < 0.001 for DOR). In the CCI group, neuropathic pain behaviors became normalized at POW 12 with corresponding changes in dorsal horn indexes for both SP and DOR similar to those of the decompression group. In contrast, changes in the dorsal horn indexes of CGRP were similar in both the CCI and decompression groups throughout the experimental period. These findings suggest that CCI and decompression cause different patterns in peptidergic and DOR (+) nerve terminals in the dorsal horn.

Improved treatment results for childhood acute myeloid leukemia in Taiwan

To improve treatment results for children with de novo acute myeloid leukemia (AML), we introduced a novel protocol, Taiwan Pediatric Oncology Group-AML-97A, for AML other than acute promyelocytic leukemia (APL), for which modified conventional protocols were used. From January 1, 1997, to December 31, 2002, 141 children younger than 17 years old with de novo AML were enrolled. In total, 117 patients with non-APL AML were treated with induction therapy of idarubicin and cytarabine (Ara-C), postremission therapy with high-dose Ara-C - containing regimens for four monthly courses, and moderate-dose therapy with idarubicin and Ara-C for four monthly courses. The first 19 patients with APL were treated with all-trans retinoic acid, idarubicin and Ara-C, with the remaining five patients receiving all-trans retinoic acid and idarubicin, followed by maintenance therapy for 2 years. Stem cell transplantation was performed in 29 patients in first remission with a similar outcome as chemotherapy alone. The remission rate in the AML-97A study was 90%, the 5-year survival 51 +/- 5.3% (s.e.) and the 5-year event-free survival 50 +/- 4.8%; for APL, these were 100%, 86 +/- 7.0, and 75 +/- 9.8%. For the whole group, the 5-year survival was 57 +/- 4.7% and the 5-year event-free survival 54 +/- 4.4%. The AML-97A regimen was well tolerated.

Pleural effusion and serum soluble fas-ligand levels are elevated in different clinical conditions

Fas ligand (FasL) plays an important role in the regulation of apoptosis. Soluble FasL (sFasL) is produced by a cleavage of FasL from the cell surface by metalloproteinase. Whether or not sFasL exists or is elevated in the pleural effusion of different etiologies is unknown. The present study is designed to determine pleural effusion and serum sFasL levels under different clinical conditions, and ascertain if there exists a significant difference in the levels found in different clinical conditions, and whether this difference can be used as a tool for differential diagnosis. Soluble FasL levels in the pleural effusion and serum of 103 patients, including 37 with malignant pleural effusion, 24 with uncomplicated parapneumonic effusion, 8 with bacterial empyema, 16 with tuberculous pleurisy, and 18 with transudate effusion (8 with congestive heart failure and 10 with viral liver cirrhosis), were analyzed with ELISA assays. Pleural effusion from patients with bacterial empyema (median 79.4 pg/ml) and TB pleurisy (median 31.9 pg/ml) contained significantly higher amounts of sFasL than the pleural effusion from all other conditions studied (p <0.001). Viral liver cirrhosis had a significantly higher serum sFasL level (median 53.6 pg/ml, p = 0.025, when compared with other patients). Patients with congestive heart failure had the lowest serum sFasL levels when compared with other patients (p = 0.014). There was no significant correlation between pleural effusion sFasL levels and other parameters, such as effusion LDH, cell count, neutrophil, and lymphocyte percentage. In conclusion, soluble FasL is a useful marker for the differentiation of bacterial empyema and TB pleurisy from other disease entities. In addition, the elevation of serum sFasL levels in viral liver cirrhosis can also be used to differentiate cirrhosis from congestive heart failure, in which both effusions are transudate.

Sexually dimorphic effect of glutamate treatment on cell cycle arrestment of astrocytes from the preoptic area of neonatal rats

Neurotoxicological studies have indicated that L-glutamate exhibits more pronounced effects on the preoptic area (POA) neurons of male rats than on those of females in the neonatal period. However, no information has previously been available as to whether or not such sexual dimorphism also exists for the effects of glutamate on astrocytes from POA. The present paper reports the differential effects of L-glutamate on astrocytes isolated from POA of neonatal male and female rats. The proliferation of astrocytes was measured by methods of cell count and cell cycle analysis. In addition, the activity of Ca(2+)/calmodulin-dependent protein kinase II (CaM kinase II) was assayed to understand its role in the glutamate-induced disturbance of the cell cycle progression of astrocytes. The results revealed that L-glutamate, at doses of 0.5 and 1.0 mM, inhibited the proliferation of astrocytes derived from male rats more severely than those derived from females. The L-glutamate treatment blocked the cell cycle progression and caused an accumulation of cells in the S phase. The activity of CaM kinase II declined more markedly in astrocytes derived from male rats than in those from females after glutamate treatment. These findings suggest that the proliferation of astrocytes derived from POA of neonatal rats can be inhibited in a sexually dimorphic manner by L-glutamate, possibly through blocking the cell cycle progression and partially related to the inactivation of the CaM kinase II.

Nonmyeloablative allogeneic bone marrow transplantation for orbital granulocytic sarcoma associated with t(8;21)(q22;q22) in acute myeloid leukemia

We report a nonmyeloablative allogeneic bone marrow transplant (allo-BMT) from an HLA-matched unrelated donor in a case of acute myeloid leukemia (AML), M2 with t(8;21)(q22;q22) and the presence of orbital granulocytic sarcoma (GS), who had residual tumor after conventional chemotherapy. The course of BMT was well tolerated, with no major procedure-related toxicity. The residual orbital GS regressed completely 4 months after BMT. She is currently 19 months post BMT, disease-free. To our knowledge, this is the first reported pediatric patient with AML, GS and t(8;21)(q22;q22) who received a nonmyeloablative allo-BMT.

Molecular cloning of the cDNAs for pituitary glycoprotein hormone alpha subunits of two species of duck and their gene regulation

The cDNAs encoding pituitary glycoprotein hormone alpha subunits (PGHalphas) of two species of duck (Muscovy duck, Cairina moschata and Pekin duck, Anas platyrhynchos domesticus) were cloned and sequenced to better understand the phylogenic diversity and evolution of PGHalpha molecules in vertebrates. Oligonucleotide primers were designed and used for reverse transcription PCR (RT-PCR) amplification of PGHalpha cDNA fragments from total cellular RNA of pituitary glands. The remaining sequences were completed by rapid amplification of the cDNA ends. The nucleotide sequence of isolated PGHalpha cDNA of both ducks are identical, including 81 bp of 5' untranslated region (UTR), 360 bp of coding region, and 272 bp of 3'-UTR followed by a 13 bp poly(A)(+) tract. The total number of amino acids deduced from the cDNA of the duck PGHalpha is 120 with a signal peptide of 24 amino acids and a mature protein of 96 amino acids. PGHalphas of the ducks (order Anseriformes) share 96% homology of amino acid sequence in signal peptide, and 100% homology in mature proteins with chicken, quail and turkey (order Galliformes). Our data thus demonstrate identical inter-order homology of PGHalpha mature protein in birds. Ten cysteine residues, presumably forming five disulfide bonds within the alpha subunit, and four proline residues, presumably responsible for folding of the molecule, are conserved in the alpha subunit of ducks. Northern blot analysis revealed that PGHalpha mRNA is expressed only in the pituitary. In order to study factors regulating the gene expression of PGHalpha mRNA, duck pituitary fragments were incubated with GnRH, TRH, testosterone, or triiodothyronine (T(3)). GnRH and TRH increased, while testosterone and T(3) decreased, PGHalpha mRNA levels. This is the first report in birds of TRH up-regulation and down-regulation by testosterone and T(3) under in vitro conditions. The present study demonstrates both ducks have the same cDNA nucleotide and deduced amino acid sequences in the PGHalpha subunit, exhibiting identical inter-genus homology within the family of Anatidae. The findings from mRNA expression work suggest that hypothalamic GnRH and TRH up-regulate, while testosterone and T(3) down-regulate, PGHalpha gene expression in ducks.

Prenatal exposure of testosterone prevents SDN-POA neurons of postnatal male rats from apoptosis through NMDA receptor

The role of N-methyl-D-aspartate (NMDA) receptor in mediating the effect of testosterone exposure prenatally on neuronal apoptosis in the sexual dimorphic nucleus of the preoptic area (SDN-POA) of rats was studied. The endogenous testosterone was diminished by prenatal stress (PNS) or simulated by testosterone exposure (TE) to understand the effect of testosterone on NR(1) (a functional subunit protein of NMDA receptor) expression and neuronal apoptosis. To further study whether the testosterone, after being converted into estradiol, modulates NR(1) expression, 4-androstein-4-ol-3,17-dione (ATD; an aromatase inhibitor) was used to block the conversion of estradiol from testosterone. The expressions of the NR(1) mRNA and NR(1) subunit protein were quantified by RT-PCR and western blotting analysis, respectively. In addition, a noncompetitive antagonist of NMDA receptor, MK-801, was used to find out whether blockage of NMDA receptor affects the naturally occurring apoptosis in SDN-POA. The results showed the following. 1) Expression of perinatal NR(1) subunit protein in the central part of the medial preoptic area of male rats was significantly higher than that of females, especially on postnatal days 1 and 3. 2) The testosterone level of male fetuses on embryonic day 18 was significantly higher than that of females, while the testosterone level of TE females or PNS males was similar to that of intact males or intact females, respectively. 3) The apoptotic incidence of intact male rats was significantly less than that of females, and the apoptosis was stimulated by PNS in male or inhibited by TE in female. 4) The expression of NR(1) subunit protein could be inhibited by PNS or ATD-treatment in male, while stimulated by TE in female. 5) NR(1) mRNA showed no significant difference among intact male, PNS male, ATD-treated male, TE female and intact female rats. 6) The low apoptotic incidence of male rats was significantly increased when NMDA receptor was blocked by MK-801. These results suggest that testosterone, after being converted to estradiol, may prevent the SDN-POA neurons of male rats from apoptosis through enhancing the expression of NR(1) at the posttranscriptional level.

Intestinal metastasis causing intussusception in a patient treated for osteosarcoma with history of multiple metastases: a case report

Intestinal intussusception caused by metastatic tumors is a very rare condition. Preoperative diagnosis is not easy because of the condition's rarity and because of mild abdominal physical presentation. We report on a patient with osteosarcoma who suffered from abdominal pain and emesis during the period of autologous peripheral blood stem cell transplantation. He had undergone tumor excision and radiotherapy several times prior to autologous peripheral blood stem cell transplantation because of multiple metastases. Intestinal metastasis was suspected initially by computed tomographic scan and sonogram and was proved by surgical resection and pathological findings. Clinicians caring for pediatric patients with osteosarcoma with a history of multiple metastases should consider the possibility of intestinal metastases when equivocal abdominal symptoms develop after intensive chemotherapy.

Molecular cloning of cDNA encoding thyroid stimulating hormone beta subunit of bighead carp Aristichthys nobilis and regulation of its gene expression

The complementary DNA (cDNA) encoding pituitary thyroid stimulating hormone beta subunit (TSH-beta) of bighead carp was cloned and regulation of its gene expression was investigated for understanding phylogenetic divergence and evolution of TSH molecule. The cDNA was obtained from bighead carp pituitary total RNA by reverse transcription and polymerase chain reaction. Oligonucleotide primers were designed from the sequence of common carp. The full length sequence was then obtained by 3' and 5' rapid amplification of cDNA ends (RACE). The full-length sequence consisting of 3' and 5' untranslated regions was 585 bp long. The predicted amino acid sequence consisted of a signal peptide of 19 amino acid residues and a mature TSH beta subunit protein of 131 residues. The coding sequences of the cDNAs showed variable percentage homologies with those of other teleosts and vertebrate species. The predicted amino acid sequence shared 71% identity with rainbow trout and salmon, 90% with goldfish, 50% with eel and 94% with common carp in the mature protein region. The percentages of identity in the same region in comparison with bovine, porcine, rat, mouse, human and chicken were only 39, 42, 41, 40, 45 and 46%, respectively. TSH beta mRNA expression was found only in the pituitary tissue out of other tissues tested as testis, muscle, brain and heart. For the first time, thyrotropin releasing hormone (TRH) and thyroxine (T4) effects on pituitary TSH mRNA expression were tested in teleosts under in vitro conditions. TRH treatment on pituitary cells increased TSH beta mRNA level, while T4 treatment decreased TSH beta mRNA level. The present study provides a direct evidence, for the first time that TRH directly upregulates TSH beta gene expression in teleosts.

Presence of Epstein-Barr virus latent membrane protein 1 gene in the nasopharyngeal swabs from patients with nasopharyngeal carcinoma

BACKGROUND

Nasopharyngeal carcinoma (NPC) is the most common head and neck malignancy in southeastern China and Taiwan. Early detection of the local disease followed immediately by proper treatment is essential to increase the cure and survival rates. Because every NPC tumor cell carries Epstein-Barr Virus (EBV) genomes, detection of EBV genomic DNA such as latent membrane protein 1 gene (LMP1) might indicate the presence of NPC. We developed a simple and noninvasive technique of nasopharyngeal swabbing to acquire nasopharyngeal cells for detecting the presence of EBV genome. The aim of this study was to investigate the feasibility and reliability of this technique.

METHODS

We collected nasopharyngeal cells by means of a nasopharyngeal swabbing technique and detected the presence of EBV LMP1 with polymerase chain reaction (PCR). Thirty-eight swab specimens were obtained from patients with NPC who were newly diagnosed or were just beginning radiotherapy. Two groups of control subjects were recruited, including 20 patients with other head and neck cancers and eight family members of the NPC patients. An additional group of 65 NPC patients were enrolled in the course of regular follow-up after definitive radiotherapy.

RESULTS

All of the samples yielded sufficient DNA for PCR amplification. Thirty-six of 38 NPC swab samples were positive for EBV LMP1, and all the control subjects had swab sample results negative for EBV. All five patients with suspected local recurrence exhibited positive EBV test results.

CONCLUSIONS

Demonstration of EBV LMP1 in the nasopharyngeal swab specimens detected NPC with a sensitivity of 94.7% and specificity of 100%. This study confirms the reliability and feasibility of nasopharyngeal swab in the predicting and screening of NPC.

Molecular cloning and sequence analysis of the cDNA for thyroid-stimulating hormone beta subunit of Muscovy duck

The cDNA-encoding thyroid-stimulating hormone beta subunit (TSHbeta) of the Muscovy duck (Cairina moschata) was cloned and sequenced to investigate the phylogenic diversity and evolution of TSH molecules. Oligonucleotide primers were designed and used for reverse transcription and polymerase chain reaction amplification of a TSHbeta cDNA fragment from the total cellular RNA of pituitary glands. The remaining sequence was completed by rapid amplification of cDNA ends. The nucleotide sequence of Muscovy duck TSHbeta cDNA includes 66 bp of 5'-untranslated region (UTR), 402 bp of coding region, and 82 bp of 3'-UTR, followed by an 18-bp poly(A)(+) tract. The total number of amino acids deduced from the cDNA of duck TSHbeta is 134, with a signal peptide of 19 amino acids and a mature protein of 115 amino acids. The homologies of the amino acid sequence of Muscovy duck TSHbeta compared with those of chicken, quail, mammals, amphibian (frog), and teleosts are 97, 98, 68-69, 56, and 42-47%, respectively. To test for tissue specificity of the duck TSHbeta cDNA, total cellular RNA samples from brain, liver, pituitary gland, testis, and thyroid gland were analyzed by Northern blotting. A band, approximately 700 bases, was found in the pituitary gland alone. The pituitary tissue fragments were treated for 24 h in serum-free medium containing thyrotropin-releasing hormone (TRH), triiodothyronine (T(3)), or thyroxine (T(4)). TRH increased and T(3) and T(4) decreased TSHbeta mRNA levels. This study demonstrated that the amino acid sequence of TSHbeta subunits is highly conserved among birds, exhibiting a high degree of inter-order homology, and that hypothalamic TRH upregulates the TSHbeta mRNA expression in duck.

Lactitol-based poly(ether polyol) hydrogels for controlled release chemical and drug delivery systems

The hydroxyl groups of lactitol were propoxylated to produce poly(ether polyol) (LPEP). The average pK(a) value of hydroxyl groups of the polyol was 1.63. Cross-linked hydrogels were synthesized by esterification with chlorinated poly(ethylene glycol) bis(carboxymethyl) ether (PEGBCOCl). The swelling ratio decreased with increasing cross-linking ratio (PEGBCOCl:LPEP) from 2:1 to 4:1 in the hydrogels and was sensitive to temperature change between 25 and 55 degrees C and concentrations of salt and glucose. The swelling ratio did not change significantly with pH in the range of 4-9. The release profiles of a model active agent, acetylsalicylic acid, from the hydrogels showed that the diffusional release rate had a half-order dependence on time, and the diffusivity decreased with increasing cross-linking ratio. This work demonstrated that LPEP-based hydrogels can be used for controlled delivery of drugs and agrochemicals and the release rates can be controlled with the cross-linking ratio of the hydrogel.

Mechanism and characteristics of protein release from lactitol-based cross-linked hydrogel

Lactitol-based cross-linked hydrogel was synthesized, and model proteins (alpha-chymotrypsin, beta-lactoglobulin, bovine serum albumin (BSA), and gamma-globulin) were incorporated into the cross-linked hydrogel. The larger-molecular-weight proteins have lower diffusivity (D(e)) in the hydrogel. Increasing temperature accelerated the diffusion rate of proteins; however, the diffusion did not follow the Arrhenius equation at temperatures above 37 degrees C. The swelling ratio of the hydrogel was slightly decreased after heating for 2 h at 37 and 45 degrees C, and significantly reduced after 1 h at 60 degrees C. Therefore, diffusion of beta-lactoglobulin and BSA may be decreased by hydrogel shrinking at temperature over 37 degrees C. The model proteins have high affinities to buffer solution compared to the hydrogel network structure, resulting in high partition coefficients (K > 1) which do not affect the calculation of D(e) values. Incorporated protein release follows the theory of hindered diffusion.

Effects of indoor environmental factors on risk for atopic eczema in a subtropical area

The objective of this study was to examine the relationship between indoor environmental factors and atopic eczema in a subtropical area. A case-control study was performed using participants from a survey that included 144 school children with atopic eczema and 144 age- and gender-matched controls. The study was confined to 4,164 primary school children aged 6-12 yr attending 8 primary schools in Kaohsiung rural municipalities who participated in the study. Cases of atopic eczema were ascertained by asking whether a physician had ever diagnosed this condition in the child. Information regarding the home environment was obtained using a structured written questionnaire, completed by the parents of the children. Of the many indoor environmental factors included in this study, such as dampness and smoking, none was found to be associated with atopic eczema.

Enlarging effects of estradiol on the nuclear volume of neurons in the hypothalamus during aging

Neuronal nuclear volumes (NNVs) were measured in the medial preoptic nucleus (MPN), anterior hypothalamic area (AHA) and arcuate nucleus (ARN) of young adult, middle-aged, and old rats of both sexes. The NNVs in the darkly stained sexual-dimorphic nucleus of the preoptic area (SDN-POA) and the lighter staining surrounding area (non-SDN-POA) within the MPN were measured separately. Intact young and middle-aged female rats had larger NNVs than those of the males in SDN-POA, non-SDN-POA and AHA but not in ARN. During aging, only intact old female rats manifested significant NNV shrinkage in all the measured areas. Long-term treatment with estradiol benzoate (EB) caused a significant enlargement of the NNVs in non-SDN-POA and ARN of middle-aged and old male rats as well as the NNVs in SDN-POA, non-SDN-POA and ARN of old female rats. The enlarging effect of EB on NNVs in both SDN-POA and non-SDN-POA of female rats could be prevented by ovariectomy. Furthermore, NNVs in SDN-POA and non-SDN-POA of ovariectomized female rats were even smaller than those of the age-matched intact female rats. These results indicate that: (1) the NNVs of MPN and ARN in male and female rats were enlarged after long-term exposure of physiological dose of estradiol; (2) the enlarging effects of EB on NNV in MPN can explain why the NNV of intact female rats is larger than that of males, and (3) during aging, the sex-specific shrinkage of NNVs in MPN, AHA and ARN of female rats may be due to an intrinsic aging process rather than long-term effects of EB.

Evaluating the protective role of the olivocochlear bundle against acoustic overexposure in rats by using Fos immunohistochemistry

Efferent inhibition on the cochlea is suggested as a possible function of the olivocochlear bundle (OCB). Substantial evidence supports the finding that the OCB may protect the inner ear from noise-induced damage. However, there is relatively less known about the effects of noise on the central auditory transmission compared to the effects on the periphery. In the present animal study, two experimental paradigms were designed to analyze the influence of OCB lesion on the central auditory transmission following acoustic overexposure. In order to evaluate the animal's auditory function, its hearing threshold and the tone-evoked Fos expression shown in auditory nuclei were examined. Fos is a protein product of proto-oncogene c-fos. Via appropriate acoustic stimulation, Fos expression reveals the activated neuronal elements along the ascending auditory pathway. Thus, in experiment 1, no exposure sound was introduced and therefore no significant differences were shown in hearing thresholds and Fos expression among all rats, regardless of the status of their OCB. This result indicates that, without acoustic overexposure, OCB lesion caused no significant effect on brainstem auditory transmission. In contrast, in experiment 2, rats were exposed to continuous 8 kHz tones at 85 dB sound pressure level (SPL). A significantly increasing threshold was observed in rats with OCB lesion following an exposure period of 5 or 10 days. In addition, Fos expression was invisible first in rats with OCB lesion following 5-day exposure and almost no Fos expression could be examined in all rats after 10-day exposure. Taken together, the present data demonstrate that damaging the OCB renders an animal more easily vulnerable to acoustic damage than that of rat with intact OCB, and then reduces its cochlear activities, which eventually leads to increasing difficulty to induce tone-evoked Fos expression along the ascending auditory pathway.

Treatment results of the TPOG-NHL92 protocols for childhood non-Hodgkin's lymphomas in Taiwan: a report from the Taiwan Pediatric Oncology Group (TPOG)

A nation-wide chemotherapeutic trial for childhood non-Hodgkin's lymphoma (NHL) was conducted by the Taiwan Pediatric Oncology Group (TPOG). Four TPOG-NHL92 protocols based on stage and histology were activated in 1992: TPOG-92LD (treatment duration: 8 months) was used for localized (stages I/II) NHL with any histology, 92LB (2 years), 92SNC (5 months), and 92LC (1 year) for advanced (stages III/IV) lymphoblastic (LB), small non-cleaved cell (SNC), and large cell (LC) lymphoma, respectively. From January 1992 through June 1998, 200 children with newly diagnosed NHL from 13 member hospitals of TPOG were enrolled. There were 140 boys and 60 girls. Their ages at diagnosis ranged from 2.4 months to 18.3 years with a median of 8.2 years. There were 54 (27.3%) patients with LB, 94 (47.5%) with SNC including B-cell acute lymphoblastic leukemia (B-ALL), and 50 (25.2%) with LC. Stages I, II, III, and IV (including B-ALL) of the disease comprised 5%, 10%, 43%, and 42% of cases, respectively. There were 176 patients eligible for evaluation of treatment results. The remission rate of induction was 82.4%, induction failed in 22 (12.5%) patients, and nine patients died during induction. As of August 31, 1999, 26 patients relapsed, six died during remission, one patient developed secondary acute myelomonocytic leukemia, and 105 patients remained in continuous remission with a median remission duration of 49 months. The event-free survival (EFS) at 7 years was 63.5%, 61.5% and 65% for LB, SNC, and LC groups (P = 0.8298). The 7-year EFS for stages I/II, III, and IV of the disease was 73%, 68.9%, and 50.3% (P = 0.0212), respectively. We concluded that following the strategy of stratification of therapy, only disease stages had prognostic significance in this study. More efforts are needed to improve our treatment results.

Blockage of N-methyl-D-aspartate receptors decreases testosterone levels and enhances postnatal neuronal apoptosis in the preoptic area of male rats

Sexual dimorphism has been found in the preoptic area of the hypothalamus (POA), a major site of glutamate actions via N-methyl-D-aspartate (NMDA) receptors. The sexually dimorphic nucleus of the preoptic area (SDN-POA) of male rats exhibits about seven-fold greater nuclear volume than that of females. A naturally occurring neonatal neuronal apoptosis, that can be prevented by testosterone, may contribute to this sexual difference in SDN-POA nuclear volume. Since activation of NMDA receptors in the POA induces GnRH secretion, it may be involved in both elevation of serum testosterone and prevention of neuronal death in the SDN-POA. In the present study, protein expression of NMDA receptors in the POA of male and female fetuses was quantified on the day preceding the fetal testosterone peak (embryonic day 16; ED 16). Rats were then distributed in four groups: (1) untreated males, (2) untreated females, (3) males pretreated with MK-801 (a noncompetitive NMDA receptor antagonist), and (4) females pretreated with MK-801. Serum levels of testosterone were estimated on the afternoon of ED 18. Expression of Bcl-2 and Bax, as well as neuronal apoptosis in SDN-POA, were observed on postnatal day 8. The results showed that (1) expression of NMDA receptors in the POA of male fetuses was higher than that of females on ED 16; (2) levels of testosterone were lower in MK-801 pretreated male fetuses than in intact males on ED 18; (3) expression of Bcl-2 in the POA of MK-801 pretreated male rats was significantly less than that of control males; (4) the apoptotic incidence in the SDN-POA of MK-801 pretreated male rats was significantly greater than in control males, while there was no significant difference in apoptotic incidence in the SDN-POA between MK-801 pretreated and intact females. These results suggest that the NMDA receptor is highly expressed in prenatal male fetuses, and that it might play an important role in the elevation of testosterone levels. Moreover, activation of NMDA receptors may protect SDN-POA neurons from naturally occurring neuronal death, by modulating testosterone and/or Bcl-2 expression.

Observations after orchiectomy in clinical stage I nonseminomatous germ cell tumors of the testis

BACKGROUND

The optimal management of clinical stage I nonseminomatous germ cell tumor (NSGCT) of the testis remains controversial. For years, retroperitoneal lymph node dissection in combination with orchiectomy, has been the standard treatment in patients with clinical stage I NSGCT. Recently, with advancement of effective cisplatin-based chemotherapy and clinical staging procedures, a new approach of observation after orchiectomy is being evaluated. We reviewed cases of orchiectomy and observation for clinical stage I NSGCT of the testis in order to evaluate the treatment outcome.

METHODS

We retrospectively reviewed the records of 13 patients with clinical stage I NSGCT of the testis treated at our hospital from February, 1981 to August, 1996. The patient age at diagnosis ranged from 0.6 to 44 years. Nine patients had yolk sac tumors, and four had mixed germ cell tumors. Median follow-up was 42 months (range, 20-132 months).

RESULTS

Prior to orchiectomy, serum beta-human chorionic gonadotropin and alpha-fetoprotein (AFP) were raised to abnormal concentrations in four and in 13 patients, respectively. With a median follow-up of 42 months, three of 13 patients relapsed at a median of three months after orchiectomy. Two patients showed elevated AFP and radiographically identifiable tumors simultaneously, and one patient showed elevated AFP as the only evidence of relapse. Following treatment with cisplatin-based chemotherapy, the three patients who relapsed responded successfully and the elevated AFP returned to normal. The patients are currently alive and disease free.

CONCLUSIONS

Observation after orchiectomy is a reasonable approach for patients with clinical stage I NSGCT of the testis.

Sex-specific expression of N-methyl D-aspartate receptor (NMDAR) in the preoptic area of neonatal rats

The relationship between the N-methyl-D-aspartate receptor (NMDAR) and the sex-specific neurotoxicity of L-glutamate on the preoptic area (POA) of neonatal rats was studied. The NMDAR were semiquantified by western blot analysis. The kinetic change of intracellular calcium and lactate dehydrogenase (LDH) efflux were monitored as rapid and delayed toxic signals, respectively. The results showed that: (1) the NMDAR expression in POA of male rat is higher than that of females; (2) the L-glutamate (500 microM) induced a more significant elevation of intracellular calcium in neuron derived from male rat than that from female; (3) after glutamate-treatment, the LDH efflux in neuronal culture of male rat is higher than that of females. These results suggest that the quantitative difference in NMDAR between male and female rats may contribute to the sex-specific neurotoxicity of L-glutamate on the POA of neonatal rats.

Kinetics of germanium dioxide in rats

The kinetics of germanium dioxide (GeO2) in single dose and repeated exposures were investigated in male Wistar rats. In the single dose GeO2 (100 mg/kg BW, p.o.) exposure study, values of several kinetic parameters were shown as follows, a maximum concentration in serum of 15.5+/-0.7 microg/ml (mean +/- S.E.M.), an absorption half-life of 0.7+/-0.1 h (mean +/- S.E.M.), an elimination half-life of 2.3+/-0.5 h (mean +/- S.E.M.), a distribution of the central compartment Vp (3.1+/-0.3 1, mean +/- S.E.M.), and the apparent volume of distribution of the tissue compartment Vt (8.5+/-2.9 1, mean +/- S.E.M.). In the repeated exposure study, 730+/-92 mg GeO2 in 1 1 double-distilled H2O ( = 100 mg/kg/day) was given daily to rats for 4 weeks (p.o.). After sacrificing the rats, the analysis of tissue distribution showed that GeO2 was accumulated in some important organs or tissues in the body, especially the peripheral nerves and kidney. These results indicate that GeO2 could be absorbed rapidly but had a longer elimination half-life in rats. In addition, GeO2 was accumulated especially in the nerves and kidney following long-term exposure.

Testicular yolk sac tumors in children

BACKGROUND

Testicular tumors in children are uncommon, comprising about 1% of pediatric malignancies. Yolk sac tumor is the most common malignant testicular tumor in children. Because yolk sac tumor in children is rarely seen, its treatment has been controversial. We reviewed the records of 15 children with testicular yolk sac tumor treated at our hospital in order to evaluate optimal management and treatment outcome.

METHODS

From February, 1981, to August, 1996, 15 children with testicular yolk sac tumor were treated. Mean patient age at diagnosis was 15.8 months (range, 7-22 months). Fourteen patients presented with stage I disease and one presented with stage III disease. Mean follow-up was 88 months (range, 2-156 months).

RESULTS

All 15 patients received radical inguinal orchiectomy as initial treatment. Serum alpha-fetoprotein (AFP) concentrations were measured in 14 stage I patients preoperatively and were elevated in all of them. During follow-up, the one stage III patient died of the disease. Of the remaining 14 patients, two (14.3%) had recurrence with elevated AFP at three months and 10 months postorchiectomy, respectively. These patients were managed with cisplatin-based combination chemotherapy. To date, they are both alive with no further recurrence, and AFP concentrations returned to normal after chemotherapy. Overall, of the 15 patients with testicular yolk sac tumor, 14 (93.3%) survived without disease.

CONCLUSIONS

Our results suggest that testicular yolk sac tumor in children is a tumor with a favorable prognosis. Serum AFP concentration is extremely useful in diagnosis and monitoring of treatment response. Radical inguinal orchiectomy alone seems adequate for patients with stage I disease if serum AFP concentrations return to normal postoperatively. Cisplatin-based combination chemotherapy should be administered in patients with tumor recurrence or metastasis.

Postchemotherapy retroperitoneal residual mass in infantile yolk sac tumor

BACKGROUND

Persistent postchemotherapy retroperitoneal residual mass with normalization of alpha-fetoprotein (AFP) in infantile yolk sac tumor is rare.

METHODS/RESULTS

A 38-month-old boy with recurrent yolk sac tumor was treated with cisplatin-based combination chemotherapy. After chemotherapy, the retroperitoneal lymph node metastasis, 7 x 6 cm in size, decreased to 2 x 2 cm. Serum AFP levels returned to normal. The retroperitoneal residual mass was resected and histologically showed complete necrosis without viable cancer cells.

CONCLUSION

The patient has remained free of disease for 36 months after operation.

The suppressive effect of the olivocochlear bundle in rats studied by brainstem auditory evoked potentials following brainstem lesion

The olivocochlear bundle (OCB) stems from the superior olivary complex in the brainstem and projects to the ipsilateral and contralateral cochlea. Several studies have suggested that the OCB has a suppressive effect on the inner ear by inhibiting the responses of the primary afferent fibers. To evaluate the action of OCB by more available measurement, radiofrequency lesion was applied to 30 Wistar rats which were divided into four groups, a sham group and another three groups with different OCB lesion sites. Consequent changes following OCB lesion were evaluated by measuring the brainstem auditory evoked potentials (BAEPs), which are considered to reflect the auditory brainstem afferent conduction. The amplitudes and latencies did not change significantly after sham treatment. However, although the BAEP peak latencies were not significantly altered after damaging the OCB, the amplitudes of the BAEP waves I to III were augmented significantly. These results indicate that increased neural activities were presented in the auditory nerves, cochlear nucleus and the superior olivary complex upon disinhibition of the OCB. Unilateral OCB lesions predominantly augmented BAEP waveform which was recorded ipsilaterally to the lesion side. Upon lesion of the midline OCB, BAEP recordings on either side showed significant increments in the amplitudes of waves I to III. These findings are compatible with those observed in the cat model and other rodents, and thus confirm that (1) OCB lesion leads to increased amplitudes in some BAEP peaks which were evoked by certain hyperactive auditory nuclei and tracts; and (2) BAEP measurment is a convenient and useful tool for assessing the OCB function.

Germ cell tumor in infancy and childhood: experience at one institute compared to other studies

To understand the difference in incidence and distribution of germ cell tumor (GCT) between cases seen in this institute and Western studies, 98 cases of GCTs collected from 1979 to 1996 were included 50 with gonadal GCTs, 9 with mediastinal GCTs; 9 with retroperitoneal GCTs, 10 with sacrococcygeal GCTs and 20 with intracranial GCTs; all were analyzed retrospectively by chart review. The incidences of testicular and intracranial GCT in all GCTs were higher in this study, i.e. 26.5%(26/98) and 20.4%(20/98) compared to 7% and 6% of American reports. But the incidence of sacrococcygeal GCT in all GCTs was lower in this study, i.e. 10.2%(10/98) compared to 41% of American reports. The incidences of testicular and ovarian GCT in all GCTs were about the same in this study, i.e. 26.5%(26/98) and 24.5%(24/98) compared to 7% and 29% of American reports; 51%(50/98) of all GCTs were gonadal in this study compared to 36% in the American reports.

Effect of olivocochlear bundle lesion on locomotor activity in rats

This study was conducted to investigate the effect of olivocochlear bundle (OCB) lesion on spontaneous locomotor activity in Wistar rats. The OCB is an auditory efferent pathway which originates from the superior olivary complex in the brainstem and terminates within the cochlea. It has an inhibitory effect on the auditory end organs. In the present study, the OCB was damaged at the floor of the fourth ventricle using radiofrequency current. The rats' locomotor activities were then monitored weekly for 2 months using an automated Digiscan activity monitor system. Six behavioral variables were collected and analyzed: horizontal activity (HA), total distance (TD), movement time (MT), vertical activity (VA), stereotypy count (SC), and margin time (MGT). Significant time-dependent increases were noted for HA, TD, VA, and SC following OCB lesion. These results of increasing exploratory and stereotyped behaviors may be caused by the rat experiencing more auditory stimulation than before due to OCB dysfunction and may cause the rat to become more curious to explore its surroundings.

The relationship between population density and cancer mortality in Taiwan

Many investigators have examined urbanization gradients in cancer rates. The purpose of this report was to identify urban-rural trends in cancer mortality rates (1982-1991) for municipalities in Taiwan. For this purpose, Taiwan's municipalities were classified as rural, suburban, urban, or metropolitan, using population density as an ordinal indicator of the degree of urbanization. Average annual age-adjusted, site-specific cancer mortality rates were calculated for both sexes within each population density group. Significant increasing trends with more urbanization were observed in mortality rates for cancers of the lung, pancreas, and kidney among both males and females, as well as male prostate cancer, and female breast and ovary cancer. In addition, this study revealed a significant rural excess for nonmelanoma skin cancer among both males and females, as well as male non-Hodgkin's lymphoma, and cancers of the female bone, and female connective tissue. Analytic studies for sites with consistent urban-rural trends may be fruitful in identifying the aspect of population density, or other unmeasured factors, that contribute to these trends.

Calcium, magnesium, and nitrate in drinking water and gastric cancer mortality

The possible association between the risk of gastric cancer and the levels of calcium, magnesium, and nitrate in drinking water from municipal supplies was investigated in a matched case-control study in Taiwan. Records of gastric cancer deaths among eligible residents in Taiwan from 1987 through 1991 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to the cases by sex, year-of-birth, and year-of-death. Each matched control was selected randomly from the set of possible controls for each case. Data on calcium, magnesium, and nitrate levels in drinking water throughout Taiwan were obtained from the Taiwan Water Supply Corporation. The municipality of residence of the cases and controls was assumed to be the source of the subject's calcium, magnesium, and nitrate exposure via drinking water. The subjects were divided into tertiles according to the levels of calcium, magnesium, and nitrate in their drinking water. The results of the present study show that there is a significant positive association between drinking water nitrate exposure and gastric cancer mortality. The present study also suggests that there was a significant protective effect of calcium intake from drinking water on the risk of gastric cancer. Magnesium also exerts a protective effect against gastric cancer, but only for the group with the highest levels.

Projection space image reconstruction using strip functions to calculate pixels more "natural" for modeling the geometric response of the SPECT collimator

The spatially varying geometric response of the collimator-detector system in single photon emission computed tomography (SPECT) causes loss in resolution, shape distortions, reconstructed density nonuniformity, and quantitative inaccuracies. A projection space image reconstruction algorithm is used to correct these reconstruction artifacts. The projectors F use strip functions to calculate pixels more "natural" for modeling the two-dimensional (2-D) geometric response of the SPECT collimator transaxially to the axis of rotation. These projectors are defined by summing the intersection of an array of multiple strips rotated at equal angles to approximate the ideal system geometric response of the collimator. Two projection models were evaluated for modeling the system geometric response function. For one projector each strip is of equal weight, for the other projector a Gaussian weighting is used. Parallel beam and fan beam projections of a physical three-dimensional (3-D) Hoffman brain phantom and a Jaszczak cold rod phantom were used to evaluate the geometric response correction. Reconstructions were obtained by using the singular value decomposition (SVD) method and the iterative conjugate gradient algorithm to solve for q in the imaging equation FGq = p, where p is the projection measurement. The projector F included the new models for the geometric response, whereas, the backprojector G did not always model the geometric response in order to increase the computational speed. The final reconstruction was obtained by sampling the backprojection Gq at a discrete array of points. Reconstructions produced by the two proposed projectors showed improved resolution when compared against a unit-strip "natural" pixel model, the conventional image pixelized model with ray tracing to calculate the geometric response, and the filtered backprojection algorithm. When the reconstruction is displayed on fine grid points, the continuity and resolution of the image is preserved without the ring artifacts seen in the unit-strip "natural" pixel model. With present computing power, the geometric response correction using the proposed projection space reconstruction approach is not yet feasible for routine clinical use.

Perturbation of platelet adhesion to endothelial cells by plasminogen activation in vitro

To investigate whether the endothelium-platelet interactions may be altered by plasminogen activation, cultured human umbilical vein endothelial cells (ECs) were treated with tissue-type plasminogen activator (t-PA) in the presence of plasminogen, and platelet adhesion to ECs was subsequently measured by using a tapered flow chamber. Our results demonstrated that platelets adhered more readily to t-PA treated EC monolayer than to the control monolayer at all shear stress levels tested. This phenomenon was treatment time-dependent and dose-dependent, and it could be blocked by adding plasmin inhibitors, such as epsilon-amino caproic acid and aprotinin. Adherent platelets on t-PA treated EC monolayer underwent more severe shape change than those on the control monolayer. While the extracellular matrix directly treated with t-PA attracted less platelets than the control matrix did, platelet adhesion to the matrix that was produced by t-PA-treated ECs was unaltered. These data suggest that t-PA treatment on ECs compromised antiplatelet-adhesion capability on their apical surface without altering the reactivity of their extracellular matrix towards platelets.

Synergestic effects of noise and aminoglycoside antibiotic (gentamicin) on auditory function in the gerbil

Exposure to excessive noise can cause auditory impairment in people as well as in animals, which can be aggravated by many different ototoxic substances, such as aminoglycosides. In the present study, the gerbil was selected as the experimental animal because the gerbil has low-frequency auditory sensitivity that is similar to human beings. Auditory function in gerbils upon exposure to noise and/or gentamicin was evaluated from non-invasive records of brainstem auditory evoked potentials (BAEPs). Fifty mature male Mongolian gerbils were divided randomly into four groups. The control group was exposed neither to noise nor to gentamicin. The noise group was exposed to 100dBA noise ten hours a day for four weeks. The gentamicin group was treated with one dose of gentamicin, 75 mg/Kg i.m., daily for four weeks. The noise + gentamicin group was exposed concurrently to both noise and gentamicin treatment. BAEPs were recorded from all gerbils 24 hours before any experimental treatment, then every week for eight consecutive weeks. Long-term exposure to noise and/or gentamicin treatment was found to reduce gerbil's body weight. The increase in auditory threshold upon concurrent exposure to both noise and gentamicin treatment (evaluated from BAEPs) exceeded the sum of effects caused by exposure to noise alone and to gentamicin alone. Although differences of peak or interpeak latencies among the four groups were not statistically significant, large standard deviations were noted in the noise+gentamicin group. Thus the apparent threshold shifts in gerbils indicated a major noise and/or gentamicin induced auditory impairment to the cochlea, and the slight latency variations probably suggested a minor injury to the auditory pathways. We emphasize that noise and aminoglycoside antibiotic gentamicin can cause damage to the hearing ability at the frequency range vital to human speech recognition, and their effects are synergetic.

The neonatal neurotoxicity of monosodium L-glutamate on the sexually dimorphic nucleus of the preoptic area in rats

The neurotoxic effect of monosodium L-glutamate (MSG) on the morphologies in the darkly stained sexually dimorphic nucleus of the preoptic area (SDN-POA) and the lighter-staining surrounding area (non-SDN-POA) within the medial preoptic nucleus (MPN) was evaluated. Male and female Long-Evans rats were used. MSG (4 mg/g of body weight) was administered subcutaneously to pups on days 1 and 3 postnatally. Normal saline was used as the vehicle. At the age of 6 months, the rats were sacrificed and the brain tissues were fixed for histological examination. The morphological changes, i.e., total volume, density, total neuron number, neuronal nuclear volume (NNV) and ratio of pyknosis, of the SDN-POA and non-SDN-POA within the MPN, were estimated using the AMS VIDS III semiautomatic image-analytic system. The results indicate that neonatal MSG treatment caused significant neuronal loss and decreases in total volume of the SDN-POA and non-SDN-POA of male and female rats. However, only the SDN-POA of MSG-treated male rats showed a significant increase of pyknosis and decrease of neuronal density. A significant enlargement of NNV in the SDN-POA and non-SDN-POA was observed in the MSG-treated male rats. These results indicate that the MPN shows sex-specific and area-specific changes after neonatal neurotoxicity due to MSG.

Automated analytical system for the examination of protein primary structure

This paper describes an automated analytical system for the examination of protein primary structure in which (i) the target protein is first purified by immunoaffinity chromatography, (ii) subsequent chromatographic and chemical reaction steps in the sequencing process are directly coupled, (iii) buffer exchange between these unit operations is achieved while the protein is absorbed on a mixed bed of strong ion exchange sorbents, (iv) proteolysis occurs in an immobilized trypsin column having a 10-1000 fold-excess of enzyme, (v) the tryptic digest is directly transferred to a perfusion dilute capture column where it is concentrated and rapidly desalted, and (vi) peptides eluted from the dilute capture column and analytical microbore and capillary perfusion reversed-phase chromatography columns are analyzed by either single-stage mass spectrometry (MS) or tandem MS/MS. Protein structure variants were easily recognized, and in the case of hemoglobin (Hb) S, the site of variation from Hb A0 was verified.

Identification of two functionally different classes of exocellulases

There are two classes of synergism in cellulase mixtures: synergism between endocellulases and exocellulases, and synergism between certain exocellulases. Exocellulases have been defined traditionally as releasing cellobiose from the nonreducing ends of cellulose, but this definition is inadequate to explain exo/exo synergism. Several recent reports indicate that some exocellulases are capable of hydrolyzing cellulose from the reducing end. The existence of two exocellulase classes with different specificities could provide an explanation for exo/exo synergism. In this paper, we report the substrate specificity of three Thermomonospora fusca (E3, E4, and E6) and two Trichoderma reesei (CBH I and CBH II) exocellulases on labeled cellooligosaccharides. We describe a new nonradioactive technique for determining substrate specificity, in which ion-spray mass spectrometry was used to analyze the products of enzymatic digests of cellopentaose labeled with 18O at the reducing end. Exocellulase reactivity was also investigated on cellopentaose labeled at the nonreducing end with 14C, and cellooligosaccharides reduced with NaBH4. The distribution of label in the reaction products supports the existence of two functional classes of exocellulases. One class (containing CBH I, E4, and E6) preferentially cleaves cellooligosaccharides from the reducing end, while the other (containing E3 and CBH II) preferentially cleaves from the nonreducing end. This classification of exocellulases is consistent with exo/exo synergism experiments, and with published cellulase crystallographic data.

Estradiol modulation of neuron loss in the medial division of medial preoptic nucleus in rats during aging

The age-related morphological changes in the darkly stained sex-dimorphic nucleus (SDN-POA) and the lighter staining surrounding area (non-SDN-POA) within the medial division of preoptic nucleus of Long-Evans rats were studied. The long-term effects of estradiol benzoate (EB) on the changes were also assessed. During aging, the neuron loss in 14-(middle-age) and 22-month-old rats as well as increased pyknotic ratio of neurons in old male rats were observed in SDN-POA, but not in the non-SDN-POA. In female rats, significant neuron loss with advancing age was observed both in SDN-POA and the non-SDN-POA. Neuron loss in SDN-POA of EB-treated males was more severe than that of the intact males, while no significant difference of neuron loss was observed between EB-treated and age-matched intact female rats. However, neuron loss in SDN-POA of ovariectomized female rats was more severe than that of the age-matched intact females. These results indicate that age-related neuron loss in medial preoptic nucleus show sex-specific and area-specific features, and estradiol may play a important role in modulating neuron loss during aging.

Detection of noncovalent FKBP-FK506 and FKBP-Rapamycin complexes by capillary electrophoresis-mass spectrometry and capillary electrophoresis-tandem mass spectrometry

The well known biospecific noncovalent receptor-ligand association complexes between the immunophilin FKBP and the immunosuppressive drugs FK506 and Rapamycin (RM) were investigated by on-line capillary electrophoresis-mass spectrometry (CE-MS) under selected ion monitoring (SIM) conditions and by CE-MS with tandem mass spectrometry (CE-MS/MS) under selected reaction monitoring (SRM) conditions. Solutions of hFKBP (33.3 µM) were dissolved in 50 mM ammonium acetate at pH 7.5. Samples that contained 100 µM of FK506 or RM also were prepared under the same solution conditions. By using these aqueous pH neutral conditions, samples were analyzed by SIM CE-MS and SRM CE-MS and the target complexes were separated by CE with mass spectrometer detection of the individual complexes between FKBP and FK506 [hFKBP + FK506 + 7HJ(7+) as well as FKBP and RM [hFKBP + RM + 7HJ(7+). In an experiment where a mixture of FK506 and RM was analyzed in the presence of FKBP, a nine-to-one ratio of ion current abundances between the RM and FK506 complexes was observed as reported in the literature from other studies. These results suggest that CE-MS and CE-MS/MS may be yet another analytical method for studying noncovalent interactions of biologically important macromolecules under physiological conditions.

Hemophilia A presenting with intracranial hemorrhage in neonate: a case report

Intracranial hemorrhage (ICH) in a neonate is an uncommon presentation of hemophilia. Its occurrence is invariably preceded by mild-to-moderate head injury, unlike adult hemophiliacs in whom ICH occurs without prior head injury in half the cases. The bleeding event may follow a minor injury of labor (eg, prolonged second stage of labor or the use of forceps). In a recent experience at our hospital, a 6 D/O male baby with hemophilia A presenting with ICH after traumatic delivery was later found to have factor VIII deficiency. We suggest that prenatal management for suspected cases should take family history of bleeding disorders and carrier testing into consideration. Any term neonate with ICH should eliminate the possibility of hemophilia until proved otherwise. Some specific diagnostic and therapeutic recommendations to assist the clinician to evaluate an infant with ICH and prolonged PTT are discussed.

Studies of non-covalent interactions of actinomycin D with single-stranded oligodeoxynucleotides by ion spray mass spectrometry and tandem mass spectrometry

Non-covalent binding of actinomycin D (AMD) to single-stranded DNA (ssDNA) was observed by ion spray mass spectrometry. Interactions between AMD and different sequences of non-self-complementary oligodeoxynucleotides were investigated as a function of pH. Non-covalent AMD/ssDNA complexes disappeared at low pH, and no ssDNA complexes were detected with rifampicin (RP). Moreover, the different binding affinities between AMD and ssDNA with and without 5'G-C3' or 5'C-G3' base sequences were also demonstrated using ion spray mass spectrometry. Additional support for the non-covalent nature of binding in AMD/ssDNA complexes was obtained from tandem mass spectrometry.

Mass spectrometric investigations of drug-receptor interactions

Mass spectrometric (MS) detection of biologically important noncovalent complexes is reviewed within the scope of on-going studies on this topic from this laboratory. The merits of ion spray MS and tandem MS are demonstrated in this area with examples that show systemic studies of several receptor-ligand, enzyme-substrate, and enzyme-product complexes associated with both an established well-characterized biological system (lysozyme hydrolysis of N-acetylglucosamine) and an important modern receptor-ligand complex (FKBP-FK-506 and FKBP-rapamycin). These examples and recent applications of negative ion MS and MS/MS with DNA adducts, heme-globin complexes, and antibiotic-binding proteins suggest an exciting new area of applications for MS that have not been previously available to investigators.

Studies on heme binding in myoglobin, hemoglobin, and cytochrome c by ion spray mass spectrometry

The ion spray mass spectra of three representative heme-containing proteins were studied, with an emphasis on results obtained under neutral (pH 7) aqueous conditions. The noncovalently bound heme in myoglobin and hemoglobin may be readily distinguished from the covalently bound heme prosthetic group attached to cytochrome c by using collisioninduced dissociation in the free-jet expansion region of the mass spectrometer as well as in the collision quadrupole with premass selection. The charge state of iron in the expelled heme from myoglobin and hemoglobin appears to be 3+ but 2f for heme expelled from cytochrome c.

Treatment of childhood acute lymphoblastic leukemia with protocol TCL-842 in Taiwan: the Taiwan Children's Cancer Study Group

From March 1984 to May 1988, 212 children with acute lymphoblastic leukemia were enrolled on Protocol TCL-842. In all, 68 patients were classified as standard risk (SR), 56 as intermediate risk (IR), and 88 as high risk (HR) groups. Remission induction for all three groups consisted of vincristine (VCR), prednisolone (PRED) and L-asparaginase (L-Asp). One consolidation course with cyclophosphamide (CP) and cytarabine (AraC) was used for the SR and IR groups, and two courses were given to patients in the HR group. Central nervous system prophylaxis was randomized using either cranial irradiation 18 Gy + 5 intrathecal methotrexate (IT MTX) or triple IT with maintenance. Reinforcement cycles were employed periodically during maintenance therapy (basically 6-mercaptopurine+MTX) and varied among the three groups. Four-week oral PRED every 16 weeks was the sole reinforcement agent for SR. Two-week VCR+dexamethasone (DEX)+adriamycin CP cycles were used to reinforce IR and HR at different intervals. Five third-form cycles with VCR+DEX+AraC were used only for HR. Treatment was discontinued after three years in patients who achieved continuous complete remissions (CCR). Eight patients died during the induction phase and eight failed to achieve complete remission (CR). The CR rate for SR was 97%, for IR was 98% and for HR was 83.3%; the overall rate was 91.8%. As of 30 June 1991, 33 patients had dropped out, 12 had died during remission, and 52 had relapsed. Twenty-eight SR, 26 IR, and 29 HR patients remained in CCR with a median follow-up duration of 66 months (38-88 months).(ABSTRACT TRUNCATED AT 250 WORDS)

Cranial computed tomography in children with acute lymphoblastic leukemia after prophylactic treatment with cranial radiation therapy and intrathecal methotrexate

BACKGROUND AND METHODS

Thirty-one children with acute lymphoblastic leukemia (ALL) who had received cranial radiation therapy (CrRT) and five concomitant doses of intrathecal methotrexate (IT MTX) for central nervous system prophylaxis (CNSP) and who had an event-free survival exceeding 5 years had cranial computed tomography (Cr CT) examination. The fractional dose for 21 of them was 1.5 Gy. The interval between the completion of CNSP and the time of Cr CT ranged from 5 to 8.5 years, with a median of 5 years 2 months.

RESULTS

Unlike the previous reports in the literature that 9-77% of children with ALL who had received Cr RT 18 Gy and IT MTX as CNSP had CT scan abnormalities, in this study no patient had CT scan abnormalities.

CONCLUSIONS

Our results might be attributable to the fractional dose of Cr RT being adequate, the IT chemotherapy being suitable, and the systemic chemotherapy not being intensive.

Acute pancreatitis in association with L-asparaginase therapy: report of one case

L-asparaginase has been used clinically for treatment of a wide variety of pediatric neoplastic diseases (e.g. acute lymphocytic leukemia, malignant lymphoma, etc.) A 14-year-old female patient, is a victim of acute lymphocytic leukemia, Pre T type. She got acute pancreatitis after the L-asparaginase therapy. We reported her clinical course and our management. It is concluded that early diagnosis of pancreatitis is usually difficult, because the symptoms are vague, physical findings may be minimal, and laboratory studies are frequently inconclusive until the injury is severe. Therefore, physicians must be cautious to the patient's chief complaint before administering the next dose of L-asparaginase, because it may occur more earlier than the laboratory or image studies and thus could be used to predict pancreatitis.

Non-Hodgkin's lymphoma in childhood--five years survey in VGH-Taipei

From January 1981 to January 1986, 34 children between 2 and 14 years of age were diagnosed as non-Hodgkin's lymphoma by the Rapport's classification at the Department of Pediatrics of Veterans General Hospital, Taipei, R.O.C. These patients were retrospectively analysed. There was male predominance with a male to female ratio of 2.4:1. The most common symptom was the palpable mass (29 cases, 85.3%) involved the neck and abdomen equally. All the cases were diffuse patterns, DUL (diffuse undifferentiated lymphoma) and DPDL (diffuse poorly differentiated lymphoma) both were the common subtypes of histological patterns. Twenty-eight cases (82%) were in the advanced stage (stage III and IV). The incidence of BM and CNS involvement was 56% and 29.4%, respectively. CNS involvement demonstrated a higher mortality of 100%. Surgery, radiation, and chemotherapy were mainly used for stage I-II and chemotherapy for stage III-IV. The 3-year survival rate of the whole series was 26.5%, and stage I, II, III, and IV was 100%, 50%, 33%, 9%, respectively. The causes of death were CNS involvement (10 cases, 40%), extensive involvement (7 cases, 28.0%), and sepsis (3 cases, 12.0%). This study shows that NHL in children are usually diffuse rather than follicular in histological patterns, often present a palpable mass involved the cervical or abdominal area, and commonly are widespread and tend to disseminate early.

Transient disappearance of immunologic disorders and remission after intercurrent measles infections in children with chronic idiopathic thrombocytopenic purpura

In two children with chronic idiopathic thrombocytopenic purpura (ITP) a transient remission of thrombocytopenia was observed after intercurrent measles infection. Both cases were girls who had a long history of thrombocytopenia. During acute measles infection, the delayed hypersensitivity response was suppressed. Total T lymphocytes, T-cell subsets, especially OKT4 cells, the lymphoproliferative response, and interleukin-2 (IL-2) and gamma-interferon production were decreased accompanying normalization of the OKT4/OKT8 ratio. However, OKT4 cells remained at a reasonably low level and the lymphoproliferative response stimulated with pokeweed mitogen was still in the lower normal range. Direct immunofluorescent study demonstrated that the measles antigen was present in the mononuclear cells, especially OKT4 cells. The levels of platelet-associated IgG antibody (PAIgG) and IgG circulating immune complex (CIC) were undetectable. One month later, the OKT4/OKT8 ratio lymphoproliferative response significantly increased, IL-2 and gamma-interferon production increased, and PAIgG and IgG CIC reappeared with the relapse of thrombocytopenia. There was also a significant increase in in vitro IgG production due to the presence of patient OKT8 cells and/or OKT4 cells. However, there was no enhancement in the presence of patient B cells. This suggests that the presence of specific OKT4 helper T cells and a defect in the suppressor function of suppressor OKT8 cells contribute to an overproduction of IgG and the appearance of PAIgG accompanied by thrombocytopenia. The transient remission associated with measles infection is probably related to the effect of the virus on the helper T cells, resulting in a decrease in specific OKT4 helper T cells and normalization of the OKT4/OKT8 ratio, suppression of IL-2 and gamma-interferon production, and platelet-associated IgG production.

The adherence of Staphylococcus aureus, Staphylococcus epidermidis and Escherichia coli on cotton, polyester and their blends

The adherent behaviour of the Gram-positive Staphylococcus aureus and Staphylococcus epidermidis and the Gram-negative Escherichia coli on cotton, polyester and their blends through contact in aqueous suspensions was studied. Staphylococcus epidermidis was found to adhere to fabrics much more so than Staph. aureus. The adherence of both Staph. epidermidis and Staph. aureus to fabrics increased as the content of polyester fibres in the fabrics increased. The attachment of E. coli to all fabrics was very low and was not affected by the fibre contents. Total numbers of adherent bacteria on cotton and polyester fabrics were related directly to the concentrations of the bacterial suspensions. The extents of adherence, expressed by the percentage of adherent bacteria from the suspension, however, were independent of the concentration. The length of contact with bacteria was also found to affect the adherence of bacteria on fabrics studied.