Transcriptional regulation of human apolipoprotein genes ApoB, ApoCIII, and ApoAII by members of the steroid hormone receptor superfamily HNF-4, ARP-1, EAR-2, and EAR-3

Apolipoproteins B, CIII, and AII are synthesized primarily in the liver and intestine and play an important role in lipid and cholesterol metabolism. It was previously shown that the cis-acting elements (BA1 (-79 to -63), CIIIB (-87 to -63), and AIIJ (-740 to -719) present in the regulatory regions of the human apoB, apoCIII, and apoAII genes, respectively, are recognized by common transcription factors present in hepatic nuclear extracts. This report shows that four members of the steroid receptor superfamily, ARP-1, EAR-2, EAR-3, and HNF-4, bind specifically to the regulatory elements BA1, CIIIB, and AIIJ. Dissociation constant measurements showed that ARP-1, EAR-2, and HNF-4 bind to elements BA1 and CIIIB with similar affinities (Kd 1-3 nM). Cotransfection experiments in HepG2 cells revealed that ARP-1, EAR-2, and EAR-3 repressed the BA1, CIIIB, and AIIJ element-dependent transcription of the reporter gene constructs and the transcription driven by homopolymeric promoters containing either five BA1 or two CIIIB elements. In contrast, HNF-4 activated transcription of reporter genes containing the elements BA1, CIIIB, and AIIJ and reversed the ARP-1-mediated repression of the apoB and apoCIII genes. These results suggested that the opposing transcription effects observed between HNF-4 and ARP-1 may be due to competition for binding to the same regulatory element. Mutations which affected the binding of HNF-4 to elements BA1 and CIIIB affected its ability to activate transcription of the apoB and apoCIII reporter genes, respectively. Transcriptional activation by HNF-4 depended on the presence of elements II (-112 to -94) and III (-86 to -62) of the apoB and H (-705 to -690), I (-766 to -726), and J (-792 to -779) of the apoCIII promoters, indicating that transcriptional activation of apoB and apoCIII genes by HNF-4 requires the synergistic interaction of factors binding to these elements. The finding that HNF-4, ARP-1, EAR-2 and EAR-3 can regulate the expression of the apoB, apoCIII, and apoAII genes suggest that these nuclear hormone receptors may be an important part of the signal transduction pathways modulating lipid metabolism and cholesterol homeostasis.

Cachexia and graft-vs.-host-disease-type skin changes in keratin promoter-driven TNF alpha transgenic mice

Tumor necrosis factor alpha (TNF alpha) orchestrates a wide range of effects that combat severe infections in animals. At lower levels, TNF alpha plays an important protective role in stimulating chemotaxis and antimicrobial activity of neutrophils, macrophages, and eosinophils. During chronic illness, TNF alpha secretion can be elevated markedly, giving rise to cachexia, hemorrhage, necrosis and, ultimately, death. Although TNF alpha may mediate many of its effects through macrophages, 30% of TNF alpha injected into animals concentrates in the skin. In recent years, it has been shown that keratinocytes can be induced to synthesize TNF alpha. To explore the role of TNF alpha synthesis in keratinocytes, we used a keratin-14 (K14) promoter to target human TNF alpha expression in the epidermis and other stratified squamous epithelia of transgenic mice. Most mice expressing the K14-TNF alpha transgene stopped gaining weight within 1 week postbirth, and exhibited retarded hair growth. In the skin, adipose production was profoundly inhibited, whereas signs of fibrosis and immune infiltration were evident in the dermis. Over time, the epidermis exhibited an increased stratum corneum, as signs of necrosis began to appear in the skin. Within 3-5 weeks, the mice displayed features characteristic of cachexia and necrosis. Our results suggest that TNF alpha expression by keratinocytes not only plays a role in inflammatory and graft-versus-host-disease-like responses in the skin, but also in other tissues, apparently by virtue of stratified squamous epithelial-derived TNF alpha entering the bloodstream. Our results have enabled the first evaluation of many of the effects of TNF alpha in transgenic animals.

Primary malignant lymphoma of the salivary gland: a tumor of mucosa-associated lymphoid tissue

The clinical, morphologic and immunohistochemical features of 10 cases of the low-grade mucosa-associated lymphoid tissue (MALT) lymphoma of salivary glands are described. Although the initial histologic diagnosis in nine of these cases was myoepithelial sialadenitis, the diagnosis of primary salivary gland MALT lymphoma was based on the demonstration of light chain restriction and on morphologic characteristics. Histologic study showed a characteristic cytology, which included centrocytoid cells (composed of small centrocytes and monocytoid B cells) and a varying degree of plasma cell differentiation; the occurrence of epithelial or acinar invasion by neoplastic centrocytoid cells; and the presence of reactive lymph follicles among the neoplastic cells. Furthermore, multinucleate giant cells resembling Warthin-Finkeldey cells were detected in seven cases. In the light of these findings, cases previously diagnosed as myoepithelial sialadenitis require careful assessment and nine out of 32 cases are, in reality, examples of primary salivary gland MALT lymphomas. Immunohistochemical analysis of paraffin sections revealed the following characteristic immunophenotype of MALT lymphoma: L26, KiB3 and LN2 positive, and a monotypic immunoglobulin pattern (predominantly IgM/kappa). It was of interest that salivary gland parenchyma, infiltrated by neoplastic centrocytoid cells, reacted with LN3 for cells expressing human leukocyte antigen-DR (HLA-DR) antigens. Whereas salivary gland epithelia devoid of a neoplastic invasion were invariably negative for LN3. This suggests a lymphocyte-mediated role in salivary epithelial HLA-DR expression. It appears that HLA-DR expression is an inducible phenomenon in MALT lymphomas of salivary gland.

Basement membranes in adenoid cystic carcinoma. An immunohistochemical study

Tissue samples from 30 patients with adenoid cystic carcinoma and 20 with adenocarcinoma of salivary gland origin were studied by immunohistochemical staining with specific antibodies to the four macromolecules that are present in normal basement membranes: type IV collagen, laminin, heparan sulfate proteoglycan, and entactin. In the adenoid cystic carcinoma samples, the four proteins were localized in different types of extracellular matrices in the tumor, namely pseudocystic spaces, hyaline stroma, and around tumor cell nests. The staining intensity was enhanced by pretreatment with hyaluronidase. The tumor cells of adenoid cystic carcinoma showed a tendency to proliferate with individual cells in contact with the basement membrane and to infiltrate through basement membrane-rich tissues, such as peripheral nerves, blood vessels, and skeletal muscles. In contrast, only circumferential staining of tumor cell nests was obtained in adenocarcinoma samples. The results suggest that adenoid cystic carcinoma is a tumor with affinity for basement membranes, and this basic feature is reflected in its histology and presumably in its biologic behavior. Immunostaining with antibodies to basement membrane proteins appears to be useful for differential diagnosis of some types of these two carcinomas.

Kappa 3 opiate receptor binding in the mouse and rat

Previous work examining the binding of [3H]naloxone benzoylhydrazone (NalBzoH) in calf brain has identified a novel binding site, kappa 3. In mice and rats NalBzoH elicits an analgesic response which can clearly be differentiated from classical mu, delta or kappa 1 mechanisms and which is pharmacologically consistent with a kappa 3 receptor mechanism of action. In the current studies we demonstrate the presence of kappa 3 sites in both mouse and rat brains. The selectivity of the kappa 3 sites for opioids clearly discriminated it from traditional mu, kappa 1, kappa 2 or delta receptors. In the rat, the density of kappa 3 sites increased 2.5-fold from age 2 days to 21 days, after which it remained relatively stable. Among a number of brain regions in the rat, the density of kappa 3 sites varied dramatically. Highest levels were present in the hypothalamus, thalamus, striatum and midbrain with very low levels in the cerebellum. Intermediate levels were present in cortex, brain stem and spinal cord. Together, these studies support the presence of kappa 3 receptors in both mouse and rat brain which are very similar to those previously reported in calf brain.

Molecular analysis of Saccharomyces cerevisiae chromosome I. On the number of genes and the identification of essential genes using temperature-sensitive-lethal mutations

Previous analyses of Saccharomyces cerevisiae chromosome I have suggested that the majority (greater than 75%) of single-copy essential genes on this chromosome are difficult or impossible to identify using temperature-sensitive (Ts-) lethal mutations. To investigate whether this situation reflects intrinsic difficulties in generating temperature-sensitive proteins or constraints on mutagenesis in yeast, we subjected three cloned essential genes from chromosome I to mutagenesis in an Escherichia coli mutator strain and screened for Ts- lethal mutations in yeast using the "plasmid-shuffle" technique. We failed to obtain Ts- lethal mutations in two of the genes (FUN12 and FUN20), while the third gene yielded such mutations, but only at a low frequency. DNA sequence analysis of these mutant alleles and of the corresponding wild-type region revealed that each mutation was a single substitution not in the previously identified gene FUN19, but in the adjacent, newly identified essential gene FUN53. FUN19 itself proved to be non-essential. These results suggest that many essential proteins encoded by genes on chromosome I cannot be rendered thermolabile by single mutations. However, the results obtained with FUN53 suggest that there may also be significant constraints on mutagenesis in yeast. The 5046 base-pair interval sequenced contains the complete FUN19, FUN53 and FUN20 coding regions, as well as a portion of the adjacent non-essential FUN21 coding region. In all, 68 to 75% of this interval is open reading frame. None of the four predicted products shows significant homologies to known proteins in the available databases.

[Studies on sedative and anticonvulsion effects of differently processed rhizoma Typhon]

Mice were employed to study sedative and anticonvulsion effects of Rhizoma Typhon processed by different methods. The results showed that processed and raw Rhizoma Typhon had marked sedative effect and delayed convulsion time, caused by cardiazole and strychnine. Processed and raw Rhizoma Typhon had similar action. With the new processing method, similar sedative and anticonvulsion effects were obtained compared with the old processing method.

Separation of albumin from autologous plasma by heat

A simplified technique has been developed to separate albumin from the plasma of a patient undergoing treatment with plasma exchange. This albumin can be returned to the patient to maintain colloid osmotic pressure without risk of transmitting disease. Patient plasma is obtained by apheresis. It is heated at 70 degrees C for 60 minutes to denature and remove autoantibodies, immune complexes, and abnormal globulins. The resulting low-concentration albumin solution (LCAS) retains its natural properties. Immunologic analysis by gel diffusion shows a reaction pattern of complete identity with that of human serum albumin. The albumin in LCAS is more than 90 percent of the remaining protein, as determined by scan of a cellulose acetate electrophoresis pattern. More than 97 percent of the albumin is in monomer form, as judged by polyacrylamide gel electrophoresis. No patient antibodies to neonantigens in the heat-treated albumin can be identified by double radial immunodiffusion. More than 80 percent of the plasma albumin is recovered in LCAS. LCAS is safe and efficient for use in plasma exchange.

Closure mechanisms of laryngeal vestibule during swallow

This study examined the temporal effects of bolus volume on closure of the laryngeal vestibule at the arytenoid to epiglottic base and the mobile portion of the epiglottis, the temporal relationships between these levels of airway closure and cricopharyngeal opening for various bolus volumes, and the mechanisms responsible for these two levels of airway protection during deglutition. Closure of the laryngeal vestibule progressed inferiorly to superiorly at all bolus volumes. Duration of closure of the airway at the arytenoid to epiglottic base increased systematically with bolus volume, as did the duration of descent of the epiglottis below horizontal. Closure at the arytenoid to epiglottic base occurred earlier in relation to maximal laryngeal elevation as bolus volume increased. In contrast, descent of the epiglottis to horizontal and the temporal relationship between closure of the airway at the arytenoid to epiglottic base and cricopharyngeal opening were independent of bolus volume. These findings indicate a tightly organized neural program for some pharyngeal swallow events with systematic variability with volume in other pharyngeal events, possibly modulated by afferent input from the periphery. The neuromuscular mechanisms responsible for closure of the airway at the arytenoid to epiglottic base and at the mobile epiglottis appear to be quite different. Closure at the arytenoid to epiglottic base is apparently under direct neural control by active anterior tilting of the arytenoid cartilage and posterior projection of the epiglottic base as the larynx elevates, whereas epiglottic downward movement to closure is the biomechanical effect of hyolaryngeal movement, downward bolus movement, and tongue base retraction.(ABSTRACT TRUNCATED AT 250 WORDS)

Immunohistochemical localization of progesterone receptor in human decidua of early pregnancy

Rat monoclonal antibodies to human progesterone receptor were used for immunolocalization studies in human decidua of early pregnancy. Frozen sections of 42 specimens of decidua were stained by the peroxidase-antiperoxidase method (PAP). Progesterone receptor was localized exclusively in the nuclei of decidual and myometrial cells with no specific staining in the cytoplasm. In the decidualized endometrium, stroma were always positively stained. Smooth muscle, pericyte and endothelial cells of blood vessels were extensively stained. Glandular epithelia showed variation in staining, which was positive in the basal but very weak or negative in the superficial layer of the decidua. No specific staining could be detected in the control sections. Of special interest was the positive staining of the endothelium of decidual blood vessels, a finding which has not been reported previously. The cells of the inner lining of vessels that stained with the antiprogesterone receptor antibodies were also Factor VIII positive, thus confirming the endothelial nature of these cells. It is concluded from these results that endothelial cells from human first trimester decidua express progesterone receptors.

Suppression of acute lymphoblastic leukemia by the human wild-type p53 gene

Independent mutations in both alleles of the p53 tumor suppressor gene are a frequent finding in human T-cell acute lymphoblastic leukemia (T-ALL) cell lines and in the cells of some T-ALL patients in relapse. One major goal of studying the status of p53 (and other tumor suppressor genes) in human cancer is to facilitate the suppression of the tumorigenic phenotype through the restoration of the expression of the wild-type allele. While the efficient insertion of a suppressor into all cells of solid/metastatic human tumors may at present be impossible, insertion into leukemia cells may be feasible due to the accessibility of the leukemia cells in the body. To examine the feasibility of suppressing the tumorigenicity of human T-leukemia cells, the human T-ALL cell line Be-13, which lacks endogenous p53 protein, was infected with a recombinant retrovirus encoding the wild-type allele of human p53 (hwtp53). Expression of p53 reduced the growth rate of infected Be-13 cells in vitro, suppressed colony formation in methylcellulose cultures, and abrogated their tumorigenic phenotype in nude mice in vivo. These results suggest that suppression of the leukemic phenotype of relapse T-ALL-derived Be-13 cells is feasible. Acute leukemia cell suppression via high-efficiency infection with retroviruses encoding wtp53 may be feasible and beneficial in T-ALL cases as part of a bone marrow transplantation regimen in an effort to reduce the frequency of posttransplantation relapse.

Genetic influences in opioid analgesic sensitivity in mice

Studies of various strains of mice revealed marked differences in their analgesic sensitivity towards morphine (mu), U50,488H (kappa 1) and naloxone benzoylhydrazone (NalBzoH; kappa 3). Sensitivity to mu and kappa analgesia varied independently of the other. Analgesic sensitivity to morphine remained relatively consistent among 3 different nociceptive assays for each strain. However, the sensitivity of an individual strain to NalBzoH remained highly dependent upon the assay used. CD-1 mice were sensitive to NalBzoH in all 3 assays, but in BALB/c mice NalBzoH produced analgesia only in the hot plate and cold water tail-flick assays. In Swiss-Webster mice, NalBzoH was active in the radiant heat and cold water tail-flicks but inactive in the hot plate. Although the levels of mu, kappa 1 and kappa 3 binding in whole brain homogenates did vary somewhat, they did not correlate with analgesic sensitivity. These results suggests that the genetic controls over mu and kappa analgesia operate independently and further illustrate the many difficulties in evaluating potential analgesics.

Binary arithmetic using optical symbolic substitution and integrated phototransistor surface-emitting laser logic

We outline an architecture for performing binary addition by using optical symbolic substitution and optical logic gates based on heterojunctionphototransistors and verticalcavity surface-emitting lasers.

Observation of the activity of factor VIII in the endometrium of women pre- and post-insertion of three types of IUDs

The endometrial materials were obtained from 90 women who had been randomly inserted with three types of IUDs (Stainless steel ring, SS; copper T 220, TCu 220, and levonorgestrel-releasing device, LNG). An immunoperoxidase reaction, PAP method, with the antiserum of Factor VIII as the primary antibody, was carried out to detect the Factor VIII activity in the endometrial endothelium pre- (control) and post-insertion of the IUDs. The results revealed that: 1. There was a generalized lower Factor VIII activity in the endometrium of women post-insertion of IUDs (except LNG). 2. Comparison of the Factor VIII activity in the endometrium of women using different types of IUDs showed that the TCu type and the SS type decreased the activity significantly whereas the activity remained unchanged after 3-6 months' use of the LNG-IUD. The different types of IUDs seemed to influence the coagulation regulatory system in different ways; the lower Factor VIII activity, the more tendency to bleeding. 3. The Factor VIII activity in the endometrium of women using IUDs was lower in all phases of the menstrual cycle including the proliferative phase when the Factor VIII activity is normally high. It cannot be excluded that this could be a contributing factor to IUD-induced bleedings.

Effects of spatial dispersion of acetylcholine release on AV conduction responses to vagal stimulation in dogs

We determined the effects on atrioventricular (AV) conduction of changing the spatial dispersion of acetylcholine (ACh) release from vagal nerve fibers in anesthetized dogs. We paced the atria at a constant rate and stimulated the vagus nerves with one stimulus burst per cardiac cycle. We varied the spatial heterogeneity of ACh release in the cardiac tissues by changing the stimulus voltage, and we varied the quantity of ACh release from each excited nerve fiber by changing the number of pulses per stimulus burst. We slightly changed the stimulus timing with each heartbeat to scan the entire cardiac cycle. We constructed phase-response curves (PRCs) by plotting the changes in AV conduction time as a function of the timing of vagal stimulation. We found that the amplitude of the PRC varied directly with average AV conduction time (AV), whereas the minimum-to-maximum phase difference of the PRC varied inversely with AV. However, for any given change in AV, the specific characteristics of the PRCs did not depend on whether we varied the number of pulses per burst or the stimulus voltage. Therefore, the phase-dependent characteristics of the dromotropic responses appear to be unaffected by the spatial dispersion of ACh release from the vagal nerve endings. The effects of vagal activity on the AV conduction time are determined by those conducting fibers that are the least restrained by neurally released ACh.

Endosonographic TNM staging of extrahepatic bile duct cancer: comparison with pathological staging

Endosonography was performed preoperatively in 33 patients with common bile duct carcinoma and in 43 patients with carcinoma of the common hepatic duct and its bifurcation. The results were correlated with the histology of resected specimens according to the new (1987) TNM (tumor, node, metastasis) classification. Endosonography was accurate in the evaluation of the depth of tumor infiltration. Overall accuracy for common bile duct carcinoma and common hepatic duct carcinoma was 82.8% and 85%, respectively. Endosonography was helpful in diagnosing regional lymph node metastases but not accurate in diagnosing nonmetastatic lymph nodes. With common bile duct carcinoma, the incidence of lymph node metastasis increased with progressive depth of tumor infiltration. No such correlation was found in common hepatic duct carcinomas. In the staging of distant metastasis, this technique was limited by the low-penetration depth of ultrasonography. Thus, additional transcutaneous ultrasonography or computed tomography was necessary for complete staging. The routine use of the biopsy channel for endosonographically guided aspiration puncture will further enhance the diagnostic value of endosonography in the future.

[Research and application of SUPER-1 intellectural instrument used in physiology laboratory]

Research work for making a biomedical signal processing instrument based on the APPLE-II computer is reported in this paper. According to the theory of the computer, two interface boards were designed as the hardware of the instrument. The memorizing waveform program was designed as the main program in the software system. Through a functional extended program, also called software inter face, more than ten programs especially for physiology can be easily linked to the main program. with the combination of both the software and hard ware several parameters of the instrument, such as sampling speed, gain of the amplifier, etc. can be controlled by a closed loop. This instrument is available in the physiology laboratory to replace oscilloscope, recorder, stimulator simultaneously. The functions of the instrument are stronger than those of the conventional instruments.

Lectin histochemistry of cystic jaw lesions: an aid for differential diagnosis between cystic ameloblastoma and odontogenic cysts

The binding sites for Ulex europaeus agglutinin I (UEA-I), Bandeirea simplicifolia agglutinin I (BSA-I), and peanut agglutinin (PNA) were comparatively examined in the surgical materials from 41 cases of cystic and solid ameloblastomas and 42 cases of non-neoplastic odontogenic cysts including dentigerous cyst, odontogenic keratocyst, and radicular cyst. In non-neoplastic cysts, most of epithelial lining layers gave positive binding with UEA-I and BSA-I. However, no positive reactions were obtained for these two lectins in the epithelial components of ameloblastoma, except for limited UEA-I binding to markedly keratinized tumor cells in four cases. PNA binding was irregular and did not make any clear distinction between ameloblastomas and cysts. The results suggest that the lectin staining for UEA-I and BSA-I is a useful histologic aid for differential diagnosis between cystic ameloblastoma and non-neoplastic jaw cysts.

Opioids regulate the release of human chorionic gonadotropin hormone from trophoblast tissue

Opioid ligands were investigated for their effect on hCG release from trophoblast tissue obtained from term human placenta. Data obtained indicate that opiate agonists stimulate in vitro basal hCG release from trophoblast tissue. The potency of these opioid agonists correspond to their kappa receptor selectivity, i.e., the greater the selectivity the lower is the effective concentration causing maximum stimulation. Opioid antagonists inhibit the release of hCG due to their reversal of the stimulation caused by endogenous opioid peptides. Potency of the antagonists correspond also to their kappa receptor selectivity. Antagonists reverse the stimulation of hCG release caused by agonists indicating that the ligand's action is mediated by the placental kappa opioid receptors. The bell shaped response curves for agonists and antagonists suggest that opioids play a role in the regulation of hCG release from trophoblast tissue, but other mechanism(s) may also exist.

[Effects of amino acids on the membrane potential of toad oocytes and the underlying mechanism]

Of the 23 amino acids tested for their effect on the membrane potential of incubated toad oocyte, alanine, leucine and lysine were found to cause a decrease of polarization (depolarization) and K+ permeability, while tryptophan causes an increase of potential (hyperpolarization) and K+ permeability. For the rest 19 amino acids, no membrane effects were observed. Accompanying the alanine, leucine and lysine caused depolarization, the oocyte progesterone content became doubled and the maturation process hastened. These effects could be completely blocked by 1 mmol/L dibutyryl cAMP (db-cAMP) or 50 mumol/L estradiol. Tryptophan on the other hand could block the progesterone (10 mumol/L) induced depolarization but had no effect on the db-cAMP induced hyperpolarization. The regulatory function of the amino acids and steroid hormones underlying oocyte maturation is discussed.

Frequent mutations in the p53 tumor suppressor gene in human leukemia T-cell lines

Human T-cell leukemia and T-cell acute lymphoblastic leukemia cell lines were studied for alterations in the p53 tumor suppressor gene. Southern blot analysis of 10 leukemic T-cell lines revealed no gross genomic deletions or rearrangements. Reverse transcription-polymerase chain reaction analysis of p53 mRNA indicated that all 10 lines produced p53 mRNA of normal size. By direct sequencing of polymerase chain reaction-amplified cDNA, we detected 11 missense and nonsense point mutations in 5 of the 10 leukemic T-cell lines studied. The mutations are primarily located in the evolutionarily highly conserved regions of the p53 gene. One of the five cell lines in which a mutation was detected possesses a homozygous point mutation in both p53 alleles, while the other four cell lines harbor from two to four different point mutations. An allelic study of two of the lines (CEM, A3/Kawa) shows that the two missense mutations found in each line are located on separate alleles, thus both alleles of the p53 gene may have been functionally inactivated by two different point mutations. Since cultured leukemic T-cell lines represent a late, fully tumorigenic stage of leukemic T cells, mutation of both (or more) alleles of the p53 gene may reflect the selection of cells possessing an increasingly tumorigenic phenotype, whether the selection took place in vivo or in vitro. Previously, we have shown that the HSB-2 T-cell acute lymphoblastic leukemia cell line had lost both alleles of the retinoblastoma tumor suppressor gene. Taken together, our data show that at least 6 of 10 leukemic T-cell lines examined may have lost the normal function of a known tumor suppressor gene, suggesting that this class of genes serves a critical role in the generation of fully tumorigenic leukemic T cells.

Effects of the spatial dispersion of acetylcholine release on the chronotropic responses to vagal stimulation in dogs

We determined the effects of changing the spatial dispersion of acetylcholine release on the phase-dependent chronotropic responses to vagal stimulation in anesthetized dogs. We stimulated the vagus nerves with one brief burst of electrical pulses each cardiac cycle, and we changed the timing of the stimulus by a small, constant amount each cardiac cycle to scan the entire cycle. To vary the heterogeneity of acetylcholine release, we changed the voltage of the stimulus pulses over a range of submaximal values. To achieve the maximum homogeneity of acetylcholine release, we used supramaximal voltages, and we varied the level of acetylcholine release from each excited fiber by changing the number of pulses per burst. We used the average cardiac cycle length of the phase-response curve to assess the overall vagal effect, independent of its timing within the cardiac cycle. We found that the amplitude of the phase-response curve varied directly and the minimum-to-maximum phase difference varied inversely with the overall efficacy of vagal activity. However, for any given alteration in the overall efficacy, the specific changes in the characteristics of the phase-response curve did not depend on whether the alteration was achieved by varying the number of pulses per burst or by varying the stimulus voltage. Therefore, we conclude that although the cardiac chronotropic response is very sensitive to changes in the timing of vagal stimulation, it is not influenced appreciably by the spatial dispersion of acetylcholine release from the vagal nerve endings over a wide range of stimulation strengths.

Clogging of biliary endoprostheses: a new perspective

Endoscopic palliation with biliary endoprostheses is now an established treatment for benign and malignant strictures of the biliary tree. These endoprostheses, however, tend to clog with time. We investigated this problem by undertaking in vitro studies on stents of different designs made of different polymer materials. The stent that performed best was then tested in an in vivo trial. There was a direct relation in vitro between the frictional coefficient of a polymer and the amount of encrusted material. Catheters perfused in bacterially contaminated bile, irrespective of material and design, accrued significantly more sludge than catheters perfused with sterilised bile. The presence of side holes significantly increased the amount of sludge in the stents, but eliminated any differences between the various materials. We therefore investigated the effect of omitting side holes in a clinical trial which consisted of two groups of 20 patients each. The group treated with conventional stents accrued significantly more sludge in the stents than the group treated with experimental stents without side holes (p less than 0.05). The absence of side holes did not cause incomplete drainage or increase morbidity. Side holes are detrimental to stent patency, which is adversely affected by other factors including bacteria and proteins.

New Taxanes from Taxus chinensis

Two new taxane diterpenes, decinnamoyltaxagifine ( 3) and decinnanioyltaxagifine acetate ( 2), have been isolated from the leaves and stems of TAXUS CHINENSIS. Their structures were elucidated by spectroscopic methods. Their (13)C-NMR chemical shifts were assigned.

[HPTLC densitometric determination of free bile acids in bezoar]

Cholic acid (CA), chenodeoxycholic acid (CDCA) and deoxycholic acid (DCA) which are extracted with CH3OH from Bezoar can be separated on HPTLC silica gel plate (made in China) with isooctane-n-butyl acetate-acetic acid (4:2:1), and the three bile acids were determined by TLC densitometry.

Immunolocalization of basement membrane molecules in the stroma of salivary gland pleomorphic adenoma

In order to determine the participation of basement membrane molecules in formation of its characteristic stroma, 30 cases of salivary gland pleomorphic adenoma were examined by immunohistochemical staining for type IV collagen, laminin, heparan sulfate proteoglycan, and entactin. The stroma was histopathologically classified into four types: hyaline, fibrous, myxoid, and chondroid. Immunohistochemically, type IV collagen and laminin were more intensively localized in hyaline, fibrous and chondroid types of stroma, whereas heparan sulfate proteoglycan was more prominent in myxoid areas. The results suggest that the stroma contains these basement membrane components, which are possibly biosynthesized by epithelial tumor cells, and that histological variety of the stroma depends on proportion of local contents of each basement membrane molecule.

Reduced GABA-mediated chloride flux in entorhinal cortex-kindled rat brains

Gamma-aminobutyric acid (GABA)-mediated chloride uptake was determined in synaptoneurosomes prepared from the brains of entorhinal cortex-kindled and paired control rats. Subjects were sacrificed either 24 h or 28 days after the experimental animals had exhibited their sixth stage 5 convulsion. In the cortex and cerebellum, no difference was observed between kindled and control animals at either time period. In the brain-stem, however, a significant reduction (approximately 50%) in chloride uptake was observed in kindled subjects both 24 h and 28 days after the last seizure. These findings are consistent with the hypothesis that the 'kindled state' results from a long-lasting decrease in GABA-mediated inhibitory activity.

Ultrastructural comparative study on endometrium of Chinese women using intrauterine devices of stainless steel ring, copper T220, and releasing levonorgestrel: morphometry of microvessels

An electron microscopic morphometric study was performed for three kinds of IUDs, the stainless steel ring (SS), the copper T220 (TCu) and the WHO levonorgestrel IUD (LNG), for comparison of their effects on microvessels of the endometrium of women wearing the devices. The morphometry of plasmolemmal vesicles (PV) of the endothelial cell as well as the contracted and degenerated endothelial cell were undertaken. The results showed that all three IUDs led to significant changes in blood vessels, i.e., a higher percentage of contracted and degenerated cells than in the control group (p less than 0.01), and an increase in PV after insertion of the devices (p less than 0.01). The TCu caused more contracted endothelial cells than the SS (p less than 0.01) and the LNG (p less than 0.05). The levonorgestrel-releasing IUD resulted in a higher increase of PV than the SS and the TCu. For the differences between bleeding and non-bleeding groups, only the TCu showed a higher percentage of contracted cells (p less than 0.05).

Homozygous deletion of the retinoblastoma gene in an acute lymphoblastic leukemia (T) cell line

Human leukemia cell lines were examined for the status of the retinoblastoma (RB) protein by immunoblotting analysis using antibodies raised against the TrpE-RB fusion protein. One of 16 cell lines examined, the T-cell acute lymphoblastic leukemia (ALL) line HSB-2, lacked the 110-Kd RB protein. Southern blot analysis of genomic DNA extracted from HSB-2 cells showed a large homozygous deletion of the RB gene, stretching from exon 18 beyond exon 27. Northern blot analysis showed multiple, abnormal RB transcripts in HSB-2. A truncated protein (72 Kd) was detected with 35S-methionine labeling but not with 32P-orthophosphate labeling of the HSB-2 cells. The genomic deletion of greater than 85 kb DNA at the RB locus (13q14) was not detectable in the karyotype of the HSB-2 cells. Among the 16 human leukemia cell lines examined for the status of the RB gene, only one, the HSB-2 line, showed an abnormal RB protein. Further study of primary leukemia and lymphoma samples appears to be warranted.

Autoantibodies to keratin in Sjögren's syndrome

In order to determine which components of the salivary duct cells are recognized by the antisalivary duct antibodies, sera of patients with Sjögren's syndrome were screened for immunoreactivity to keratin by using an ELISA test and a Western blot analysis. The autoantibodies which reacted with keratin were demonstrated in 8 of 9 definite cases of Sjögren's syndrome and in 3 of 6 probable cases, and they reacted with different keratin peptides in each case. The results suggest that the antisalivary duct antibodies include antibodies against keratin, which exists ubiquitously as a cytoskeleton in the salivary gland epithelial cells. Detection of antikeratin antibody might be a useful aid for diagnosis of Sjögren's syndrome.

Endoscopic placement of expandable metal stents for biliary strictures--a preliminary report on experience with 33 patients

The main problem with palliative treatment of extrahepatic cholestasis with an endoscopic biliary endoprosthesis is clogging. One of the factors thought to be of importance is the diameter of the stent. In order to avoid being limited by the size of the instrumentation channel of the endoscope, expandable stents have been developed. In this article we report on our preliminary clinical experience with an endoscopically placed expandable metal stent ("Wallstent") in 33 patients with extrahepatic bile duct stenoses. When fully expanded, the stent has a diameter of 30 F and a length of 6.7 cm. It was possible to successfully place a stent in every patient. Clinical improvement was achieved in all patients except one. Two patients underwent elective surgery, while one died of renal failure. Another died of septic shock after 5 weeks, but no autopsy was performed. In conclusion, our initial experience with this stent shows that at least in the short term biliary drainage was excellent, with no complications of pancreatitis or hemorrhage. Longer follow-up than our 4 weeks is necessary to establish the position of this stent in comparison with the conventional endoprosthesis in the management of obstructive jaundice.

The effect of intrauterine devices (stainless steel ring, copper-T220 and levonorgestrel) on the DNA content in isolated human endometrial cells

The effect of three different intrauterine devices on the DNA content in human endometrial cells has been studied in 29 women before and after the insertion of an IUD; a stainless steel ring (9 subjects), Copper-T220 (11 subjects) and a medicated IUD releasing levonorgestrel at a rate of 2 micrograms/day (9 subjects). The material was grouped into "bleeders" (having more than 8 days of bleeding and spotting per month) and "non-bleeders" (having less than 8 days of bleeding and spotting per month). The DNA content was assessed on isolated endometrial cells smeared from thin biopsies and the amount of DNA per cell nucleus was measured by means of a Feulgen microspectrophotometric method. No significant difference was found between the "bleeders" and the "non-bleeders" as to the DNA content. Nevertheless, when the total number of subjects were pooled together, a significant increase in the DNA content was found in the post-insertion specimens in the groups of women using the SS and the T-Cu IUDs. Furthermore, a significant decrease in the DNA content was also found when the specimens obtained after the insertion of the LNG IUD were compared with those obtained after 24 months' use of the stainless steel ring and the Copper-T220 device (p less than 0.01 and p less than 0.002, respectively). It is concluded that the insertion of an inert IUD or an T-Cu IUD, induces significant alterations in the DNA content of the human endometrium adjacent to the device, whereas the use of the LNG device does not significantly modify the DNA synthesis when used for 3-10 months. No correlation was found between the DNA content per cell and the number of days of bleeding and spotting.

Analysis of submandibular gland sialograms in Sjögren's syndrome

We report here the sialographic appearances of the submandibular gland in both primary and secondary Sjögren's syndrome (SS). In order to compare these with those of the parotid gland, we defined new criteria for the staging for SS based on the degree of depiction of the peripheral ducts. In 24 out of 74 cases the submandibular sialogram showed more advanced, destructive disease compared with the parotid. This study suggests that although SS involves the parotid gland first, it progresses in the submandibular gland more rapidly.

The effect of intrauterine devices, the stainless steel ring, the copper T220, and releasing levonorgestrel, on the bleeding profile and the morphological structure of the human endometrium--a comparative study of three IUDs. A morphometric study of 96 cases

Thirty-four women using the stainless steel ring (SS), 43 women using the Copper T220 (TCu), and 19 women using levonorgestrel-releasing intrauterine devices (LNG) were admitted to the study. The light microscopic biopsy material was subjected to morphometric studies including 8 indices of endometrial activity before (Control) and after 24 months of exposure to the SS and TCu device and 3-10 months of exposure to the LNG device. The women were grouped into subjects with and without intermenstrual and prolonged bleeding. The results revealed that there were highly significant differences between the IUDs at the endometrial level as displayed by morphometry. However, the difference between bleeders and non-bleeders was not significant in any of the three types of IUDs. Although the mode of action of these IUDs at the endometrial level is different, the mechanism responsible for the irregular endometrial bleeding needs to be further investigated.

Cyclosporin in the treatment of severe aplastic anemia: report of one case

According to recent reports, cyclosporin (CsA) has been proven to be a cure for some patients with severe aplastic anemia (SAA). The use of CsA to treat SAA is based on both experimental and clinical evidences showing that this disease is sometimes caused by immune-mediated mechanisms. This report describes a fourteen-year-old boy who recovered from SAA after being treated with CsA, together with to a lesser extent prednisolone. In June of 1986, when he failed to improve after receiving six months of corticosteroid treatment, CsA was introduced. Following three weeks of CsA therapy no further blood transfusion was needed. Danazol was added on the 28th day of CsA therapy. On the 105th day the blood counts began to improve, and on the 375th day bone marrow aspirate revealed normal hematopoiesis. Along with these improvements, however, some side effects from the CsA treatment were observed. These included: hirsutism, hypertension and gingival hyperplasia, all of which eventually subsided on tapering and finally terminating CsA. For the time being, no side effects have been observed in the six-months period since CsA was stopped and the patient is leading a normal life.

Heat stroke: a clinical review of 27 cases

Heat stroke is the most serious entity amongst the heat disorders. Whilst potentially fatal, it is preventable and salvageable. A retrospective study involving 27 patients admitted for exertional heat stroke to the Medical Unit, Toa Payoh Hospital, Singapore from January, 1984 to January, 1987 was carried out. These patients presented with a rectal temperature of greater than 40 degrees C and central nervous system disturbances. All were males and, except for three, were local born. All except two were below thirty years old. The patients were treated with a standard regime of IV fluids and sponging in the ICU. 19 patients (70.4%) presented in coma whilst abnormal behaviour, e.g. aggression and mental confusion was seen in the remainder. Fits were seen in only 5 patients (18.5%). Metabolic acidosis was seen in 93.3%. Hypokalaemia was present in 3 patients (11.1%). Of the enzymes, creatinine phosphokinase was elevated in all except 1 patient (mean: 4868.8, range: 146-28850). There were no deaths recorded in this series. Complications include reversible DIVC (3 instances), oliguric renal failure (4 instances) and residual neurological deficit (2 instances). 9 patients (39.1%) took more than 4 hours for the rectal temperature to attain 37.5 degrees C. All the above complications except for 1 instance of DIVC occurred in this group with delayed cooling. Heat stroke is a serious condition with serious complications and require prompt treatment.

Vagal stimulation decreases rate of left ventricular relaxation

We determined the effects of vagal stimulation on the time constant (tau) of left ventricular isovolumic pressure decay and on the maximum rates of left ventricular pressure change (dP/dt) during contraction and relaxation in anesthetized dogs. In each dog, the atria were paced at a constant rate of 150 beats/min. We recorded left ventricular pressure waveforms in the absence (control) and in the presence of vagal stimulation at frequencies of 1, 2, and 3 Hz. During the control periods and during vagal stimulation at each frequency, we determined tau, the maximal rate of contraction, and the maximal rate of relaxation from left ventricular pressure waveforms recorded at medium (100 mmHg), high (130 mmHg), and low (73 mmHg) afterloads. Vagal stimulation at a frequency of 3 Hz increased tau by 23%. This effect of vagal stimulation on tau was most pronounced at the high afterload. Vagal stimulation at 3 Hz decreased the maximal rate of relaxation by 19%, but it decreased the maximal rate of contraction by only 8%. Thus vagal stimulation significantly decreased the rate of left ventricular relaxation and had a greater depressant effect on ventricular relaxation than on contraction.

Post-treatment calcification of mesenteric non-Hodgkin lymphoma: CT findings

We report the clinical course, plain radiographic, and CT findings in two cases of post-treatment calcification in non-Hodgkin lymphoma. A peripheral curvilinear pattern of calcification appears to be characteristic.

In situ correlative immuno-identification of mononuclear infiltrates and invasive bacteria in diseased gingiva

The purpose of this study was to identify and quantify mononuclear cells and invasive bacteria in consecutive histological sections in diseased gingiva. Gingival biopsies were obtained from sites displaying evidences of severe periodontitis (pocket depth greater than 5 mm, bleeding on probing) in six patients. Specimens were frozen and serially sectioned at 8 micron in a cryostat. Monoclonal antibodies (mAb) directed against membrane markers of mononuclear infiltrate cells and rabbit polyclonal sera against specific bacteria shown to be invasive in association with an immunoperoxidase technique and specific point quantification were used. The mAb panel included Leu 1 (Pan T), Leu 2a (T suppressor/cytotoxic), Leu 3a (T helper/inducer), Leu 6 (Langerhans/dendritic), Leu 7 (NK/K), Leu M3 (monocyte/macrophage), and B7 (B cell). This methodology allows for in situ per cent quantification of mononuclear cell subsets along with identification and quantification of invasive bacteria in the same gingival tissue site. This may be a practical approach to establish the relationship between bacterial invasion and cellular immune response by the host. This technique enabled the characterization of the mononuclear infiltrate in relationship to specifically identified invasive bacteria in diseased gingiva.

Brain neurotransmitters in glycine encephalopathy

We measured neurotransmitter markers in autopsied brain of infants with glycine encephalopathy (GE). Because patients with GE develop intractable seizures, special attention was devoted to those neurotransmitter systems implicated in human epilepsy. Mean levels of glycine in the frontal cortex of GE patients were three times higher than control values. No abnormalities were observed for concentrations of gamma-aminobutyric acid (and related receptors), other major neurotransmitter amino compounds, or activities of cholineacetyltransferase and aspartate aminotransferase. Mean acetylcholinesterase activity was significantly elevated by 46%. As experimental data suggest, glycine markedly potentiates the action of the excitatory neurotransmitter glutamic acid. To the extent that the brain seizures in patients with GE can be explained by this mechanism, pharmacotherapy with excitatory amino acid antagonists may represent a new approach to the treatment of GE.