Iejimalides A and B inhibit lysosomal vacuolar H+-ATPase (V-ATPase) activity and induce S-phase arrest and apoptosis in MCF-7 cells

Iejimalides are novel macrolides that are cytostatic or cytotoxic against a wide range of cancer cells at low nanomolar concentrations. A recent study by our laboratory characterized the expression of genes and proteins that determine the downstream effects of iejimalide B. However, little is known about the cellular target(s) of iejimalide or downstream signaling that lead to cell-cycle arrest and/or apoptosis. Iejimalides have been shown to inhibit the activity of vacuolar H(+)-ATPase (V-ATPase) in osteoclasts, but how this inhibition may lead to cell-cycle arrest and/or apoptosis in epithelial cells is not known. In this study, MCF-7 breast cancer cells were treated with iejimalide A or B and analyzed for changes in cell-cycle dynamics, apoptosis, lysosomal pH, cytoplasmic pH, mitochondrial membrane potential, and generation of reactive oxygen species. Both iejimalides A and B sequentially neutralize the pH of lysosomes, induce S-phase cell-cycle arrest, and trigger apoptosis in MCF-7 cells. Apoptosis occurs through a mechanism that involves oxidative stress and mitochondrial depolarization but not cytoplasmic acidification. These data confirm that iejimalides inhibit V-ATPase activity in the context of epithelial tumor cells, and that this inhibition may lead to a lysosome-initiated cell death process.

Long-term AZT exposure alters the metabolic capacity of cultured human lymphoblastoid cells

The antiretroviral efficacy of 3′-azido-3′-deoxythymidine (AZT) is dependent upon intracellular mono-, di-, and triphosphorylation and incorporation into DNA in place of thymidine. Thymidine kinase 1 (TK-1) catalyzes the first step of this pathway. MOLT-3, human lymphoblastoid cells, were exposed to AZT continuously for 14 passages (P₁–P₁₄) and cultured for an additional 14 passages (P₁₅–P₂₈) without AZT. Progressive and irreversible depletion of the enzymatically active form of the TK-1 24-kDa monomer with loss of active protein was demonstrated during P₁–P₅ of AZT exposure. From P₁₅ to P₂₈, both the 24- and the 48-kDa forms of TK-1 were undetectable and a tetrameric 96-kDa form was present. AZT-DNA incorporation was observed with values of 150, 133, and 108 molecules of AZT/10⁶ nucleotides at the 10μM plasma-equivalent AZT dose at P₁, P₅, and P₁₄, respectively. An exposure-related increase in the frequency of micronuclei (MN) was observed in cells exposed to either 10 or 800μM AZT during P₁–P₁₄. Analysis of the cell cycle profile revealed an accumulation of S-phase cells and a decrease in G₁-phase cells during exposure to 800μM AZT for 14 passages. When MOLT-3 cells were grown in AZT-free media (P₁₅–P₂₉), there was a reduction in AZT-DNA incorporation and MN formation; however, TK-1 depletion and the persistence of S-phase delay were unchanged. These data suggest that in addition to known mutagenic mechanisms, cells may become resistant to AZT partially through inactivation of TK-1 and through modulation of cell cycle components.

Distinctive Acid-Base Pattern in Wernicke’s Encephalopathy

Wernicke's encephalopathy may result in severe morbidity and possible mortality when unrecognized. We report a distinctive acid-base pattern that has not been associated with this syndrome. This is a case series of patients with Wernicke's encephalopathy who had an arterial blood gas measurement performed on initial presentation. Exclusion criteria were patients with an unclear diagnosis of Wernicke's encephalopathy and those for whom no arterial blood gas measurement was performed. Four patients with Wernicke's encephalopathy were included in the analysis. All 4 patients exhibited an anion-gap (primary) metabolic acidosis, accompanied by a primary respiratory alkalosis. Three of 4 patients exhibited a significant lactic acidosis. None of the patients had any competing diagnoses or dysfunction to account for this acid-base pattern. Patients with Wernicke's encephalopathy may exhibit a distinctive acid-base pattern consisting of a primary metabolic acidosis in conjunction with a primary respiratory alkalosis. Observation of this acid-base disturbance should prompt clinicians to consider thiamine deficiency disorders as a possible cause.

Aerobic training in a patient with nonsevere aplastic anemia: a case report

This case report examined whether a 26-year-old man with a 5-year history of nonsevere aplastic anemia could perform aerobic training and whether exercise was beneficial. Testing was performed at baseline and at 8 and 16 weeks and included complete blood tests, graded exercise tests with breath-by-breath gas analyses, and health status assessment with the Medical Outcomes Survey SF-12 health survey. Training consisted of treadmill walking for 25 minutes, 3 days a week for 16 weeks, at 75% of maximal heart rate. The patient successfully completed 16 weeks of training and had no adverse effects from testing or training. Training did not produce changes in disease-related measures (hematologic values) or impairment measures (cardiopulmonary measures of fitness). The mental component of the SF-12 improved from below 2 standard deviations from the population mean to within 1 standard deviation of the population mean. The benefits of aerobic training for this person with aplastic anemia were that he showed that he could participate in aerobic-type activities and that training appeared to improve his mental health.

A cardiovascular health needs assessment of university students living in residence

The purpose of this study was to determine the cardiovascular health needs of university students living in residence. A survey was administered to students living in residence at a university in Nova Scotia, Canada to identify eating patterns, physical activity, smoking behaviours and perceived stress. Data were analyzed using descriptive statistics and chi-square tests of association. Qualitative data were collected using focus group interviews. Results showed that fewer than half of the students participated in exercise three or more times per week, and 82% are less than the recommended amount of fruits and vegetables. As perceived knowledge of CVD increased so did level of physical activity and consumption of fruits and vegetables. Fifty-six percent of students rated their stress as high or very high; exams and course assignments are a major cause of this stress. Fifteen percent of the university students surveyed were daily smokers. Barriers to a healthy lifestyle include time constraints and limited food choices in the residence cafeteria.

A modified newborn intensive care unit environment may shorten hospital stay

Premature infants with birth weights from 1121 to 2000 gm were assigned randomly to two groups. Experimental group infants were placed on a microprocessor-controlled cradle that provided levels of motion and sound analogous to those of the third-trimester intrauterine environment. Periods of motion totaling 50% of the time were randomized on and off; motion speed was reduced 35% during a 12-hour night period. A uterine souffle sound was generated continuously but varied in pulse rate and volume with the motion and speed of the bed. Experimental group infants (n = 20) were placed on the cradle under a radiant warmer as soon as their condition was stable clinically. Control group infants (n = 18) were usually placed initially under a radiant warmer and transferred to an incubator when their condition was stable. Otherwise, both groups received standard newborn intensive care unit care. The mean length of hospital stay was significantly shorter for experimental group infants than for control group infants after controlling for gestational age and weight on entry to the study. Experimental group infants began nippling earlier and stopped requiring gavage feedings sooner. Experimental group infants had a decreased incidence of apnea. Blinded Brazelton Neonatal Behavioral Assessment Scale scores for the Orientation and Range of State cluster scales were significantly better for experimental group infants. A retrospective contrast group of preterm infants who met study criteria had an average length of stay similar to that of the control group infants. These data support the hypothesis that appropriate levels and kinds of stimulation may facilitate the maturation of preterm infants.

Church-state relations and the development of Irish health policy: the mother-and-child scheme, 1944-53

The singularity of the apparent clash of church and state in 1951 and its easy resolution in 1953 should alert us to the dangers of accepting the perception of events as the reality This paper attempts to explain the complexity of factors that gave rise to the appearance of conflict. The evolution of health policy, the relationship of de Valera and Archbishop McQuaid, the intricate politicking of the first inter-party government, the role of the Knights of St Columbanus, the lobbying of the Private Practitioners’ Group of the Irish Medical Association and the medical profession’s influence with the catholic church and the Irish government — these are some of the factors entangled in the controversy The crisis of 1951, however, provides the touchstone by which one can judge the relevance of any record, and the reader should bear; in mind that the confusion of influences covered here relates ultimately to the illusion of conflict. We must go back to the seminal period, the Emergency — the period of the Second World War — to begin to unravel perception from reality

Munchausen's syndrome: an unusual case

Unlike most Munchausen patients, Miss A. was willing to define herself as a psychiatric, as well as a medical-surgical patient. Consequently, it was possible to engage her in therapy in which observation could occur. It was found, also, that Miss A. had used eye drops to dilate her pupils to simulate a neurological disorder and had accidentally induced an anticholinergic delirium.

Staphylococcal infections in a hemodialysis unit

Experience with Staphylococcus aureus infections in a hemodialysis unit in which arteriovenous fistulas were used routinely for dialysis is reviewed, including an epidemic involving multiple bacteriophage types. Most infections involved the fistula site and were associated with bacteremia, although bacteremia without an obvious fistula infection did occur. Despite recurrent bacteremia, endocarditis was not documented, and patients did not develop teichoic acid antibodies as measured by an immunodiffusion technique. Patients with fistula infections responded to antibiotic therapy and did not require removal of the fistula except in two patients whose fistulas ruptured. Patients with shunt infections had to have their shunts removed to control infection. The epidemic developed after the hemodialysis unit was moved into a larger area to facilitate an increasing number of patients and after diabetic patients were admitted to the dialysis program. Both autoinfection and cross-infection contributed to the epidemic, which resolved with improvements in aseptic techniques. A culture survey indicated that the nasal carriage of staphylococci was not unusually high during the epidemic. This report emphasizes that staphylococcal infections remain a problem in continually changing hospital environments.

Psychological adjustment of nonpatient homosexuals: critical review of the research literature

This paper critically reviews research studies comparing adjustment levels of nonpatient homosexuals and heterosexuals, and concludes that findings to date have not demonstrated that the homosexual individual is any less psychologically adjusted than his heterosexual counterpart.

Self-concept and psychological adjustment differences between self-identified male transsexuals and male homosexuals

Self-concept and adjustment data from anatomical males seeking sexual reassignment surgery were compared with that from a male homosexual group. Findings indicated that the homosexual group had a better self-image and was better adjusted than the sex change group. Other findings are presented that reinforce the view that the norm violations in homosexuality and transsexualism do not necessarily imply serious character damage.

Sex-role related countertransference in psychotherapy

Data from one psychological and one psychiatric agency were collected to determine if psychotherapists' treatment decisions about opposite-sex persons might be influenced by sex-role prescriptions for dealing with sexual impulses. Accordingly, male therapists were hypothesized to prolong and female therapists to avoid treatment situations likely to arouse their sexual curiosities. The results at both facilities provide some support for these notions and, if generalizable, establish sex-role primed countertransference as a factor in patient selection and termination.

Gender identification and the female impersonator

This case study supports the plea by a number of psychiatrists for thorough psychiatric and psychologic screening of all persons seeking sexual reassignment surgery. The patient, a female impersonator taking estrogen, was seriously considering such an operation in order to cope with identity problems and an inability to achieve gratification in life. His psychiatric and psychologic evaluations indicated that his profession and desire for anatomic change were more a reflection of a borderline personality than true feminine gender identity.