Botulinum toxin injections combined with or without sodium hyaluronate in the absence of electromyography for the treatment of infantile esotropia: a pilot study

OBJECTIVE

To evaluate the feasibility and safety of a revised technique of botulinum toxin type A (BTA) injections for the treatment of infantile esotropia.

METHODS

Forty-seven patients with infantile esotropia were randomly divided into two groups. In group A, 23 cases were treated with a bilateral injection of 2.5-3.75 U BTA combined with sodium hyaluronate (SH) to the medial rectus muscle. In group B, 24 cases were treated with a bilateral injection of 2.5-3.75 U BTA solution alone to the medial rectus muscle. Electromyography was not used in the study. All patients received one injection and were evaluated 2 weeks, 3 months, and 6 months following injection.

RESULTS

The measured changes between groups A and B included the frequencies of good alignment 6 months after injections (30.4% vs 37.5%), complicated ptosis (2.2% vs 20.8%), and vertical deviation (2.2% vs 2.1%).

CONCLUSION

BTA injections combined with or without SH in the absence of electromyography demonstrated effectiveness and feasibility in the treatment of infantile esotropia. A relative decrease in the frequency of complicated ptosis resulted from injections of BTA+SH.

Antibody targeting of anaplastic lymphoma kinase induces cytotoxicity of human neuroblastoma

Anaplastic lymphoma kinase (ALK) is a receptor tyrosine kinase aberrantly expressed in neuroblastoma, a devastating pediatric cancer of the sympathetic nervous system. Germline and somatically acquired ALK aberrations induce increased autophosphorylation, constitutive ALK activation and increased downstream signaling. Thus, ALK is a tractable therapeutic target in neuroblastoma, likely to be susceptible to both small-molecule tyrosine kinase inhibitors and therapeutic antibodies-as has been shown for other receptor tyrosine kinases in malignancies such as breast and lung cancer. Small-molecule inhibitors of ALK are currently being studied in the clinic, but common ALK mutations in neuroblastoma appear to show de novo insensitivity, arguing that complementary therapeutic approaches must be developed. We therefore hypothesized that antibody targeting of ALK may be a relevant strategy for the majority of neuroblastoma patients likely to have ALK-positive tumors. We show here that an antagonistic ALK antibody inhibits cell growth and induces in vitro antibody-dependent cellular cytotoxicity of human neuroblastoma-derived cell lines. Cytotoxicity was induced in cell lines harboring either wild type or mutated forms of ALK. Treatment of neuroblastoma cells with the dual Met/ALK inhibitor crizotinib sensitized cells to antibody-induced growth inhibition by promoting cell surface accumulation of ALK and thus increasing the accessibility of antigen for antibody binding. These data support the concept of ALK-targeted immunotherapy as a highly promising therapeutic strategy for neuroblastomas with mutated or wild-type ALK.

Controlling physiological angiogenesis by hypoxia-induced signaling

The full sequence of signals leading to new blood vessel formation is a physiological response to tissue hypoxia through upregulation of angiogenic factor cascades. Controlled initiation of this mechanism for therapeutic/engineered angiogenesis must rely on precisely localized hypoxia. Here we have designed a 3D in vitro model able to test the effect and predictability of spatially positioned local hypoxic stimuli using defined cell depots within a 3D collagen matrix. Cell-mediated hypoxia was engineered using human dermal fibroblasts (HDFs), to generate a local population of Hypoxia-Induced Signaling (HIS) cells. HIS cell depots released angiogenic factors which induced directional endothelial cell (EC) migration and tubule formation in a spatially defined assay system. Non-hypoxic baseline control cultures induced minimal EC migration with little tubule formation. Furthermore, depots of HIS cells, positioned in the core of 3D collagen constructs directed host vessel in-growth deep into the implant by 1 week, which was at least 7 days earlier than in non-hypoxia pre-conditioned constructs. The functionality of in vivo vascularisation was verified by real-time monitoring of O2 levels in the core of implanted constructs. These findings establish the angiogenic potential of HIS cells applicable to in vitro tissue modeling, implant vascularization and engineering predictable angiogenic therapies.

Trichosanthin, an extract of Trichosanthes kirilowii, effectively prevents acute rejection of major histocompatibility complex-mismatched mouse skin allograft

Trichosanthin is an active component extracted from the root tuber of the Chinese medicinal herb Trichosanthes kirilowii. Trichosanthin has abortifacient, anti-tumor, anti-HIV, and immunoregulatory functions. In the current study, we explored its potential effect on allograft rejection in a murine skin transplantation model across a fully mismatched major histocompatibility complex. It was found that treatment of recipient mice with trichosanthin (0.25 or 1 mg/kg, IP) significantly delayed allograft rejection. T cells that originated from recipients treated with trichosanthin were restimulated with donor-specific splenocytes showed a significantly reduced response compared with that of control recipients. In line with these results, the mRNA levels for interleukin (IL)-2 and interferon-gamma were decreased and the levels of IL-4 and IL-10 were increased in splenic T cells originating from trichosanthin-treated recipients. These results indicated that trichosanthin may have potential therapeutic value for transplantation rejection and other inflammatory diseases.

Combination of CsA, MTX and low-dose, short-course mycophenolate mofetil for GVHD prophylaxis

In an effort to reduce the incidence and severity of acute GVHD (aGVHD), we have developed a new prophylaxis regimen combining cyclosporine and MTX with a short 30-day course of low-dose (500 mg per day) mycophenolate mofetil. This regimen was studied prospectively 100 patients undergoing HLA-matched and 1-antigen-mismatched allogeneic peripheral blood SCT from related donors. The cumulative incidence of aGVHD was 16% (grades II-IV (9.5%) and grades III-IV (1%)). The cumulative incidence of chronic GVHD (cGVHD) was 53% with 28% extensive cGVHD. The cumulative incidence of transplant-related mortality at 100 days and 3 years were 6 and 13%. The estimated probabilities of disease-free survival at 3 years in standard- and high-risk patients were 77 and 30%, respectively (P<0.0001). The estimated probabilities of overall survival at 3 years in standard- and high-risk patients were 77 and 37%, respectively (P<0.0001). These data show a substantial decrease in the risk of developing aGVHD without an increase in relapse or any adverse impact on survival in standard-risk patients.

Hyperhexosemia induced functional and structural changes in the kidneys: role of endothelins

BACKGROUND/AIMS

Glomerular basement membrane (GBM) thickening and mesangial matrix expansion are characteristic features of diabetic nephropathy. The present study investigates the role of endothelins (ETs) in the pathogenesis of such changes in diabetic nephropathy.

METHODS

Diabetic (streptozotocin-induced, 65 mg/kg), galactose-fed (30%) and control animals were followed up for 1 and 6 months. Animal groups also included diabetic and galactose fed animals on dual ET(A)/ET(B) receptor antagonist bosentan (100 mg/kg). A semi-quantitative reverse transcription polymerase chain reaction method was used to quantify mRNA expression of ET-1, ET-3, ET(A), ET(B), fibronectin and collagen alpha2(IV). Histological analyses of the kidneys and ET-1, ET-3 and fibronectin immunohistochemistry were performed. Morphometric assessment of the GBM after 6 months was performed.

RESULTS

Diabetes increased mRNA expression of ET-1, ET-3, ET(A), ET(B), fibronectin and collagen alpha2(IV) after one and six months. In contrast, although increased ET(A) and ET(B) mRNAs were present following galactose feeding both at 1 and 6 months, ET-1, ET-3, fibronectin and collagen alpha2(IV)mRNAs were increased after 6 months. Both diabetes and galactose feeding caused increased GBM thickening. Furthermore, diabetes caused an increase in mesangial matrix production. Bosentan prevented increased fibronectin and collagen alpha2(IV) mRNA expression, increased mesangial matrix deposition and GBM thickening.

CONCLUSION

This study has demonstrated that diabetes and galactose feeding induced functional and structural changes in the kidney are mediated via ETs.

[Inhibitive effects of lip repair on maxillary growth in patients with complete unilateral cleft lip and palate]

OBJECTIVE

The aim of this study was to assess the isolated effects of lip repair on inhibition of maxillary growth in patients with complete unilateral cleft lip and palate.

METHODS

The lateral cephalometric analysis were applied to 20 patients with unilateral cleft lip and palate who only had lip repaired in childhood, 32 patients with unilateral cleft lip and palate who had both lip and palate repaired in childhood, as well as 37 normal Chinese of the same age as controls.

RESULTS

Both complete unilateral cleft lip and palate groups had almost the same significant degree of maxillary retrusion compared with the normal control group.

CONCLUSION

Lip repair is one of important factors that could inhibit maxillary growth in patients with complete unilateral cleft lip and palate.

[The effect of lip repair on maxillary growth in patients with complete unilateral cleft lip and(or) palate]

OBJECTIVE

To investigate the different effects of lip repair on maxillary growth among patients with cleft lip and(or) palate, and also the possible mechanisms accounting for that differences.

METHODS

The lateral cephalometric analysis was applied to 84 Chinese patients with unilateral cleft lip and(or) palate at the early stage of permanent dentition, which included 32 UCLA, 20 UCLP (CP unrepaired), and 32 UCLP, and 37 normal Chinese of the same age as controls.

RESULTS

The patients with unilateral cleft lip and palate who had lip repaired while the palate was left unrepaired exhibited the similar inhibition on maxillary growth to those who had both lip and palate repaired but the patients with unilateral cleft lip and alveolus had much less inhibition on their maxilla.

CONCLUSIONS

The cleft and tissue defect of patients with cleft lip and palate might be the main cause that induced the inhibitive effects of lip repair on maxillary growth.

Helicobacter spp. infection in cats: evaluation of the humoral immune response and prevalence of gastric Helicobacter spp

The principal aims of this study were to evaluate the humoral immune response (IgG) of cats with gastric Helicobacter spp. infection, and to determine the prevalence of different types of Helicobacter spp. in the stomachs of cats. The Helicobacter infection status of 45 cats (12 healthy spay/neuter cats, 9 sick cats, 24 colony cats) was determined by evaluating endoscopic gastric biopsies for urease activity, presence of Helicobacter-like organisms (HLO) on histopathology, and genus and species-specific PCR. Serum samples were evaluated with a kinetic enzyme linked immunosorbent assay (ELISA) utilizing the high molecular cell-associated protein (HM-CAP) fraction of H. felis ATCC 49179.Seventeen of 45 cats were infected with Helicobacter spp.: "H. heilmannii" 9/17, H. felis 4/17, mixed "H. heilmannii" and H. felis 3/17, unclassified-Helicobacter spp. 7/17. H. pylori was not detected in any cat. Kinetic ELISA results were significantly higher for infected cats, than for uninfected cats. Cats infected with different Helicobacter spp. showed similar distribution of OD/min values. There were no effects of age or clinical signs on the results of kinetic ELISA. No correlation between colonization density and seroconversion was observed. There were statistically significant, but weak correlations between the degree of seroconversion and the degree of inflammation, and the number of lymphoid follicles. Infected cats had more severe inflammation in the pylorus and fundus than uninfected cats. Infected sick cats had a higher degree of pyloric, but not fundic inflammation, than healthy infected cats and uninfected sick cats. The results indicate that naturally acquired infection with gastric Helicobacter spp. is associated with seroconversion (IgG) in cats. The similar ELISA values in cats infected with a variety of Helicobacter spp. suggests substantial antigenic homology between different Helicobacter spp. The higher degree of inflammation in infected than uninfected cats, supports a role for Helicobacter as a cause of gastritis in cats.

Ovine metabolism of saponins: evaluation of a method for estimating the ovine uptake of steroidal saponins from Narthecium ossifragum

A sheep was dosed three times per day over six consecutive days with 70 g Narthecium ossifragum, and once on the seventh day with 70 g N. ossifragum. Additionally, it was dosed once on days 1-7 with 20 mg of [20,23,23-2H3]sarsasapogenin. After 7 days, the sheep was killed and GC-MS analysis of the free and conjugated sapogenin content in bile, urine, rumen, duodenum, jejunum, colon and rectum samples collected from the sheep, faecal samples collected on days 4-7, and dosed plant material was performed. The N. ossifragum contained mainly sarsasapogenin and smilagenin. Only neglible levels of deuterium-labelled sarsasapogenins were detected in the samples from the animal. Ingested saponins were quickly hydrolysed in the rumen to free sapogenins and, in part, epimerized at C-3 to afford episapogenins. The absorption of free sapogenins appeared to occur in the jejunum. The concentration of sapogenins in faeces reached a plateau 108 h after dosing started.

[Analysis of the methylation in CpG island by denaturing high-performance liquid chromatography]

OBJECTIVE

To establish a new approach for analyzing methylation circumventing the limitations of the existing methods.

METHODS

A region containing CpG sites in mismatch repair gene hMLH1 promoter was amplified by strand-specific polymerase chain reaction (PCR) after sodium bisulfite treatment. The retention time of the PCR product at partially denaturing temperature was determined by denaturing high-performance liquid chromatography (DHPLC). The methylation status obtained by DHPLC was proved by comparing it with that from sodium bisulfite-restriction enzyme digestion.

RESULTS

Methylation of hMLH1 promoter from a colorectal cancer cell line RKO and a gastric cancer cell line PACM82 was analyzed by DHPLC. The retention time of the PCR product from RKO was obviously longer than that from PACM82 (6.7 min vs. 6.2 min). Thus, it was concluded that the hMLH1 promoter from RKO was methylated, while that from PACM82 was not, since the longer retaining time of RKO was due to the higher C/G content after sodium bisulfite treatment. The results from DHPLC were consistent with those from sodium bisulfite-restriction enzyme digestion.

CONCLUSION

DHPLC method is a rapid and reliable approach for analyzing methylation in CpG island of the sequence of interest.

[Diagnosing complicated congenital heart disease with two-dimensional echocardiography and three-segment concept]

OBJECTIVE

To apply three-segment heart anatomy concept to two-dimensional echocardiography (2DE) in the diagnosis of complicated congenital heart disease (CHD).

METHODS

920 cases of CHD were diagnosed with 2DE and three-segment heart anatomy concept. 822 out of the 920 cases underwent angiocardiography, and 584 cases were confirmed by operation.

RESULTS

According to three-segment heart anatomy concept of atrial position, 855 cases were situs solitus (including 89 cases of left superior vena cava and 31 cases of complete anomalous pulmonary venous drainage), 53 cases were situs inversus, and 12 cases were situs ambigus. As to atrial-ventricular valve, 747 cases were both opening, 112 cases had one-side atresia, and 61 cases had one together valve; As to ventricle position, 606 cases were dextro-loop, 111 cases had levo-loop, and 203 cases had single ventricle (including 24 cases), As to cor biloculare of great artery relation, 304 cases had normal relation of great arteries, including 35 cases of pulmonary atresia, 219 cases had right-transposition of great arteries, 240 cases had left-transposition of great arteries, 32 cases were mirror to normal, and 25 cases had persistent truncus arteriosus. 823 cases were diagnosed with 2DE, with a total accurate rate of 89.5%.

CONCLUSION

Applying three-segment heart anatomy concept to 2DE to diagnose complicated CHD and analyzing the heart segment by segment will make the diagnosis simple and systematic, providing a concise basis for heart surgeries.

Formation of N-(Nitrosomethyl)urea in stomachs of experimental pigs and human volunteers given fish sauce in vivo

N-(Nitrosomethyl)urea (NMU) was characterized in carcinogenic nitrosated fish sauce recently (Deng et al. J. Agric. Food Chem. 1998, 46, 202-205; Biomed. Environ. Sci. 1999, 12, 54-61). To study the possibility of intragastric synthesis of NMU, experimental mini-pigs surgically fitted with a flexible stomach cannula and human volunteers were used. Fish sauce samples (20-30 mL) and nitrite were injected into the gastric lumen through the cannula for pigs or taken orally for human volunteers. Gastric juice samples were taken out 30 min later. Concentration of NMU in condensed extracts of these samples was analyzed with HPLC-photohydrolysis-pyrolysis-thermal energy analyzer. Results showed that there was formation of NMU in the gastric lumen of both models in vivo and that the formation of NMU was nitrite- and pH-dependent. NMU was also detectable in the condensed extract of 100 mL of a mixture of pooled fasting human gastric juice samples and fish sauce sample (9:1, v/v) after treatment with 500 micromol/L of nitrite in vitro. In conclusion, there is intragastric formation of NMU, even at natural amounts of nitrite.