A comparison study of the reference curves of bone mineral density at different skeletal sites in native Chinese, Japanese, and American Caucasian women

To understand the differences among reference curves for bone mineral density (BMD) for Chinese, Japanese, and American Caucasian women, we measured the BMD at the anteroposterior (AP) lumbar spine (L1-L4), lateral lumbar spine (L2-L4), hip (including the femoral neck, trochanter, intertrochanter, Ward's triangle, and total hip), and ultradistal forearm by the dual-energy X-ray absorptiometry (DXA) in a total of 2728 healthy Chinese women, aged 5-96 years. Documented BMD data for Japanese women and device manufacturer's BMD new reference databases (including the NHANES III dataset) for American Caucasian women were also used in this study. The cubic regression model was found to fit best in analyzing the age-associated variations of BMD at various sites in Chinese women, i.e., the equations had the largest coefficient of determination (R2). At the AP/Lat spine, trochanter, intertrochanter, and Ward's triangle, BMD reference curves for Chinese women were lower than those for Japanese or Caucasian women, while at the femoral neck, total hip, and ultradistal forearm, the reference curves for Chinese women were higher than those for Japanese women, with overlaps and crossing of the curves for some age spans in comparing the Chinese and Caucasian women. There were significant differences in the peak BMD (PBMD) at various sites among the Chinese, Japanese, and Caucasian women (P = 0.000). The PBMDs for Chinese women at the lumbar spine and various sites of the hip were 5.7% +/- 2.1% (mean +/- SD, range, 2.7-7.9%) lower than those for Japanese women and 5.1% +/- 2.7% (range, 0.5-7.2%) lower than those for Caucasian women; however, the PBMDs for Chinese women were 26.2% higher than those for Japanese women and 10% higher than those for Caucasian women at the ultradistal forearm. After the PBMD, average T-scores of Chinese women for losses at the AP lumbar spine with increasing age were nearly identical to those for Japanese women, but both were greater than those for Caucasian women. The average T-scores for BMD loss at various sites in Chinese women were higher than those for both Japanese and Caucasian women except at the femoral neck, where the T-scores of Chinese women were exceeded by those of both Japanese and Caucasian women. Estimated from the T-score curve of BMD loss, the age of osteoporosis occurrence at the femoral neck in Chinese women was about 10 years later than that in Japanese or Caucasian women; at the AP spine, Chinese women were similar to Japanese women; at the other sites, the age for occurrence of osteoporosis in Chinese women was about 5-15 years earlier than that in either Japanese or Caucasian women. There are differences in prevalence or odds ratio (OR) of osteoporosis at the same skeletal region for Chinese, Japanese, and Caucasian women aged > or = 50 years or at different skeletal regions in women of the same race. The prevalences of osteoporosis at various regions of the hip in Chinese women are 10.1-19.8% and ORs are 22.0-32.3, of which prevalence at the femoral neck is the lowest (10.1%); the prevalences of osteoporosis in Japanese women are 11.6-16.8% and ORs are 21.1-26.3, of which prevalence at the femoral neck is the lowest (11.6%); and the prevalences of osteoporosis in Caucasian women are 13.0-20.0% and ORs are 19.4-48.9, of which prevalence at the femoral neck is the highest (20%). In conclusion, racial differences in BMD reference curves, prevalences, and risks of osteoporosis at various skeletal sites exist among native Chinese, Japanese, and American Caucasian women.

[Observation on the infectivity of different densities of Plasmodium vivax to Anopheles sinensis]

AIM

To study the infectivity of different densities of P. vivax to An. sinensis.

METHODS

Venous blood samples from 38 volunteers artificially infected with P. vivax of South-Yunnan collected at the time of initial parasitaemia, primary attack and relapse, were used to infect Anopheles sinensis by feeding on parasitaemia blood in vitro. The finding of oocysts in the mid-gut of the mosquito by microscope was taken as criteria of positive infection.

RESULTS

P. vivax in the initial parasitaemia did not infect the mosquito. In the cases of primary attack, when the density of parasite was more than 100/microliter blood, the infectivity and intensity rose with the prolongation of the course of the disease and the increase in the density of the parasite. The infectivity of the P. vivax in the relapse cases was higher than in the primary attack cases, the mosquitoes could be infected at a parasite density of 1/microliter blood. The mosquitoes acquired a higher infection rate, a higher positive rate of mosquito mid-gut and a higher oocyst index in the primary attack cases whose parasite density were higher than 1,000/microliter blood and in the relapse cases whose parasite density were higher than 100/microliter blood.

CONCLUSION

The P. vivax in the period of clinical attack was one of the most dangerous period of the spread of malaria. The cases of relapse were the more dangerous infective sources in malaria transmission.

Two case reports of pituitary adenoma associated with Toxoplasma gondii infection

The involvement of the pituitary in cases of toxoplasmosis has been described in the literature only rarely. This is the first report to describe pituitary adenoma in association with Toxoplasma gondii infection. The two patients were 43 and 19 year old women. Radiological examination revealed tumours in the sellar region. Microscopically, the tumours consisted of small homogeneous polygonal or round cells. Toxoplasma cysts were found among the tumour cells, a finding confirmed by Toxoplasma gondii specific antibody immunohistochemistry. The association between pituitary adenoma and toxoplasma raises the possibility that T gondii might be involved in the development of certain cases of pituitary adenoma.

Congou tea drinking and oesophageal cancer in South China

The study from a large hospital-based case-control for 1248 cases with oesophageal cancer and the same number of controls in South China showed that Congou, a grade of Chinese black tea, may protect against cancers of the oesophagus and reduce the risk of a combination of alcohol drinking and smoking (especially smoking), regardless of temperature when drinking.

A novel Notch ligand, Dll4, induces T-cell leukemia/lymphoma when overexpressed in mice by retroviral-mediated gene transfer

Notch receptors mediate cell-fate decisions through interaction with specific ligands during development. The biological role of a novel Notch ligand, Dll4, in mice was explored by reconstituting lethally irradiated mice with bone marrow (BM) cells transduced with Dll4 retroviral vector. White blood cell and lymphocyte counts in Dll4-overexpressing mice were reduced at the early stage of reconstitution but increased significantly at approximately 10 weeks after BM transplantation. BM, spleen, lymph nodes, and peripheral blood of Dll4-overexpressing mice contained predominantly CD4(+)CD8(+) T cells and virtually lacked B cells. The Dll4-overexpressing mice eventually developed a lethal phenotype that was characterized by the progression of a T-cell lymphoproliferative disease (restricted to BM and lymphoid tissues) to transplantable monoclonal T-cell leukemia/lymphoma scattered to multiple organs. Results suggest that the interaction of Dll4 with Notch1 may provide key signals for T-cell development.

[Construction of a subtracted cDNA library of differentially expressed genes in human normal liver tissue and primary hepatocellular carcinoma tissue]

OBJECTIVE

To construct a subtracted cDNA library of differentially expressed genes in human normal liver tissue and primary hepatocellular carcinoma (HCC) tissue.

METHODS

Using the suppression subtractive hybridization (SSH), a novel technique has been described recently. cDNA fragments of missing or low expressing tumor suppressor genes in HCC tissue were isolated using paracancerous normal liver tissue and HCC tissue as targets. Then these cDNA fragments were directly inserted into T/A cloning vector to set up the subtractive library. Amplification of the library was carried out with transformation of E.coli by high voltage electroperforation. One hundred positive bacteria clones were randomly picked and identified using enzyme restriction method.

RESULTS

The amplified library contained more than 4,000 positive bacteria clones. Random analysis of 100 clones with enzyme restriction method showed that all clones contained 200-600 bp inserts.

CONCLUSIONS

A subtracted cDNA library of differentially expressed genes in human normal liver tissue and HCC tissue is constructed successfully with SSH and T/A cloning techniques. The library is efficient and lays solid foundation for screening and cloning new and specific missing or low expressing tumor suppressor genes of HCC.

[Study of peak expiratory flow in normal young, middle-aged and old persons in Chengdu area]

OBJECTIVE

To build the normal ranges and regression equations of peak expiratory flow (PEF) in normal young, middle-aged and old persons.

METHODS

PEF, FVC, V75, V50, V25 were measured in 393 normal young, middle-aged and old persons with the youngest aged 20 years and the eldest 84 years. Regression equations of PEF were built for younger group (20 yr-49 yr) and elder group (50 yr-84 yr) respectively.

RESULTS

PEF, FVC, V75, V50, V25 were decreased with increase of age. The regression equations showed that both in younger and elder groups, PEF was negatively correlated with age in male (P < 0.0001-0.002, r = 0.32-0.39) and positively correlated with FVC in female (P < 0.0001-0.0005, r = 0.32-0.59). PEF was highly correlated to V75 with r = 0.87-0.94 in male and r = 0.93-0.96 in female. The coefficient of variation (CV) of PEF was in normal range (16%-24%) for all age groups except male and female above 70 years old with CV of 30% and 27% respectively. This confirmed the data was reliable.

CONCLUSION

The normal ranges and regression equations of PEF constructed as a result of this study for normal humans of 20-84 years old can be put to use in clinical work and public health.

Aspirin as an adjunct to screening for prevention of sporadic colorectal cancer. A cost-effectiveness analysis

BACKGROUND

Aspirin may decrease colorectal cancer incidence, but its role as an adjunct to or substitute for screening has not been evaluated.

OBJECTIVE

To examine the potential cost-effectiveness of aspirin chemoprophylaxis in relation to screening.

DESIGN

Markov model.

DATA SOURCES

Literature on colorectal cancer epidemiology, screening, costs, and aspirin chemoprevention (1980-1999).

TARGET POPULATION

General U.S. population.

TIME HORIZON

50 to 80 years of age.

PERSPECTIVE

Third-party payer.

INTERVENTION

Aspirin therapy in patients screened with sigmoidoscopy every 5 years and fecal occult blood testing every year (FS/FOBT) or colonoscopy every 10 years (COLO).

OUTCOME MEASURES

Discounted cost per life-year gained.

RESULTS OF BASE-CASE ANALYSIS

When a 30% reduction in colorectal cancer risk was assumed, aspirin increased costs and decreased life-years because of related complications as an adjunct to FS/FOBT and cost $149 161 per life-year gained as an adjunct to COLO. In patients already taking aspirin, screening with FS/FOBT or COLO cost less than $31 000 per life-year gained.

RESULTS OF SENSITIVITY ANALYSIS

Cost-effectiveness estimates depended highly on the magnitude of colorectal cancer risk reduction with aspirin, aspirin-related complication rates, and the screening adherence rate in the population. However, when the model's inputs were varied over wide ranges, aspirin chemoprophylaxis remained generally non-cost-effective for patients who adhere to screening.

CONCLUSIONS

In patients undergoing colorectal cancer screening, aspirin use should not be based on potential chemoprevention. Aspirin chemoprophylaxis alone cannot be considered a substitute for colorectal cancer screening. Public policy should focus on improving screening adherence, even in patients who are already taking aspirin.

[The effect of monocarboxylate transporter gene on the regulation of pHi and growth character in cancer cells]

OBJECTIVE

To study the influence of the first subtype of monocarboxylate transporter (MCT1) gene on pHi regulation, lactate transport and cell growth in tumor cells.

METHODS

(1) With RT-PCR technique, MCT1 cDNA fragment was cloned from human lung cancer cells A549, and the cloned fragment MCT1 was reversely inserted into the vector pLXSN to acquire antisense expression recombinant vector pLXSN-MCT1. (2) pLXSN, pLXSN-MCT1 were respectively introduced into the A549 cells by electroporation. The transfected A549 cell resistant to G418 drug was selected as positive clones and proved by PCR. The changes of intracellular pH and lactate in the transfected A549 cells were detected by spectrophotometric method. Cell growth was studied by cell growth curve.

RESULTS

(1) The cloned fragment was in the length of 640 bp and successfully bound to pLXSN. It was also proved to be the objective one by DNA sequencing. (2) Intracellular pH and lactate were remarkably decreased in the cells transfected pLXSN-MCT1, comparing to A549 cells without transfection (P < 0.001). The growth of A549 cells transfected pLXSN-MCT1 was also inhibited remarkably.

CONCLUSION

MCT1 gene could play an important role in pHi regulation, lactate transport and cell growth in tumor cells.

Osteoclast clearance from periodontal tissues during orthodontic tooth movement

The presence of osteoclasts at locations of alveolar bone remodeling is antecedent to orthodontic tooth movement. Cell recruitment and clearance are the mechanisms by which osteoclast populations are regulated. Research in other tissues has revealed that many cells die after their functional lives are past by a process called apoptosis, or programmed cell death. The purpose of this study was to examine the role of apoptosis in osteoclast clearance at orthodontically treated sites as a function of time and location. Orthodontic appliances were placed on 96 rats of the Sprague-Dawley strain. The rats were assigned to either treatment or sham (control) groups and killed 1, 3, 5, and 7 days after appliance placement. Tissue samples were prepared for histochemical evaluation and quantification of morphologic features. Tartrate-resistant acid phosphatase (TRAP) and ApopTag (TdT-mediated dUTP-biotin nick 3' end labeling) stains were used to identify osteoclasts and committed preosteoclasts and to discriminate between apoptotic and nonapoptotic nuclei. Pyknotic nuclei and apoptotic bodies were also counted as a morphologic assessment of apoptosis. The percentages of TRAP/ApopTag-positive nuclei were measured in 4 different periodontal regions. There was a highly significant difference in the overall percentage of TRAP/ApopTag-positive nuclei between the control and the treatment groups at 3, 5, and 7 days (P <.001). Morphologic criteria were also statistically different at days 5 and 7 (P <.05). These data strongly suggested that osteoclasts recruited for orthodontic tooth movement are, at least in part, cleared by apoptosis.

Nonlinear modulation of multidimensional lattice waves

The equations governing weakly nonlinear modulations of N-dimensional lattices are considered using a quasidiscrete multiple-scale approach. It is found that the evolution of a short wave packet for a lattice system with cubic and quartic interatomic potentials is governed by the generalized Davey-Stewartson (GDS) equations, which include mean motion induced by the oscillatory wave packet through cubic interatomic interaction. The GDS equations derived here are more general than those known in the theory of water waves because of the anisotropy inherent in lattices. The generalized Kadomtsev-Petviashvili equations describing the evolution of long-wavelength acoustic modes in two- and three-dimensional lattices are also presented. Then the modulational instability of an N-dimensional Stokes lattice wave is discussed based on the N-dimensional GDS equations obtained. Finally, the one- and two-soliton solutions of two-dimensional GDS equations are provided by means of Hirota's bilinear transformation method.

[Evidence for retinoic acid modulating expression of cyclin-dependent kinase inhibitors in rat hepatic stellate cells]

OBJECTIVE

To study the effects of retinoic acid on regulation of expressions of cyclin-dependent kinase inhibitors, i.e. p16, p21 and p27 in cultured rat hepatic stellate cells.

METHODS

Stellate cells were isolated from healthy rat livers and cultured. After stimulated with 1 ng/ml transforming growth factor beta 1, subcultured hepatic stellate cells were treated with or without 1 nmol/ml retinoic acid. MTT assay, immunocytochemistry for p16, p21, p27 and alpha-smooth muscle actin protein, in situ hybridization for retinoic acid receptor beta 2 and p16, p21 and p27 mRNA and quantitative image analysis (partially) were performed.

RESULTS

Retinoic acid markedly inhibited hepatic stellate cells proliferation (41.50%, P<0.05), decreased the protein level of alpha-smooth muscle actin (55.09%, P<0.05), and induced hepatic stellate cells to express retinoic acid receptor beta 2 mRNA. In addition, retinoic acid increased the protein level of p16 (218.75%, P <0.05) and induced p21 protein expression; meanwhile, p27 was undetectable by immunocytochemistry in both control and retinoic acid-treated hepatic stellate cells. However, retinoic acid had no influence on the mRNA level of p16, p21 or p27 as determined by in situ hybridization.

CONCLUSIONS

Up-regulation of p16 and p21 on post-transcriptional level may contribute, in part, to retinoic acid inhibition of transforming growth factor beta 1-initiated rat hepatic stellate cells activation in vitro.

Results of surgical resection of patients with primary lung cancer: a retrospective analysis of 1,905 cases

BACKGROUND

Surgical resection, combined therapies, and lymphadenectomy are extensively utilized in the treatment of patients with lung cancer. In the present study, we summarized the clinical data of patients with primary lung cancer after surgical resection alone or combined with adjuvant therapy, and evaluate the main factors influencing long-term survival.

METHODS

A retrospective review of 1,905 consecutive patients with primary lung cancer treated at the Cancer Institute of the Chinese Academy of Medical Sciences from March 1961 through December 1995 was performed. Statistical analysis was done using STATA software. The survival rate was estimated using the life-table method. Survival differences were performed using the log-rank test. The modified 1997 TNM staging system was used.

RESULTS

There was a 12.28% morbidity rate and a 1.31% hospital mortality in our series. The 5-year survival rate for the complete resection was 49.5% and for the palliative resection 18.8% (p < 0.01). The 5-year survival rate was 72.0% in stage IA and 61.0% in stage IB (p < 0.05), 32.9% in stage IIA and 34.5% in stage IIB, 22.6% in stage IIIA and 15.9% in stage IIIB (p < 0.05), and 7.1% in stage IV.

CONCLUSIONS

Multiple factors influence the long-term survival of patients with primary lung cancer after surgery. They include TNM staging, the extent of surgical resection (complete or palliative), resection margin (positive or negative), pathologic type of tumors, and type of resection.

[Study of peak expiratory flow in 728 normal adolescents in Chengdu area]

OBJECTIVE

This study was carried out to build the normal values and regression equations of peak expiratory flow (PEF) in normal adolescents.

METHODS

PEF and routine ventilatory functions, FVC, V75, V50, V25 were measured in 728 normal adolescents aged 8-19.

RESULTS

The PEF and FVC, V75, V50, V25 rose with the increase of age. The regression equations showed that PEF was highly positively correlated with age and FVC both in male and female adolescents, and also positively correlated with body weight in males; the coefficients of multiple correlation were 0.85 and 0.78 in male and female ones respectively. Correlations of PEF with V75, V50, V25 were also high, especially with V75 of which the correlation coefficients came up to 0.98 both in male and female adolescents. The coefficients of variation were 15%-20% both in male and female adolescents, and were in normal ranges.

CONCLUSION

The normal ranges and regression equations of PEF provided for normal adolescents can be used to evaluate the pulmonary functions of patients who are in the same age-group suffering from bronchial asthma and other respiratory diseases.

[Determination of puerarin in three traditional Chinese patent medicines by high performance liquid chromatography]

A simple and accurate reversed-phase high performance liquid chromatographic method to determine puerarin in three traditional Chinese patent medicines, namely "Xiao'er qingganling" tablet, "Buchang xinnaoxintong" capsulae and "Ganmao qingre" granule is described. "Xiao'er qingganling" tablet and "Buchang xinnaoxintong" capsulae were extracted with methanol in an ultrasonic bath and "Ganmao qingre" granule was extracted with water and ethanol. After being centrifuged and filtered, the samples were separated on an ODS column with a mobile phase of 100 mmol/L ammonium acetate buffer (pH 5.0)-methanol(75:25, volume ratio). The flow rate was 0.8 mL/min, and the detection wavelength was 250 nm. The calibration curve was linear in the range of 2 mg/L-20 mg/L puerarin (r = 0.9999). The average recoveries were 99.0%, 93.4% and 97.5% for "Xiao'er qingganling" tablet, "Buchang xinnaoxintong" capsulae, "Ganmao qingre" granule respectively. The average contents of puerarin in the medicines were 3.48 mg/g, 1.08 mg/g and 1.52 mg/g (sucrose), and the relative standard deviations were 1.9%, 1.4% and 1.4% respectively.

Signaling through TNF receptor p55 in TNF-alpha-deficient mice alters the CXCL13/CCL19/CCL21 ratio in the spleen and induces maturation and migration of anergic B cells into the B cell follicle

The organization of secondary lymphoid tissues into distinct T and B cell compartments supports proper regulation of an immune response to foreign Ags. In the splenic white pulp, this compartmentalization is also thought to be important in the maintenance of B cell tolerance. Using lymphotoxin-alpha-(LT-alpha)-, TNF-alpha-, or TNFRp55-deficient mice, all with disrupted splenic architecture, we tested whether normal T/B segregation and/or intact follicular structure are necessary for the maintenance of anti-dsDNA B cell anergy. This study demonstrates that anti-dsDNA B cells remain tolerant in LT-alpha(-/-), TNF-alpha(-/-), and TNFRp55(-/-) mice; however, TNF-alpha or a TNF-alpha-dependent factor is required for their characteristic positioning to the T/B interface. Providing a TNF-alpha signal in TNF-alpha(-/-) mice by systemic administration of an agonist anti-TNFRp55 mAb induces the maturation of the anti-dsDNA B cells and their movement away from the T cell area toward the B cell area. Additionally, the agonist Ab induces changes in the follicular environment, including FDC clustering, up-regulation of the CXC chemokine ligand CXCL13, and down-regulation of the CC chemokine ligands CCL19 and CCL21. Therefore, this study suggests that a balance between B and T cell tropic chemokine signals may be an important mechanism for positioning anergic B cells at the T/B interface of the splenic white pulp.

[The effect analysis of tuberculosis control project loaned by World Bank in Guangdong province]

OBJECTIVE

To evaluate the effect of tuberculosis control project loaned by World Bank in Guangdong province.

METHODS

The registration and the treatment effect of pulmonary tuberculosis patients according to Guangdong tuberculosis report were analyzed.

RESULTS

The above program had been conducted widespread since 1995. Over the past five years, 601,913 cases of suspicious tuberculosis patients have been received and diagnosed, in which 111,164 infectious patients (containing 91,612 newly-attacked infectious cases) were found. Just in 1999, the number of newly-attacked infectious patients was 1.2 times to that(19,858 newly-attacked infectious cases) of 1981-1990 prior to this program. And the average cure rate of infectious patients reached to 95.2%. The cure rate showed an uptrend amounting to 97.2% from 87.6%.

CONCLUSION

Satisfactory effect have been achieved by the World-Bank loaned TB control project in Guangdong province.

Outcome prediction in severe traumatic brain injury with transcranial Doppler ultrasonography

OBJECTIVE

To investigate the value of transcranial Doppler (TCD) ultrasonography in evaluating the outcome of severe traumatic brain injury and to correlate the TCD values with intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring.

METHODS

A prospective study was conducted to evaluate the contribution of TCD ultrasonography to neurological outcome in a series of 96 severe traumatic brain injury patients. The quantitative variables of TCD ultrasonography included the mean blood flow velocity of the middle cerebral artery (MCA) and pulsatility index within the first 24 hours of admission. The ICP and CPP values were a lso recorded. Outcome in 6 months postinjury was evaluated using the Glasgow Outcome Scale (GOS 4-5 was considered as "good" and GOS 1-3 as "poor").

RESULTS

The mean blood flow velocity of the MCA was larger than 40 cm/s in 30 (51%) patients with good outcome whereas it was less than 40 cm/s in 27 (73%) patients with poor outcome (P<0.025). The mean PI in cases of good outcome (34 patients, 57%) was lower than 1.5 whereas in poor outcome (30 patients, 83%) was higher than 1.5 (P<0.001). The correlations of ICP and CPP to pulsatility index were statistically significant (P<0.01).

CONCLUSIONS

TCD ultrasonography is valid in predicting the patient's outcome of 6 months and correlates significantly with ICP and CPP values when it is performed in the first 24 hours of severe traumatic brain injury.

Phox homology domains specifically bind phosphatidylinositol phosphates

The recruitment of specific cytosolic proteins to intracellular membranes through binding phosphorylated derivatives of phosphatidylinositol (PtdIns) controls such processes as endocytosis, regulated exocytosis, cytoskeletal organization, and cell signaling. Protein modules such as FVYE domains and PH domains that bind specifically to PtdIns 3-phosphate (PtdIns-3-P) and polyphosphoinositides, respectively, can direct such membrane targeting. Here we show that two representative Phox homology (PX) domains selectively bind to specific phosphatidylinositol phosphates. The PX domain of Vam7p selectively binds PtdIns-3-P, while the PX domain of the CPK PI-3 kinase selectively binds PtdIns-4,5-P(2). In contrast, the PX domain of Vps5p displays no binding to any PtdInsPs that were tested. In addition, the double mutant (Y42A/L48Q) of the PX domain of Vam7p, reported to cause vacuolar trafficking defects in yeast, has a dramatically decreased level of binding to PtdIns-3-P. These data reveal that the membrane targeting function of the Vam7p PX domain is based on its ability to associate with PtdIns-3-P, analogous to the function of FYVE domains.

Synthesis and evaluation of hydroxylated polyamine analogues as antiproliferatives

A new means of accessing N(1)-cyclopropylmethyl-N(11)-ethylnorspermine (CPMENSPM) and the first synthesis of (2R,10S)-N(1)-cyclopropylmethyl-2,10-dihydroxy-N(11)-ethylnorspermine [(2R,10S)-(HO)(2)CPMENSPM] are described. Both of these polyamine analogues are shown to be more active against L1210 murine leukemia cell growth than either N(1),N(11)-diethylnorspermine (DENSPM) or (2R,10R)-N(1),N(11)-diethyl-2,10-dihydroxynorspermine [(2R,10R)-(HO)(2)DENSPM] after 96 h of treatment; the activity was comparable to that of (2S,10S)-N(1),N(11)-diethyl-2,10-dihydroxynorspermine [(2S,10S)-(HO)(2)DENSPM] at 96 h. Both cyclopropyl compounds reduced putrescine and spermidine pools, but less effectively than did DENSPM and its derivatives. Only CPMENSPM, and not (2R,10S)-(HO)(2)CPMENSPM, lowered spermine pools. As with DENSPM and (2R,10R)-(HO)(2)DENSPM, both cyclopropyl analogues diminished ornithine decarboxylase and S-adenosylmethionine decarboxylase activity. Unlike the hydroxylated DENSPM compounds, both cyclopropyl norspermines substantially upregulated spermidine/spermine N(1)-acetyltransferase. The most interesting effect of hydroxylating CPMENSPM is the profound reduction in toxicity compared with that of the parent drug. The same phenomenon had been observed for the DENSPM/(2R,10R)-(HO)(2)DENSPM pair. Thus, hydroxylation of norspermine analogues appears to be a way to maintain the compounds' antiproliferative activity while reducing their toxicity.