Interleukin-4 suppression of monocyte tumour necrosis factor-alpha production. Dependence on protein synthesis but not on cyclic AMP production. The molecular mechanisms by which human interleukin-4 (IL-4) down-regulates tumour necrosis factor-alpha (TNF-alpha) production by monocytes remain unknown. Other studies of IL-4 action in B lymphocytes and large granular lymphocytes (LGL) suggested that IL-4 may suppress mediator production by augmenting intracellular cyclic AMP (cAMP) levels. However, this study did not find evidence for involvement of a cAMP-dependent signalling pathway for expression of IL-4 activity in monocytes. IL-4 reduced TNF-alpha production by monocytes when IL-4 and lipopolysaccharide (LPS) were added concomitantly, or upon subsequent activation by LPS 16 hr after first exposure to IL-4. The continued presence of IL-4 at the time of LPS stimulation was not necessary; however, the suppressive effects of IL-4 were dependent on protein synthesis. This sustained activity of IL-4 for down-regulation of the production of inflammatory signals may be important for control in vivo of excessively activated monocytes/macrophages, and in therapy.


Inhibition of the serine/threonine protein phosphatases PP1 and PP2A in lymphocytes: effect on mRNA levels for interleukin-2, IL-2R alpha, krox-24, p53, hsc70 and cyclophilin. Lymphocyte activation requires signal transduction mediated by reversible phosphorylation. Changing profiles of phosphorylated intermediates relate to the progressive series of transduction pathways in cells moving from G0 to G1, and thereafter through the cell cycle. We have previously shown that transient inhibition of the serine/threonine protein phosphatases PP1 and PP2A by okadaic acid enhances early mitogenic stimulation. Thus target proteins of PP1/PP2A may be involved in regulation of early mitogenic signalling, with the phosphorylated form(s) being associated with signal enhancement. Later, pathways require dephosphorylation of these proteins, since continuous treatment with okadaic acid blocks lymphocyte progression through the cell cycle. Delayed addition of okadaic acid showed that this blockade occurs between 8 and 24 hr. Here we have furthered these observations to the level of gene induction by measuring messenger RNA (mRNA) levels for the following proteins: interleukin-2 (IL-2) and IL-2R alpha; p53, a tumour suppressor protein; the transcription factor krox-24; and two mediators of protein folding, namely cyclophilin and the heat-shock protein hsc70. An external standard was used to quantitate the mRNA levels per cell. We found that 24 hr exposure to okadaic acid has a general suppressive effect on concanavalin A (Con A)-stimulated gene induction. However, at 4 hr okadaic acid enhanced IL-2 mRNA levels induced by Con A. Moreover, in unstimulated lymphocytes, okadaic acid caused the induction of krox-24, indicating a role for PP1 and PP2A in the regulation of this gene in resting cells.


Down-regulation of cyclooxygenase product generation by human peritoneal macrophages. Isolated human peritoneal macrophages under resting conditions synthesize and release significant quantities of the cyclooxygenase products prostaglandin E2 (PGE2) and thromboxane B2 (TXB2). These increased linearly with time and were dependent on de novo protein synthesis. Following the addition of calcium ionophore A23187 there was a marked decrease in total generation of immunoreactive cyclooxygenase products. In contrast, there was a concomitant increase in the release of 5-lipoxygenase products. The down-regulation of both PGE2 and TXB2 was not due to diversion of substrate from the cyclooxygenase pathway to the 5-lipoxygenase pathway nor was it due to inhibitory effects of products of the 5-lipoxygenase pathway on the generation of cyclooxygenase products. Instead, the inhibitory effects of A23187 were thought to be due to a down-regulation of cyclooxygenase itself, a hypothesis supported by the finding that TXA2 synthase proved to be unaltered and Western analysis of crude peritoneal macrophage (PM phi) membranes demonstrated lesser quantities of cyclooxygenase in membranes from A23187-treated PM phi than in those prepared from control cells.


A cytotoxic rabbit T-cell line infected with a gamma-herpes virus which expresses CD8 and class II antigens. A rabbit T-cell line, BJ-610, has been derived from a New Zealand White rabbit infected with Alcelaphine herpes virus-1, which has the characteristics of a lymphokine activated killer (LAK) cell. The surface phenotype of this cell line has been studied by flow cytometry, using a panel of monoclonal antibodies (mAb) to rabbit leucocyte surface markers, and compared with that of another rabbit T-cell line, RL-5, transformed with herpes virus ateles. The expression of a number of markers is common to the two lines; these include the rabbit analogues of CD11a/CD18, CD43, CD44 and CD45. Three antigens are expressed on BJ-610 but not RL-5. One of these is recognized by a mAb thought to recognize CD8, while a second is a class II R-DQ molecule. The third antigen is expressed on thymocytes, a subset of T cells, neutrophils and platelets but its molecular nature is unknown. These two cell lines should prove useful in preparing reagents which recognize subsets of rabbit T cells and for studying the mechanism of herpes virus-induced lymphoid cell deregulation.


Direct evidence for antibody bipolar bridging on herpes simplex virus-infected cells. Cells infected with herpes simplex virus type 1 (HSV-1) express a cell-surface receptor able to bind the Fc portion of immunoglobulin G (IgG). In this study we provide direct evidence that bipolar bridging of antibodies, bound to the surface antigens on HSV-infected cells and to the Fc-receptor through the Fc part, offers the virus a survival advantage. Evidence was obtained by comparing the binding of FITC-labelled protein A, which has a similar binding site on IgG as the HSV-FcR, to cell-bound antibodies on HSV-infected cells and non-infected cells. The effectiveness of antibody bipolar bridging was dependent on the concentration of cell-bound IgG. At low concentrations of serum (0.1%) an 80% reduction in protein A-FITC binding to HSV-infected cells compared to non-infected cells was found. Even at higher concentrations of serum, antibody bipolar bridging resulted in a 40% reduction in the number of 'free' available Fc parts on HSV-infected cells compared to non-infected cells. Furthermore, these findings could be confirmed in a functional assay. The Fc-mediated attachment of granulocytes was significantly lower in HSV-infected cells compared to non-infected cells. From this study we conclude that HSV-FcR, by binding immune IgG in a bipolar fashion, provides the virus with an effective defence mechanism.


Identification on receptors for leukotriene B4 expressed on guinea-pig peritoneal eosinophils. We have recently reported that guinea-pig eosinophil chemotactic factor of anaphylaxis (ECF-A), an activity present in diffusates from antigen-challenged sensitized lung, is largely accounted for by leukotriene B4 (LTB4) and to a lesser extent 8(S)15(S)-dihydroxy 5,9,11,13 (Z,E,Z,E) eicosatetraenoic acid. We characterized cell surface receptors for LTB4 on guinea-pig eosinophils in order to demonstrate an association between receptor occupancy and eosinophiliotactic activity of guinea-pig ECF-A. Equilibrium binding studies showed that peritoneal eosinophils bound [3H]LTB4 in a cell concentration and time-dependent fashion. The binding was saturable and specific for LTB4 as other eosinophil chemoattractants, i.e. platelet-activating factor (PAF) and 8(S)15(S)-diHETE, were unable to displace significant amounts of [3H]LTB4. In addition the binding was readily reversed by the LTB4 receptor antagonist LY 255283 (Ki 4.30 nM). Scatchard plot analysis revealed two discrete populations of binding sites, high affinity (Kd1 = 0.30 nM; Bmax = 900 sites/cell) and low-affinity sites (Kd2 = 140 nM; Bmax = 60,000 sites/cell). The major migratory component of LTB4-stimulated eosinophil locomotion was chemotaxis, optimal at 1 x 10(-7) M (P < 0.01) with EC50 value of 3 x 10(-9) M. A comparison of the profile of arachidonic acid metabolism by RP-HPLC analysis showed that following stimulation with calcium ionophore (A23187) guinea-pig eosinophils preferentially synthesized LTB4 (10 ng/10(6) cells) while in contrast human eosinophils synthesized LTC4 (10 ng/10(6) cells). Therefore our data show that guinea-pig eosinophils express both high- and low-affinity receptors for LTB4 and that the chemotactic response to this mediator may be mediated by ligation of the high-affinity binding site. Furthermore guinea-pig peritoneal eosinophils can synthesize LTB4, a mediator which constitutes > 60% of guinea-pig ECF-A.


Prevalence of antibodies to hepatitis C virus in HBsAg negative hemodialysis patients. The prevalence of hepatitis C virus (HCV) infection was estimated in a 14-month study using anti-C100-3 antibody assay in 31 HBsAg negative patients on maintenance hemodialysis (MHD) for > or = 3 months. One and three patients respectively had ALT elevation and anti-HCV positivity at entry. During MHD (mean period of follow up 9.9 mo), 11 (35.5%) patients had, on fortnightly estimation, ALT elevation which lasted for < or = 6 months in seven patients and for > 6 months in four. Fourteen (45.2%) patients had anti-HCV (including the three positive at entry). There was no significant difference in frequency of anti-HCV positivity in patients with normal and elevated ALT (57.1% and 42.9% respectively). The number of blood transfusions and duration of MHD were similar in anti-HCV positive and anti-HCV negative patients. We conclude that our MHD patients have a high frequency of hepatitis and anti-HCV positivity, and these may not be related to blood transfusions.


Effect of early onset angiotensin converting enzyme inhibition on myocardial capillaries. We investigated the preventive effects of long-term treatment with the angiotensin converting enzyme inhibitor ramipril on myocardial left ventricular hypertrophy and capillary length density in spontaneously hypertensive rats. Rats were treated in utero and subsequently up to 20 weeks of age with a high dose (1 mg/kg per day) or with a low dose (0.01 mg/kg per day) of ramipril. Animals given a high dose of ramipril remained normotensive, whereas those given a low dose developed hypertension in parallel to vehicle-treated controls. At the end of the treatment period, converting enzyme activity in heart tissue was inhibited dose-dependently in the treated groups. Both groups revealed an increase in myocardial capillary length density together with increased myocardial glycogen and reduced citric acid concentrations. Left ventricular mass was reduced only in high dose- but not in low dose-treated animals. Our results demonstrate that early onset treatment with a converting enzyme inhibitor can induce myocardial capillary proliferation, even at doses too low to antagonize the development of hypertension or left ventricular hypertrophy. We hypothesize that potentiation of kinins is responsible for this effect, probably by augmenting myocardial blood flow, which is a well-known trigger mechanism of angiogenesis in the heart.


Platelet sodium-hydrogen antiport in obese and diabetic black women. In this investigation we correlated platelet Na-H antiport parameters with blood pressure and serum lipids in a sample population of non-insulin-dependent diabetic obese, nondiabetic obese, and nondiabetic nonobese black women. Parameters of the Na-H antiport were examined in aspirin-treated platelets. These parameters were not altered in resting or in thrombin-stimulated platelets of diabetic patients. The activity index of platelet Na-H antiport after thrombin stimulation was positively correlated with the blood pressure (systolic blood pressure, r = 0.5320 and p = 0.0001; diastolic blood pressure, r = 0.5123 and p = 0.0017). Lower high density lipoprotein cholesterol levels were associated with an alkaline shift in the cytosolic pH set point for activation of the Na-H antiport. Highly significant correlations were also observed between the total cholesterol/high density lipoprotein cholesterol ratio and the cytosolic pH set point for activation of the Na-H antiport. These correlations were independent of diabetes or the body mass index. Together, these observations indicate that parameters of platelet Na-H antiport are altered with an increase in blood pressure and a decrease in serum high density lipoprotein cholesterol.


Expression of adrenergic receptors in individual astrocytes and motor neurons isolated from the adult rat brain. Attempts to show the distribution of adrenergic receptors (ARs) in autoradiographs of a brainstem motor nucleus following elimination of motor neurons yielded the unexpected result of an increase in beta-AR density. This increase was related to the gliosis accompanying the motor neuron degeneration. To determine the cells on which the AR subtypes were located, we dissociated cells from various regions of the adult rat brain and subsequently identified astrocytes by glial fibrillary acidic protein (GFAP) immunofluorescence. Slides containing the astrocytes were prepared for autoradiography using the nonselective beta ligand 125I-iodocyanopindolol (125ICYP) or the alpha 1 ligand 125IBE 2254 (125I-HEAT). The addition of the selective beta 1 blocker betaxolol or the beta 2 blocker ICI 118.551 to the incubation medium to displace 125ICYP binding was used to determine the binding of beta-AR subtypes. The great majority (greater than 88%) of isolated astrocytes sampled from the trigeminal motor nucleus, cerebral cortex, striatum, and cerebellum showed beta-AR binding. Astrocytes from the first three regions had similar average densities of beta-ARs, whereas the density in cerebellar astrocytes was 2- to 3-fold greater. The beta 2-AR subtype was proportionally greater than the beta 1 subtype in each region. Reactive astrocytes isolated from the trigeminal motor nucleus after degeneration of motor neurons showed a beta-AR density nearly 2-fold greater than resting astrocytes from the same region, with the beta 1 subtype showing the greater proportional increase. There was no beta-AR binding on trigeminal motor neurons. Astrocytes also showed a significant level of alpha 1-AR binding. No differences in alpha 1-AR binding were found in normal astrocytes isolated from the different regions, nor was there an increase in reactive astrocytes. In contrast, trigeminal motor neurons had an alpha 1-AR density nearly 10 times greater than astrocytes. In terms of the NE modulation of synaptic responses in motor neurons, the distribution of ARs would permit NE to act indirectly through alpha 1 and beta receptors on astrocytes and directly through alpha 1 receptors on motor neurons.


Calcium dependence of serotonin-evoked conductance in C6 glioma cells. Whole-cell membrane currents and imaging of intracellular calcium concentrations ([Ca2+]i) were used to investigate the role of calcium in a response to serotonin of C6 glioma cells. Activation of a high-affinity serotonin receptor induced a transient rise in calcium concentration in these cells and activated a predominantly potassium conductance, with a small chloride component. Perfusion of the cytoplasm with an internal solution containing high calcium concentration induced similar but prolonged increase of membrane conductance. The responsiveness of C6 cells to serotonin was negatively correlated with the concentration of the unbound calcium chelator BAPTA when BAPTA-buffered calcium-containing intracellular solutions were used. Responses to serotonin persisted in the absence of external calcium, decreased gradually, and then recovered partially after replenishment of extracellular calcium. These findings substantiate the direct role of intracellular calcium in mediating the serotonin response, and indicate that serotonin-induced release of calcium from intracellular stores is sufficient for the activation of conductance in the C6 glioma cell line.


Rotavirus and bacterial enteropathogens causing acute diarrhea. The etiology of rotavirus in acute diarrhoeal illness in children 0-5 years of age, admitted to the Pediatric wards of Kasturba Medical College Hospital, Manipal was studied, over a period of one year. Rotavirus in the faecal samples detected by the slide latex agglutination test accounted for 14.9% of the diarrheas with maximum incidence in the 7-12 months of age group (57.5%). Bacterial enteropathogens continued to play a significant role in diarrheal diseases. Salmonella enteritis was found more in the age group 0-6 months and shigellosis in 37-60 months. In a control study of 100 children who had no diarrhea, 2 were found positive for rotaviruses.


Postnatal development of dye-coupling among astrocytes in rat visual cortex. Intercellular coupling among astrocytes was studied in rat visual cortex slices from animals aged 1 week to 4 months. Cell coupling via gap junctions was determined by the dye spread of the low molecular weight dye Lucifer Yellow CH injected into electrophysiologically identified cells to adjacent cells. Coupling among glial cells was first detected at postnatal day 11 and was thereafter consistently observed until adulthood. Dye spread was observed up to 300 microns radially from the injected cell covering multiple cortical layers. Following dye injection into a single cell up to several hundred Lucifer Yellow-positive cells could be observed. Quantitative analysis revealed a similar extent of dye spread at different developmental stages including a quite constant number of dye-coupled astrocytes from the end of the second postnatal week to adulthood. Double labelling of Lucifer Yellow-filled cells with an antiserum against the glial fibrillary acidic protein confirmed the astrocytic nature of the injected and coupled cells. Comparison of the density of dye-coupled cells in a given area and the total number of astrocytes as revealed by immunocytochemical staining suggests that dye-coupling includes the entire local astrocytic population. It is concluded that coupling among astrocytes via gap junctions in rat visual cortex occurs shortly after birth and reflects one of the first steps in astroglial maturation.


Voltage-gated currents expressed by rat microglia in culture. Using the whole-cell patch-clamp technique, at least three types of voltage-gated currents expressed by cultured rat microglia were identified: an inward rectifier K+ current, a delayed rectifier K+ current (IK), and a Na+ current activated by depolarization. The inward rectifier conductance was activated by hyperpolarization to potentials more negative than -80 mV, depended on the external K+ concentration, and declined over time during whole cell recording, as the cell was internally dialyzed. The delayed rectifier current was activated by depolarization to potentials more positive than -40 mV and the rates of activation and deactivation showed a voltage-dependence similar to such currents seen in other preparations. An inward current possibly carried by Na+ was seen in a small percentage of cells. Recordings had been made from two morphological cell types, namely process-bearing ("ramified") and non-process-bearing ("ameboid"). Each of these currents was present in microglia of both morphological types. However, microglial morphology, which is thought to represent different states of activation, was significantly related to the types of combinations of currents expressed in a given cell.


Functional characterization of neurokinin-1 receptors on human U373MG astrocytoma cells. The neurokinin-1 (NK-1, substance P) receptor belongs to the class of seven transmembrane domain (7-TM) receptors that interact with cellular effector systems via guanine nucleotide binding regulatory proteins (G-proteins). In this study, coupling mechanisms of functional NK-1 receptors endogenously expressed in a human astrocytoma cell line (U373MG) were analyzed. Stimulation with substance P (SP) resulted in 1) a rapid increase in inositol 1,4,5-trisphosphate (IP3) synthesis; 2) a rise in cytosolic free calcium concentration ([Ca2+]i); 3) induction of immediate early gene transcription as monitored by c-fos and c-jun expression; and 4) a significant increase in de novo DNA synthesis. Thus, the functional responses induced by stimulation of NK-1 receptors on U373MG strongly correlate with those observed after treatment of primary astrocytes with SP and make U373MG cells a useful in vitro model system for the analysis of NK-1 receptor function on astrocytes in vivo.


Modification in penicillin-binding proteins during in vivo development of genetic competence of Haemophilus influenzae is associated with a rapid change in the physiological state of cells. By using whole-cell labeling assay with 125I-penicillin V, we observed a reduction in the binding of the radiolabeled beta-lactam to four or five penicillin-binding proteins (PBPs) in Haemophilus influenzae cells cultivated under specific conditions. PBPs 3A, 3B, 4, and 6 were altered after the growth of bacteria in diffusion chambers implanted in the peritoneal cavity of rats. PBP 2 was also modified when cells were cultivated in human cerebrospinal fluids. Because this observation may have important consequences on the efficacy of beta-lactams during antibiotic therapy, we characterized the physiological state of bacteria cultivated in animals in the hope of explaining how such important changes in cell properties develop in vivo. Since the development of natural genetic competence occurs at the stationary phase of growth in H. influenzae, we used a DNA transformation assay to evaluate the physiological state of bacteria grown in diffusion chambers implanted in rats. Chromosomal DNA isolated from an antibiotic-resistant donor strain was mixed with bacteria in diffusion chambers. At different times during a 5-h incubation period, recipient bacteria were collected from the chambers, CFU were determined by plate counting, and antibiotic-resistant transformants were isolated on selective plates. Genetic competence rapidly developed in cells grown in rats, and the frequency of transformation by test DNA was elevated. Electron microscopy revealed an irregular cell shape and blebs at the surface of bacteria cultivated in animals and in cerebrospinal fluids. In an attempt to induce a similar physiological state in vitro, we supplemented broth cultures with cyclic AMP or synchronized cultures by a nutritional upshift. No changes in PBPs were observed with supplemental cyclic AMP or during a single cell cycle. Finally, a reduction in the affinity of PBPs for 125I-penicillin V identical to that observed in bacteria grown in rats was observed in cells isolated from the stationary phase of growth in vitro. These results clearly indicate that H. influenzae cells grown in animals undergo a rapid change to a physiological state similar to that found in late-stationary-phase cultures in vitro. This observation indicates that the rational design of future and improved antibiotic therapy of H. influenzae infections should consider cell properties of slow-growing or latent bacteria.


Glycoprotein receptors for a heat-stable enterotoxin (STh) produced by enterotoxigenic Escherichia coli. Glycoprotein receptors for heat-stable enterotoxin STh of enterotoxigenic Escherichia coli in the rat intestinal cell membrane were identified and characterized. Incubation of rat intestinal cell membranes with radioiodinated N-5-azidonitrobenzoyl-STh[5-19] (125I-ANB-STh[5-19]) followed by photolysis resulted in specific radiolabeling of two distinct proteins with M(r)s of 200,000 (designated STR-200A and STR-200B). STR-200A was found to be composed of two molecules of a protein with an M(r) of 70,000 (70-kDa protein), whereas STR-200B was composed of two different protein molecules with M(r)s of 53,000 (53-kDa protein) and 77,000 (77-kDa protein). These proteins showed no guanylate cyclase activity. The 70-kDa protein was labeled most with 125I-ANB-STh[5-19], suggesting that STR-200A is the main receptor protein in the rat intestinal cell membrane. The carbohydrate moieties of STR-200A and STR-200B were examined by enzymatic deglycosylation. The 70-kDa protein of STR-200A was found to contain N-linked high-mannose-type and/or hybrid-type oligosaccharides, and results suggested that it possesses at least three N glycosylation sites. The 53-kDa protein of STR-200B was found to have an N-linked complex-type oligosaccharide side chain. The deglycosylated 70-kDa protein retained activity for binding to STh, suggesting that the carbohydrate moieties of these receptor proteins are not important for binding with STh.


Interleukin-6 antagonizes tumor necrosis factor-mediated mycobacteriostatic and mycobactericidal activities in macrophages. Interleukin-6 (IL-6) is a cytokine produced by a number of cells, including macrophages, and is directly involved in the inflammatory response. The production of IL-6 can be stimulated by monokines such as IL-1 and tumor necrosis factor (TNF). Mycobacterium avium complex organisms frequently cause disseminated disease in patients with AIDS. M. avium is an intracellular bacterium that that mainly infects macrophages. Treatment of M. avium-infected macrophage monolayers with recombinant IL-6 decreased the ability of TNF to activate cultured macrophages to inhibit growth of or kill intracellular M. avium (68% +/- 14% decrease in intracellular killing compared with that in monolayers not treated with IL-6). To further evaluate whether this effect was dependent on the down regulation of membrane receptors to TNF, we examined 125I-TNF binding to macrophages previously exposed to IL-6: the expression of TNF receptors was decreased by 78% +/- 9%. The effect of IL-6 on TNF receptors was observed after 4 h and was reversible. Infection of macrophages with different M. avium serovars was associated with release of IL-6, and IL-6 production peaked at 48 h after infection in concentrations ranging from 328 +/- 87 ng/10(5) cells to 907 +/- 224 ng/10(5) cells. IL-6 did not have any influence on the rate of growth of the tested strains of M. avium within or outside macrophages. These results suggest that release of IL-6 by M. avium-infected macrophages may influence the host's immune response and the outcome of the disease.


von Willebrand factor release and thrombomodulin and tissue factor expression in Rickettsia conorii-infected endothelial cells. Mediterranean spotted fever, a tick-borne rickettsiosis caused by Rickettsia conorii, may lead to small-vessel or deep-vein thrombosis. In order to evaluate the role of endothelial cell alteration in this lesion, we infected human endothelial cells derived from umbilical veins with R. conorii. We report the induction of two previously unreported prothrombotic mechanisms in rickettsial disease: (i) a progressive decline in thrombomodulin antigen and (ii) early expression of tissue factor, and, as described for R. rickettsii infection, later release of von Willebrand factor from Weibel-Palade bodies. Thrombomodulin expression in infected endothelial cells, measured by the thrombin-dependent activation of protein C or flow cytometric analysis, decreased steadily between 4 and 24 h after inoculation with rickettsiae. R. conorii infection induced tissue factor expression, measured by clotting assay and flow cytometric analysis, which was detectable 2 h postinoculation, reached its maximum 4 h postinoculation, and progressively decreased thereafter. Infection resulted in a relatively late release of von Willebrand factor antigen into the culture medium. A double-label immunofluorescence assay for the simultaneous evaluation of von Willebrand factor and R. conorii showed that the depletion of cytoplasmic von Willebrand factor stored in Weibel-Palade bodies was due to a direct effect of the intracellular R. conorii. These disturbances of endothelial function observed with R. conorii-infected cells may provide a paradigm for the elucidation of thrombotic pathobiology with Mediterranean spotted fever.


Opportunistic infections and retrovirus-induced immunodeficiency: studies of acute and chronic infections with Toxoplasma gondii in mice infected with LP-BM5 murine leukemia viruses. Mice infected with LP-BM5 murine leukemia viruses develop a syndrome, termed mouse AIDS (MAIDS), characterized by increasingly severe immunodeficiency and progressive lymphoproliferation. Virus-infected mice were examined for the ability to resist acute infection and to control chronic infection with the protozoan Toxoplasma gondii, a major opportunistic pathogen of individuals infected with human immunodeficiency virus. Mice infected with the retroviruses for 2 or 4 weeks responded normally to challenge with the parasite, but mice inoculated with the protozoan 8 or 12 weeks after viral infection died with acute disease due to T. gondii. Increased sensitivity to acute infection was associated with a reduced ability to produce gamma interferon (IFN-gamma) and with established changes in CD4+ T-cell function. Mice latently infected with T. gondii and then inoculated with the retrovirus mixture were found to reactivate the parasite infection, with 30 to 40% of dually infected animals dying between 5 and 16 weeks after viral infection. Reactivation was associated with reduced proliferation and impaired production of IFN-gamma in response to stimulation with soluble T. gondii antigens or to concanavalin A. Continuing resistance to lethal reactivation in the remaining mice was shown to require CD8+ T cells and expression of IFN-gamma. In addition, it was found that chronic infection with T. gondii altered the course of MAIDS by inhibiting the progression of splenomegaly and immunodeficiency and reducing the expression of both the helper and etiologic defective viruses. These results support previous studies which indicate that infection with T. gondii is controlled by synergistic interactions between CD4+ and CD8+ T cells, the functions of which are progressively impaired during the course of MAIDS.


Immunochemical and biological characterization of outer membrane proteins of Porphyromonas endodontalis. Outer membrane proteins (OMP) of Porphyromonas endodontalis HG 370 (ATCC 35406) were prepared from the cell envelope fraction of the organisms. The cell envelope that had been obtained by sonication of the whole cells was extracted in 2% lithium dodecyl sulfate and then successively chromatographed with Sephacryl S-200 HR and DEAE-Sepharose Fast Flow. Two OMP fractions, OMP-I and OMP-II, were obtained, and their immunochemical properties and induction of specific antibodies were examined. The OMP-I preparation consisted of a major protein with an apparent molecular mass of 31 kDa and other moderate to minor proteins of 40.3, 51.4, 67, and 71.6 kDa, while the OMP-II preparation contained 14-, 15.5-, 27-, and 44-kDa proteins as revealed by sodium dodecyl sulfate-polyacrylamide gel electrophoretic analysis. OMP-I was found to form hydrophilic diffusion pores by incorporation into artificial liposomes composed of egg yolk phosphatidylcholine and dicetylphosphate, indicating that OMP-I exhibited significant porin activity. However, the liposomes containing heat-denatured OMP-I were scarcely active. Spontaneous and antigen-specific immunoglobulin M (IgM)-, IgG-, and IgA-secreting spot-forming cells (SFC) enzymatically dissociated into single-cell suspensions from chronically inflamed periapical tissues and were enumerated by enzyme-linked immunospot assay. In patients with radicular cysts or dental granulomas, the major isotype of spontaneous SFC was IgG. In radicular cysts, the OMP-II-specific IgG SFC represented 0.13% of the total IgG SFC, while the antigen-specific IgA or IgM SFC was not observed. It was also found that none of these mononuclear cells produced antibodies specific for OMP-I or lipopolysaccharide of P. endodontalis.


Limited T-cell receptor beta-chain diversity of a T-helper cell type 1-like response to Mycobacterium leprae. Delayed-type hypersensitivity (DTH) is the standard measure of T-cell responsiveness to infectious organisms. For leprosy, the Mitsuda reaction, a local immune response to cutaneous challenge with Mycobacterium leprae, is considered to represent a measure of DTH against the pathogen. We analyzed the diversity of the T-cell receptor beta-chain repertoire in Mitsuda reactions to determine the breadth of the mycobacterial antigens involved. The polymerase chain reaction was used to compare V beta usage in the Mitsuda reaction T-cell lines established and unstimulated peripheral blood. These molecular analyses revealed a skewed T-cell receptor V beta gene usage in the Mitsuda reaction and in T-cell lines from lesions. To examine the reactivity of T cells from these lesions, T-cell lines were tested against the available native and recombinant antigens of M. leprae. T-cell lines derived from Mitsuda reactions responded more strongly to the 10-kDa M. leprae antigen, a homolog of GroES in Escherichia coli, than to other M. leprae proteins. T-cell lines were also shown to proliferate strongly in response to the 17- and 3-kDa proteins. The pattern of the lymphokine mRNA of these cells was reminiscent of the pattern of murine TH1 cells, positive for interleukin-2 and gamma interferon and weakly positive for interleukin-4. These data indicate that a limited array of T cells, perhaps recognizing stress proteins, secrete a type 1 lymphokine profile in the DTH response to mycobacteria.


Polymorphism of the 35- and 50-kilodalton surface glycoconjugates of Trypanosoma cruzi metacyclic trypomastigotes. In this study, we examined the immunochemical properties of the 35- and 50-kDa (35/50-kDa) surface glycoconjugates expressed on the surface of metacyclic trypomastigotes of Trypanosoma cruzi using three different monoclonal antibodies directed to this component. The 35/50-kDa surface antigen was expressed by metacyclic trypomastigotes of 11 different strains of T. cruzi and displayed a significant degree of molecular polymorphism. Results of immunoblotting and complement-mediated lysis were consistent with such diversity. Different monoclonal antibodies reacted with distinct epitopes on the 35/50-kDa antigen, which is resistant to proteases and behaves as an amphiphilic component.


Lipopolysaccharides of Bacteroides intermedius (Prevotella intermedia) and Bacteroides (Porphyromonas) gingivalis induce interleukin-8 gene expression in human gingival fibroblast cultures. Lipopolysaccharides (LPS) prepared from Bacteroides intermedius (Prevotella intermedia) and Bacteroides (Porphyromonas) gingivalis by hot phenol-water extraction induced interleukin-8 (IL-8) mRNA in normal human gingival fibroblast cultures, as demonstrated by Northern (RNA) blot analysis. IL-8 mRNA levels began to increase after a 2-h exposure, reached a maximum after 12 h, and then dropped to the unstimulated level at 48 h. IL-8 mRNA levels were also enhanced in a dose-dependent manner. By contrast, LPS specimens from various Salmonella species with S and R chemotypes and bacterial [corrected] and synthetic lipid A preparations did not increase IL-8 mRNA levels in fibroblasts. Although recombinant human IL-1 alpha induced IL-8 mRNA expression in fibroblast cultures, an antiserum to recombinant human IL-1 alpha did not decrease the IL-8 mRNA accumulation induced by B. intermedius LPS. Fibroblasts primed with natural human gamma interferon (IFN-gamma) expressed higher IL-8 mRNA levels upon stimulation with B. intermedius LPS, but not with Salmonella LPS, compared with nontreated cells. Natural human IFN-beta exhibited a similar priming effect on the fibroblasts, and antiserum to IFN-beta added to the cultures together with B. intermedius LPS decreased the IL-8 mRNA levels. Therefore, endogenous IFN-beta enhanced IL-8 mRNA production in response to B. intermedius LPS in fibroblasts.


Vibrotactile perception threshold measurements for diagnosis of sensory neuropathy. Description of a reference population. Recognition of the fact that impairment of the tactile sense may occur independently of other disturbances in the vibration syndrome has rekindled an interest in developing a diagnostic method for early detection of vibration-induced neuropathy. There is also evidence suggesting that vibrotactile measurements represent a valuable diagnostic tool in compressive neuropathies, such as the carpal tunnel syndrome. The method may also become useful for diagnosing sensory neuropathies caused by other factors, such as solvents, pesticides, heavy metals, alcoholism, and diabetes. However, before vibrotactile measurement can be accepted and established as a tool for clinical diagnostic purposes, for screening, and in research, the level and the shape of the normal threshold curve have to be specified. With the purpose of assembling normative data, the vibrotactile perception thresholds (8-500 Hz) of the right index fingertip were measured in 171 healthy males (19-75 years) not exposed to vibration. A Békésy audiometer was modified to operate in combination with a vibration exciter, instead of headphones, at frequencies lower than usual (8-500 Hz). The results showed that the perception thresholds increased from about 100 dB to about 140 dB (rel. 10(-6) m/s2rms) as a function of frequency and age. The frequency-dependent changes were not linear, however, but displayed a peak in sensitivity at 125 Hz. Threshold changes due to aging were most pronounced at the highest frequencies. It is of the utmost importance that these natural changes are taken into account when making comparisons between groups or individuals.


General principles for the delivery of active agents from mouthrinses. Mouthrinses are a convenient and accepted method of delivering oral therapeutic agents. Efficacy, however, depends on several factors including the type of drug used and its properties, use of an optimal delivery vehicle, patient compliance or usage practices and the therapeutic indication for which they are used. Three classes of therapeutic agents currently used in mouthrinses are reviewed, including fluorides, tartar control agents and antimicrobial compounds. The specific agents in these categories, some of which are currently used in mouthrinses, span a broad range of chemical and pharmacological properties. A basic understanding of these properties allows for a rational use of these agents in therapeutically optimised formulations.


Rinses for the control of supragingival calculus formation. Recent epidemiologic studies have confirmed the widespread presence of calculus in teenagers and adults of all ages. Among the multiple anticalculus strategies that have been proposed over the years inhibition of crystal growth has been the most attractive. Current formulations in antitartar toothpastes utilise either zinc salts or various pyrophosphate combinations. In mouthrinses three recent clinical studies have established the superiority of a formulation that contains 1 per cent soluble pyrophosphate, 0.45 per cent of the copolymer of methoxyethelene and maleic acid (Gantrez) and 0.02 per cent sodium fluoride. Three and six month studies demonstrated reductions in calculus scores of 31.7-37.7 per cent using the Volpe-Manhold scoring method. A comparative study of 1 per cent pyrophosphate rinses with and without the copolymer (Gantrez) affirmed its importance to the efficacy of the formulation (31.7 per cent vs 14.4 per cent).


Reproductive factors and the risk of hepatocellular carcinoma in women. The relationship between reproductive factors and the risk of primary liver cancer was analyzed using data of a case-control study conducted in Northern Italy between 1984 and 1991 on 79 women with histologically or serologically confirmed hepatocellular carcinoma and 344 controls in hospital for a wide spectrum of acute, non-neoplastic diseases. The multivariate relative risk (RR) for parous vs. nulliparous women was 2.6 (95% confidence interval (CI) 1.2 to 5.8), and the risk increased with parity from 2.1 for 1, to 2.6 for 2, to 3.2 for 3, to 3.5 for 4 or more births (chi 2(1) trend = 6.49, p = 0.01). The relative risks were above unity, though not significantly, in women reporting spontaneous (RR = 1.3) and induced (RR = 1.6) abortions, and there was a significant trend in risk with total number of abortions. An apparent inverse trend in risk with age and first birth was accounted for by parity. No relationship emerged with age at menarche, at menopause or other menstrual factors. The association between parity and hepatocellular carcinoma was, if anything, more marked at older ages, since the RR was 1.6 (95% CI 0.5 to 4.6) below age 60, and 4.8 (95% CI 1.3 to 18.1) at age 60 or over. This observation has relevant public-health implications, since in developed countries primary liver cancer is extremely rare among young women, but not at older ages. The association between parity and hepatocellular carcinoma is similar to that described for combined oral contraceptives, again confirming that the impact of contraceptives on the risk of several neoplasms is similar to that of pregnancy.


Presence and physical state of HPV DNA in prostate and urinary-tract tissues. Neoplastic and non-neoplastic tissues from the urinary tract and the prostate were analyzed for the presence of human papillomavirus (HPV) DNA. The analysis was performed by PCR using primers specific for HPV 6/11 and 16. HPV DNA was present in bladder, ureter, kidney and prostate, with percentages ranging between 46% and 87%. Benign and oncogenic HPV types were detected with similar frequencies both in non-neoplastic and in neoplastic biopsies, and HPV 16 was not preferentially associated with malignant lesions. In all instances, small amounts of HPV DNA were present in the tissues, suggesting the absence of productive infection. Analysis of the physical state of HPV DNA performed by 2-dimensional gel electrophoresis and Southern blot hybridization revealed that HPV 16 DNA harbored in the urinary tract can be integrated also in non-neoplastic tissues. The results indicate that HPV 16 does not seem to be associated with urinary-tract and prostate oncogenesis, but that these tissues may represent an important reservoir for the transmission of HPV types normally infecting the genital tract.


Isolation of two keratinocyte cell lines derived from HPV-positive dysplastic vaginal lesions. Explant cultures were started from human papillomavirus (HPV)-infected genital lesions in order to isolate and propagate abnormally differentiating cells from squamous intraepithelial neoplasia. A medium with high calcium concentration was used to induce terminal differentiation of cells from surrounding normal epithelium. Two cell lines with extended life-spans were established. The UT-DEC-1 cell line was derived from an HPV-33-positive mild vaginal dysplasia (VAIN I). In cultured UT-DEC-1 cells, HPV 33 DNA was detected with Southern-blot hybridization and the polymerase chain reaction (PCR) technique. The restriction pattern of HPV 33 changed during early passages and flow cytometric analysis detected a decrease in chromosomal DNA content. HPV 33 RNA from the E6-E7 region could be amplified by PCR at late passage. UT-DEC-2 cell line was derived from an HPV-16-positive moderate vaginal dysplasia (VAIN II). HPV 16 DNA was also detected in cultured cells by the PCR technique. The senescence of normal keratinocytes and growth selection in favor of aneuploid cells was observed by flow cytometric analysis at subsequent passages. Karyotype analysis showed clonal chromosomal abnormalities in both cell lines. To date, UT-DEC-1 cells have undergone 40 and UT-DEC-2 cells 25 passages. This study shows that the isolation of HPV-infected dysplastic cells can be achieved by culturing the cells in a medium with high calcium concentration. The cell lines presented provide the opportunity of evaluating the early stages of squamous-cell carcinogenesis.


Progressive abrogation of TGF-beta 1 and EGF growth control is associated with tumour progression in ras-transfected human keratinocytes. This study examined the response of human keratinocytes in different stages of transformation to exogenous TGF-beta 1 and EGF as well as their receptor and growth-factor expression. Cells of the spontaneously immortalized HaCaT cell line and c-Ha-ras transfected clones (I-6, I-7, II-3, II-4) exhibited different tumorigenic potentials when transplanted to athymic mice. HaCaT- and I-6 cells were non-tumorigenic, I-7 cells formed persisting epidermal cysts (benign tumours) and II-3 and II-4 cells developed into invasive squamous-cell carcinomas. TGF-beta 1 inhibited thymidine uptake in a dose-dependent manner, a progressive decrease in response being associated with an increasing malignant potential (HaCaT greater than I-6 greater than I-7 = II-4). HaCaT-cells and ras-clones expressed TGF-beta 1 mRNA at similar levels, but cells of increasing malignant potential secreted markedly less receptor-binding TGF-beta (HaCaT greater than I-6 = I-7 greater than II-3 greater than II-4) into the culture medium. Whilst ras-transfected cells expressed fewer TGF-beta receptors than HaCaT cells, there was little difference between TGF-beta receptor number or affinity between the 4 transfected cell clones. The same was true for the TGF-beta receptor types, but Type-II receptors were expressed at lower levels by the malignant clones II-3 and II-4. When HaCaT and ras-transfected cells were investigated for their response to exogenous EGF, cells were refractory (I-7, II-4), partially stimulated (I-6) or fully stimulated (HaCaT). Cells with increasing malignant potential produced increasing amounts of endogenous TGF-alpha (II-4 = II-3 greater than I-7 = I-6 greater than HaCaT). All tumorigenic ras clones expressed higher mRNA levels than HaCaT-cells. Ras-transfected clones expressed fewer high- and low-affinity EGF receptors than HaCaT cells with a tendency toward increased numbers of high-affinity EGF receptors associated with increasing malignant potential (II-4 = II-3 greater than I-7 greater than I-6) but these changes were associated with a progressive decrease in receptor affinity. The results indicate that tumour progression in human epidermal keratinocytes transfected with c-Ha-ras is associated with a progressive abrogation of TGF-beta 1 and EGF growth control. They suggest that the increased autonomous growth potential associated with advanced stages of epithelial tumour progression can be defined more closely using a cellular profile of TGF-beta and EGF.


Prevalence of the Rhesus-negative phenotype in Caucasian patients with small-cell lung cancer (SCLC). We report that the Rhesus (Rh)-negative phenotype is more prevalent in patients with small-cell lung cancer (SCLC) than in the normal Caucasian population (SCLC: 25% Rh-negative vs. 15% expected, p less than 0.0001). This finding has been validated for a Central and a Northern European population (Switzerland and UK). In contrast, the Rh-negative phenotype is no more frequent in non-small-cell lung cancer patients or in heavy smokers with coronary heart disease than in the general population. There was a normal distribution of the ABO blood group phenotype in all patients studied. Whilst the significance of this observation is unclear, we hypothesize that a genetic predisposition to the development of SCLC may be linked to a hitherto unidentified gene on chromosome 1p near the Rh locus. Our observation may perhaps allow further progress to be made in understanding genetic mechanisms of SCLC carcinogenesis.


Lung cancers associated with thorotrast exposure: high incidence of small-cell carcinoma and implications for estimation of radon risk. The widely accepted concept that the alpha-emitting radionuclide radon (222Rn, 220Rn) induces lung cancers in humans has been based on the excess of lung tumours observed in underground miners extracting uranium or other substances. However, this poses the important question of whether radon is the only carcinogenic factor because such miners are also heavily exposed to mine dusts including silicates, diesel exhaust, etc. in their working environment. Patients to whom Thorotrast was administered continuously exhale radon (220Rn) derived from 232Th deposits in the body and therefore provide a good model for lung carcinogenesis by radon without concomitant dust exposure. We therefore investigated lung-cancer incidence in our epidemiological follow-up series, analysing the histological types of 11 lung cancers which were found among 359 Thorotrast autopsy cases and measuring radioactivity in the breath of living Thorotrast patients. The study revealed that, while the proportion of small-cell lung cancers considered to be related to alpha-particles was significantly increased, the overall lung cancer incidence was not significantly higher than in controls, in spite of the high level of 220Rn in the patients' breath. This result suggests that radon in the lung does induce cancers (particularly small-cell carcinomas) but that the induction rate is not as high as expected from risk factors associated with mining. Thus, excess lung cancers among the miners might be related to the combined effects of exposure to radon and mine dusts, and not solely to radon.


Radiation-induced lymphoid tumors and radiation lethality are inhibited by combined treatment with small doses of zinc aspartate and WR 2721. Combined small doses of zinc aspartate and WR 2721 provided additive protection against radiation lethality in mice. Survival obtained with a small dose of WR 2721 which was ineffective alone could be enhanced to 83% by combining the drug with zinc aspartate, which on its own also displayed no effect. The survival of 25% provided by a higher dose of WR 2721 was increased significantly by adding zinc aspartate. Additivity was also tested in a model of radiation carcinogenesis. For this purpose, lethality and occurrence of lymphoid tumors induced by fractionated total-body irradiation were studied in C57B1/6 mice treated with zinc aspartate and WR 2721. In order to reveal additive effects, both agents were used at sub-optimal dosages. In mice subjected to 5 daily exposures of 1.9 Gy, the combination of zinc aspartate and WR 2721 was effective and enhanced the survival to 83% as compared with 25% afforded by WR 2721 alone (p < 0.005). Similarly, histological assessment of organ involvement with lymphoma revealed that zinc aspartate and WR 2721 alone did not bring about a significant reduction of lymphoma incidence. On the other hand, the combined agents diminished organ involvement with lymphoma to 9.1% as against 90% in the controls (p < 0.0005) and 62.5% with WR 2721 alone (p < 0.025). Thus, combined treatment with zinc aspartate and WR 2721 also inhibited radiation-induced lymphoid tumors.


An anti-mucin immunotoxin BrE-3-ricin A-chain is potently and selectively toxic to human small-cell lung cancer. Monoclonal antibodies (MAbs) known to recognize epithelial mucin or defined carbohydrate structures present on mucin molecules were screened for their ability to form cytotoxic agents with ricin A-chain active against human small-cell lung cancer (SCLC) in an indirect assay of immunotoxin cytotoxicity. Anti-X hapten and anti-Y hapten antibodies binding to a high proportion of SCLC cells mediated only weak to moderate effects on 3H-leucine incorporation in combination with the screening agent, sheep anti-mouse IgG F'ab-ricin A-chain. In contrast, the mouse MAb BrE-3, recognizing the polypeptide core of the MUCI mucin gene product, exerted potent and selective cytotoxic effects in the assay. An immunotoxin made by the direct attachment of ricin A-chain to BrE-3 was selectively toxic to SCLC cell lines in tissue culture. The cytotoxic activity of BrE-3-ricin A-chain was enhanced 100-fold in the presence of monensin but not by lysosomotropic amines or calcium antagonists. Our findings suggest that anti-mucin immunotoxins may have a therapeutic role to play in the treatment of SCLC.


Prevention of programmed cell death in Burkitt lymphoma cell lines by bcl-2-dependent and -independent mechanisms. Burkitt lymphoma (BL) cell lines which retain the phenotypic characteristics of the freshly-isolated tumour cells (group I cells) readily enter programmed cell death (apoptosis) in response to a variety of triggers. By contrast, isogenic BL cells which are phenotypically altered as a result of activation of their resident EBV genome (group-III cells) are highly protected from apoptosis. Phenotypic changes in group-III cells include the up-regulation of the oncogene, bcl-2. Expression of the 26-kDa bcl-2 protein in group-I BL cells following gene transfer was found to afford protection from apoptosis: the degree of protection was proportional to the amount of bcl-2 protein expressed. When group-I bcl-2 transfectants were compared with their group-III counterparts it was found that, whilst bcl-2 made a significant contribution in protecting from entry into apoptosis, hyper-expression of bcl-2 protein in group-I cells (well beyond that of group-III cells) was necessary to attain the high levels of protection observed in group-III cells. These results suggested that additional, bcl-2-independent, survival mechanisms could operate in BL cells. In support of this notion it was also found that: (1) prolonged culture of group-I lines in vitro resulted in enhanced survival in the absence of bcl-2 up-regulation, and (2) exposure of group-I cells to interferon-alpha triggered a bcl-2-independent protective response. The molecular mechanisms of both the bcl-2-dependent and -independent survival pathways remain to be determined.


Effects of drug misuse treatment on symptoms of depression and suicide. In this longitudinal study of 9,904 clients who were treated at methadone, outpatient drug-free (OPDF), and residential treatment facilities, at intake more than half of all clients reported symptoms of depression or suicide. Females and multiple nonnarcotics users were at highest risk for suicide attempts. Despite a dramatic drop in the level of symptomatology by 4 weeks in treatment, many clients remained suicidal throughout the study period. Suicidal tendencies at both intake and 4 weeks were strongly related to suicidal tendencies at 12 months post-treatment; even more strongly related was the return to weekly or more frequent use of narcotics or nonnarcotics for residential and OPDF clients.


Prevalence and cytologic manifestations of human papilloma virus (HPV) types 6, 11, 16, 18, 31, 33, 35, 42, 43, 44, 45, 51, 52, and 56 among 500 consecutive women. The prevalence and associated cytologic manifestations of cervical infection with human papillomavirus (HPV) types 6, 11, 16, 18, 31, 33, 35, 42, 43, 44, 45, 51, 52, and 56 were studied among 500 consecutive women attending the Harborview Medical Center Sexually Transmitted Diseases (STD) Clinic in Seattle, WA. Using radiolabeled-probes without prior amplification of DNA, HPV DNA was detected in cervical specimens from 120 (24%) of the women and was found to be more prevalent than Chlamydia trachomatis (13%), Neisseria gonorrhoeae (12%), or mucopurulent cervicitis (20%). High-risk HPV types 16 or 18 were present alone in 5% of the women; intermediate-risk types 31, 33, 35, 45, 51, 52, or 56 in 3%; and low-risk types 6, 11, 42, 43, and 44 in 5%. In an additional 8% HPV DNA was detected but could be characterized only as being type 6, 11, 16, 18, 31, 33, or 35. Each grouping of HPV types was equally associated with squamous intraepithelial lesions (SILs) of the cervix. In the absence of SIL and koilocytosis, the cytologic changes associated with HPV infection included frequent binucleation and variation in nuclear size and chromatin distribution. Parakeratosis and hyperkeratosis without nuclear atypia were not associated with HPV DNA. The natural history and clinical significance of these HPV-associated lesions remain to be defined.


Correlation of cervical cytology and human papillomavirus DNA detection in postmenopausal women. This study correlated the cytological features of cervical swabs from postmenopausal women with the histological findings and the detection of human papillomavirus (HPV) using filter hybridization analysis. Of 17 postmenopausal women seen at colposcopy for an abnormal Papanicolaou (Pap) smear, most often squamous atypia, HPV DNA was detected in one (6%) cervical swab. Biopsy-proven cervical squamous intraepithelial lesions (SILs) were noted in two of the 17 (12%). The HPV DNA detection rate was equivalent to that found in 47 postmenopausal women who had hysterectomies for noncervical disease. The rates of HPV detection and biopsy-proven SIL in premenopausal women seen at colposcopy was 55% and 66%, respectively. The HPV DNA detection rate for postmenopausal women with biopsy-proven SILs as determined by in situ hybridization was 19/26 (73%), which is equivalent to the rate in premenopausal women. It is concluded that squamous atypia in postmenopausal women is rarely associated with either biopsy-proven SIL or HPV DNA detection and thus, in many cases, may represent atrophic changes.


Human papillomavirus in benign and malignant ovarian and endometrial tissues. Ovarian and endometrial cancer tissues were examined for the presence of human papillomavirus (HPV) and the results were compared with the findings in normal tissues by polymerase chain reaction. Putative DNA of HPV types 16 and 18 that target DNA sequences from paraffin-embedded tissues were amplified with paired oligonucleotide primers that encode the E6 gene of HPV. The amplified DNA sequences were then detected with Southern blot hybridization analysis. The HPV DNA sequences were detected in both benign (50% ovarian, 70% endometrial) and malignant ovarian (27.2%) and endometrial (37.5%) tissue samples. Interestingly, eight hepatoma samples were also analyzed as tissue controls. The results were negative in seven, but positive in one with repeated tests. The results suggest that the spread of HPV in the upper genital tract may not be uncommon. The explanation of a positive liver tissue study result will have to await further study.


Epidermal growth factor receptor expression and the presence of human papillomavirus in cervical squamous intraepithelial lesions. To determine the relationship between the expression of epidermal growth factor receptor (EGFR) and the presence or type of human papillomavirus (HPV) in cervical squamous intraepithelial lesions (SIL), paired colposcopically directed cervical biopsies were obtained from 88 patients referred for abnormal Papanicolaou smears. One biopsy was formalin-fixed and processed for conventional light microscopy, and the other was immediately frozen. A portion of the frozen tissue was used for Southern blot HPV DNA hybridization and a portion for immunohistochemical studies for EGFR using a monoclonal antibody. Forty-seven cases were SIL and 41 were normal. In 41 (87%) of the cases of SIL and in eight (20%) of the normal cases, HPV DNA was detected. Of the SIL cases, HPV 16 was the most frequently detected type, being present in 12 (25%), followed by 10 (21%) types 31 or 35, nine (19%) types 52 or 56, five (11%) uncharacterized types, three (6%) type 18, and two (4%) multiple types. Regardless of histology, EGFR was detected in all cases. In normal cases, EGFR expression was detected in the basal cells only and in SIL in abnormal proliferating parabasal cells such that it correlated with the grade of SIL. When stratified by grade of SIL, no differential expression of EGFR was seen in cases where HPV was detected; in contrast, in cases where no HPV was detected, no differential expression was seen between cases of different HPV type. Thus, EGFR is expressed by all proliferating squamous epithelial cells and as such correlates with the grade of SIL.(ABSTRACT TRUNCATED AT 250 WORDS)


Mixed germ cell-sex cord stromal tumor with heterologous structures. A mixed germ cell-sex cord stromal tumor developed in the right ovary of a 4-year-old girl. The patient's cells contained sex chromatin and the karyotype was 46,XX. Clinically, she exhibited mild isosexual pseudopuberty. Some of the tumor cells showed differentiation to Sertoli cells, whereas others had characteristics of germ cells. The neoplasm was composed of solid cords consisting of a mixture of the two tumor cell types and surrounded by a delicate connective-tissue network. In one small area, the tumor contained heterologous development in the form of glands and cysts lined by columnar mucinous epithelium containing numerous goblet cells and occasional argyrophilic neuroendocrine cells. Normal ovarian tissue was present at the periphery of the tumor. Electron microscopic study confirmed the presence of both Sertoli-like and germ cell-type cells. Immunohistochemical studies demonstrated vimentin positivity in both cell types (with preference for the Sertoli-like cells) and cytokeratin positivity in the Sertoli-like cells. The patient was symptom free 4 years after right oophorectomy, radiotherapy, and chemotherapy.


Flow cytometric DNA analysis of placental-site trophoblastic tumors. The placental-site trophoblastic tumor is a rare form of gestational trophoblastic neoplasia. Although originally considered benign, it is now apparent that this lesion can be associated with aggressive clinical behavior. Our study examined the DNA ploidy status and clinicopathologic features of four new cases of placental-site trophoblastic tumor. Three cases demonstrated diploid DNA stemlines with S-phase fractions ranging from 6% to 16%. These patients were alive and well at follow-up and had low-serum human chorionic gonadotrophin (hCG) levels. A fourth patient, who had a large tumor, demonstrated a tetraploid DNA peak with a prominent S-phase fraction. This patient exhibited an elevated serum hCG at limited follow-up. Flow cytometric DNA analysis may be a useful adjunct for the identification of placental-site trophoblastic tumors with malignant potential.


Human papillomavirus and its prognostic significance in invasive carcinoma of the cervix in young patients. Of 1,200 Chinese patients treated for carcinoma of the cervix between 1975 and 1984, those aged 40 years (n = 70) or less had a poorer prognosis. Of the latter group, 71% had disease classified as less than International Federation of Gynecology and Obstetrics (FIGO) stage Ib, and in 91% the disease was less than stage IIa; however, the 5-year survival of the 45 patients with verified invasive carcinoma was 75% compared with 82% for the overall group. The polymerase chain reaction (PCR) was used to test for the presence of human papilloma virus (HPV) types 16 and 18 within paraffin-embedded tissue from the primary tumors. HPV-16 DNA sequences were detected in 69% of the cases, HPV-18 DNA sequences in 44%, and in 31% both HPV-16 and -18 DNA could be identified. Of the cases of invasive carcinoma, 82% (37 of 45) contained DNA of HPV types 16 and/or 18. The effects of the presence or absence of HPV DNA on known prognostic factors was investigated. Although the influence of traditional factors, especially lymph node involvement, was confirmed, careful statistical analysis could not demonstrate a prognostic influence for HPV-16/18.


Superficial nuclear enlargement without koilocytosis as an expression of human papillomavirus infection of the uterine cervix: an in situ hybridization study. Nuclear enlargement of the superficial cervical epithelial cells in the absence of koilocytosis is frequently observed. The purpose of this study was to investigate whether this change represents human papillomavirus (HPV) infection. We reviewed 257 cervical biopsies with the diagnosis of "suggestive of condyloma," mild or moderate dysplasia, or both. Of the 257 consecutive biopsies, 23 fulfilled the two criteria: the superficial cells had a nuclear diameter of at least twice that of the basal nuclei, and complete absence of koilocytosis was seen. Parallel sections from each paraffin block were hybridized with biotinylated probes for HPV 6/11, 16/18, and 31/35/51 under high-stringency conditions. The cases that were negative at high-stringency conditions were then hybridized under low-stringency conditions with a mixture of the three HPV probes. Twelve of the 23 cases (52.17%) were positive for HPV, including one positive for HPV 16/18 in one area and for HPV 31/35/51 in another area, four positive for HPV 31/35/51, two positive for HPV 16/18, two positive for HPV 6/11, and three positive for HPV probe mixture at low-stringency conditions. The positive in situ hybridization was located predominantly in the enlarged nuclei in the superficial layers. In conclusion, HPV infection can be expressed as nuclear enlargement in the superficial layers of the cervical epithelium in the absence of koilocytosis.


Parity-related weight change in women.

Parity-related weight change in women. Pregnancy is thought to be a major contributor to the excess prevalence of obesity in women compared to men. Pregnancy-related increases in weight are purported to increase the risk that women will develop chronic diseases associated with high body weight. The assertion that pregnancy is associated with permanent weight gain and overweight was examined among 41184 post-menopausal women participating in a population-based study. Women reported lifetime parity, weight at ages 18, 30, 40 and 50 years, and current height. Body weight and body mass index (BMI) increased with age. On average, women gained 11.05 kg, or 0.35 kg per year between the ages of 18 and 50 years. Parity was associated with an increase in body weight from age 18 to 50 years of 0.55 kg per live birth, or 0.09 kg per live birth per year. At each age, women with lifetime parity of one or two live births had lower mean body weight and BMI, and a lower proportion overweight (BMI greater than 27 kg/m2), than either nulliparous women or those with three or more lifetime births. These results indicate a strong association between ageing and weight gain and a weak association between parity and both weight gain and overweight in women.


Adiposity in children: is mental retardation a critical variable? Several authors have suggested that obesity is more prevalent amongst children with mental retardation than non-mentally retarded children. However, studies on which this suggestion is based typically lack adequate control groups. The current research compared adiposity amongst mentally retarded versus non-mentally retarded children. Study 1 compared 110 mentally retarded children with 107 non-mentally retarded children (162 males, 61 females; age range 11 months-20 years). The independent (predictor) variables included IQ and mental retardation. Dependent (criteria) variables were BMI and age-corrected BMI. Study 2, using the National Health and Nutrition Examination Survey-II data bank compared 20 children with reported mental retardation with 4015 control children on three variables: BMI, age-corrected BMI, and subscapular to triceps skinfold ratio. Results of both studies found no significant difference in adiposity or body fat distribution between mentally retarded and non-mentally retarded children. Moreover, no significant difference emerged when either age or gender were controlled and no curvilinear or interaction effects were observed.


Taste responses and food preferences in obese women: effects of weight cycling. Taste preferences for sensory stimuli composed of sugar and fat are predictive of some food preferences and may help distinguish between potential subtypes of human obesity. A sample of 37 obese females was divided into high-flux and low-flux groups according to the magnitude of fluctuations in body weight. Variability in body weight is thought to be indicative of the weight cycling syndrome. The subjects tasted and rated five sucrose solutions in water and nine ice creams of varying sugar and fat content. Perceptions and preferences for sweet solutions were the same for both groups. In contrast, the high-flux group showed higher preferences for ice cream stimuli than did the low-flux group. High-flux females also rated sweet desserts higher on a food preference questionnaire than did low-flux females. Prior consumption of milkshake pre-loads did not affect preference ratings for sweet solutions. However, hedonic preferences for ice creams after pre-load consumption were reduced in the high-flux group. The weight cycling syndrome may be associated with elevated hedonic preferences for sweet and high fat foods.


How reliable is bio-electrical impedance analysis for individual patients? We performed bio-electrical impedance analysis (BIA) on 38 healthy adults with an initial body mass index (+/- s.d.) of 30 kg/m2 (+/- 5) before and after a low calorie diet. Five weeks later a mean weight loss of 4.2 +/- 2.3 kg was observed. According to BIA, fat-free mass (FFM) decreased in 28 subjects and increased in ten. In four cases the reduction was greater than the weight loss. At the end of the ten week diet regimen all 27 subjects followed up demonstrated a further weight reduction. According to BIA, FFM decreased in 22 subjects, increased in four and did not change in one case. In one case the reduction was greater than the weight loss. Although mean FFM values assessed by skinfolds and BIA were not significantly different before and after the weight loss period, no correlations were found among the individual changes in FFM evaluated by the two methods. Our results suggest that single frequency (50 KHz) impedance must be used with care in clinical conditions.


Body composition and the expiratory reserve volume of pre-pubertal lean and obese boys and girls. Previously, we examined the expiratory reserve volume (ERV) of the lungs as a function of percentage body fat in an adult population (age range 18-58 years). A negative correlation resulted when ERV (expressed as a percentage of vital capacity, (ERV/VC) x 100) was regressed on percentage fat for both sexes. In the present study, similar comparisons were made for 33 pre-pubertal boys and girls (aged 7-12.5 years). The regression equation for the boys ((ERV/VC) x 100 = 44.2 - 0.56%fat, r = -0.77, P = 0.002) was similar to that of the adult men ((ERV/VC) x 100 = 48.7 - 0.80 %fat, r = -78) and women ((ERV/VC) x 100 = 49.5 - 0.63 %fat, r = -0.70). However, the girls studied did not follow the same pattern. In this group of pre-pubertal girls, a significant increase in (ERV/VC) x 100 with increasing body fatness was seen ((ERV/VC) x 100 = 29.3 + 0.19 %fat, r = 0.48, P = 0.03). In all four groups, no correlation was seen with age or height. Whereas there was a significant correlation between weight and (ERV/VC) x 100 in the adults, no such relationship was evident in the younger subjects. In pre-pubertal obese girls limited upper body muscle development, perhaps as a result of limited physical activity, may explain the different relationship between ERV and body fatness.


Evidence for independent genetic influences on obesity in middle age. The National Heart, Lung, and Blood Institute (NHLBI) Twin Study provided longitudinal data on a cohort of 514 pairs of adult male twin pairs who were examined at approximate ages of 48, 57, and 63 years. Because the sample was selected from military veterans, height and weight data were also available from their induction physical examinations when they were approximately 20 years of age. From the total NHLBI Twin Study cohort, 124 monozygotic and 119 dizygotic male twin pairs had complete data available for both members of the pair at induction and three examinations spanning 43 years of adult life. Using these data, the contributions of genetics and shared and non-shared environmental factors to BMI over the 43 year period were estimated by model fitting procedures. Model fitting included both a factor decomposition of these effects as well as a developmental path model. Results from the decomposition procedure indicate significant genetic effects at each examination cycle. Fitting a developmental path model, two independent genetic contributions to the variability of BMI were found: one at, or prior to, the induction examination about age 20, and a second between ages 20 and 48. Significant non-shared environmental contributions at each examination were also indicated, but shared environmental effects were not significant. We conclude that cumulative genetic effects explain most of the tracking in obesity over time; non-shared environmental effects, although significant at each age, are relatively short-lived and make only a minor contribution to tracking.


Fasting respiratory exchange ratio and resting metabolic rate as predictors of weight gain: the Baltimore Longitudinal Study on Aging. The authors followed 775 men (aged 18-98 years) participating in the Baltimore Longitudinal Study in Aging for an average of ten years. Resting metabolic rate and fasting respiratory exchange ratio (RER) were measured by indirect calorimetry on their first visit and related to subsequent weight change. Deviations from the predicted value of resting metabolic rates (predicted from their estimated fat-free mass) were calculated. Average weight change was 0.07 kg (s.d. 6.4 kg); 122 men (15.3%) gained more than 5 kg and 40 (5.2%) more than 10 kg during the follow-up. After adjustment for initial age, body mass index, fat-free mass, and duration of follow-up, RER, but not RMR or deviations from predicted RMR, was positively related to weight change (P less than 0.001). Major weight gain (from at least 5 kg to at least 15 kg) was related to initial RER in non-obese men only (initial body mass index less than 25 kg/m2). From Cox proportional hazard regression analyses the adjusted relative risk of gaining 5 kg or more in initially non-obese men with a fasting RER of 0.85 or more was calculated to be 2.42 (95% confidence interval: 1.10-5.32) compared to men with a fasting RER less than 0.76. It was concluded that a relatively high fasting RER is a weak but significant predictor of substantial weight gain in non-obese white men.


Changes in fat-free mass in obese subjects after weight loss: a comparison of body composition measures. Estimates of body composition by densitometry were made in 84 apparently healthy subjects (42 men, 42 women) with a mean age of 40 +/- 6 years (mean +/- s.d.), before and after weight loss. The initial body mass index (BMI) was 30.7 +/- 2.3 kg/m2 and the achieved weight loss on a 4.2 MJ/day energy deficit diet for 13 weeks was 12.2 +/- 3.7 kg. The results by densitometry were compared with estimates obtained by four other techniques: deuterium oxide dilution, skinfold thickness, bioelectrical impedance (three equations) and BMI (two equations). The fat-free mass (FFM) loss estimated by densitometry in men and women was 2.8 +/- 1.8 kg and 1.3 +/- 1.3 kg respectively. The dilution technique gave comparable results with densitometry. The losses of FFM assessed by skinfold thicknesses, BMI and impedance equations were almost similar, but significantly larger than the reduction in FFM measured by densitometry. These deviations were mainly the result of significantly larger differences from densitometry before compared to after weight loss. No correlation was found between change in FFM by densitometry and change in resistance measured by the bioelectrical impedance method in both sexes. It is concluded that application of published prediction formulae in weight loss studies are less appropriate and will lead to changes in FFM that are significantly different from the changes estimated by densitometry or deuterium oxide dilution.


Association of obesity and distribution of obesity with glucose tolerance and cardiovascular risk factors in the elderly. The association of obesity and fat distribution with glucose tolerance and cardiovascular risk factor levels were investigated in a population-based study in East Finland including 396 non-diabetic men and 673 women aged from 65 to 74 years. Obese men and women (BMI greater than 27 kg/m2) had higher levels (P less than 0.001) of fasting and 2 h plasma glucose and insulin as well as total triglycerides and diastolic blood pressure, and lower levels of HDL cholesterol than normal weight men and women. Central fat distribution (the highest vs. the lowest tertile of waist-hip ratio) was associated independently of obesity with high fasting glucose (5.7 vs. 5.5 mmol/l in non-obese subjects, 5.9 vs. 5.7 mmol/l in obese subjects, P less than 0.05) and insulin levels (13.7 vs. 10.6 mU/l in non-obese subjects, 18.4 vs. 15.6 mU/l in obese subjects, P less than 0.01) and with adverse changes (P less than 0.05) in lipid and lipoprotein levels (triglycerides: 1.59 vs. 1.41 mmol/l in non-obese subjects, 1.92 vs. 1.69 mmol/l in obese subjects; HDL cholesterol: 1.33 vs. 1.43 mmol/l in non-obese subjects, 1.20 vs. 1.32 mmol/l in obese subjects). There were no marked differences in metabolic aberrations related to obesity between men and women. However, the association between waist-hip ratio and risk factors was non-linear in men whereas it was linear in women. In conclusion, obesity per se rather than its distribution was a more significant determinant of glucose and insulin as well as total triglyceride and HDL cholesterol levels in elderly subjects.


Childhood body mass index--genetic and familial environmental influences assessed in a longitudinal adoption study. Studies of twins and adoptees have shown that the resemblance of adult family members in body mass index (weight/height2) is due more to shared genes than to shared rearing environment. In the present adoption study we assessed the genetic and environmental influences on body mass index in childhood. Among 3651 adult Danish adoptees we selected 840, comprising thin, medium weight, overweight, and obese groups, and for 269 of them we obtained height and weight measured at school health examinations at ages 7-13 years. The correlation in body mass index between the adoptees at these ages and their biological and adoptive relatives as well as among these relatives were estimated. The correlations were stable across the ages 7-13 years. The average correlation of adoptees with biological mothers was 0.17 (95% confidence limits: 0.03, 0.31), with biological fathers, 0.16 (0.00, 0.32), and with biological full siblings at same ages, 0.59 (0.28, 0.90). These correlations were comparable to the correlations within the biological families and comparable to the previously reported correlations for adult adoptees. The correlations with members of the adoptive families were lower--with adoptive mothers, 0.10 (-0.03, 0.23), with adoptive fathers, 0.03 (-0.11, 0.17), and with adoptive siblings, 0.14 (-0.13, 0.41). In conclusion, a genetic influence on body mass index as strong as that in adult life is already expressed by age 7 years. The rearing environment shared by the family has a weak influence during childhood.


Effect of electrophilic and nucleophilic substituents on the protonation microequilibria of tyrosine derivatives. The microscopic protonation constants of 10 tyrosine-like, unusual amino acids used in the syntheses of opioid peptides have been determined by using a combined pH-metric-spectrophotometric method, at 0.10 mol dm-3 (NaCl) ionic strength and 25.0 degrees. The role of the different electrophilic and nucleophilic substituents on the individual basicity of the aliphatic amine and phenolic hydroxylate basic centers is discussed in detail. The interactivity parameters between these two groups correlate fairly well with the structure of the skeleton and the distance between the two basic centers, but they were found to be substituent-independent. This finding made it possible to extend the calculations to compounds having non-overlapping protonation equilibria.


Assessment of delta-opioid receptor activation by a series of peptides in cultured cells. This study was designed to investigate the relative ability of a series of cyclic opioid peptides to initiate the first activation steps following their binding of delta-opioid receptors. The extent of stimulation of low Km guanosine-triphosphatase (GTPase activity) and inhibition of hormonally-stimulated cAMP accumulation in the NG108-15 (neuroblastoma-glioma) hybrid cell line were determined and compared for six closely related peptides. In addition, their binding affinity was assessed by competition with 3H-[D-Pen2D-Pen5]-enkephalin (3H-DPDPE) in membranes from these cells. All peptides tested elicited comparable maximal effects for both functional responses. Different potencies in stimulating the low Km GTPase was observed at sub-maximal agonist concentrations, although the shallow dose-response behavior did not allow accurate determination of ED50s. Estimation of ED50s for inhibition of cAMP accumulation could be made by curve fitting and were similar for four of these peptides, while DCDPE and 3R-methylDCDPE, the highest affinity analogs, were considerably more potent. In general, the observed differences in hormonal activity somewhat parallel the rank order of binding affinities, but no strict relationship was found between receptor binding and activation.


Conformation of a neurokinin antagonist in solution. 2D NMR and restrained molecular dynamics study. The hexapeptide [cyclo(Leu1 psi(CH2NH2)Leu2-Gln3-Trp4-Phe5-Gly6)]+1 is a potent antagonist of neurokinin A activity in tissues of hamster urinary bladder. The solution conformation of this cyclic hexapeptide has been characterized by the combined use of two dimensional nuclear magnetic resonance spectroscopy and restrained molecular dynamics. The proton spectrum of the peptide was fully assigned by the sequential assignment procedure. Interproton distances were derived from crosspeak volumes in two dimensional Nuclear Overhauser Effect spectra, and dihedral angles were calculated from appropriate coupling constants. Temperature coefficients of the amide protons were determined. Restrained molecular dynamics simulations were carried out using the backbone interproton distances as constraints. During 210 ps of restrained molecular dynamics the peptide interconverted among three closely related families of conformations. These interconversions occurred at picosecond timescales under the simulation conditions.


Design of chimeric peptide ligands to galanin receptors and substance P receptors. Several chimeric peptides were synthesized and found to be high-affinity ligands for both galanin and substance P receptors in membranes from the rat hypothalamus. The peptide galantide, composed of the N-terminal part of galanin and C-terminal part of substance P (SP), galanin-(1-12)-Pro-SP-(5-11) amide, which is the first galanin antagonist to be reported, recognizes two classes of galanin binding sites (KD(1) less than 0.1 nM and KD(2) approximately 6 nM) in the rat hypothalamus, while it appears to bind to a single population of SP receptors (KD approximately 40 nM). The chimeric peptide has higher affinity towards galanin receptors than the endogenous peptide galanin-(1-29) (KD approximately 1 nM) or its N-terminal fragment galanin-(1-13) (KD approximately 1 microM), which constitutes the N-terminus of the chimeric peptide. Galantide has also higher affinity for the SP receptors than the C-terminal SP fragment-(4-11) amide (KD = 0.4 microM), which constitutes its C-terminal portion. Substitution of amino acid residues, which is of importance for recognition of galanin by galanin receptors, such as [Trp2], in the galanin portion of the chimeric peptide or substitution of ([Phe7] or [Met11]-amide) in the SP portion of chimeric peptide both cause significant loss in affinity of the analogs of galantide for both the galanin- and the SP-receptors. These results suggest that the high affinity of the chimeric peptide, galantide, may in part be accounted for by simultaneous recognition/binding to both receptors.(ABSTRACT TRUNCATED AT 250 WORDS)


Tongue gastric choristoma: failure to localize by technetium-99m pertechnetate scan. Congenital rests of gastric epithelium have been reported in a variety of head and neck locations. Presenting symptoms of these lesions range from an asymptomatic cyst to one which is compromising the airway. The true diagnosis is rarely suspected prior to excision. A case of a gastric choristoma of the tongue is presented which was noted at birth as an intermittently bleeding ulcer. Complete excision of the mass was difficult to ascertain due to poor delineation of the tumor margins from the tongue musculature. A postoperative technetium-99m pertechnetate scan failed to demonstrate residual gastric mucosa. Conservative management resulted in only transient healing of the ulcer. Repeat excision demonstrated abundant residual gastric mucosa. Technetium-99m pertechnetate scanning may not be a reliable indicator of ectopic gastric mucosa in the head and neck region.


A case of congenital angiofibroma.

A case of congenital angiofibroma. A case of angiofibroma affecting the right maxilla of a new born baby is presented with histological evidence. We believe this to be the first congenital case of this condition to have been reported.


Inhibitory effect of theophylline, theophylline-7-acetic acid, ambroxol and ambroxol-theophylline-7-acetate on rat lung cAMP phosphodiesterase isoenzymes. It is assumed that theophylline (THEO) and its xanthinic derivatives inhibit lung phosphodiesterase (PDE) and block adenosine receptors in the induction of bronchodilatation. Since the theophyllinic compound ambroxol-theophylline-7-acetic acid (ATA) has been shown in vivo to be a sound bronchodilator, this paper compares the action of ambroxol-theophylline-7-acetate (ATA), its two components, theophylline-7-acetic acid (TAA) and ambroxol (AMB), and theophylline (THEO) on the hydrolytic activity of three rat-lung cAMP PDE (types I, III and IV) and on striatal adenosine receptors. THEO inhibited all three isoenzymes with equal intensity, whereas ATA was as powerful but inhibited types III and IV only, on which AMB and TAA also showed lower effects. Lastly, unlike THEO, ATA and its two components were unable to antagonize adenosine receptors. Taken as a whole, these results suggest that the bronchodilating activity of ATA is the result of specific inhibition of particular forms of PDE and is thus more specific than that of THEO alone.


Germ cell testicular tumours with lung metastases: chemotherapy and surgical treatment. Eighty patients with stage IV testicular germ cell tumours with lung metastases were treated with PVB chemotherapy and subsequent surgery in cases of residual disease. Out of 80 patients 28 (35%) achieved complete response following chemotherapy alone. Thirty-six patients (45%) with partial response underwent surgery: 17 had lymphadenectomy because of residual mass in the retroperitoneum, 15 had pulmonary surgery alone and 4 had both operations. Of these 36 patients 27 achieved complete response following cytostatic and surgical treatment. Sixteen patients died following PVB chemotherapy, 10 of them due to progression of disease, and there were six (7.5%) drug-related deaths. The authors refer to the importance of surgical treatment of residual metastatic mass in the lungs following PVB chemotherapy. Germ cell tumours of the testis are the most curable solid neoplasms treated by the oncologist. Advances in their management are due to the introduction of cisplatin-based combination chemotherapy and surgical removal of the residual mass [8]. Progress in chemotherapy of testicular tumours has changed the attitude towards thoracotomy and surgical removal of lung metastases. The aim of this study is to evaluate combined cytostatic and surgical treatment of disseminated testicular tumours with emphasis on surgical removal of residual lung metastases following chemotherapy.


A study of possible causal relations between squamous cell carcinoma of the penis and carcinoma of the cervix uteri. The authors investigated 26 regular sexual female partners of 24 men with squamous cell carcinoma of the penis. Neoplasms were diagnosed in 6 (23.1%) of the total of 26 women. STDs were found in 6 (23.1%) women. In 2 the cytologic findings on the cervix were classified as PAP III (PAP IIIa-CIN I, PAP IIIb-CIN III). Squamous cell carcinoma of the uterine cervix was found in 2 women (1 case PAP IV-CIN III; 1 case PAP V-suggestive of invasive carcinoma). Endometrial adenoacanthoma, mammary adenocarcinoma, squamous cell carcinoma of the right hand and non-Hodgkin's malignant lymphoma (centroblastic) were found in 1 case each.


Role of surgery in ductal carcinoma of the pancreas. Data of 111 patients with ductal carcinoma of the pancreas examined over a decade (1979-1989) at the 1st Department of Surgery, "La Sapienza" University of Rome, are presented. 21.6% of them underwent pancreatic resection and 40.5% biliodigestive diversion. Resectability was 26.5% for tumors of the head, 11.8% for tumors of the body and tail, nil for diffuse tumors. Overall operative mortality was 13.5%. Only stage I patients were shown to be resectable for cure and benefited from surgery with 21% probability of 5-year survival.


Intracellular pH regulation in fresh and cultured bovine corneal endothelium. I. Na+/H+ exchange in the absence and presence of HCO3-. A detailed comparison of intracellular pH (pHi) regulatory mechanisms was made between fresh (FBCE) and cultured (CBCE) bovine corneal endothelium to: (1) identify the ion transport mechanisms that could directly or indirectly affect transendothelial HCO3- transport; and (2) determine if cultured cells could serve as a model for studying transendothelial bicarbonate transport. We used the pH-sensitive fluorescent probe BCECF-AM to measure pHi. FBCE and CBCE readily incorporated the dye and showed pHi calibration curves that were not significantly different with respect to pK (7.39 for FBCE and 7.35 for CBCE). Resting pHi in bicarbonate free Ringer's (pH 7.5) was significantly lower in cultured cells (7.17 +/- .02, n = 50) than in fresh cells (7.30 +/- .02, n = 54). Steady-state pHi was reduced by addition of 0.5 mmol/l amiloride, a Na+/H+ exchange blocker (-.16 pH U for FBCE, -.18 for CBCE) or removal of Na+ (-.47 pH U for FBCE, -.51 for CBCE). Recovery from an (NH4)2SO4-induced acid load was blocked by Na+ removal, and the rate of recovery was inhibited 74% and 79% in the presence of amiloride for FBCE and CBCE, respectively. The dependence of proton efflux on Na+0 showed simple saturating kinetics (apparent Km = 30 and 31 mmol/l for FBCE and CBCE, respectively), consistent with the presence of Na+/H+ exchange in FBCE and CBCE. Na+/H+ exchange activity, as measured by amiloride-sensitive acid recovery, was inversely proportional to pHi. The activity in FBCE was about twice that in CBCE. Furthermore, the zero flux point for Na+/H+ exchange was at least 0.1 pH U higher in FBCE. Changing from bicarbonate-free Ringer's to bicarbonate Ringer's (5% CO2/28 mmol/l HCO3-, pH 7.5) induced a rapid and short acidification followed by an alkalinization .09 and .18 pH U above the starting pHi for FBCE (final pHi 7.37) and CBCE (final pHi 7.33), respectively. This transition was unaffected by amiloride. Similarly, amiloride had no effect on resting pHi in bicarbonate Ringer's for FBCE or CBCE, indicating that Na+/H+ exchange does not contribute to the maintenance of the steady-state resting pHi in bicarbonate Ringer's. Although most of the characteristics of Na+/H+ exchange for FBCE and CBCE were similar, the differences in overall activity and the low levels of activity in resting cells must be considered when using CBCE to model ion coupled fluid transport in BCE.


cAMP production via the adenylyl cyclase pathway is reduced in RCS rat RPE. cAMP production was investigated in retinal pigment epithelium (RPE) cells isolated from normal rats and from rats with an inherited retinal dystrophy (Rdy/p+). In normal RPE cells, 5'-[N-Ethylcarboxamido]-adenosine (A2 receptors) produced a fivefold increase in the level of cyclic adenosine monophosphate (cAMP) over basal levels. However, only a onefold increase in cAMP was observed in dystrophic cells. cAMP production by prostaglandins E1 and E2 (prostaglandin receptors) in dystrophic RPE cells was only 29-38% of the level observed in normal cells. Direct stimulation of adenylyl cyclase by 10 mumol/l forskolin increased cAMP levels in normal RPE cells by 90 fold over basal, but only by sixfold in the dystrophic cells. These data suggest there may be a defect in the adenylyl cyclase signaling pathway in dystrophic RPE cells.


Aqueous humor messengers in the transient decrease of intraocular pressure after ganglionectomy. Intraocular pressure (IOP) decreases in rabbits 1 day after superior cervical ganglionectomy. It was hypothesized that this IOP decrease was caused by an accumulation of norepinephrine (NE) released from the iris-ciliary body into the aqueous humor during nerve degeneration. Direct measurement of aqueous humor NE concentration, however, was not successful because of the technical difficulty. In the current study, aqueous humor NE after superior cervical ganglionectomy was extracted and quantified using high-performance liquid chromatography-electrochemical detection. Twelve New Zealand albino rabbits were maintained in a daily 12-hr light-12-hr dark environment. Unilateral ganglionectomy was done on these rabbits during the light phase under halothane anesthesia. Twenty-two hours after the procedure, a significant IOP decrease occurred. The IOP was 16.1 +/- 0.6 mmHg (mean +/- the standard error of the mean) in the operated eye and 20.9 +/- 0.6 mmHg in the contralateral eye (P < 0.01). Aqueous humor NE concentration in the operated eye (475 +/- 81 pg/ml) was not different from that in the contralateral eye (469 +/- 58 pg/ml). However, the concentration of aqueous humor cyclic adenosine monophosphate (cAMP) in the operated eye (29.8 +/- 6.8 pmol/ml) was significantly higher (P < 0.05) than that in the contralateral eye (11.7 +/- 0.8 pmol/ml). These data indicate that aqueous humor NE per se does not cause the transient IOP decrease after superior cervical ganglionectomy and cAMP-mediated ocular activities may be involved in this change in IOP.


Prostanoid-induced relaxation of precontracted cat ciliary muscle is mediated by EP2 and DP receptors. The pharmacology of prostanoid-induced relaxation of the precontracted cat ciliary smooth muscle was characterized using synthetic prostaglandin (PG) analogues that are selective for specific prostanoid receptors. Relaxation was studied using carbachol to precontract the isolated longitudinal ciliary muscle, followed by application of the PG agonist. Of the compounds studied, PGE2 was the most potent relaxant (concentration that produced 50% of maximum relaxation, 10(-7) mol/l), and its maximal effect in each preparation was used as a standard for comparison. Both PGD2 and PGF2 alpha produced relaxations that were approximately 30- and 100-fold weaker, respectively, than those produced by PGE2. Prostanoids with activity at the EP2 (19-(R)-hydroxy PGE2 and 11-deoxy PGE1) and DP (BW 245C) receptors potently relaxed the ciliary muscle. Other EP receptor subtypes and the TP receptor were not involved as indicated by the lack of relaxant activity of sulprostone (EP3 > EP1), MB 28767 (EP3 > TP), and U-46619 (TP). Although 17-phenyl trinor PGE2 (EP1 and EP3) and PGI2 (IP) had some activity, it occurred at a nonselective dose (10(-4) mol/l). The presence of DP receptors in the cat ciliary muscle was confirmed by using BW A868C, a selective DP-receptor antagonist. This drug (concentration, 1 mumol/l) displaced the relaxant effects of PGD2 but had no effect on the activities of PGE2 and 11-deoxy PGE1. In addition, 17-phenyl trinor PGF2 alpha (FP) was inactive, indicating that the FP receptor was not involved in ciliary muscle relaxation.(ABSTRACT TRUNCATED AT 250 WORDS)


Radiographic analysis of an investigational hydroxyapatite-coated total hip replacement. The impetus to discover cementless techniques for fixing implants to bone is the result of the high failure rates of cemented arthroplasty in young, active patients. The application of hydroxyapatite (HA) to implants represents an alternative. The purpose of this investigation is to define the early radiographic pattern of an HA femoral stem and compare this definition with an identical stem without the HA treatment. Radiographic analysis was performed on 98 hips: 63 HA stems and 35 non-HA stems, with a 1-year follow-up. Radiographic parameters analyzed included: 1) radiolucent line formation; 2) endosteal bone formation; 3) calcar response; 4) periosteal bone formation; 5) heterotopic bone formation; 6) stem subsidence; and 7) quality of fit. The HA stem demonstrated greater proximal endosteal sclerosis and distal radiolucency (P < .001). The non-HA (control) stem demonstrated greater proximal and distal radiolucency (P < .02) and distal endosteal sclerosis (P < .001). The HA pattern suggests proximal load transference and bony fixation. The control pattern suggests distal loading and fixation, in addition to motion between the stem and native femur. These patterns indicate an advantage of the HA fixation over traditional implants.


[A rare metabolic disease: alkaptonuria--ochronosis]. The authors describe the case of a 40-year-old female patient. Since childhood her urine had caused black discoloration on her underwear. For about a year the skin of the axillae and pinnae had been bluish-black without subjective complaints. One year before admission, pain in the thoracic and lumbar spine began, with limitation of motion. Examination of the urine, histological and electron microscopical findings, and X-ray examination of the spinal column confirmed the diagnosis of alkaptonuria and congenital ochronosis.


Some thoughts on the "unattached" fraction of radon decay products. A problem exists in the meaning and use of the term "unattached fraction" to describe the highly diffusive portion of the airborne radon progeny. The term was originally developed to aid in lung dosimetry but now that more detailed size measurements can be made, there are ambiguities in its definition between a physical size basis and a dosimetric definition. Some possible ways to resolve these ambiguities are presented and discussed. It is suggested that the term only be used in the context of complete size information rather than as the conventional operationally defined term.