Supportive care of neurologic complications.

Approximately one cancer patient in five will suffer from injuries to either the central or peripheral nervous system. These complications occur preferentially in the advanced stages of neoplastic disease, and their management is an important aspect of the supportive care of these patients. The most common neurologic complications seen in patients with cancer are related to metastases or to local tumor spread. Antineoplastic treatments, mainly chemotherapy or radiotherapy, account for more than 10% of these complications. A much smaller percentage (probably less than 1%) are paraneoplastic manifestations. In this review, we discuss the most recent developments in the management of neurologic complications specifically related to cancer as well as some less specific problems such as thromboembolic complications and the use of steroids.


Kaposi's sarcoma.

In the era before the acquired immunodeficiency syndrome, Kaposi's sarcoma was a rare cutaneous event. Most reported cases usually originated from one of two geographic regions, an induced immunosuppressed state, or sporadically with various neoplasms that have been known to cause immunosuppression. Since the first cases described with acquired immunodeficiency syndrome in 1981 from New York and San Francisco, this uncommon disorder has had an increased incidence that crosses geographic boundaries. This article describes the current understanding of the pathogenesis of Kaposi's sarcoma and treatments used to ameliorate this disorder.


Current strategies for the treatment of hepatocellular carcinoma.

Although hepatic resection for hepatocellular carcinoma is the only known modality that offers an opportunity for cure, the practicing oncologist must be aware of alternative modes of therapy. A multidisciplinary approach between surgeon, medical oncologist, and invasive radiologist is necessary in exploring all potential therapeutic options. The oncologist must not only consider the stage of the tumor, but must also take into account the functional reserve of the nontumor-bearing liver in selecting appropriate therapy. More recently, hepatic transplantation has been recognized as a potential curative modality for specific tumor types and stages. Percutaneous ethanol injection and chemoembolization are excellent palliative measures. However, it remains clear that new and innovative techniques are necessary in the therapeutic, adjuvant, and palliative settings in the comprehensive care of the patient with hepatocellular carcinoma.


CAPD and pancreatitis: no connection.

Autopsy studies have shown that approximately 56% of patients on long-term continuous ambulatory peritoneal dialysis (CAPD) develop various pancreatic abnormalities, such as acute and chronic pancreatitis, fibrosis, and acinar dilatation. This prevalence of anatomical abnormalities is similar to that observed in patients on hemodialysis and higher than that in those with normal renal function. However, clinical acute pancreatitis is an uncommon complication of CAPD (0.9%), and this prevalence is similar to that (1.7%) of patients on hemodialysis. We can attribute acute pancreatitis in CAPD patients to no single factor. Perhaps preexisting anatomical abnormalities of the pancreas make the CAPD patient susceptible to acute pancreatitis when exposed to a variety of physiological and nonphysiological influences. The diagnosis of acute pancreatitis in CAPD patients is difficult, because symptoms and signs are similar to those of dialysis-associated peritonitis. Serum amylase values three times greater than the upper limit of normal and effluent amylase greater than 100 U/L suggest the diagnosis of acute pancreatitis. Serum lipase, isoamylase, and pancreatic secretory trypsin inhibitor are not helpful. In confirming the diagnosis, a computed tomography (CT) scan is more helpful than ultrasound, although it is positive in only 50-60% of cases. One should harbor a high index of suspicion concerning acute pancreatitis if a CAPD patient presenting with suspected peritonitis has either a negative effluent culture or does not respond to antibiotic therapy.


Distribution of proline-specific aminopeptidases in human tissues and body fluids.

The proline-specific peptidases, aminopeptidase P (EC 3.4.11.9) and dipeptidyl peptidase IV (EC 3.4.14.5), were measured in human tissue homogenates and physiological fluids. All tissues examined contained measurable aminopeptidase P and dipeptidyl peptidase IV activities. High specific activities for both enzymes under study were found in benign prostatic hypertrophy. Normal prostate and prostatic adenocarcinoma had a much lower activity. This difference, however, is not reflected in the serum values of the patients. The most striking finding is the extremely high activity of dipeptidyl peptidase IV in prostatosomes, prostate-derived organelles, which occur freely in human seminal plasma, and which are important for enhancement of sperm forward motility.


Effect of progestin, antiprogestin, and relaxin on the accumulation of prolactin and insulin-like growth factor-binding protein-1 messenger ribonucleic acid in human endometrial stromal cells.

Prolactin (PRL) and insulin-like growth factor-binding protein (IGFBP-1) are two major secretory proteins of human endometrial/decidual cells. We have characterized the mRNA of PRL and IGFBP-1 and studied the effect of progestin, medroxyprogesterone acetate (MPA), anti-progestin (RU486), and relaxin (RLX) on the levels of these two mRNA transcripts in a long-term culture of human endometrial stromal cells. Northern blot analysis showed that the size of PRL mRNA was 1.15 kb and that of IGFBP-1 mRNA, 1.6 kb. Primer extension of endometrial/decidual IGFBP-1 mRNA showed two transcription initiation sites identical to those found in HepG2 human hepatoma cell line. The levels of mRNA in control samples remained low, approximately 2 pg PRL and approximately 5 pg IGFBP-1/microgram RNA at various times of culture. When stromal cells were treated with MPA for 28 days, PRL mRNA gradually increased 100-fold whereas IGFBP-1 mRNA exponentially increased approximately 1000-fold compared to control values and leveled after 25 days in culture. The timing of maximal stimulation was shortened by withdrawing MPA or by replacing MPA with RU486. After removal of MPA, levels of both mRNAs increased and each peaked after approximately 10 days, with PRL showing a 2-fold and IGFBP-1 a 20-fold increase compared to cells treated with MPA continuously. Replacing MPA by RU486 caused a rapid increase of PRL mRNA (2-3-fold) in 2-3 days followed by a gradual reduction to less than 20% of peak levels over the next 3 days. IGFBP-1 mRNA levels increased 30- and 100-fold in 1-2 days followed by a reduction to less than 20% of peak levels over the next 24 h. The reduction of mRNA levels by RU486 was reversed when cells were rechallenged with MPA. Relaxin alone caused a transient stimulation of PRL and IGFBP-1 mRNA. Maximal stimulation occurred between 10 and 20 days of culture and was 100-fold for PRL and 1000-fold for IGFBP-1 relative to control values. Cells treated with MPA and RLX in sequence had higher mRNA levels than cells treated with MPA continuously or cells subjected to MPA withdrawal. Maximal mRNA levels reached 0.4 ng PRL and approximately 8 ng IGFBP-1/microgram total RNA, approximately 0.04% and 0.8% of cellular RNA. The mRNA levels under various hormonal manipulations were similar to the previously published synthesis and secretion patterns of PRL and IGFBP-1 proteins in this system.(ABSTRACT TRUNCATED AT 400 WORDS)


Increased plasma decay-accelerating factor levels in paroxysmal nocturnal hemoglobinuria.

Decay-accelerating factor (DAF) is a complement regulatory membrane protein that is often absent from the cell surface of blood cells in paroxysmal nocturnal hemoglobinuria (PNH). DAF has also recently been found in the body fluids of healthy individuals. However, its precise structure and biological significance are not yet clear. To clarify the clinical and pathological implications of free DAF, we measured plasma DAF levels in PNH patients, using a newly developed quantitative enzyme-linked immunosorbent assay (ELISA), with a measurable range between 0.2-12 ng, for soluble DAF. ELISA assays revealed significantly increased plasma DAF levels in PNH patients (258 +/- 150 ng/ml, mean +/- S.D., n = 9) as compared with healthy controls (80 +/- 41 ng/ml, n = 17) (p less than 0.01). Taken together with the finding that DAF is synthesized in and released extracellularly from affected PNH cells, plasma DAF levels would be useful for clinical diagnosis and for the quantitative evaluation of the clonal expansion of affected cells in PNH.


Interleukin-3 and granulocyte colony-stimulating factor as survival factors in murine hemopoietic stem cells in vitro.

We examined the role of various hemopoietic factors in the survival of hemopoietic stem cells in methylcellulose culture. Bone marrow cells from 5-fluorouracil (5-FU)-treated mice were cultured without hemopoietic factors. Several days later, a mixture of colony-stimulating factors (CSF interleukin-3 (IL-3), interleukin-6 (IL-6), granulocyte colony-stimulating factor (G-CSF), and erythropoietin (Ep)) was added to the culture (delayed addition of CSF) to induce the maximal colony growth in surviving progenitors. In this system few colonies grew, suggesting that some hemopoietic factors are required for the survival of hemopoietic stem cells in vitro. In a further series of experiments, similar cultures were initiated with single known hemopoietic factors or with a mixture of CSF, followed by the addition of CSF 7 days later. Although IL-3 and G-CSF, as single factors, supported colony growth, the other factors did not. In this experiment, while the total number of colonies in cultures initiated with IL-3 or G-CSF was less than that observed in cultures initiated with a mixture of CSF, the number of multipotential GEMM (granulocyte-erythrocyte-macrophage-megakaryocyte) colonies remained constant. We concluded that IL-3 and G-CSF played important roles as single factors in the survival of murine dormant hemopoietic stem cells in vitro.


Colocalization of thrombospondin and syndecan during murine development.

Thrombospondin is an adhesive glycoprotein that is thought to play a role in tissue genesis and repair. We have used a monoclonal anti-thrombospondin antibody, designated 5G11, to localize thrombospondin in paraformaldehyde fixed, paraffin-embedded sections of developing mouse embryos. Thrombospondin expression is observed in uterine smooth muscle, endometrial glands, the decidua, and trophoblastic giant cells during the initial phase of post-implantation development in the embryo. Cardiac myocytes and neuroepithelial cells show positive staining for thrombospondin at day 8.5 of gestation, and this expression continues throughout the development of the myocardium and central nervous system. Strong staining for thrombospondin is seen in developing bone and in the liver. Thrombospondin is also observed in developing smooth muscle and skeletal muscle, as well as in a variety of epithelia, including the epidermis, small intestinal epithelium, lens epithelium, renal tubular epithelium, and the epithelium of the developing tooth. Comparison of thrombospondin staining with that of two known cell surface receptors for thrombospondin, syndecan and the vitronectin receptor, reveals remarkable colocalization of thrombospondin and syndecan in all tissues, but almost no coexpression with the vitronectin receptor. Coexpression of thrombospondin and syndecan may play an important role in cell-cell or cell-matrix interactions during development.


Histochemical localization of Statin--a non-proliferation-specific nuclear protein--in nuclei of normal and abnormal human thyroid tissue.

Surgical specimens of 29 human thyroid masses, both benign and malignant, were examined by means of a novel monoclonal antibody immunoreactive to statin, which is expressed only in quiescent G0 cells. The nuclei of normal thyroid follicle tissue together with nodular goitres and follicular adenomata had similar labelling indices of 96 +/- 2.67, 95 +/- 2.43 and 94 +/- 1.98 respectively. By contrast the labelling indices of papillary and undifferentiated thyroid malignancies were 82 +/- 3.05 and 15.2, respectively. These results indicate that normal thyroid tissues as well as benign thyroid tumors have similar non-proliferative activities. The differentiated papillary cancers have a smaller non-cycling compartment, the smallest being present in the most biologically aggressive undifferentiated thyroid cancer. The immunohistological evaluation of statin in the nuclei of human thyroid malignancies correlates with their biological behaviour in an inverse relationship.


Study of infection by human papillomavirus in severe dysplasias and carcinomas in situ of the uterine cervix using immunohistochemistry and in situ hybridization.

Diagnosis of human papillomavirus (HPV) infection in uterine cervical lesions is usually based on histopathological criteria and, in some cases, is confirmed by immunohistochemistry. The recent development of in situ hybridization techniques has facilitated the detection of HPV in these lesions. Consequently, we carried out a study on 18 uterine cervical biopsy specimens histopathologically diagnosed as severe dysplasias and carcinomas in situ, using an immunohistochemical method with a rabbit polyclonal antibody against the HPV common structural antigen and in situ hybridization techniques with three biotinylated DNA probes for HPV types 6/11, 16/18, and 31/35/51. By immunohistochemistry only one case (5.5%) proved to be positive, whereas by in situ hybridization 12 HPV-positive cases were obtained (66.6%), of which 7 were positive for HPV types 16/18 (38.8%) and 6 for HPV types 31/35/51 (33.3%). One case was positive with positive with both DNA probes. From our results it can be inferred that in situ hybridization is a more sensitive technique than immunohistochemistry for confirming the presence of HPV in severe dysplasias and carcinomas in situ of the uterine cervix. Furthermore, in situ hybridization provides much more information than immunohistochemistry since it permits the identification of the HPV types causing the lesion.


Staining reaction for beta-galactosidase in immunocytochemistry and in situ hybridization.

beta-galactosidase, revealed by an indigo blue reaction product, represents a valid tracer in immunohistochemistry. Observations on the instability of the indigo precipitate led us to investigate this phenomenon. We conclude that avoiding of xylene, and mounting of the preparates in Histoclear (a xylene substitute) and Canada balsam (instead of synthetic resin mountants) yields a sharp and stable indigo precipitate. In addition, we propose a sensitive alternative staining procedure for beta-galactosidase, based on TNBT reduction and precipitation. These reactions can be used both in immunohistochemistry and in in situ hybridization.


Morphological and histochemical study of supragingival human calculus and dental plaque using ruthenium hexammine trichloride and acridine orange.

Ruthenium hexammine trichloride (RHT) and acridine orange were used to preserve and visualize anionic groups in human plaque and dental calculus. RHT-reacting material was present on the membrane of micro-organisms and in intermicrobial spaces of the calcifying areas, and seems to correspond to, and derive from, acidic glyco- and phospholipids of the plasma membrane of the micro-organisms. However, the presence of acidic salivary peptidoglycans cannot be ruled out. Two types of calcification were found: extramicrobial and intramicrobial. The former consisted of calcified deposits irregularly scattered in the intermicrobial matrix. They were in close relationship with RHT-reacting material, or were placed inside vesicular structures delimited by a membrane. Intramicrobial calcification consisted of small aggregates of needle-shaped crystals and/or of granular deposits; in both cases, they either masked the whole cytoplasm of the micro-organisms, or were located only over the plasma membrane. These results suggest that mineral deposition occurs in connection with acidic components of intermicrobial matrix, microbial plasma membranes, and cytoplasms. The addition of RHT and acridine orange to fixing and decalcifying solutions yields satisfactory preservation of dental calculus and plaque, and apparently reduces loss of their anionic organic components and increases their electron density. However, these substances are not sufficient to preserve all ultrastructural details in decalcified areas, probably because the inorganic substance prevents reaction of acridine orange and RHT with the organic components of the calcified matrix.


Importance of acidic mucin secretions by foveolar and mucous neck cells of rat fundic mucosa as the defence mechanisms against HCl as revealed by fasting.

The localization of neutral mucin and acidic mucins in both control and fasted rat gastric fundic mucosa were examined by microscopic and electron microscopic histochemical methods. By Carnoy's fixation, the surface mucous coat of the control rat gastric fundic mucosa was found to be composed of alternating layers of acidic mucins and neutral mucin, indicating the synchronous and cyclic secretions of them. In many gastric pits of the fundic glands, the acidic mucins were found to spring out from the deep foveolar regions like volcanoes. This phenomenon may suggest that the acidic mucins play a fundamental role in protecting the pit cells against HCl during its passage, and the layers of neutral mucin and acidic mucins in the surface coat is the safeguard against the HCl and digestive enzymes in the gastric lumen. In the fasting rat gastric fundic mucosa, the acidity and the amount of the gastric juice were markedly decreased, indicating the suppressed secretions of mucins and HCl. The decreased production of sulfomucin was directly demonstrated by 35SO4-autoradiography. Many mucous neck cells existing in close association with the parietal cells were ballooned due to accumulation of alcian blue (AB)-positive but high iron-diamine (HID)-negative sialomucin, which was not demonstrable in the control. The secretory granules of sialomucin contained in the ballooned mucous neck cells were positively stained ultrastructurally with cacodylate-ferric colloid to stain acid mucopolysaccharides.


Recurrent chromosome alterations in transitional cell bladder carcinomas.

A karyotype study was performed in 42 cases of transitional cell bladder carcinoma. The results, confirmed by DNA content evaluation, showed a prevalence of near-diploid modes not related to the histologic grade of differentiation. Nonrandom alterations were represented by monosomy of chromosome 13 and 22, trisomy of chromosome 7 and deletion of chromosomes 6 and 11. These anomalies allow the identification of different sub-groups of tumors, each with its own biological characteristics of aggressiveness. Prognosis was particularly poor in cases with monosomy of chromosomes 13 and 22 but more favourable in poorly differentiated carcinomas with trisomy of chromosome 7.


Mallory stain may indicate differential rates of RNA synthesis: II. Comparative observations in vertebrate nuclei.

The differential staining of nuclei by the use of the Mallory trichrome method was investigated in a variety of tissues of representative vertebrates. By this method nuclei stained orange or blue; erythrocyte nuclei stained red. Since the higher affinity for aniline blue is due to an increased RNA synthesis, it was possible to reveal not only the changing metabolic status of a cell type, as shown for instance in the liver parenchyma and other glandular tissues, and nervous tissue, but also in different cell populations in the same tissue, such as the spleen.


Electron spectroscopic imaging and X-ray microanalysis of phosphorus in mouse sperm chromatin.

The influence of HCl hydrolysis on DNA detection in a Feulgen-type reaction using osmium ammine has been analyzed at the electron microscopic level by means of electron spectroscopic imaging, electron energy loss spectroscopy and X-ray microanalysis in energy dispersive spectroscopy. Both the stained DNA and the phosphorus mapping for a given hydrolysis condition were studied in parallel on the same nucleus. We have found that the pattern of osmium ammine-stained DNA and phosphorus imaging can be superimposed for a short hydrolysis time. After long HCl treatment, DNA is barely detectable by osmium ammine while phosphorus is still present in the thin sections. Taking into account the fact that the cells are embedded in a plastic resin, it is reasonable to think that in this case DNA depolymerization does not completely correspond to DNA loss. An incomplete loss of this highly denatured and depolymerized DNA from the plastic sections will explain both the presence of phosphorus and the poor stainability with a Schiff-type reagent.


Immunocytochemical detection of dendritic cell by S-100 protein in the chicken.

Positivity for S-100 protein in paraffin embedded chicken lymphoid tissue was found by using a polyclonal antibody against whole bovine S-100 protein. The S-100 protein-containing cells were observed in the locations which have been reported to contain avian dendritic cells such as the medulla of the bursal follicles, and the germinal centers and T-dependent areas in the spleen, Peyer's patches, caecal tonsil and Harderian gland. Positive cells were also found in the location where ellipsoid associated cell have been described, and between epithelial cells covering the Peyer's patches and the caecal tonsil, as well as between the cells lining the ducts within the Harderian gland. Macrophages were devoid of immunostaining. Our results confirm the location described elsewhere for chicken dendritic cells and indicate that S-100 protein can be considered as a cell marker for the identification of the chicken dendritic cell. Intraepithelial positive cells may be interdigitating dendritic cells in an unusual location (their function being the transport of the antigen from the epithelium to the diffuse lymphoid tissue), or cytotoxic T-lymphocytes which, in mammals, are immunoreactive for S-100 protein.


A histochemical study of the microglial cells in the brain of Salamandra salamandra by lectin binding.

Seven biotinylated lectins were utilized as histochemical markers for the study of microglial cells in the brain of Salamandra salamandra. It has been demonstrated that SBA, BSA-I, BSA-I-B4 and RCA120 label the microglial cells and, on the basis of the binding selectivity of the single lectins for specific carbohydrates, it was found that alpha-galactosyl residues are present in high density on the microglial membrane of S. salamandra. The reaction was localized not only to the ramified microglial cells, but also to other round cells without extensions, interpreted as ameboid microglial cells. The results show that lectin binding is a reliable molecular probe for identifying microglial cells in urodels.


Comparative histopathological alterations in the digestive gland of marine bivalves exposed to Cu and Cd.

This study compares the histopathological alterations in the digestive gland cells of mussels, Mytilus galloprovincialis and clams, Ruditapes phillipinarum following exposure to copper and cadmium. The results show degenerative processes undergone in the digestive gland ranging from inflammatory responses to extreme vacuolation, particularly in Cd-exposed individuals. Unsaturated neutral lipids tend to accumulate in pathologically enlarged lysosomes of the homogeneous-type or heterogeneous-type depending of the species and of metal. Lipofucsins containing granules were mainly found in Cu-exposed mussels and Cd-exposed clams. No granules were detected in Cd-mussels. The comparison of the methods indicate that paraffin sections are also a suitable material for the localization of lipofucsins.


Acid phosphatase activity in the supramedullary neurons of Coris julis (L.).

This work describes the acid phosphatase activity in supramedullary neurons of Coris julis, analyzed by a cytochemical method. The presence of both acid phosphatase-positive and -negative membrane bound granules indicates that only a part of the numerous electrodense granules in the supramedullary neurons can be interpreted as lysosomes. The great number of lysosomes in these large neurons of young animals is indicative of the rapid turnover of cell structures, which may be correlated with the high rate of synthesis. The electrodense granules showing no acid phosphatase activity are postulated to be vesicles containing gastrin/CCK-like peptide or precursors of this neuromediator.


A light-microscopic immunocytochemical study of the endocrine pancreas in the Australian brush-tailed possum (Trichosurus vulpecula).

The endocrine pancreas of the Australian brush-tailed possum (Trichosurus vulpecula) was investigated by means of immunocytochemistry using the avidin-biotin-peroxidase technique. This was a light microscopic study using this established technique. Serial paraffin sections were stained individually with primary antibodies for glucagon, insulin, somatostatin, and pancreatic polypeptide (PP), showing the same islet. Cells immunoreactive to glucagon, insulin, somatostatin and PP were found in endocrine islets. PP cells appear to be scattered amidst the exocrine portion also. Insulin immunoreactive cells were located in the central region of islet, glucagon in the periphery, somatostatin in periphery and had elongated processes. PP cells were more sparse and located both in the periphery of islet and amidst the exocrine tissue. These results can then be related to a similar study in the same marsupial, but using the immunofluorescence technique and to studies in other marsupials such as grey kangaroo (Macropus fuliginosus) fat-tailed dunnart (Sminthopsis crasicaudata) and the American opossum (Didelphis virginiana). These investigations are part of a study in Australian mammals.


Correction of emission spectra in microspectrofluorimetry using a reference lamp: computations.

Accurate correction of emission spectra in microspectrofluorimetry, using a reference lamp, may require that a factor for the emissivity of tungsten be introduced. This is only possible provided that the true temperature of the lamp filament is known. A method is given for obtaining the true temperature from the knowledge of the colour temperature. Also, the values of the spectral concentration of the radiance of the black body, either computed according to Planck's equation or taken from available published tables, have to be converted from energetic units to units of quanta since the photomultiplier is linear not to absorbed power but to units of quanta. When the fluorescence spectra to be corrected extend into the far red it is preferable to use a lower temperature (by lowering the supply voltage) than that for which the lamp is certified. It is possible to determine the new temperature (and then the corresponding spectral distribution) by taking a few pairs of measurements at different wavelengths both at the lower voltage and at the voltage for which the lamp is certified and then introducing these values in a non-linear regression soluble on a PC with a curve fitting program. The microscope tungsten halogen lamp can conveniently be used as a reference, thanks to its small size and its steady spectral characteristics. When high accuracy is required, however, the halogen lamp should be calibrated against a certified ribbon filament lamp.


Neurochemical predisposition to self-administer morphine in rats.

Using in vivo microdialysis, this study attempted to determine whether a neurochemical predisposition to self-administer morphine could be identified. Extracellular levels of dopamine and its metabolites were measured bilaterally in the mesocorticolimbic and nigrostriatal systems of naive rats that were subsequently trained to self-administer morphine intravenously. There were several significant relationships between dopamine metabolite 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) levels and rates of morphine self-administration during both acquisition and asymptotic phases of testing. DOPAC and HVA levels in the striatum were inversely correlated with self-administration rates during the asymptotic phase whereas hemispheric asymmetries in striatal metabolite levels were inversely correlated with self-administration during the acquisition phase. DOPAC and HVA levels in in the right but not in the left side of the medial prefrontal cortex were positively correlated with self-administration rates during the acquisition phase; right/left asymmetries in cortical metabolite levels were also correlated with acquisition rates. There were no significant relationships between neurochemical indices and rates of bar-pressing for water. These results suggest that the normal variability in drug seeking behavior is at least in part attributable to individual differences in the organization and activity of brain dopamine systems. Furthermore, different mechanisms appear to be responsible for the initiation and maintenance of morphine intake: DA release in the nucleus accumbens appears to be a critical component of both mechanisms; DA release in the striatum appears to modulate maintenance and, in relationship to striatal lateralization, modulate initiation; DA release in the right but not in the left medial prefrontal cortex appears to be an important predictor of initiation.


Effects of repeated injections of cocaine on catecholamine receptor binding sites, dopamine transporter binding sites and behavior in rhesus monkey.

In order to determine if repeated injections of cocaine produced long-lasting alterations in catecholaminergic binding sites, rhesus monkeys were treated with saline (1.0 ml/15 kg) or cocaine (3.0-4.0 mg/kg) four times daily for 14 consecutive days and sacrificed two weeks after the last injection. The densities of dopamine D1 receptor binding sites, dopamine transporter binding sites and beta adrenergic receptor binding sites were significantly decreased in caudate nucleus to 51%, 17% and 61% of control, respectively, two weeks after repeated cocaine injections. There were no differences in D2 receptor binding site densities in the caudate, nor were there differences in binding sites between groups in the other brain regions examined: prefrontal cortex (D1, D2, dopamine transporter, beta), nucleus accumbens (D1, D2, dopamine transporter) and substantia nigra (D2). Behavioral observation showed that the cocaine-treated monkeys became sensitized to the repeated injections. Early in the regimen, these animals displayed stereotypic grooming, buccal movements and visual checking after each injection that differed significantly from the saline-treated animals. As the regimen progressed, the frequency of grooming decreased while the frequencies of visual tracking and splayed legs increased in a manner consistent with the development of behavioral sensitization. Together, these findings suggest that the caudate nucleus may be more sensitive than other dopamine-containing brain regions to long-lasting pre- and post-synaptic effects of repeated cocaine administration, and that the changes seen in dopaminergic neurons may be related to behavioral sensitization.


Chloride current induced by alcohols in rat dorsal root ganglion neurons.

We have recently demonstrated that ethanol and longer-chain alcohols (n-alcohols) enhance gamma-aminobutyric acid (GABA)-induced chloride currents before desensitization takes place. The potencies of n-alcohols increase with lengthening of the carbon chain. We now report that n-alcohols induce chloride currents by themselves in rat dorsal root ganglion neurons in primary culture. The whole cell variation of the patch clamp techniques was used to record currents as induced by external application of alcohols and other test compounds. Ethanol, n-butanol, n-hexanol and n-octanol induced inward currents with their potencies increasing in that order. The potencies were approximately one order of magnitude less than those to augment GABA-induced currents. The maximum amplitudes of currents induced by the alcohols were less than those produced by GABA. The n-octanol-induced currents were carried largely by chloride ions because the reversal potentials were changed according to the Nernst chloride potential as the internal chloride concentration was changed. Bicuculline and picrotoxin suppressed the n-octanol-induced current, and chlordiazepoxide and pentobarbital augmented the n-octanol-induced current. Therefore, the alcohol-induced chloride currents flow through the chloride channels associated with the GABAA receptors. When applied after the GABA-induced current was desensitized to a lower level, n-octanol suppressed rather than augmented the current. Thus, n-alcohols mimic barbiturates in augmenting the GABA-induced currents and in generating chloride currents by themselves. These actions of both agents may play a role in causing anxiolytic, sedative and/or anesthetic effects.


The anatomical evidence of recurrent axonal collaterals of the thalamus projecting neurons of the rostral pole of the trigeminal sensory nuclear complex in the rat.

Thalamus projecting neurons and their recurrent axonal collaterals were observed in the dorsomedial part of the trigeminal principal sensory nucleus (Vpdm) and the caudolateral part of supratrigeminal nucleus (Vsup CL) after injection of horseradish peroxidase (HRP) into the contralateral ventrobasal complex of the thalamus (VBm) by using the HRP retrogradely tracing-Golgi-like staining method. About 7% (8/120) parent axons of the labeled cells gave rise to recurrent axon collaterals. However, no retrogradely labeled cells were observed in the VBm after injection of HRP into the Vpdm and Vsup CL. In an electron microscopic study, the terminals of recurrent axon collaterals made synapses with the dendrites of the thalamus projecting neurons or non-labeled neurons in the neuropil of the Vpdm and Vsup CL. It is suggested that the recurrent axon collaterals might play a role of negative feedback in transmission of the proprioceptive message from the jaw-closing muscle spindles to the thalamus.


Tyrosine hydroxylase-, neurotensin-, or cholecystokinin-containing neurons in the nucleus tractus solitarii send projection fibers to the nucleus accumbens in the rat.

A double-labeling method combining the retrograde tracing of horseradish peroxidase (HRP) with the immunocytochemical technique was used in the present study. The results suggest that the neurons containing tyrosine hydroxylase (TH), neurotensin (NT) or cholecystokinin (CCK) in the nucleus tractus solitarii (NTS) of the rat send their axons to the nucleus accumbens bilaterally with ipsilateral dominance. HRP-TH, HRP-NT or HRP-CCK double-labeled cell bodies were mainly located in the medial and the commissural subnucleus of the NTS. HRP-TH double-labeled cells were the largest in number, followed by HRP-NT cells, with HRP-CCK cells present in the lowest numbers.


Modulation of dye coupling among glial cells in the myenteric and submucosal plexuses of the guinea pig.

Dye coupling among glial cells in the ganglia of the myenteric and submucosal plexuses of the guinea-pig ileum was studied by intracellular injection of the dye Lucifer yellow (LY), which crosses gap junctions. The injection of a single glial cell with LY resulted in the staining of many glia. The mean number of cells coupled to the injected one was 87.0 +/- 7.9 in the myenteric plexus, and 20.7 +/- 5.6 in the submucosal plexus. As previously shown for myenteric plexus, injection of horseradish peroxidase into submucosal glia resulted in the staining of only a single cell. Dye coupling was significantly reduced in both plexuses by lowering intracellular pH, by replacing 100 mM of the chloride ions with propionate ions or by bubbling the solution with 100% CO2. Octanol (0.3 mM) also markedly diminished dye coupling in the two preparations. These treatments are known to block gap junctions in a variety of tissues. It is concluded that, like central glial cells, enteric glia are extensively coupled. This coupling is apparently mediated by gap junctions.


Chronic MPTP treatment reduces substance P and met-enkephalin content in the basal ganglia of the marmoset.

Common marmosets were treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP, 1.25-2.5 mg/kg s.c., twice a week) for 5-10 consecutive months. The initial doses of MPTP produced a severe parkinsonian syndrome but motor activity was partially recovered at the end of treatment. Fifteen days or 6 months after the last MPTP dose, monkeys were sacrificed. In addition to a strong decrease of dopamine in the striatum, there were significant reductions in substance P and Met-enkephalin content in the substantia nigra, caudate nucleus and putamen. In the globus pallidus, the reduction in peptide levels did not reach statistical significance as compared to controls. Neurotensin levels were also decreased in the caudate nucleus. The chronic administration of MPTP for 5-10 months induces changes in substance P and Met-enkephalin systems which resemble the degeneration found in brains from parkinsonian patients.


Immunohistochemical localization of nerve growth factor in the rat pineal gland.

Sympathetic nerve fibers arising from the superior cervical ganglia are the main innervation of the rat pineal gland. Since most organs innervated by these ganglia contain nerve growth factor (NGF), the hypothetical existence of NGF in the pineal gland was investigated. The peroxidase anti-peroxidase technique was applied for the immunohistochemical demonstration of NGF using a polyclonal antiserum on Bouin-fixed, paraffin-embedded pineal glands from adult, young and 6-hydroxydopamine (6-OHDA)-treated rats. Few immunopositive cells were observed in the adult pineal gland. A more conspicuous population of immunoreactive cells was noted in young animals (20-45 days old), especially in those chemically denervated with 6-OHDA. NGF immunoreactive cells displayed a stellate shape resembling the interstitial or glial cells previously described in the rat pineal gland. Since NGF plays a trophic effect on sympathetic neurons during development and adulthood, we postulate that its presence in the pineal gland may exert a trophic role on its sympathetic innervation.


Projection from the deep cerebellar nuclei to the pedunculopontine nucleus in the squirrel monkey.

Large injections of the anterograde tracer biocytin in the deep nuclei of the cerebellum of squirrel monkeys (Saimiri sciureus) led to a massive labeling of the superior cerebellar peduncle fibers which could be followed up to their major termination site in the thalamus. Along their course through the brainstem, biocytin-labeled fibers emitted fine collaterals that arborized profusely within the entire rostrocaudal extent of the pedunculopontine nucleus (PPN). These fibers were long, slightly varicose, and broke off into numerous shorter and thinner fibers whose terminal portions consisted of a few large varicosities that were often closely apposed to dendrites and cell bodies of PPN neurons. Some PPN cells that were contacted displayed immunoreactivity for choline acetyltransferase. Ultrastructural analysis revealed that synapses formed by cerebellar fibers in PPN were of the asymmetric type and occurred predominantly on dendrites of PPN neurons. Thus, beside the well established cerebellothalamic projection, our findings reveal the existence of a cerebellotegmental projection, whereby the cerebellum may influence the basal ganglia and/or the thalamus via a relay in PPN.


Dynamics of 7B2 and galanin expression in solitary magnocellular hypothalamic vasopressin neurons of the homozygous Brattleboro rat.

The homozygous Brattleboro rat (di/di), displaying a hypothalamic form of diabetes insipidus, synthesizes a vasopressin (VP) precursor with an abnormal C-terminus. The phenotypic expression of coexisting peptides in mutant magnocellular VP cells shows a differential pattern. 7B2 is one of the peptides which is not detectable, whereas there is a clear galanin expression. During postnatal life a small but increasing number of solitary post-mitotic VP neurons of the di/di rat undergoes a switch to a heterozygous phenotype. Here we report the presence of 7B2 and galanin in these heterozygous cells, which suggests that for the expression of 7B2, but not for that of galanin, the relative amount of mutant VP precursor must be diminished. Possible underlying mechanisms for this differential phenotypic expression of coexisting peptides are compartmentalization of precursor synthesis within the RER or a competition for sites involved in the translocation of the functionally reduced RER.


Identification of a src family protein specifically expressed in rat astrocytes by immunohistochemistry and double immunofluorescent study.

Identification of a src-related tyrosine kinase and its regional and cellular distributions were studied in rat brain. The study was performed using a specific antibody raised against a synthetic peptide corresponding to the conserved autophosphorylation site of src-family tyrosine kinases. The antibody (alpha-src antibody) recognized a 43 kDa polypeptide in plasma membrane enriched fraction. The immunohistochemical data revealed that the polypeptide is localized in astrocytes of corpus callosum and fimbria hippocampus. The presence of this src-related protein in astrocytes suggests that it may have some control in their proliferation and differentiation.


Chondroitin sulfate in the extracellular matrix of the medial and lateral superior olivary nuclei in the dog.

Chondroitin sulfate was examined in the extracellular matrix of the canine medial and lateral superior olivary nuclei by light and electron microscopic immunocytochemistry. The extracellular matrix around the large neurons was intensely stained with a monoclonal antibody recognizing D-glucuronic acid 2-sulfate----N-acetylgalactosamine 6-sulfate (D-unit) and this staining degree was remarkably reduced after chondroitinase ABC digestion. Neuronal cytoplasm, glial cells or capillaries in these nuclei were not stained with the monoclonal antibody. The results indicate the presence of disaccharide residue of D-glucuronic acid 2-sulfate----N-acetylgalactosamine 6-sulfate in the chondroitin sulfate proteoglycan of the extracellular matrix.


Intracellular calcium release in N1E-115 neuroblastoma cells is mediated by the M1 muscarinic receptor subtype and is antagonized by McN-A-343.

Experiments using muscarinic receptor antagonists were done to determine which muscarinic receptor subtypes(s) mediate carbachol-evoked calcium release in N1E-115 cells. McN-A-343 and a new analog, (+/-)BN228, were weak antagonists and neither compound caused release on its own. The rank order of potency was 4-DAMP greater than pirenzepine greater than AFDX116 greater than (+/-)BN228 and McN-A-343. This profile, pirenzepine's high potency (19-fold greater than AFDX116) and its IC50 of 31 nM suggest that calcium release in this neuronal cell line is mediated by the M1 muscarinic receptor subtype.


Non-dopaminergic neurons in the substantia nigra project to the reticular formation around the trigeminal motor nucleus in the rat.

The dorsolateral part of the substantia nigra (SN) of the rat was observed to send projection fibers to the reticular formation (RF) around the trigeminal motor nucleus (Vm), bilaterally with a clear-cut ipsilateral dominance, by the anterograde and retrograde tracing techniques with PHA-L and WGA-HRP. A combination of retrograde tracing and immunohistochemistry for tyrosine hydroxylase (TH) revealed that no SN neurons sending their axons to the RF around the Vm showed TH-like immunoreactivity.


Post-train administration of 9-amino-1,2,3,4-tetrahydroacridine enhances passive avoidance retention and decreases beta-adrenoceptor-linked cyclic AMP formation in middle-aged rats.

The possible involvement of beta-adrenoceptor system in the effectiveness of 9-amino-1,2,3,4-tetrahydroacridine (THA) to attenuate retention deficits exhibited by middle-aged rats in a one-trial passive avoidance task has been investigated. THA (2.5 mg.kg-1), injected i.p. after training, induced a significant increase in test step-through latency (STL) in middle-aged rats. Post-training injection of THA reduced basal and isoprenaline stimulated cyclic AMP accumulation in cortex and hippocampus of every group of rats. It is suggested that the effect of THA on memory processes may involve an action on beta-adrenoceptor-linked cyclic AMP accumulation.


Protection of rat hippocampus against ischemic neuronal damage by pretreatment with sublethal ischemia.

We examined whether preconditioning with sublethal ischemia protects against neuronal damage following subsequent lethal ischemic insults. Forebrain ischemia for 3 min in Wistar rats increased heat shock protein-70 immunoreactivity in the hippocampal CA1 subfield but produced no neuronal damage. Preconditioning with 3 min of ischemia followed by 3 days of reperfusion protected against hippocampal CA1 neuronal damage following 6 and 8 min of ischemia but not damage after 10 min of ischemia. The result strongly suggests that stress response induced by sublethal ischemia protects against ischemic brain damage.


1,9-Dideoxyforskolin does not mimic all cAMP and protein kinase A independent effects of forskolin on GABA activated ion currents in adult rat sensory neurons.

The effect of forskolin on GABAA receptor activated events has been the subject of recent investigations, the conclusions of which are conflicting. Forskolin can reduce current amplitude and increase the rate of decay of current activated by 100 microM GABA and these effects are not mimicked by 1,9-dideoxyforskolin (Tehrani et al., Synapse, 4 (1989) 126-131). On the other hand, both forskolin and 1,9-dideoxyforskolin inhibit 36Cl- flux induced by lower concentrations of muscimol (Heuschneider and Schwartz, Proc. Natl. Acad. Sci. USA, 86 (1989) 2938-2942). Using the whole-cell patch clamp technique to measure GABA activated current in dorsal root ganglion neurons that were freshly isolated from adult rats, we have confirmed the finding of Tehrani et al. (Synapse, 4 (1989) 126-131) using 100 microM GABA; however, the effects of forskolin that were not mimicked by 1,9-dideoxyforskolin were not blocked by the kinase inhibitor H-7 (50 microM). In contrast, at lower concentrations of GABA (10-20 microM), both forskolin and 1,9-dideoxyforskolin increased the decay rate of GABA activated current. In addition, all effects of forskolin occurred within 200 ms of application of forskolin and the effects were not blocked or occluded by H-7, 10 microM cAMP, or the active subunit of protein kinase A. We conclude that: (1) 1,9-dideoxyforskolin is not a reliable indicator of forskolin specificity in this system because its effects are dependent upon GABA concentration; and (2) the most prominent effects of forskolin on amplitude and decay time course of GABA activated ion current are not mediated by cAMP or protein kinase A (PKA).


Trigeminal nerve endings of lingual mucosa and musculature of the rat.

Horseradish peroxidase conjugated with wheat germ agglutinin (HRP-WGA) was injected into the trigeminal ganglion of adult rats to label the peripheral sensory receptors of the tongue. The conjugate was transported anterogradely to all the ipsilateral fungiform papillae and filiform papillae. Some labeled fibers crossed over to the contralateral papillae. In the intrinsic tongue muscle undulating nerve fibers along or across muscle fibers were often observed, and formed simple spiral endings.


Laminin immunohistochemistry in brain is dependent on method of tissue fixation.

Normal adult and lesioned rat and mouse brains were fixed by formaldehyde perfusion by two methods that differ primarily in the length of the post-fixation period. Sections were subsequently immunostained using monoclonal and polyclonal antibodies to laminin. With relatively short post-fixation periods (up to 4 h), vascular basement membrane (BM)-laminin was immunostained, but intraneuronal laminin-like immunoreactivity was faint. With longer post-fixation periods (18-24 h), intraneuronal laminin-like immunoreactivity was distinct, while vascular BM-laminin immunoreactivity was reduced drastically. These findings are particularly relevant to studies examining laminin immunoreactive blood vessels in response to lesions, especially ischemic stroke. In fact, the present results suggest that the apparent neovascularization or up-regulation of vascular BM-laminin following CNS injury likely relates to differences in regional tissue fixation.


Identification of nociceptive neurons in the medial thalamus: morphological studies of nociceptive neurons with intracellular injection of horseradish peroxidase.

Somatosensory neurons including nociceptive ones in the medial thalamus have been studied extracellularly, and are classified into three types: nociceptive-specific, wide dynamic range, and tap neurons. However, the morphological characteristics of these three neurons have not yet been clarified. We studied the morphological characteristics of the neurons by iontophoretic injection of HRP into single neurons in 32 cats. Nine wide dynamic range neurons and two tap neurons were electrophysiologically identified and successfully stained with HRP in and around the parafascicular and subparafascicular nuclei, and in the mediodorsal nucleus. All nine wide dynamic range neurons had fewer dendrites which formed scanter tufts, whereas the two tap neurons had many more dendrites which formed denser tufts: i.e. wide dynamic range neurons were of the isodendritic type, and the tap neurons were of the allodendritic type, according to Ramón-Moliner's classification. The axons of the two tap neurons ran antero-laterally whereas those of wide dynamic range neurons ran in many directions. These morphological differences suggest that tap neurons may have more specialized and fixed functions than wide dynamic range neurons.


Glutamine synthetase immunoreactivity in two types of mouse brain glial cells.

The localization and distribution of glutamine synthetase (GS) in the adult mouse brain were studied by immunohistochemistry. GS immunoreactivity was found in two morphologically distinct types of glial cells apart from Bergmann glia, one asteroid and the other ovoid. The light and electron microscopic features of the GS-positive asteroid and ovoid cells were well consistent with those of astrocytes and oligodendrocytes, respectively. The GS-positive asteroid cells were present in the hippocampus, cerebral cortex, neostriatum, and cerebellar granular layer, where many synapse receptors for excitatory amino acids such as glutamate are densely distributed. Weakly GS-positive asteroid cells were also scattered in the white matter. The GS-positive ovoid cells were present throughout the gray matter regions of the brain except for the hippocampus, and they were the predominant type of GS-positive cells in the thalamus and brainstem gray matter where excitatory amino acid receptors are relatively sparse. No GS-positive ovoid cells were found in the white matter. These results suggest that, in the mouse brain, GS is localized in oligodendrocytes of the gray matter and in astrocytes. These two types of GS-positive glial cells may play different roles in the metabolism of glutamate.


Melittin enhances excitatory amino acid release and AMPA-stimulated 45Ca2+ influx in cultured neurons.

Melittin, a potent activator of phospholipase A2, enhanced both spontaneous and depolarization-induced release of D-[3H]aspartate in primary cultures of cerebellar granule cells. The action of melittin was concentration-dependent (EC50 value = 300 ng/ml) and did not require the presence of extracellular Ca2+. Melittin also stimulated the release of glutamate and aspartate, in addition to other endogenous amino acids (taurine, alanine and gamma-aminobutyric acid). These effects were accompanied by an enhanced influx of 45Ca2+, which was in part mediated by the activation of excitatory amino acid receptors by endogenous agonists. Low concentrations of melittin (50 ng/ml) potentiated the efficacy of AMPA in stimulating 45Ca2+ influx without affecting stimulation by kainate or by glutamate added in the absence of extracellular Mg2+ (a condition that favors the activation of NMDA receptors). These results indicate that activation of phospholipase A2 evokes both an enhanced glutamate release and an increased sensitivity of AMPA receptors, two events that may support synaptic facilitation and LTP formation.


Xanthine derivatives IBMX and S-9977-2 potentiate transmission at an Aplysia central cholinergic synapse.

In an attempt to investigate the role of cAMP-dependent phosphorylations on synaptic transmission at an Aplysia cholinergic buccal ganglion synapse, the effects of xanthine derivatives such as 3-isobutyl-1-methylxanthine (IBMX), which is well known to inhibit phosphodiesterase activity thereby promoting cAMP accumulation, and a novel xanthine derivative, S-9977-2 were evaluated. They were found to potentiate cholinergic transmission by significantly increasing the time constant of decay (Tc) of inhibitory postsynaptic currents (IPSCs). The postsynaptic origin of the phenomenon was supported by the observation that responses to the ionophoretic application of acetylcholine (ACh) were also potentiated in duration as well as in amplitude. No effects of S-9977-2 on the ACh-gated Cl- channel conductance or mean open time were observed. The finding that responses to the hydrolysis-resistant cholinergic analogue carbachol were unaffected by the two xanthines suggested that the observed effects were at least partly caused by an inhibition of acetylcholinesterase (AChE) activity. That these substances inhibit AChE activity was confirmed in vitro. Phosphorylation processes nonetheless appear to be partly involved in the synaptic effect of the xanthines as the kinase blocker H-8 blocked part of the IPSC Tc lengthening. Possible mechanisms are discussed.


Pain control. Barriers to the use of available information. World Health Organization Expert Committee on Cancer Pain Relief and Active Supportive Care.

One of the World Health Organization's (WHO) top priorities is cancer pain relief. Simple guidelines for assessing and relieving pain have been developed, published, and field tested. WHO has concluded that there is enough knowledge currently to permit an approach to cancer pain relief that can be implemented on a worldwide basis. This information, when used correctly, allows pain control in 75% or more of patients with cancer pain. However, numerous barriers prevent the application of this knowledge and the achievement of cancer pain relief. Assessing the patient's cancer pain and effective use of analgesic drugs, especially opioid agents, are hampered by a lack of education of health-care professionals and the fact that the pain sensation is entirely subjective. Unfortunately, these factors often result in pain management being determined on the basis of personal opinion rather than scientific knowledge. This leads to inconsistent and often inadequate care of patients with cancer pain. The extent of the cancer pain problem and the WHO analgesic-ladder approach to cancer pain relief are reviewed along with recommendations from the American Pain Society. Lack of education of health-care professionals is discussed, focusing on pain assessment, underuse of oral and rectal routes of administration, fears of addiction, and titration of doses of opioid drugs. Simple strategies for beginning to correct these problems are presented.


Expression of human prostatic acid phosphatase activity and the growth of prostate carcinoma cells.

Human prostatic acid phosphatase (PAcP) is a tissue-specific differentiation antigen and is the major phosphotyrosyl (p-tyr) protein phosphatase in normal differentiated prostate epithelial cells. In prostate carcinomas, cellular PAcP has a low expression. We examined the expression of cellular PAcP activity and its correlation with cell growth that may lead us to understand the role of tyrosine phosphorylation in human prostate cells. LNCaP cells, which expressed the highest cellular PAcP activity, had the slowest growth rate and the lowest p-tyr level among three human prostate carcinoma cell lines: LNCaP, DU145, and PC-3. This inverse correlation was further examined in LNCaP cells, since these cells remain hormone-sensitive. Androgen, a classical stimulator of prostate cells, stimulated the growth of LNCaP cells while cellular PAcP activity decreased and p-tyr levels increased. This phenomenon was also observed when cells were treated with epidermal growth factor and fetal bovine serum. Both epidermal growth factor and fetal bovine serum stimulated the growth of LNCaP cells whereas cellular PAcP activity decreased. Furthermore, when cell growth was arrested at low temperatures (23 degrees C), cellular PAcP activity was elevated. To establish the relationship of cellular PAcP activity with cell growth rate, we transfected a complementary DNA encoding the full length PAcP protein into another human prostate carcinoma line, PC-3, that lacks endogenous PAcP. Two stable transfectants, designated PC-18 and PC-416 cells, were obtained and shown to express PAcP mRNA transcribed from the transfected complementary DNA. The expression of PAcP activity in PC-416 cells, but not PC-18 cells, was associated with a lower p-tyr level and a slower growth rate than control cells transfected with the expression vector alone. In conclusion, in LNCaP cells, the stimulated cell growth is associated with an increased p-tyr level and a decreased cellular PAcP activity. In PAcP complementary DNA-transfected PC-416 cells, the low level of p-tyr corresponds to a slow growth rate.


Down-regulation of tenascin expression by antiprogestins during terminal differentiation of rat mammary tumors.

Studies on tenascin expression in hormonally dependent growing tissues of breast and endometrium suggested that its expression parallels the progression of normal or malignant proliferative alteration of the tissue. With the study presented here we addressed the question of whether antiprogestin-induced terminal differentiation down-regulates tenascin expression. By comparative immunolocalization of tenascin in sections of untreated 7,12-dimethylbenz[alpha]anthracene-induced tumors, tumors grown in ovariectomized animals, tamoxifen-treated tumors, and antiprogestin-treated tumors, we obtained the following results. (a) The entire extracellular space of the stromal mesenchyme was filled by tenascin immunoreactivity in cases of untreated control tumors. (b) Both ovariectomy and antiestrogen treatment with tamoxifen did not affect the overall staining pattern and resulted in a slight increase of the arbitrarily judged staining intensity. (c) Within antiprogestin-treated tumors tenascin-like immunoreactivity predominantly was restricted to fiber-like, collagenous connective tissue structures, which appeared in the stromal compartment as a result of the antiprogestin treatment. In large areas of the tumor composed of apparently secretory active tumor cells we failed to immunolocalize tenascin. Our results provide further evidence that expression of tenascin reflects both benign and malignant proliferative alterations of the tissue, whereas its down-regulation is correlated to differentiation of the tissue. Additionally, evidence is provided that the mechanism of tumor growth inhibition by antiprogestins indeed is induction of terminal differentiation of tumor cells.


Sensitive detection of rare circulating neuroblastoma cells by the reverse transcriptase-polymerase chain reaction.

The presence of circulating tumor cells in patients with localized or disseminated neuroblastoma may be a significant prognostic factor at diagnosis and may antedate the detection of relapse by other diagnostic studies. We report the development of a highly sensitive detection assay for circulating neuroblasts based on the reverse transcriptase-polymerase chain reaction (RT-PCR), using the neuroendocrine protein gene product 9.5 (PGP 9.5) as the tumor marker. Analysis of RT-PCR products by agarose gel electrophoresis demonstrated that neuroblastoma cell lines were uniformly positive, whereas peripheral blood mononuclear cells were negative. Alkaline Southern blotting with a PGP 9.5-specific probe revealed scant expression of PGP 9.5 in peripheral blood mononuclear cells, well below the limits of detection by electrophoresis alone. The system was able to detect a single neuroblastoma cell in 10(7) peripheral blood mononuclear cells. Eighteen patient samples were analyzed by PGP 9.5 RT-PCR and the results compared with immunocytology in 16. Ten of the 18 were negative by both studies. Eight of the 18 were positive by PGP 9.5 RT-PCR, 4 of which were also positive by immunocytology. PGP 9.5 RT-PCR was able to detect circulating neuroblasts in two patients with negative immunocytology, the first with progressive bone marrow disease and the second at high risk for relapse but no other evidence of disease. PGP 9.5 RT-PCR allows the detection of circulating neuroblastoma cells with a sensitivity greater than immunocytology. It will be useful in evaluating the clinical significance of circulating tumor cells with respect to prognosis and early detection of relapse, and in the screening of peripheral stem cell harvests prior to autologous infusion.


Influence of tamoxifen on plasma levels of insulin-like growth factor I and insulin-like growth factor binding protein I in breast cancer patients.

Plasma levels of insulin-like growth factor I (IGF-I) and insulin-like growth factor binding protein I (IGFBP-I) were measured in fasting blood samples obtained from 16 postmenopausal breast cancer patients before and during tamoxifen treatment for 1 to 6 months. Tamoxifen suppressed total plasma IGF-I by a mean of 28.5% (P less than 0.001) but elevated plasma IGFBP-I by a mean value of 78% (P less than 0.001). Changes in plasma levels of growth hormone, insulin, or insulin C-peptide were not observed. These findings suggest that tamoxifen exerts its influence on plasma IGF-I and IGFBP-I by mechanisms other than those known to regulate the plasma levels of these peptides, primarily growth hormone and insulin, respectively. A dual effect suppressing plasma IGF-I and elevating plasma IGFBP-I suggests that tamoxifen may have a significant influence on endocrine and possibly paracrine delivery of IGF-I to breast cancer cells in vivo.


Specific diagnosis by CT and HRCT in six chronic lung diseases.

CT and high-resolution CT (HRCT) are both important modalities for imaging lung chronic disease, and certain features (distribution of disease in the axial plane, unilateral or bilateral disease, bronchovascular bundle thickening, septal thickening, central dot thickening, polygons, distortion of parenchyma, air-space disease, nodules) are well known to suggest specific diagnoses. In a series of 54 consecutive patients with six specific diseases (scleroderma or UIP, sarcoidosis, lymphangitic carcinomatosis, drug toxicity, lymphomas, eosinophilic granuloma), these diagnostic CT features were always present. In 50/54 cases, a histologic proof was obtained. In 36 patients with histologic confirmation of four different diseases and in six normal controls, we compared sensibility, specificity, and accuracy of chest radiography, chest CT, and HRCT and found the highest diagnostic accuracy by HRCT together with standard CT.


Resistance of human cervical carcinoma cells to tumor necrosis factor correlates with their increased sensitivity to cisplatin: evidence of a role for DNA repair and epidermal growth factor receptor.

Alterations in cellular biochemistry which are associated with the development of resistance to cytotoxic peptides, such as tumor necrosis factor (TNF), may also be responsible for changes in the response of cells to cytotoxic agents. Culturing ME-180 cervical carcinoma cells in the presence of escalating concentrations of TNF resulted in the development of an ME-180 cell variant (ME-180R) resistant to TNF but expressing a 3-5-fold increased sensitivity to cisplatin (CDDP) when measured following continuous exposure (low doses) or short-term incubation with CDDP (high doses) and clonogenic analysis. Cellular platinum uptake, efflux, and nuclear platinum content as well as the extent of DNA platination were examined and found to be identical in both ME-180 parental and ME-180R cell lines. Although ME-180R cells showed a relatively higher glutathione content than ME-180 parental cells, the effect of buthionine sulfoximine on the cellular sensitivity to CDDP and glutathione S-transferase activities of both cell lines were almost identical, suggesting that glutathione content or its metabolism did not appear to play a major role in differential CDDP cytotoxicity. Unscheduled DNA synthesis following exposure to CDDP was more inducible in ME-180 parental cells than in CDDP-sensitive ME-180R cells. Alkaline elution studies of cross-linked DNA in CDDP-treated ME-180 cells suggested that accumulation of DNA adducts reached maximal levels 10-15 h after CDDP treatment and was similar in both TNF-resistant and parental cells. Within 24 h after CDDP exposure, the extent of DNA cross-linking was markedly reduced in parental cells but remained elevated in the CDDP-sensitive ME-180R cell line. To examine the proposed regulatory role of phosphorylation in CDDP and TNF-mediated cytotoxicity, epidermal growth factor (EGF) receptor tyrosine kinase activity was measured in both TNF-resistant and parental ME-180 cells. Analysis of cell lysates demonstrated a 3-4-fold higher EGF receptor tyrosine kinase activity in ME-180R cells when compared to the parental population which correlated with increased expression of EGF receptor protein by immunoblot analysis. Based upon colony-forming assays, EGF treatment of ME-180 parental cells resulted in an increased sensitivity to CDDP (similar to ME-180R cells) and 3-fold stimulation of EGF receptor tyrosine kinase activity. Taken together, these results suggest that TNF resistance in ME-180 cervical carcinoma cells correlates with both increased EGF receptor expression and enhanced CDDP cytotoxicity.(ABSTRACT TRUNCATED AT 400 WORDS)


Characterization of protein tyrosine kinases from human breast cancer: involvement of the c-src oncogene product.

Tyrosine phosphorylation is an important regulatory mechanism in response to the action of growth factors and oncogenes. Since many oncogenes code for tyrosine kinases, increased or altered oncogene expression may be reflected in increased tyrosine kinase activity. In a recent study (Hennipman et al., Cancer Res., 49: 516-521, 1989), we found that the tyrosine kinase activity of the cytosolic and membrane fractions of malignant human breast tissue was significantly higher compared to the benign or the normal breast tissue. Moreover, the increase in the cytosolic fractions was found to be of prognostic value. In the present study we determined the protein tyrosine kinase (PTK) activity of another 72 breast cancer specimens, and it could be shown again that the PTK activity in all 72 of these tumors was elevated compared to normal controls. We characterized these cytosolic PTKs by anion exchange chromatography using fast protein liquid chromatography, and it could be shown that at least two different forms of PTK exist. Using antibodies against a number of known oncogene products, we could determine that at least 70% of the PTK activity in the cytosol originated from the presence of the c-src oncogene product. Both of the PTK activity peaks seen in the fast protein liquid chromatography patterns could be precipitated with the anti-Src antibody. Furthermore, using the MCF-7 breast cancer cell line, it could be shown that the antibody against c-src also precipitated a part of the cytosolic PTK activity. In normal human peripheral lymphocytes, no precipitation of the cytosolic and membrane PTK activity could be achieved using the anti-Src antibody. Inasmuch as the cytosolic PTK activity parallels the malignancy in breast tumors (Hennipman et al., Cancer Res., 49: 516-521, 1989), and the majority of this activity is precipitated by anti-Src antibodies, the c-src protooncogene may play a key role in the manifestation of breast cancer.


Detection of allogeneic Qa/TL and Ly specificities on murine tumor cells with IgD in tumor-regressor serum.

Serum from C3H/He mice, which show regression of MM2 tumor cells after transplantation and removal (regressor serum, RS) contains non-gammaglobulin components that cross-react with various tumor cells of mice [22, 23]. In addition to tumor cells, various allogeneic lymphocytes are also susceptible to an RS-dependent lymphocyte-mediated cytotoxic reaction. To identify tumor cell surface antigens that cause the cross-reactive host response, the serum components were analyzed by absorption of RS with allogeneic lymphocytes. RS components were found to recognize allogeneic lymphocyte antigens including Qa-2 and Ly6.2. Specificity for the Qa-2 antigen was further tested using Qa-2-congenic mice. The expression of Qa-2 antigen was detected on the surfaces of MM2 and other tumor cells derived from H-2k mice (seven among nine cell lines tested) by a membrane immunofluorescence method using a Qa-2-specific mAb. Physical characteristics of the Qa-2-specific component in RS were determined and found to differ from those of regular IgGs but to be similar to those of IgDs. Using an enzyme-linked immunosorbent assay with an IgD-specific mAb and Qa-2-lacZ fusion protein, the existence of IgD in RS with specificity for Qa-2 was confirmed. These results suggest that the RS component with Qa-2 specificity is an IgD, the specificity and physiological role of which are unknown.


Silencing of immunodominant epitopes by contiguous sequences in complex synthetic peptides.

We have previously shown that the T cell response to the synthetic peptide cI12-26:NP365-380 (covalently linked epitopes of lambda repressor (cI) and influenza A nucleoprotein (NP) polypeptides) requires amino acid sequences located in the junctional region between the cI12-26 and NP365-380 epitopes in the H-2d and H-2k haplotypes. In this study, we show that the dominant epitope of cI12-26:NP365-380 in H-2b mice is also located within the junctional region of the peptide, indicating that the same amino acid sequence is immunodominant in three different H-2 haplotypes. Based on results using fixed APC, there was no qualitative difference in epitope recognition due to antigen processing. In addition, antigen presentation by APC expressing mutant I-A molecules constructed by hemiexon shuffling of regions of the molecule containing primarily beta sheet or alpha helix showed that many different substitutions were permissive for at least one of the T hybridomas. More importantly, however, when the junctional sequences are covalently linked in composite synthetic peptides containing additional previously defined T cell epitopes, antigenicity of the immunodominant junctional region was silenced and a new epitope assumed immunodominance. Thus, immunodominance does not correlate with the primary amino acid sequence of the potential epitope. Instead, the immunodominant epitope is determined by complex interactions among the epitopes, which most likely depend on the structural conformation of the composite peptide.


Induction of strong homotypic adhesion in human T cell lines positive with human T-cell leukemia virus type 1 by monoclonal antibodies to MHC class I and beta 2-microglobulin.

To identify the cellular receptors and other cell surface molecules playing essential roles in the transmission of human T-cell leukemia virus type 1 (HTLV-1), we have been isolating monoclonal antibodies (mAbs) that are capable of inhibiting HTLV-1-induced syncytium formation. In the present study, we isolated two mAbs, H11 (IgM) and H14 (IgG1), inhibitory to syncytium formation in the coculture of TOM-1 or C91/PL (both HTLV-1-positive human T-cell lines) and MOLT-4/8 (HTLV-1-negative human T-cell line) by immunizing the membrane fraction of human osteosarcoma line HOS. By immunoprecipitation and immunoblotting, H11 and H14 were found to be specific for MHC class I heavy chain and beta 2-microglobulin (beta 2 M), respectively. Among the four commercially obtained mAbs, two mAbs for MHC class I antigen and two mAbs to beta 2 M, one mAb to MHC class I antigen and one mAb to beta 2 M were also found to be inhibitory to the syncytium formation. The functional comparison of these mAbs revealed that the syncytium-inhibitory mAbs induced strong homotypic cell adhesion particularly in the HTLV-1-positive T-cell lines. This cell adhesion was dependent on temperature, energy metabolism, and microfilament function but not on the activity of protein kinase C or divalent cations. These results suggest a novel type of LFA-1-independent cell adhesion induced by signal transduction via MHC class I antigen.


Modulation of human lymphocyte marker expression by gamma irradiation and mitomycin C.

gamma irradiation (GR) or mitomycin C (MC) treatment of stimulator cells is frequently used to achieve unidirectionality of response in the mixed lymphocyte reaction. As GR differs from MC in the pathways used to block lymphocyte replication, this study analyzes the effects of these modalities upon the expression of various differentiation and Class II major histocompatibility antigens on lymphocytes cultured for 24, 48, and 72 hr. There was a decrease in the mean density of HLA-DR expression on CD3+ and on CD8+ cells at 24, 48, and 72 hr after exposure to GR (42 and 35, 60 and 69, and 26 and 49%, respectively) or to MC (26 and 11, 26 and 18, and 46 and 30%, respectively). There was a parallel decrease in the levels of the corresponding cell subsets when compared with control cultured cells not exposed to GR or MC. In contrast, the density of HLA-DR markers on CD3-negative cells was increased at 24, 48, and 72 hr of culture following exposure to GR (73, 82, and 102%, respectively) or to MC (9, 45, and 80%, respectively). There was a more profound decrease in CD3+, CD8+, and CD19+ cell subset levels and in the density of the corresponding markers in GR-treated cells than in those of cells exposed to MC when the results were compared with those of untreated cultured control cells. Although GR appears to exert a more profound effect than MC, the results indicate that both modalities have the capacity to reduce the density of polymorphic determinants on Class II (HLA-D region)-encoded molecules on T (CD3+ and CD8+) and B (CD19+) cells which are known to trigger potent MLR responses. Both modalities may therefore affect profoundly the relative strength of MLC responses and the derived measurements of the degree of HLA Class II compatibility between stimulator and responder cells.


Antibodies to adhesion molecules inhibit the lytic function of MHC-unrestricted cytotoxic cells by preventing their activation.

We evaluated the effect of the antibodies to adhesion molecules CD2, CD11a/CD18 (LFA-1), and CD56 (N-CAM) on MHC-unrestricted cytotoxicity mediated by polyclonal NK cells and LAK cells or by CD3+ or CD3- cytolytic cell clones against a panel of tumor cell targets selected according to expression or absence of the corresponding ligands. We show that (i) antibodies to CD11a/CD18 and, to a lesser extent, antibodies to CD2 inhibit target cell lysis, whereas anti-CD56 antibodies exert little if any effect; (ii) in a model system using polyclonal NK/LAK cells as effectors and K562 or HL60-R (NK-resistant) cells as targets, inhibition of cytotoxicity occurs without a significant impairment of effector to target cell binding; (iii) the cytotoxic function of CD3+ or CD3- cytotoxic cell clones is inhibited differentially by antibodies to adhesion molecules; (iv) conjugates formed in the presence of antibodies which inhibit target cell lysis display a significant reduction of target to effector cell contact surface; and (v) this may lead to defective activation of effector cells, as indicated by lack of redistribution of the microtubular apparatus. We conclude that (i) MHC-unrestricted cytotoxicity is regulated by a number of molecular interactions that span far beyond our present knowledge and that it is strictly dependent on the surface phenotype of the effector cell and of the target cell; (ii) in certain types of effector/target cell interactions, antibodies to adhesion molecules do not prevent conjugate formation but reduce the extent of cell-to-cell surface contact which, in turn, leads to defective activation of the effector cell and, therefore, to inhibition of target cell lysis.


Hyaluronan and cell locomotion.

Hyaluronan (HA), a glycosaminoglycan, has long been implicated in cell locomotion. We have shown that HA production regulates the locomotion of H-ras-transformed cells. This autocrine motility mechanism is mediated by a novel HA receptor termed RHAMM, an acronym for Receptor for HA Mediated Motility. HA:RHAMM interactions regulate directional locomotion of tumor cells and result in enhanced protein tyrosine phosphorylation that may be a critical messenger mechanism for initiation of locomotion.


Developmental changes in the effects of drugs acting at NMDA or non-NMDA receptors on synaptic transmission in the chick cochlear nucleus (nuc. magnocellularis).

The developmental pharmacology of excitatory amino acid (EAA) receptors in the chick cochlear nucleus (nucleus magnocellularis, NM) was studied by means of bath application of drugs and recording of synaptically-evoked field potentials in brain slices taken from chicks aged embryonic day (E) 14 through hatching (E21). The abilities of various EAA agonists (N-methyl-D-aspartate [NMDA], kainic acid, and alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid [AMPA]) to suppress postsynaptic responses by depolarization block and of EAA antagonists ((3-[RS]-2-carboxypiperazin-4-yl)-propyl-1-phosphonic acid [CCP], dizocilpine [MK-801], 6-nitro-7-sulfamoyl-benzo(F)quinoxaline-2,3 dione [NBQX], 6-cyano-7-nitroquinoxaline-2,3-dione [CNQX] and 6,7-dinitroquinoxaline-2,3-dione [DNQX]) to suppress these responses directly were assessed quantitatively. The results support the existence of NMDA receptors in NM and suggest that the ability of these receptors to influence synaptically-evoked responses declines dramatically during the last week of embryonic life. The results similarly suggest that the non-NMDA receptors in NM undergo changes in density and/or function during a period of development when the cochlear nucleus is undergoing a variety of morphological and functional transformations.


Galanin-like immunoreactivity in the adult and developing Brazilian opossum brain.

The distribution of galanin-like immunoreactivity has been characterized in the brain of the adult and developing Brazilian opossum (Monodelphis domestica). Two commercially available antisera were used to examine the distribution of galanin-like immunoreactive (GAL-IR) cells and fibers. Nuclear groups containing GAL-IR cell bodies and fibers were seen throughout the adult opossum brain. The distribution of GAL-IR elements seen is similar to that reported for other mammals. Based on these findings, we believe that galanin may have similar physiological functions in the adult Brazilian opossum as has been reported for other mammals. In the developing brain, GAL-IR structures were seen as early as 1 day postnatal (PN) in the developing hypothalamus and brainstem. By days 5 and 10 PN, there was a robust expression of galanin-like immunoreactivity in specific regions of the brain. Since neurogenesis and brain morphogenesis are actively occuring postnatally in the opossum, galanin may be playing a role in the differentation of specific regions of the brain.


Early myelination in zitter rat: morphological, immunocytochemical and morphometric studies.

Early myelination in zitter rat was investigated by light and electron microscopic observations, by immunostaining for myelin basic protein (MBP), proteolipid protein (PLP) and myelin-associated glycoprotein (MAG), and by morphometric analysis from the 1st to the 28th day of age. Although the commencement of myelination in zitter rats was not delayed in comparison with control rats, the density or the number of myelinated fibers in zitter rats was significantly below that in controls, both in the ventral column of the cervical spinal cord and in the optic nerve. In contrast, the density or the number of aberrant myelin sheaths was increased in zitter rats, and this difference became more marked with increasing age. The persistent presence of abnormal membranous structures associated with the oligodendroglial nuclear membrane and the increased number of aberrant myelin sheaths were characteristic to the zitter mutation, although these alterations were also observed transiently in control rats. Quantitative analysis supported the proposition that hypomyelination in zitter rats is primarily pathological and becomes more prominent with advancing age. However, the fundamental structure of the myelin lamellae appeared to be normal and the immunoreactivities for MBP, PLP and MAG were slightly delayed and weakend in comparison with age-matched controls. Thus, in zitter rat there is the functional abnormality of the oligodendrocytes to integrate the processes of membrane biosynthesis and to expel excessive production of membranous structures associated with the membranous organellae such as nuclear membrane, and it is postulated that this functional abnormality is characteristic to only the zitter mutation.


Adrenergic expression in the rat adrenal gland: multiple developmental regulatory mechanisms.

Phenylethanolamine N-methyltransferase (PNMT, EC 2.1.1.28) has been used as a marker to examine development of adrenergic expression in the rat adrenal gland and the putative role of glucocorticoids in this process. PNMT enzymatic activity increases 7-10-fold from birth to postnatal day 35. Immunotitration studies show that PNMT protein only increases 4-5-fold during this same time period. Moreover, the slopes from the immunotitration curves decrease with increasing age. Thus, a more active enzyme with lower affinity for the antiserum appears to be present in the older animals. Quantitative solution hybridization shows that PNMT mRNA increases 2.5-fold from birth through postnatal day 11. Thereafter, it declines, and eventually plateaus at values insignificantly different from birth by postnatal day 25. Northern analysis further shows that two forms of PNMT mRNA are expressed. Adrenal corticosterone remains low from birth through postnatal day 11, but then increases nearly 10-fold by adulthood. The lack of concordance between changes in PNMT activity, protein, and mRNA suggests that adrenergic expression is developmentally regulated at multiple levels; the above provides evidence for both transcriptional and post-transcriptional controls, since changes in PNMT mRNA may differ in both magnitude and direction from changes in PNMT activity and protein during the developmental window examined. These developmental regulatory mechanisms may be in part glucocortocoid-mediated, but corticosteroid control of PNMT gene expression does not appear to be the predominant mechanism of control.


Induction of molecular layer ectopias by puncture wounds in newborn rats and mice.

Molecular layer ectopias spontaneously occur in immune-disordered mice, and the accompanying paper demonstrates that these ectopias are associated with a break in the external glial limiting membrane and with distortion of radial glial fibers at birth. It was hypothesized that injury to the developing neocortex is the main etiologic event for molecular layer ectopias. To test this hypothesis, puncture wounds were made on the surface of the cerebral cortex of newborn rats and mice. These wounds produced, in adulthood, molecular layer ectopias similar in appearance to those seen spontaneously in immune-disordered mice. Further, these ectopias show similar distortions of radial glial fibers during development, and of neurofilaments in adulthood. This work supports the notion that injury could be a factor in the production of molecular layer ectopias.


Effect of long-term use of Norplant implants on haemostatic function.

This study describes the effects of Norplant on haemostatic function after 5 years of use in 97 women. There was a decrease in vitamin-K dependent Factors II, V, VII and reduction in fibrinolytic activity at 2 and 4 years of use. Increased platelet numbers and accelerated platelet aggregation were found throughout the 5 years of Norplant use, whilst raised alpha 2-Macroglobulin (a2-M) and antithrombin III (ATIII) antigen level were observed for up to 4 years of use. Prolonged Norplant use does not appear to activate the coagulation system and does not enhance a state of hypercoagulation.


Diffusion of tosufloxacin into prostatic tissue.

The diffusion of tosufloxacin (TFLX) into the prostatic tissue was studied in 25 patients with benign prostatic hypertrophy. TFLX concentrations in the serum and prostatic tissue were measured at scheduled intervals after oral administration of 450 mg of TFLX on the day before surgery, followed by administration of 150 mg of TFLX immediately before surgery. The mean TFLX levels in prostatic tissue (and tissue/serum levels) at 2, 4 and 6 h were 0.35 +/- 0.16 microgram/g (0.93 +/- 0.36) in 7 patients, 0.58 +/- 0.92 microgram/g (1.10 +/- 0.45) in 10 patients and 0.22 +/- 0.09 microgram/g (0.95 +/- 0.45) in 8 patients. The TFLX levels in prostatic tissue exceeded the minimum inhibitory concentration for several pathogenic bacteria detected in the infected prostatic fluid. Therefore, TFLX shows promise as a useful drug in the treatment of bacterial prostatitis and infections developing after prostatic surgery.


Development of effective drug combinations for the inhibition of multiply resistant mycobacteria, especially of the Mycobacterium avium complex.

Rationally designed combinations of rifampicin (RAMP) and thiacetazone plus isonicotinic acid hydrazide and/or ethambutol are highly effective in the treatment of patients (including HIV-positive) infected with multiply resistant mycobacteria of the Mycobacterium avium complex (MAC). Clinical results are very promising. The high efficacy of these combinations is due to the synergistic potentiation of single-drug activities. As soon as rifabutin is marketed, it should replace RAMP in the combination treatment of patients with highly RAMP-resistant MAC bacteria.


Changes in motor and sensory nerve conduction parameters with temperature in normal and diseased nerve.

The effects of temperature on conventional motor and sensory nerve conduction parameters were studied in normals and in some pathological conditions. Surface stimulating and recording electrodes were used to examine the function of the median nerve. The motor and sensory conduction velocities, the parameters of compound muscle action and sensory nerve potentials were correlated with skin temperature. In the control subjects all nerve conduction parameters changed with temperature. These findings were similar to those published previously, but the mean slope for MCV was lower than that reported in the literature. The amplitude values widely scattered as a consequence of methodological factors, which may mask effects of temperature. Only minor differences were revealed between control subjects and patients. The effect of temperature proved to be similar in the patients and in the normal controls. Therefore, the correction factors determined in normals may be acceptable for abnormal nerves in standardising the measured values with respect to temperature. However, in pathological cases, above all in diabetes mellitus, the slightly reduced changes of conduction velocities vs. temperature may be the source of false negative results in borderline cases when using the normal correction factors. The combination of preserved temperature dependence but decreased conduction velocities may indicate that demyelination and temperature influence the conduction velocities via different mechanisms.


Human startle reflex: technique and criteria for abnormal response.

Because quantitative norms for the normal audiogenic startle response to repeated stimuli have not been previously reported, we now describe a technique for eliciting the startle response and analysing its habituation with repeated stimuli. We used binaural 105 dB tones delivered in 5 blocks of 4 tones. Successive blocks were separated by a 5 min period without tones stimuli and had progressively shorter inter-stimulus intervals (ISIs) beginning with 5 min in the first block and reducing to 1 min in the final, fifth block. We contrast the response and its habituation in a group of 8 normal subjects with that in a patient with clinically exaggerated startle. Based on the differences observed, we propose that the following criteria may be used to ascertain an abnormally increased startle response: (1) excessive duration of the myogenic response; (2) persistence of extracranial responses after the initial two blocks of stimuli; and (3) reduced habituation of the response (as measured by decreases in response duration and in the area under the curve of rectified EMG for the orbicularis oculi myogenic response). Our patient was abnormal on each of these measures. This result is consistent with past qualitative reports which have indicated that abnormal startle is associated both with excessive startle and with subnormal habituation. Study of further patients with hyperekplexia will be necessary to either confirm our data or modify our proposed criteria.


Repetitive doublets of human motoneurones: analysis of interspike intervals and recruitment pattern.

In order to study the probable mechanisms of repetitive doublets in human motoneurones, the firing patterns of single motor units (MUs) of the trapezius were analysed during a weak voluntary muscle contraction. The mean frequencies of MUs were 9.4-21.7 imp/sec (the mean interspike interval ranged from 46.0 to 106.7 msec). Repetitive doublets (up to 28 in succession) were recorded in 21 out of 120 MUs, mostly at the onset of a slow recruitment. These were followed by single discharges. Intradoublet intervals ranged between 2.5 and 20.0 msec. A significant difference between single spike firing and doublet firing was revealed by plotting interspike interval histograms, showing that two distinct mechanisms were involved. The analysis of interspike interval successions belonging to several MUs firing simultaneously showed that one of the MUs could start with doublets while the others went on firing single spikes with the regular mean frequency and interspike interval scatter. The results lead us to suggest that the intrinsic properties of motoneurones can be regarded as the main factor in the origin of repetitive doublets. It seems that a descending synaptic drive also contributes to the control of double firing since in a number of cases no doublets were produced at the beginning of MU activity. The findings are discussed with regard to the problems of regulating repetitive firing of human motoneurones by after-potentials. Steady delayed depolarization is assumed to be a possible mechanism of repetitive doublets.


Motor potentials of inferior orbicularis oculi muscle to transcranial magnetic stimulation. Comparison with responses to electrical peripheral stimulation of facial nerve.

Magnetic stimulation at the vertex evoked a motor potential (MP) in the inferior orbicularis oculi muscle of 10 healthy subjects with an onset latency of 8-13 msec. Its amplitude increased and its latency decreased when the muscle was contracted: the latency measured 9.5 +/- 1.3 msec with an intensity of stimulation 10-15% above threshold in the contracted muscle. This MP is secondary to excitation of the motor cortex. With the coil placed over the occipital scalp and the same stimulation intensity, an MP was recorded with an onset latency at 4.5 +/- 0.6 msec. This response reflects the activation of the facial nerve root. The peripheral electrical stimulation of the facial nerve at the mandible angle elicited an MP with an onset latency at 3.5 +/- 0.4 msec. Most records showed the presence of late components at about 30 msec for all types of stimulation.


Determining the site of stimulation during magnetic stimulation of a peripheral nerve.

Magnetic stimulation has not been routinely used for studies of peripheral nerve conduction primarily because of uncertainty about the location of the stimulation site. We performed several experiments to locate the site of nerve stimulation. Uniform latency shifts, similar to those that can be obtained during electrical stimulation, were observed when a magnetic coil was moved along the median nerve in the region of the elbow, thereby ensuring that the properties of the nerve and surrounding volume conductor were uniform. By evoking muscle responses both electrically and magnetically and matching their latencies, amplitudes and shapes, the site of stimulation was determined to be 3.0 +/- 0.5 cm from the center of an 8-shaped coil toward the coil handle. When the polarity of the current was reversed by rotating the coil, the latency of the evoked response shifted by 0.65 +/- 0.05 msec, which implies that the site of stimulation was displaced 4.1 +/- 0.5 cm. Additional evidence of cathode- and anode-like behavior during magnetic stimulation comes from observations of preferential activation of motor responses over H-reflexes with stimulation of a distal site, and of preferential activation of H-reflexes over motor responses with stimulation of a proximal site. Analogous behavior is observed with electrical stimulation. These experiments were motivated by, and are qualitatively consistent with, a mathematical model of magnetic stimulation of an axon.


Cerebello-frontal cortical projections in humans studied with the magnetic coil.

Focal stimulation over human cerebellum with a figure 8 magnetic coil (MC) results in an evoked wave recorded from bipolar scalp electrodes on the interaural line and more anteriorly. In 3 subjects, the wave responses along the interaural line had latencies of 8.8-13.8 msec, lasted 17.4-29.0 msec and had a maximum amplitude of 14.4-26.8 microV. The responses were recorded more anteriorly from leads midway between the interaural line and frontal leads; responses recorded from frontal leads were up to 3.5 msec later. The evoked wave was preceded by a diphasic EMG response with a latency of 1.2-2.0 msec. Analysis of the averaged responses recorded by adjoining bipolar leads indicated that the response was predominantly surface positive and crossed. Control experiments eliminated eye movement and somatosensory input as explanations of the evoked response, thereby identifying it as a cortical response. The surface positive wave in humans was compared with the responses recorded in cat and monkey to cerebellar stimulation. The responses in humans could reflect dysfacilitation through MC activation of Purkinje cells, or feed-forward facilitation through transsynaptic or antidromic activation of dentate neurons. The latency of the surface positive wave exceeds that of cerebellar inhibition of MC elicited hand muscle responses, but the discrepancy is at least partly accounted for by the extra delay required to set up the indirect cortico-spinal component required for motoneuron discharge. Estimates made of the cerebello-frontal cortical and peripheral feedback loop times suggest that the central has less than one quarter the delay of the peripheral loop, which would be especially advantageous during fast skilled movements of the fingers.


Inhibitory period following motor potentials evoked by magnetic cortical stimulation.

Following motor potentials evoked (MEPs) by magnetic cortical stimulation, there is a transient suppression of muscle action potentials (inhibitory period). We recorded MEPs, the inhibitory period, V1 waves and F waves from the abductor pollicis brevis muscle in 20 normal subjects and in 17 patients with spastic hyperreflexia due to cerebral infarction. The duration of the inhibitory period increased in correspondence with increasing stimulus intensity and did not necessarily depend on the amplitude of the MEPs. The duration of the inhibitory period elicited by a twin coil, which can stimulate the motor cortex locally, was shorter than by a single coil. The mean duration of the inhibitory period was significantly shorter in patients with spastic hyperreflexia than in normal subjects, and it correlated with the amplitude of F waves. The effects of the inhibitory period on V1 waves were different from its effects on F waves in one patient with large V1 and F waves. The amplitudes of V1 waves recorded during the inhibitory period were approximately 30-50% of the maximal amplitude of V1 waves, but F waves were not smaller. The inhibitory period is probably caused primarily by central inhibitory mechanisms.


Analysis of the coil generated impulse noise in extracranial magnetic stimulation.

An intense impulse noise artifact is generated by the coil used in extracranial magnetic stimulation (EMS) of the brain and cranial nerves. In this study we measured and analyzed the sound pressure level (SPL), spectral content, wave form, and time course of the magnetic coil acoustic artifact (MCAA) impulse noise in the sound field and in the ear canal of life-size models of the human cranium. Two different clinical magnetic stimulators and coils were used. Sound field measurements from both coils showed the MCAA to be a transient impulse noise with a rapid rise-time, brief duration, broad acoustic spectrum, and high intensity. Measurements made on models of the human head with the magnetic coils positioned at selected standard clinical positions for EMS, particularly the peripheral facial nerve, auricle and mastoid areas, indicated that the MCAA may reach sound pressure levels that exceed noise damage-risk criteria limits for sensorineural hearing loss. The maximum peak energy in the acoustic spectrum of the MCAA measured in the ear canal of the model heads was from 2 to 5 kHz, the range of highest sensitivity in human ears. Ear protectors were found to attenuate the SPL of the MCAA, reaching the ear canal of the model heads by 15-22 dB SPL, and were recommended for use by patients and subjects exposed to EMS.