Vascular endothelial growth factor and nitric oxide synthase expression in human lung cancer and the relation to p53

Vascular endothelial growth factor (VEGF) expression and mutations of cancer-related genes increase with cancer progression. This correlation suggests the hypothesis that oncogenes and tumour suppressors regulate VEGF, and a significant correlation between p53 alteration and increased VEGF expression in human lung cancer was reported recently. To further examine this hypothesis, we analysed VEGF protein expression and mutations in p53 and K-ras in 27 non-small-cell lung cancers (NSCLC): 16 squamous cell, six adenocarcinomas, one large cell, two carcinoids and two undifferentiated tumours. VEGF was expressed in 50% of the squamous cell carcinomas (SCC) and carcinoids but none of the others. p53 mutations occurred in 14 tumours (52%), and K-ras mutations were found in two adenocarcinomas and one SCC; there was no correlation between the mutations and VEGF expression. As nitric oxide also regulates angiogenesis, we examined NOS expression in NSCLC. The Ca2+-dependent NOS activity, which indicates NOS1 and NOS3 expression, was significantly reduced in lung carcinomas compared with adjacent non-tumour tissue (P < 0.004). Although the Ca2+-independent NOS activity, which indicates NOS2 expression, was low or undetectable in non-tumour tissues and most carcinomas, significant activity occurred in three SCC. In summary, our data do not show a direct regulation of VEGF by p53 in NSCLC. Finally, we did not find the up-regulation of NOS isoforms during NSCLC progression that has been suggested for gynaecological and breast cancers.

Detection of Staphylococcus aureus in milk by use of polymerase chain reaction analysis

OBJECTIVE

To evaluate polymerase chain reaction (PCR) analysis for detection of Staphylococcus aureus (nuc gene) in fresh and formalin-preserved milk.

SAMPLE POPULATION

Samples from 80 lactating sheep and 100 lactating dairy cows.

PROCEDURE

4 lactating sheep were inoculated with S aureus by intramammary infusion. A set of primers specific for the nuc gene of S aureus was used to develop a PCR technique, and modification of the rapid boil method was used to isolate bacterial DNA. Milk was obtained from experimentally infected sheep before and after infusion with S aureus, and from the 100 cows and remaining 76 sheep. Samples were screened by bacteriologic culture and PCR. To validate the PCR assay, S aureus or other pathogens were added to distilled water and "normal" sheep milk samples, with and without formalin.

RESULTS

The PCR assay was 100% specific for S aureus when known negative and positive samples were tested. Sensitivity was 100% for samples with added S aureus or other pathogens. Sensitivity was lower for samples obtained from experimentally infected sheep, but increased from 53% to 90% with increased washing of target DNA.

CONCLUSIONS

The PCR technique based on the nuc gene is able to detect S aureus in sheep milk yields results faster than does traditional culturing, is highly specific, and is able to detect S aureus in formalin-fixed milk samples.

CLINICAL RELEVANCE

The assay is particularly suitable for analysis of samples shipped or stored without refrigeration. Although antibiotics in milk may inhibit growth in culture, they should not affect the results of the PCR assay.

Aqueous based polymeric dispersion: Plackett--Burman design for screening of formulation variables of atenolol gastrointestinal therapeutic system

Bilayered osmotically controlled Gastrointestinal Therapeutic System of atenolol has been obtained by using cellulose acetate pseudolatex prepared by polymer emulsification method. Various factors such as orifice size, coating thickness, amount and nature of polymeric excipients, and amount of osmotic agent influence the drug release from GITS. Therefore, in the present study a 7-factor, 12-run Plackett-Burman screening design was employed to evaluate the formulation variables for atenolol GITS coated with CA pseudolatex. The variables studied were orifice size, %coating weight gain, amounts of sodium chloride. Polyox N80 and 303, and Carbopol 934P and 974P on drug release. The screening design has revealed that orifice size, %coating weight gain and amount of Carbopol 934P have prominent influence on in-vitro atenolol release. The response variable was cumulative percent atenolol released (Y) in 24 h with constraints on percent release at 2, 6, 12 and 18 h. The polynomial equation obtained was Y24 = 149.82 - 0.13 X1 - 0.34X2 + 0.06X3 - 0.13X4 - 0.23X5 - 76.25X6 - 2.46X7. The results indicated that the drug release under constrained conditions was influenced by the factors with decreasing order of importance as %coating weight gain > Carbopol 934P > Polyox N80 > Carbopol 974P > Polyox 303 > amount of sodium chloride > orifice size.

Pure mucinous carcinoma of the breast: a clinicopathologic correlation study

BACKGROUND

Pure mucinous carcinoma (PMC) of the breast has a better prognosis than does invasive ductal carcinoma not otherwise specified and is more prevalent in older patients. We investigated the correlation between prognostic indices and clinical outcome in this histologic subset.

METHODS

A retrospective review was done of patients with PMC treated between 1989 and 1996. Demographic data, pathologic indices of prognosis, axillary nodal status, and outcome were assessed.

RESULTS

Out of 6083 cases of breast carcinoma, 30 were PMC. Only 3 of 25 (12%) axillary dissections were positive. The average age of the group with positive nodes was 57 years, as compared to 69.5 years (95% CI; 63.24-75.76) in the group with negative nodes. All the tumors with positive nodes were aneuploid and had a high nuclear grade, compared to a 31.25% aneuploidy rate in the group without nodal disease (P = .058). Negative ER receptors were found in only 2 of 20 (10%) of the patients tested. Both had axillary disease (P = .016). Tumor size did not correlate with axillary metastasis. Two of the 29 patients died from unrelated diseases. The other 27 patients are alive with no evidence of disease.

CONCLUSIONS

Axillary nodal disease is rare in PMC and correlates with a younger age, aneuploidy, high nuclear grade, or a negative ER receptor status. Sentinel lymph node biopsy may help identify the need for axillary dissection.

Risperidone in Indian patients with schizophrenia

Conventional antipsychotic agents are not effective against negative symptoms of schizophrenia and are also noted for their extrapyramidal side effects. Risperidone is a noval antipsychotic agent whose dual antagonism of dopamine and serotonin receptors is believed to underlie its efficacy against negative symptoms and the low incidence of extrapyramidal side effects. An open, non-comparative study of seven weeks duration was performed to evaluate risperidone in the treatment of schizophrenia in Indian patients. Previous antipsychotic therapy was discontinued for a week before risperidone therapy was initiated. At the end of six weeks of risperidone therapy, clinical improvement (≥ 20% reduction in total score on positive and negative syndrome scale for schizophrenia (PANSS;; was shown by 128 (87.7%) of the 146 evaluable patients. Statistically significant reduction (p < 0.05) occurred in the total score of this scale and in the subscale scores for positive, negative and general psychopathology symptoms and in the clinical global impression severity score. The number of patients with adverse experiences were 108 (65.5%) at baseline and 120 (72.7%) at the end of risperidone therapy. Extrapyramidal symptoms, seen in 65 (39.4%) patients compared to 22 (13.3%) patients at baseline, were largely mild to moderate in intensity.

Arthritis and HLA-B27 in native North American tribes

Whereas it is clear that HLA-B27 is increased in many North American natives, the prevalence varies a great deal. There is still a paucity of data on a large number of tribes. There is, however, a suggestion that HLA-B27 positive prevalence follows cultural/linguistic groupings. Reactive arthritis, sacroiliitis, and ankylosing spondylitis also appear to be increased in these people, but their relationship to HLA-B27 and possibly additional genetic predisposing factors is far from clear. Given these data and the known association of infectious agents, more extensive studies are warranted, especially in those tribes with a large enough population to achieve statistical significance.

Hiatal hernia in achalasia

Barium esophagograms of 89 patients out of 110 with manometrically proven achalasia were reviewed. Only four (4.4%) patients showed association of hiatal hernia, indicative of its rare occurrence. Presence of hiatal hernia, is said to have less likelihood of associated achalasia but this association does exist as per our report and that of others.

Allelic deletion analysis of the FHIT gene predicts poor survival in non-small cell lung cancer

The fragile histidine triad (FHIT) gene at chromosome 3p14.2 is a candidate tumor suppressor gene linked to cancers of the lung, breast, colon, pancreas, and head and neck. Reports of frequent allelic deletion and abnormal transcripts in primary lung tumors plus recent evidence that it is targeted by tobacco smoke carcinogens suggest that it plays an important role in lung carcinogenesis. Non-small cell lung carcinoma still maintains a poor 5-year survival rate with the stage of disease at presentation as a major determinant of prognosis. We examined for allelic deletion at the FHIT locus in a series of 106 non-small cell lung carcinomas for which a full clinical, epidemiological, and 5-year survival profile was available. We found an allelic deletion frequency of 38% at one or two intragenic microsatellites. Allelic deletion of FHIT was related to tumor histology with 4 of 20 adenocarcinomas (20%) displaying loss of heterozygosity (LOH) compared with 12 of 22 (55%) nonadenocarcinomas (P = 0.03). We found that 63% of tumors with LOH of FHIT also had p53 missense mutations whereas only 26% with LOH had wild type p53 negative sequence (P = 0.02). We also found a significant trend toward poorer survival in patients with LOH of at least one locus of the FHIT gene (log rank, P = 0.01). This survival correlation is independent of tumor stage, size, histological subtype, degree of differentiation, and p53 mutation status. Our data support the hypothesis that the loss of the FHIT contributes to the molecular pathogenesis of human lung cancer and is an indicator of poor prognosis.

Epidemiology of childhood tuberculosis in a hospital setting

A study of two hundred cases of tuberculosis over a span of two years was carried out at the pediatric department of a hospital in Islamabad. The diagnosis was based upon history, clinical examination, chest and other relevant radiography, Mantoux test, erythrocyte sedimentation rate (ESR) and where necessary cerebrospinal, pleural and ascitic fluid examinations and lymph gland histopathology were done. An equal number of male and female children upto 12 years of age were enrolled. The children usually presented with fever, cough, weight loss or failure to thrive and pallor. The most commonly affected age group was between 2-5 years and pulmonary tuberculosis was the most frequent diagnosis followed by tuberculous adenitis.

Solid-state stability assessment of controlled release tablets containing Carbopol 971P

A tablet formulation containing dyphylline, Carbomer, magnesium stearate, talc and lactose was prepared by the direct compression method. The objective of the study was to assess the stability of these tablets after subjecting them to exaggerated conditions of temperature (4, 25, 37, 45 and 55 degrees C) and humidity (37 degrees/11%RH, 37 degrees/51%RH and 37 degrees C/91%RH). The samples were analyzed for crystalline, thermal and dissolution changes with time for a period of 12 months using X-ray diffractometry (XRD), differential scanning calorimetry (DSC) and U.S.P. Dissolution Apparatus 2. Moisture sorption studies of all tablets indicated sorption of large amounts of moisture at 37 degrees C/91%RH. The fit factors, f1 andf2, were calculated and used to compare the dissolution profiles. The results showed increased f1 and decreased f2 values at higher humidity, while the samples were fairly stable at lower humidity and at all temperatures studied. Powder XRD patterns of tablets showed a change in crystallinity at higher humidity. The thermal and crystalline data indicated that the change in dissolution behavior at higher humidity may be due to the conversion of dyphylline to its hydrate form.

Significance of reverse transcription polymerase chain reaction in the detection of human cytomegalovirus gene transcripts in thoracic organ transplant recipients

BACKGROUND

Cytomegalovirus disease is a major cause of morbidity in transplant recipients. We have evaluated the clinical value of detecting viral mRNA transcripts for the diagnosis of active infection leading to disease in recipients of thoracic organ transplants.

METHODS

Blood samples from 10 transplant recipients were analyzed before transplantation and weekly after transplantation for 12 weeks. The profile of viral immediate-early, early, and late gene expression was determined by the reverse transcription polymerase chain reaction and compared with cytomegalovirus (pp65) antigenemia and host antibody status (serologic study).

RESULTS

Two patients showed no active cytomegalovirus infection, one had asymptomatic infection detected serologically and seven patients had development of symptomatic infection with a significant serologic change. Viral immediate-early mRNA transcript was detectable in all 10 patients, including the two with no active infection. Early and late gene expression occurred in seven patients who were all antigenemia positive and in whom disease developed. Of the seven patients with development of antigenemia, six showed viral early and late gene expression before pp65 antigenemia, whereas one patient showed antigenemia before early and late gene expression.

CONCLUSION

We have shown that the detection of viral early and late gene expression by reverse transcription polymerase chain reaction can act as diagnostic markers of cytomegalovirus disease with expression of early gene preceding the detection of antigenemia in most cases. In contrast, viral immediate early gene expression did not correlate with clinical infection. This diagnostic approach could be useful in the treatment of thoracic organ transplant recipients.

Characterization of Coxsackie B virus RNA in myocardium from patients with dilated cardiomyopathy by nucleotide sequencing of reverse transcription-nested polymerase chain reaction products

This study was performed to detect and characterize the enterovirus present in myocardium of some patients with heart muscle disease by nucleotide sequencing of polymerase chain reaction (PCR) products after amplification with enterovirus group-specific primers. Enterovirus sequences have been detected previously in myocardium of patients with myocarditis or dilated cardiomyopathy and seem causal, although the particular virus serotypes involved have not been identified. In a prospective study of endomyocardial biopsy specimens from 35 consecutive patients with suspected heart muscle disease, enterovirus sequences from the 5' nontranslated region were amplified by reverse transcription-nested PCR using group-specific primers. This region contains both conserved and variable sequence motifs, characteristic of particular enterovirus serotypes. The nucleotide sequences of individual PCR products were determined by cycle sequencing and compared with all known sequences (GenBank/EMBOL), using the GCG software package. Endomyocardial biopsy specimens from 9 of 21 (42.9%) patients with a histologically confirmed diagnosis of dilated cardiomyopathy were positive for enterovirus by PCR, compared with only 1 of 14 (7.1%) patients with other myocardial pathological conditions (Fisher's exact probability=0.0275: odds ratio=9.75; 95% confidence interval=1.31-72.78). The nucleotide sequence of the PCR products differed, indicating no cross-contamination. However, computerized comparison showed that each had greatest homology with the 5' nontranslated region of Coxsackie B virus but contained up to 11% sequence variations compared with the prototype Coxsackie B3 strain Nancy. Parallel investigation of tissue from our mouse model of Coxsackievirus B3-induced myocarditis showed that nucleotide sequence changes are not introduced by reverse transcription or PCR. These data support the link between enteroviral infection and dilated heart muscle disease and suggest that Coxsackie B serotypes are the enteroviruses most frequently involved.

p53 mutations in cyclophosphamide-associated bladder cancer

Cyclophosphamide is a known bladder carcinogen, with cumulative dose directly related to increased risk. There is no consensus, however, on which major cyclophosphamide metabolite (i.e., acrolein or phosphoramide mustard) drives bladder carcinogenesis. We examined 19 cyclophosphamide-related bladder tumors to test the hypothesis that they might contain somatic mutations in the p53 tumor suppressor gene that could link a specific metabolite to the etiology of these cancers. Forty-three % (9 of 19) of the cases had a mutation in p53, with a predominance at G:C bp (7 of 9, 77%), a preference for non-CpG sites (6 of 7, 86%), and frequent G:C-->A:T transitions (5 of 7, 71%). The p53 mutation spectrum of these cyclophosphamide-associated bladder cancers differed significantly from patterns reported for sporadic (P = 0.020), smoking-related (0.043), and schistosomiasis-linked (P = 0.002) tumors but not arylamine-associated neoplasms (P = 0.860). Differences between the cyclophosphamide and arylamine-associated spectra included an unusual degree of clustering of exon 6 mutations (43% versus 17%, respectively) and an absence of multiple mutations in the former. Notably lacking in our series were G:C-->T:A transversions, the principal mutation associated with acrolein. Instead, the mutation spectrum matches the phosphoramide mustard adduction sequences determined by a repetitive primer-extension assay (P = 0.024), indicating that this metabolite might be a key mutagen in cyclophosphamide-related bladder cancer.

Nutritional evaluation of some legume-based dishes consumed in Saudi Arabia

Chemical composition and nutritional quality of five Saudi dishes based on legumes were evaluated. On fresh weight basis, the dishes contained 35.3-78.1% moisture, 4.4-10.2% protein (NX6.25), 1.2-19.1% fat, 8.0-24.8% carbohydrates, 2.4-7.7% dietary fibre, 1.4-2.9% ash and 71-311 Kcal (297-1301 KJ) per 100 g dish. The contents of vitamin A (retinol equivalent), thiamin, riboflavin and vitamin C ranged from 85-378 micrograms, 0.01-0.12 mg, 0.02-0.46 mg and 0.3-1.2 mg per 100 g respectively. The mineral contents (mg/100 g) were calcium 2.1-22.1, phosphorus 49.1-330.3, iron 1.1-13.3, sodium 348.3-1356.9, and potassium 119.1-624.8. The dishes contributed 13-25%, 15-64% and 16-60% of the total food energy from protein, fat and carbohydrates respectively. Most of the dishes were good sources of dietary fibre, vitamin A and iron.

Role of serum angiotensin converting enzyme in sarcoidosis

This study was conducted to determine the role of Serum Angiotensin Converting Enzyme (SACE) as a marker in the differential diagnosis of pulmonary diseases and prognosis of sarcoidosis. A retrospective analysis of 113 medical records of patients at The Aga Khan University Hospital, with laboratory investigation for SACE was performed. Among 113 patients, 51 cases were found to have sarcoidosis, 44 of them had SACE levels greater than 52 IU/L (mean ACE 104.44). SACE levels were also found elevated in other clinical conditions like tuberculosis (mean 58.64 IU/L), but the enzyme level were less (p 0.04) than those found in sarcoidosis (mean (92.97 IU/L). SACE activity was found to be considerably lower in other chronic lung diseases such as, fibrosing alveolitis (mean 43.98 IU/L), interstitial lung disease (mean 42.11 IU/L) and chronic obstructive lung disease (mean 40.85 IU/L). Twenty patients of sarcoidosis, who received steroid treatment subsequently showed a decline in the SACE levels. SACE is a useful marker in differential diagnosis as 37.2% cases of sarcoidosis compared to only 9.09% of tuberculosis had SACE levels greater than 100 IU/L. In addition, our data also suggest that serum ACE is useful for the diagnosis as well as monitoring prognosis in sarcoidosis.

Epidemiology of childhood tuberculosis in a hospital setting

Two hundred paediatric cases of tuberculosis were studied over two years. The children usually presented with fever, cough, weight loss or failure to thrive and pallor. The diagnosis was based on history, clinical examination, chest and other relevant radiographs, Mantoux test, erythrocyte sedimentation rate (ESR) and where necessary cerebrospinal, pleural and ascitic fluid examinations and lymph gland histopathology were done. The most commonly affected age group was between 2-5 years and pulmonary tuberculosis was the most frequent diagnosis followed by tuberculous adentitis.

Induction of hepatic cytochrome P-450 by phenobarbital in semi-aquatic frog (Rana pipiens)

Hepatic microsomal cytochrome P450 (equivalent to rat P4502B1 isozymic form, a CYPIIB gene product) can be induced by pentobarbital (PB) in the adults of the semiaquatic frog, Rana pipiens (as in other terrestrial vertebrates), but not in adults of the aquatic frog Xenopus laevis or in bluegill sunfish (Lepomis macrochirus). The activity of PB-induced P450 (2B1) towards aldrin and pentoxyresorufin increases respectively by about 2- and 10-fold. This enzyme is not inducible during larval and postlarval stages of R. pipiens. However, cytochrome P4501A1 (CYPIA1 gene product) is inducible by beta-naphthoflavone in all these species. Both CYPIA and CYPIIB genes are expressed, as determined by the catalysis of their protein products, during larval, postlarval, and adult stages of R. pipiens. The concentration of P450 increases slightly during the postlarval stages until the adult stage, ready to migrate to land, is reached. This increase seems to be mostly due to 2B1-type cytochrome P450 as judged by a large increase in aldrin epoxidase but not of 7-ethoxyresorufin O-deethylase activity. It is hypothesized that the evolution of true terrestrialness, and not the evolution of air-breathing lungs alone, is required for the transcriptional activation of CYPIIB gene by PB.

A normal electrocardiogram precludes the need for left ventriculography in the assessment of coronary artery disease

OBJECTIVE

To assess whether a normal electrocardiogram can identify good left ventricular function and obviate the need for routine left ventriculography in patients undergoing cardiac catheterization for suspected coronary artery disease.

DESIGN

A prospective study of patients undergoing cardiac catheterisation.

SETTING

A regional cardiac centre.

PATIENTS

The electrocardiograms, coronary angiograms, and left ventriculograms of 391 consecutive patients undergoing investigations for suspected coronary artery disease were entered into the study. Patients with arrhythmias and cardiac pathologies other than coronary artery disease were excluded.

MAIN OUTCOME MEASURES

The electrocardiogram was assessed using a 29 point QRS scoring system, and classified by two cardiologists and a trainee cardiologist as normal or abnormal. Left ventricular function was assessed by digital ventriculography.

RESULTS

The sensitivity, specificity, and negative predictive value of a QRS score of 0 (normal QRS complexes) for discriminating good left ventricular function (ejection fraction > or = 50%) were 92.6%, 41.5%, and 97.2%, respectively. The figures for a normal electrocardiogram as assessed by a doctor were 96.3%, 40.4%, and 98.6% for cardiologist A; 96.3%, 37.4%, and 98.4% for cardiologist B; and 94.4%, 49.6%, and 98.2% for the cardiology trainee.

CONCLUSIONS

If a cardiologist judges the ECG to be normal, left ventriculography is unnecessary and a formal QRS score does not improve reliability of this clinical judgment. Adopting this strategy would save 30-40,000 Pounds in consumables and 65-87 hours of catheter laboratory and staff time for a department catheterising 3000 patients with suspected coronary artery disease annually.

Effects of photoisomers of cyclodiene insecticides on liver and microsomal cytochrome P450 in rats

Threshold dosages of the photoisomers of cyclodiene insecticides, namely photochlordane, photodieldrin, and photoheptachlor, for the induction of hepatic microsomal cytochrome P450 (P450) and liver hypertrophy in male rats were at least one-quarter of those reported for corresponding parent cyclodienes. Maximum increase in total P450 concentration (30%) and demethylases activities (100%) was always respectively one-third or one-tenth of that reported for parent cyclodienes. The P450 isozymic form induced by photoheptachlor resembled that induced by pentobarbital (P4502B1) in its substrate specificity, spectral characteristics, and electrophoretic mobility. The induction of P450 was initially followed by hepatic hypertrophy. However, higher dosages of photoisomers caused wasting and lowered both the liver weight and the activity of aniline hydroxylase while those of mirex and endrin, which also caused wasting and lowered aniline hydroxylase activity, continued causing further hepatic hypertrophy.

Partial volume rat lung irradiation: an evaluation of early DNA damage

PURPOSE

1. To investigate early DNA damage induced in rat lung cells following single-dose, partial-volume irradiation (lung base and lung apex). 2. To determine the variation in DNA damage in different lung regions. 3. To investigate the possible mechanisms associated with early DNA damage after lung irradiation.

METHODS AND MATERIALS

The whole lung or the upper or lower half of the entire lung of Sprague-Dawley rats was exposed to 10 Gy 60Co gamma rays. The animals were sacrificed at various times up to 42 h after irradiation. A trypsin-digested lung cell suspension was prepared and cells that attached to slides in the initial 24-h period were then grown in the presence of culture medium with cytochalasin-B for a further 72 h. Radiation-induced DNA damage was quantified in the cells (primarily fibroblasts) from both irradiated and unirradiated lung regions by using a well-characterized micronucleus assay.

RESULTS

When the lungs were removed at 16-18 h after whole-lung irradiation, about 0.85 micronuclei (MN) per binucleate cell (BNC) were observed in the lung cells of the irradiated animals, compared to 0.02 MN/BNC in the lung cells of the controls. When only the lung base was irradiated, the frequency of micronuclei was 0.85 MN/BNC compared to 0.43 MN/BNC observed in cells from the irradiated lung apex. Of particular interest was the finding that the unirradiated lung apex also showed a large frequency of micronuclei (0.43 MN/BNC) after the irradiation of the lung base, whereas the unirradiated lung base showed only a marginal (approximately 2-fold) increase relative to the spontaneous frequency following irradiation of the lung apex. The changes in the frequency of micronuclei varied with the time at which the lungs were removed from the rats for early times, but had stabilized by 18 h after irradiation. Normal (unirradiated) cells grown in filtered or unfiltered conditioned media obtained from irradiated cell cultures showed an insignificant marginal increase in the number of micronuclei relative to the spontaneous frequency. Lung cells obtained from the lung base or the lung apex of healthy controls and irradiated separately in vitro showed no regional differences in the induction of micronuclei. Cells from the lungs of rats injected with superoxide dismutase, within 1 h prior to irradiation of the lung base, and processed 16-18 h after irradiation showed a reduction in the number of MN in the shielded lung apex, indicating the possible involvement of oxygen radicals.

CONCLUSIONS

These data indicate that cells in the lung base sustain more DNA damage than those in the lung apex when either region is irradiated; however, when the whole lung, is irradiated, the lung damage observed is similar in the two regions. Also, out-of-field effects are observed for the lung apex but not the lung base. Possible mechanisms include a clastogenic (chromosome damaging) factor produced in the plasma following irradiation and/or the production of oxygen radicals by activated lymphocytes/monocytes. The partial blocking of the DNA damage, observed in the unirradiated lung apex following irradiation of the lung base, by superoxide dismutase, suggests that oxygen radicals are involved in this out-of-field effect. These radicals are likely produced as a result of the induction of inflammatory cytokines, such as tumor necrosis factor (TNF) and interleukin-1 (IL-1) by the irradiation. The reason for the lack of an out-of-field effect in the lung base when the lung apex is irradiated is unknown, but may be due to the greater volume of lung irradiated in the lower lung field, because this is likely to affect the level of cytokines produced. Alternatively, it may reflect cytokines produced as a result of the partial liver irradiation that occurs with the lower lung field.

Magnitude of lipoprotein (a) in diabetes mellitus

One hundred and three patients, 76 with diabetes mellitus alone (48- Non-Insulin dependent diabetes and 28 Insulin dependent diabetes) and 27 diabetics having coronary heart disease (CHD) and 27 normal control subjects were included in this study. All the 27 diabetics with CHD were Non-Insulin dependent. The patients and the controls were investigated for serum Lp (a), triglycerides, cholesterol, VLDL-C, LDL-C, HDL-C, apo A1 and apo B. The objective was to assess and compare the level of lipoproteins, especially the lipoprotein (a), in diabetic and non-diabetic subjects and to compare the level of the aforementioned parameters in diabetics with and without CHD. The Lp (a) and other lipid parameters were significantly raised (P < 0.001) except HDL-C and apo A1 that were significantly decreased (P < 0.001) both in diabetic patients with and without CHD, as compared to the control group. The diabetics with CHD showed significantly elevated (P < 0.001) Lp (a) and lipid profile, and significantly low (P < 0.001) HDL-C and apo A1 levels as compared to the patients having diabetes alone. No significant difference was observed in the levels of the above parameters when NIDDM patients were compared with IDDM group. In both NIDDM and IDDM patients significantly low (P < 0.001) HDL-C level and significantly high (P < 0.001) Lp (a) level along with the aforementioned lipid parameters was observed as compared to control group. Elevated levels of Lp (a) and lipid profile in diabetic subjects suggest their involvement in atherogenesis and subsequent development of CHD.