Intracellular correlates of acquisition and long-term memory of classical conditioning in Purkinje cell dendrites in slices of rabbit cerebellar lobule HVI

Intradendritic recordings in Purkinje cells from a defined area in parasaggital slices of cerebellar lobule HVI, obtained after rabbits were given either paired (classical conditioning) or explicitly unpaired (control) presentations of tone and periorbital electrical stimulation, were used to assess the nature and duration of conditioning-specific changes in Purkinje cell dendritic membrane excitability. We found a strong relationship between the level of conditioning and Purkinje cell dendritic membrane excitability after initial acquisition of the conditioned response. Moreover, conditioning-specific increases in Purkinje cell excitability were still present 1 month after classical conditioning. Although dendritically recorded membrane potential, input resistance, and amplitude of somatic and dendritic spikes were not different in cells from paired or control animals, the size of a potassium channel-mediated transient hyperpolarization was significantly smaller in cells from animals that received classical conditioning. In slices of lobule HVI obtained from naive rabbits, the conditioning-related increases in membrane excitability could be mimicked by application of potassium channel antagonist tetraethylammonium chloride, iberiotoxin, or 4-aminopyridine. However, only 4-aminopyridine was able to reduce the transient hyperpolarization. The pharmacological data suggest a role for potassium channels and, possibly, channels mediating an IA-like current, in learning-specific changes in membrane excitability. The conditioning-specific increase in Purkinje cell dendritic excitability produces an afterhyperpolarization, which is hypothesized to release the cerebellar deep nuclei from inhibition, allowing conditioned responses to be elicited via the red nucleus and accessory abducens motorneurons.

Pairing-specific long-term depression prevented by blockade of PKC or intracellular Ca2+

Long-term depression was established in cerebellar Purkinje cells using 20 pairings of a brief, high frequency train of parallel fiber stimulation with a subsequent 100 ms depolarizing current injection. Effects were assessed on the peak amplitude of Purkinje cell excitatory post synaptic potentials (EPSPs) elicited by single parallel fiber test pulses. Intradendritically recorded Purkinje cell EPSPs exhibited long-term (>20 min) reduction in peak amplitude following paired stimulation but not if pretreated with the protein kinase C inhibitor calphostin C or iontophoretically injected with the calcium chelator EGTA. The similarity of the stimulation protocol and behavioral conditioning paradigms suggests pairing-specific long-term synaptic depression is a valuable model for understanding the cellular mechanisms underlying cerebellar cortical contributions to learning.

[Chitosan pin fixation of rabbit proximal tibia osteotomy]

Degradatable chitosan pin, 4 millimeters in diameter and 30 to 40 millimeters in length, was studied radiographically and histologically (oxytetracycline-labeling) at 3, 6, 12, 24 and 48 weeks after the implantation for fixation of a transverse proximal tibia osteotomy in fourty rabbits. The results showed that new bone formation and oxytetracycline uptake were increased 3-6 weeks after operation and the fracture was completely healed 12 weeks after operation, but in two rabbits the chitosan pin broke, in 3 weeks. Histologically, there was a massive inflammation (non-specific foreign body reaction) 3-12 weeks after implantation, which gradually subsided 24 weeks aften operation. Chitosan pin was slowly degradated in bone and was not replaced by normal tissue 48 weeks after operation. The questions to be addressed in future include how to increase the mechanical strength of chitosan pin and how to improve the characteristics of its surface.

[FTIR-PAS of rare earth coordinated compounds of Schiff base derived from vanillin and p-toluidine]

The Fourier transform infrared photoacoustic spectra (FTIR-PAS) of Schiff base derived from vanillin (3-methoxy-4-hydroxybenzaldehyde) and p-toluidine and its rare earth coordinated compounds in the 3800-200cm(-1) were measured and inverstigated. The coordinated compounds have two classes: [LnL2Cl x 3H2O]Cl2(Ln:La,Ce,Pr,Nd,Sm,Eu,Gd,Dy;L:Schiff base ligand) and [LnL2Cl2 x 2H2O] Cl x H2O(Ln:Ho,Er,Tm,Yb,Lu). In the coordinated compounds there is intermolecular hydrogen bond derived from phenolic hydroxy group. The bands at 400 and 300cm(-1) are respectively assigned to bonds M-O (water) and M-N.

Viscerosomatic interactions in the thalamic ventral posterolateral nucleus (VPL) of the squirrel monkey

In anesthetized squirrel monkeys single cell recordings were performed using tungsten microelectrodes. The responses of 29 viscerosomatoceptive and somatoceptive VPL neurons to noxious distension of the urinary bladder, the lower esophagus and the distal colon and to innocuous and noxious somatic stimuli were assessed when these stimuli were presented separately or together. Neuronal responses were defined as additive or interactive depending on the relative changes in responses to individual somatic or visceral stimuli, and on their responses during conditioning (somatic and visceral stimuli applied concurrently). In 13 neurons interactions between the somatosensory and visceral inputs could be demonstrated. The dominant interactive effect was inhibition, although facilitatory effects were seen as well (2 of 13). The magnitude or direction of the interactions seemed independent of the location of the somatic and visceral receptive fields. The mean population response of the neurons showing interactions was 4.66 spikes/s to somatic stimulation, and 0.07 spikes/s to visceral stimulation. During conditioning the mean interactive effect was -62% of the calculated additive effect. This implies that overall the somatic responses are halved during a coincident visceral stimulus. In a subgroup of the VPL neurons, which were classified as pure somatic responsive (n=14) due to their unresponsiveness during visceral stimulation alone, a third (n=5) still exhibited visceral convergence during conditioning. The latter neurons, therefore, receive visceral inputs, which function in a purely interactive (modulatory) manner. It is concluded that part of the described effects is due to competition (cross modality suppression) between the visceral and somatic inputs. We further conclude that the suppression of somatic information by noxious visceral stimuli may contribute to a more effective processing of the discriminatory aspects of nociceptive visceral information previously demonstrated in VPL.

[Quantitative determination of niphensamide by high performance liquid chromatography (HPLC)]

An HPLC method for the quantitative determination of Niphensamide in pesticide powder was developed. Column:Micropak-CH 5 microns (300 mm x 4.0 mm i.d.), mobile phase: CH3OH-H2O(1:1), detector: UV 254 nm, flow rate: 0.7 mL/min, column temperature: 25 degrees C. Under the above conditions, Niphensamide and other components were separated from each other. The method is simple, rapid, sensitive and accurate.

Activation of hPAK65 by caspase cleavage induces some of the morphological and biochemical changes of apoptosis

Apoptosis is a highly regulated form of cell death, characterized by distinctive features such as cellular shrinkage and nuclear condensation. We demonstrate here that proteolytic activation of hPAK65, a p21-activated kinase, induces morphological changes and elicits apoptosis. hPAK65 is cleaved both in vitro and in vivo by caspases at a single site between the N-terminal regulatory p21-binding domain and the C-terminal kinase domain. The C-terminal cleavage product becomes activated, with a kinetic profile that parallels caspase activation during apoptosis. This C-terminal hPAK65 fragment also activates the c-Jun N-terminal kinase pathway in vivo. Microinjection or transfection of this truncated hPAK65 causes striking alterations in cellular and nuclear morphology, which subsequently promotes apoptosis in both CHO and Hela cells. Conversely, apoptosis is delayed in cells expressing a dominant-negative form of hPAK65. These findings provide a direct evidence that the activated form of hPAK65 generated by caspase cleavage is a proapoptotic effector that mediates morphological and biochemical changes seen in apoptosis.

Conversion of dorsal from an activator to a repressor by the global corepressor Groucho

The Dorsal morphogen acts as both an activator and a repressor of transcription in the Drosophila embryo to regulate the expression of dorsal/ventral patterning genes. Circumstantial evidence has suggested that Dorsal is an intrinsic activator and that additional factors (corepressors) convert it into a repressor. These corepressors, however, have previously eluded definitive identification. We show here, via the analysis of embryos lacking the maternally encoded Groucho corepressor and via protein-binding assays, that recruitment of Groucho to the template by protein:protein interactions is required for the conversion of Dorsal from an activator to a repressor. Groucho is therefore a critical component of the dorsal/ventral patterning system.

Increased levels of cyclooxygenase-2 mRNA in the rat spinal cord after peripheral inflammation: an in situ hybridization study

Cyclooxygenase-2 (COX-2) is considered to play a major role in inflammation processes by catalyzing the production of prostaglandins (PGs). Using in situ hybridization histochemistry we studied the localization of COS-1 and COX-2 mRNA in the spinal cord and dorsal root ganglia (DRGs) after peripheral inflammation or after axotomy in the rat. No COX-2 mRNA signals were detected in the spinal cord under normal conditions, but strong expression was seen bilaterally in non-neuronal cells within the grey and white matter and along the leptomeninges and blood vessels 6 h after unilateral carrageenan injection into the hind paw, but not after peripheral nerve injury. The results suggest that COX-2 expressed in non-neuronal cells contributes to PG production in and around the spinal cord under peripheral inflammatory processes.

Viscero-somatic neurons in the primary somatosensory cortex (SI) of the squirrel monkey

Thirty-eight neurons in the primary somatosensory cortex (SI) in alpha-chloralose/Nembutal, or halothane (in N2O/O2) anesthetized squirrel monkeys were tested for responses to distention of the urinary bladder, the distal colon and the lower esophagus. Of the 38 SI neurons studied 13 were classified as visceroceptive. Eight of the 13 visceroceptive neurons responded to stimulation of a single viscus, the other five responded to two viscera. All SI neurons investigated had somatic low threshold type responses. Anesthesia was a critical factor, because 6 of 11 neurons responded to visceral stimulation only under a light halothane anesthetic level, and during moderate halothane anesthesia levels significantly more neurons exhibited visceral inputs than under alpha-chloralose/Nembutal. The results suggest that the squirrel monkey SI is involved in processing of visceral information.

Characterization of viable bacteria from Siberian permafrost by 16S rDNA sequencing

Viable bacteria were found in permafrost core samples from the Kolyma-Indigirka lowland of northeast Siberia. The samples were obtained at different depths; the deepest was about 3 million years old. The average temperature of the permafrost is -10 degrees C. Twenty-nine bacterial isolates were characterized by 16S rDNA sequencing and phylogenetic analysis, cell morphology, Gram staining, endospore formation, and growth at 30 degrees C. The majority of the bacterial isolates were rod shaped and grew well at 30 degrees C; but two of them did not grow at or above 28 degrees C, and had optimum growth temperatures around 20 degrees C. Thirty percent of the isolates could form endospores. Phylogenetic analysis revealed that the isolates fell into four categories: high-GC Gram-positive bacteria, beta-proteobacteria, gamma-proteobacteria, and low-GC Gram-positive bacteria. Most high-GC Gram-positive bacteria and beta-proteobacteria, and all gamma-proteobacteria, came from samples with an estimated age of 1.8-3.0 million years (Olyor suite). Most low-GC Gram-positive bacteria came from samples with an estimated age of 5,000-8,000 years (Alas suite).

Expression and regulation of the neuropeptide Y Y2 receptor in sensory and autonomic ganglia

The Y2 subtype of neuropeptide tyrosine (NPY) receptors (Y2R) and some neuropeptides have been studied with in situ hybridization in sensory and autonomic neurons of rat and monkey. Between 10% and 20% of the lumbar dorsal root ganglion (DRG) neuron profiles (NPs) contain Y2R mRNA in the rat and monkey. In rat DRGs Y2R mRNA is expressed in calcitonin gene-related peptide (CGRP)-positive, medium-sized, and large neurons, that is in a complementary fashion to the Y1R that is located in small CGRP neurons. In monkey DRGs Y2R mRNA is expressed mainly in small neurons. Peripheral axotomy up-regulates the Y2R in small and large DRG neurons in both species. Y2R and NPY mRNAs are colocalized in many large neurons in axotomized rat DRGs. Y2R mRNA is expressed in 50% of the NPs in the nodose ganglion with a modest increase after axotomy. Y2R mRNA is detected in a few NPs in normal rat superior cervical ganglia, with a marked increase after transection of the carotid nerves. No Y2R mRNA-positive, but many (approximately 30%) weakly Y1R mRNA-positive NPs were found in the sphenopalatine ganglion. Finally, Y2R mRNA levels increase in rat spinal motoneurons after axotomy. Thus, under normal circumstances NPY may act on Y1 and Y2Rs expressed, respectively, in small and large CGRP-positive DRG neurons in the rat. Y2R may be an important receptor in the viscero-sensory neurons. Y2Rs may be particularly important after axotomy serving as presynaptic and/or autoreceptors on rat DRG, superior cervical ganglion, and nodose ganglion neurons and as presynaptic receptors in monkey DRG neurons.

In vitro tumor growth inhibition by bispecific antibodies to human transferrin receptor and tumor-associated antigens is augmented by the iron chelator deferoxamine

Previously, a panel of mouse monoclonal antibodies (mAbs) to several tumor-associated antigens was chemically crosslinked to an IgG1 anti-human transferrin receptor antibody, 454A12. We called this new class of bispecific antibodies (BmAbs) "antigen forks" and showed that these antigen forks inhibited but did not completely prevent tumor cell growth. We speculated that the conjugates acted by heterologously crosslinking two antigens in a manner that interfered with the functions of one or both. The most effective BmAbs all shared one specificity for the human transferrin receptor. A monoclonal antibody to this receptor has been shown by others to reduce tumor cell growth when used with the iron chelator deferoxamine. When we combined our antigen forks with deferoxamine, two of five BmAbs synergized with deferoxamine to arrest tumor cell count at or below input levels. The most effective BmAbs were 317G5/454A12 (3/4) and 520C9/454A12 (5/4). mAb 317G5 recognizes a 42-kDa tumor-associated glycoprotein, and mAb 520C9 recognizes the c-erbB-2 protooncogene product. BmAb 3/4 was most effective against colorectal cancer cell line HT-29, and BmAb 5/4 was most effective against breast cancer cell line SK-BR-3. When deferoxamine and BmAb were replaced by fresh medium after a 6- or 7-day treatment period, no regrowth of tumor cells was observed during the next 4 days, although regrowth was seen if either deferoxamine or BmAb was used alone. Our results show that BmAbs with specificities for transferrin receptor and certain tumor-associated antigens effectively inhibit tumor growth in vitro. When used in combination with deferoxamine, such BmAbs may have therapeutic potential for the treatment of cancer.

Murine bispecific antibody 1A10 directed to human transferrin receptor and a 42-kDa tumor-associated glycoprotein

Previously, we observed that bispecific antibodies ("antigen forks") that bound to certain pairs of different tumor surface antigens could inhibit cell growth. The chemically linked heteroconjugate of MAb 454A12 (murine IgG1 recognizing human transferrin receptor) and 317G5 (murine IgG1 recognizing a 42-kDa tumor-associated glycoprotein) was particularly inhibitory toward human colorectal cancer cell lines, and the iron-chelating agent deferoxamine was found to augment inhibition of tumor cell growth by this antigen fork. Further experiments revealed that an antigen fork constructed by linking Fab' fragments instead of whole antibodies retained activity, which led us to construct a fork-secreting hybrid hybridoma. Hybridoma 454A12 was fused with hybridoma 34F2 (murine IgG1 with the same specificity as 317G5). Hybrid hybridomas whose supernatants blocked binding of both 454A12 and 34F2 probes were further tested for the ability to block growth of SW948 human colorectal cancer cells in an MTT growth assay, and were chosen for subcloning. Ascites produced by clone 1A10 was purified by affinity and cation exchange chromatography. Purified 1A10 bispecific antibody showed growth inhibitory activity comparable to that of a chemically linked heteroconjugate of its parental antibodies 34F2 and 454A12. Adding deferoxamine greatly enhanced the inhibitory activity of 1A10 and effectively prevented regrowth of tumor cells in vitro. By heterologously crosslinking two antigens that are coexpressed on many tumor cells, this bispecific antibody is able to inhibit tumor growth with enhanced selectivity.

Binding characteristics and antitumor properties of 1A10 bispecific antibody recognizing gp40 and human transferrin receptor

The bispecific murine monoclonal antibody (MAb) 1A10 has specificity for the human transferrin receptor (TfR) and the human tumor-associated antigen gp40. This antibody, therefore, functions as an "antigen fork" by binding to two distinct antigens on the same malignant cell. Highly purified 1A10 inhibits the growth of cells coexpressing high levels of human TfR and the tumor-associated antigen gp40 by binding to both target antigens. In SW948 cells, the majority of 1A10 binding is via its gp40 specificity, and half-maximal inhibition of cell growth by 3-(4, 5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay requires 20-30-micrograms/ml concentrations of 1A10. The binding of 1A10 correlates with growth inhibition in the cell lines HT-29, SK-OV-3, OVCAR-2, and OVCAR-3. The growth of OVCAR-10 cells, which express little gp40 and TfR, is not inhibited by 1A10. However, SK-BR-3 cells, which express abundant gp40 and extremely high levels of TfR, are insensitive to the effects of 1A10. In some cell lines, combined exposure to 1A10 and the iron chelator deferoxamine mesylate has synergistic antiproliferative effects. A single i.p. dose of 600 micrograms 1A10 is sufficient to achieve an estimated tumor concentration of at least 30 micrograms/ml for 7 days in C.B17/Icr-scid mice bearing SW948 human tumor xenografts. Treatment of scid mice bearing day 2 or day 4 SW948 xenografts with single or multiple 1A10 doses inhibits tumor growth in a dose-related fashion. Antitumor effects are not seen with therapy using either parental antibody of 1A10. The antiproliferative properties of 1A10 in tumor cells overexpressing gp40 and TfR suggest avenues for the development of new bispecific antibody-promoted treatment strategies.

Morphology of thalamocortical neurons projecting to the primary somatosensory cortex and their relationship to spinothalamic terminals in the squirrel monkey

This study examined the morphology of thalamocortical neurons projecting to the primary somatosensory cortex (SI; hand region of areas 3a, 3b, 1, and 2) and their relationship to the spinothalamic (STT) terminals in the squirrel monkey. Retrogradely labeled thalamocortical neurons were intracellularly filled with Lucifer yellow (LY), and the STT terminals were anterogradely labeled with biotinylated dextran. Both filled neurons and labeled terminals were differentially visualized in the same field by a dual immunocytochemical staining method. SI-projecting neurons appeared at the light level to be in contact with STT terminal boutons in the ventroposterior lateral (VPL), ventroposterior inferior (VPI), and centrolateral (CL) nuclei and the posterior complex (PO). The analyses of the neuronal morphology revealed that somatic and dendritic morphologies of SI-projecting neurons in these thalamic nuclei, as well as in the anterior pulvinlar (Pulo), centromedial (CM), and ventrolateral (VL) nuclei, were generally comparable with some exceptions: VL neurons had the largest soma sizes, the most primary dendrites, and the longest total dendritic length among all neurons studied; VPI neurons had the smallest soma sizes; VPL SI-projecting neurons were different from those in VPI in their soma sizes, shape factors, and orientations; in VPL the cells projecting to the superficial layers of SI were smaller than those projecting to the deeper layers, but in VPI the two groups of neurons were similar in soma sizes. In general, the SI-projecting neurons in VPL, VPI, and CL were similar in their dendritic morphologies and branching patterns, and varied from those in Pulo, PO, CM, and VL.

[Inclusion compounds of jiuxin oil with beta-cyclodextrin]

The inclusion compounds of Jiuxin Oil with beta-cyclodextrin were prepared. The influence of temperature, ratio of host and guest molecules, stirring time on inclusion were observed. The quantitative determination was performed by gas chromatography. Inclusion compounds of Jiuxin Oil were confirmed by differential scanning calorimetry and powder X-ray diffractometry.

High-affinity monoclonal antibodies against P-glycoprotein

Cancer patients treated with one anticancer agent often develop resistance to a broad spectrum of chemotherapeutic agents. This type of multiple drug resistance (MDR) is often accompanied by a decrease in drug accumulation and an increase in expression of a 170,000-Da plasma membrane glycoprotein (P-170) that can effectively pump various anticancer agents out of cytoplasm. A panel of 12 IgG1, IgG2a, or IgG2b monoclonal antibodies was generated against the extracellular portion of P-glycoprotein by immunizing mice with a human MDR1 gene-transfected BA3T3 fibroblast line. We have characterized two of the anti-P-glycoprotein monoclonal antibodies, 15D3 and 17F9, in some detail. Both antibodies immunoprecipitate a 170- to 180-kDa protein from MDR cells, but do not block binding of the known anti-P-glycoprotein antibody MRK16, suggesting that 15D3 and 17F9 bind to a different epitope on the extracellular domain of P-glycoprotein than MRK16. Scatchard analysis revealed that 15D3 and 17F9 had association constants of 1.3 and 1.1 x 10(8) M-1, respectively. 15D3 and 17F9 had little effect on MDR cell growth except for a minor inhibition of KB-V1 cells when the cells were incubated in the presence of vinblastine. Neither antibody inhibited the efflux of P-glycoprotein substrates from MDR cells. Because of their strong binding activity, these antibodies may be useful for diagnostic detection of MDR in patients undergoing chemotherapy or as targeting components of immunotherapeutic agents.

Squirrel monkey lateral thalamus. I. Somatic nociresponsive neurons and their relation to spinothalamic terminals

The incidence and response properties of nociresponsive neurons, their locations relative to spinothalamic terminals, and their relations to cytoarchitectonic borders were studied in the lateral thalamus of the squirrel monkey. Nociceptive neurons were found in ventral posterior inferior nucleus (VPI), in the lateral and medial nuclei (VPL and VPM) of the ventral posterior complex (VP = VPL + VPM), as well as the posterior complex (PO). The overall incidence of nociresponsive cells was 19% (50 of 270 cells). The proportion of nociresponsive neurons within VPI was 50% (23 of 46), 38% in PO (8 of 21), and 10% in VP (19 of 203). Most nociresponsive cells (90%) in VP were of wide-dynamic-range type, while within VPI 43% of nociresponsive cells were nociceptive-specific type. Most of these nociresponsive cells had thermal and mechanical responses, and a small number also responded to cooling. The receptive fields of nociresponsive cells in VPL were in continuity, in both size and body location, with surrounding low-threshold units. The receptive fields of VPI and PO nociresponsive cells were larger than those in VPL. The probability of encountering nociresponsive cells located within 100 microns of spinothalamic terminations was high in VPI (73%) and low in VPL (33%). On the other hand, the probability of encountering non-nociceptive cells located within 100 microns of spinothalamic terminals was low in both VPI (20%) and VPL (26%). The results indicate segregation of nociresponsive cell types across VP, VPI, and PO and suggest that VPI, and perhaps PO, is an important region for discriminative processing and perception of painful stimuli.

Squirrel monkey lateral thalamus. II. Viscerosomatic convergent representation of urinary bladder, colon, and esophagus

The response properties of 106 visceroceptive lateral thalamic neurons were investigated in anesthetized squirrel monkeys. Most neurons were located in the ventral posterior lateral nucleus (VPL), and a smaller number of cells was also found in a variety of thalamic nuclei around VPL. Ninety (85%) of these cells responded to distension of the urinary bladder, the distal colon, and/or the lower esophagus. The majority of the visceral-responsive cells also had convergent somatic and multivisceral responses (71% of the 85%). A small population (6%) was visceral specific; that is, these neurons were not activated with somatic stimuli. Visceral responses were excitatory, inhibitory, or mixed, and most were either visceral nociceptive specific (65%) or visceral wide-dynamic-range type (34%). Very few visceral responses (1%) could be classified as low threshold. The incidence of these response types were highly dependent on the specific viscus stimulated. Most visceral responses were able to code stimulus duration and intensity. The majority (69%) of the visceroceptive neurons had somatic low-threshold convergent input mainly from the surface of the lower body. The somatic receptive field locations and the somatic response properties seem unrelated to the convergent visceral input and the visceral response properties, although there were some exceptions. No obvious viscerotopical organization was found in VPL. The results lead us to propose two different modes of representation for processing of and distinguishing between visceral and somatic inputs: a distributed population code for visceral inputs, and a local code for somatic inputs. Based on these codes, we discuss a new hypothesis for referred pain.

Neurologic deterioration in noncomatose patients with supratentorial intracerebral hemorrhage

OBJECTIVE

To determine the frequency, time course, and predictors of neurologic deterioration (ND) in noncomatose patients with supratentorial intracerebral hemorrhage (ICH).

BACKGROUND

Patients with worsening ICH may benefit from therapy aimed at reducing mass effect due to active bleeding or cerebral edema.

METHODS

We analyzed 46 noncomatose (Glasgow Coma Scale [GCS] score > or = 8) patients with ICH in the Stroke Data Bank (SDB). All subjects were examined within 24 hours of onset (mean, 13.6 hours) and were prospectively followed with serial examinations during hospitalization. ND was defined as (1) a > or = 2-point decrease in the GCS score, (2) a > or = 1-point increase in the SDB weakness score, or (3) a new deficit, unrelated to medical or surgical complications.

RESULTS

ND occurred in 15 of 46 patients (33%). The frequency of ND was greatest on the first hospital day (eight of 15 patients) and decreased progressively thereafter. Patients with ND had larger hemorrhages (mean volume, 45 ml versus 16 ml, p < 0.01) and more frequently demonstrated marked mass effect (60% versus 19%, p < 0.01) on initial CT than those with stable deficits, but did not differ with regard to mean GCS score, mean blood pressure, or other clinical variables on admission. Hematoma enlargement was judged to be the cause of worsening in four of 15 (27%) patients. Thirty-day case fatality was 47% in those with ND compared with 3% in those with stable deficits (p = 0.001).

CONCLUSIONS

ND occurs in one-third of noncomatose patients with supratentorial ICH and carries a poor prognosis. Large hematoma volume on CT, rather than clinical predictors, identifies patients at high risk for subsequent worsening.

Antigen forks: bispecific reagents that inhibit cell growth by binding selected pairs of tumor antigens

Bispecific antibodies of a new category, termed "antigen forks", were constructed by crosslinking antibodies that recognized pairs of distinct tumor cell surface antigens. At concentrations of 1-100 nM, several such forks inhibited the growth of human tumor cell lines bearing both relevant antigens. The same cells were not inhibited by unconjugated component antibodies, and the active conjugates did not inhibit the growth of human cell lines that expressed lower levels of relevant antigens. The three most active antigen forks all contained monoclonal antibody 454A12, which recognizes human transferrin receptor. This antibody was conjugated respectively to antibodies 113F1 (against a tumor-associated glycoprotein complex), 317G5 (against a 42-kDa tumor-associated glycoprotein), or 520C9 (against the c-erbB-2 protooncogene product). The 317G5-454A12 fork strongly inhibited the HT-29 and SW948 human colorectal cancer cell lines, while the 113F1-454A12 and 520C9-454A12 forks strongly inhibited the SK-BR-3 human breast cancer cell line and the 113F1-454A12 fork was also effective against SW948. By designing forks against antigens of incompatible function that are co-expressed at high levels on tumor cells but not on normal tissues, it may be possible to generate reagents that inhibit tumor growth with enhanced selectivity.

Outcome after carotid endarterectomy for asymptomatic carotid stenosis

OBJECTIVE

To compare the long-term outcome in patients with asymptomatic carotid stenosis (ACS) among those treated with carotid endarterectomy (CE) or medical therapy.

BACKGROUND

Until randomized trials are completed, treatment of ACS will depend on identification of subgroups likely to benefit from CE.

METHODS

A retrospective cohort study was done on 215 patients with ACS: 107 underwent CE, and 108 were treated medically (MED). A neurologist reviewed medical records and performed a telephone interview to detect outcome (stroke and death). Mean follow-up was 3.8 years; only 4% were lost to follow-up.

RESULTS

Among CE patients, there was a 4.7% risk of postoperative ipsilateral stroke within 30 days. Four of five postoperative strokes occurred among patients with prior contralateral symptoms. There was no significant difference between CE and MED in the cumulative life-table 5-year risk of ipsilateral stroke, any stroke, or survival free of any stroke. Among diabetics, however, there were no ipsilateral strokes at 5 years after CE compared to 20% in MED (p = 0.03). Excluding postoperative complications, the 5-year risk of ipsilateral stroke was reduced among CE patients who "ever smoked" (CE 1%, MED 8%, p = 0.03) and the 5-year risk of any stroke was reduced among CE patients who had no prior myocardial infarction (CE 6%, MED 16%, p = 0.02). Among those with prior contralateral carotid territory symptoms, the 5-year risk of any stroke was worse in the MED patients (CE 5% MED 32%, p = 0.004). Among CE patients, a Cox proportional hazards model determined that the independent predictors of worse long-term outcome were: a history of myocardial infarction; admission systolic blood pressure greater than 160 mm Hg; and age greater than 65.

CONCLUSION

The approach to patients with ACS will await completion of large, randomized clinical trials, now in progress. Even if these studies are negative, there may remain specific subgroups of patients who show clear benefit from carotid endarterectomy.

Predictors of mortality and recurrence after hospitalized cerebral infarction in an urban community: the Northern Manhattan Stroke Study

OBJECTIVE

To identify determinants of recurrence and mortality after ischemic stroke in a mixed-ethnic region.

BACKGROUND

The determinants of ischemic stroke outcome are not uniformly characterized and will be of increasing importance as the frequency of ischemic stroke survivors increases in our aging population.

METHODS

A cohort of 323 patients (40% black, 34% Hispanic, 26% white) with cerebral infarction from northern Manhattan over age 39 were followed for a mean of 3.3 years, with only 6% lost to follow-up. Cumulative life table risk of mortality and recurrence was calculated. Risk factors classified at the time of index ischemic stroke were selected based on univariate analyses and then entered into a Cox proportional hazards model for mortality and for recurrence.

RESULTS

The life table cumulative risk of mortality was 8% at 30 days, 22% at 1 year, and 45% at 5 years after ischemic stroke. The immediate cause of death was related to vascular disease in 60%. After age adjustment, the significant predictors of mortality were congestive heart failure (risk ratio [RR] = 2.6), admission glucose > 140 mg/dl (RR = 1.7), and presentation with either a large dominant, nondominant, or major basilar syndrome (RR = 2.0). Patients with a lacunar syndrome had a better survival (RR = 0.6). Recurrent strokes occurred in 72 patients. The life table cumulative risk of recurrence was 6% at 30 days, 12% at 1 year, and 25% at 5 years after ischemic stroke. Ethanol abuse (RR = 2.5), hypertension requiring discharge medications (RR = 1.6), and elevated blood glucose within 48 hours of index ischemic stroke (RR = 1.2 per 50 mg/dl) were the independent predictors of recurrence. Among 30-day survivors, the effect of ethanol abuse was greater (RR = 3.5), indicating its impact on late recurrence.

CONCLUSIONS

After accounting for age and presenting syndrome, initial glucose predicts stroke mortality and recurrence after ischemic stroke. This association may reflect uncontrolled and undiagnosed diabetes in our urban population. Furthermore, ethanol abuse may be a determinant of ischemic stroke recurrence. Reduction of the stroke public health burden will require targeted modification of such conditions and behaviors.

Spinothalamocortical inputs nonpreferentially innervate the superficial and deep cortical layers of SI

Using a combined anterograde and retrograde tracing technique, we examined the distribution pattern of the thalamocortical cells which projected to superficial layers of the hand region of the primary somatosensory cortex (hSI), and quantitatively analyzed the retrogradely labeled cells which putatively contacted terminals of the spinothalamic tract (STT) in the squirrel monkey and the macaque. Less than 25% of the superficial hSI projecting cells were putatively contacted by terminals of cervical enlargement spinothalamic neurons. These cells were primarily located in ventroposterior lateral, ventroposterior inferior and centrolateral nuclei. Although the number of superficial hSI projecting cells numbered less than 20% of the total hSI projecting cells, their patterns of location and their proportion of overlap with STT terminals within each thalamic nucleus were similar. It is suggested that the spinothalamic nociceptive information input to to the cortex equally accesses both superficial and deep SI.

Free protein S deficiency in acute ischemic stroke. A case-control study

BACKGROUND AND PURPOSE

Deficiency of free protein S, a naturally occurring anticoagulant, may be acquired in the setting of acute illness and increasingly has become recognized as a possible stroke risk factor. We sought to determine whether free protein S deficiency is associated with acute cerebral infarction among older individuals at risk for stroke.

METHODS

Free protein S was measured by Laurell rocket immunoelectrophoresis in 94 adults admitted for acute cerebral infarction and in 94 hospitalized control subjects of similar age, sex, and race. Patients with a history of cerebrovascular disease, acute thrombotic or hematologic diseases, or medical conditions known to cause free protein S deficiency were excluded from the control group.

RESULTS

The percentage of patients with free protein S deficiency (< 20% normal total protein S) was similar in the case and control groups (21% versus 20%, respectively). Among all subjects, free protein S deficiency was more common in blacks than nonblacks (34% versus 13%, p = 0.001). A very low free protein S (< 15% normal total protein S) was more frequent among case patients than control subjects (11% versus 5%), but this trend failed to reach statistical significance.

CONCLUSIONS

Free protein S deficiency is common among hospitalized patients, even in the absence of a recognized predisposing condition. Our findings indicate that acquired deficiency of free protein S is not a major risk factor for ischemic stroke.

In vitro cytotoxic targeting by human mononuclear cells and bispecific antibody 2B1, recognizing c-erbB-2 protooncogene product and Fc gamma receptor III

Bispecific murine monoclonal antibody 2B1, possessing dual specificity for the human c-erbB-2 protooncogene product and human Fc gamma receptor III (CD16) was evaluated for the ability to promote specific lysis of c-erbB-2-positive tumor cells in vitro. In short-term 51Cr release assays with human mononuclear cells as effectors and SK-Br-3 human breast cancer cells as targets, neither parental antibody of 2B1 mediated significant specific lysis, but bispecific antibody was as active as a chemical heteroconjugate, with 5 ng/ml of 2B1 causing half-maximal lysis at an effector/target ratio of 20:1 and 2 ng/ml 2B1 causing half-maximal lysis at an E/T ratio of 40:1. The cytotoxic targeting activity of 2B1 F(ab')2 fragment was the same as that of whole bispecific antibody, and the activity of whole 2B1 was not reduced when assays were performed in 100% autologous human serum, indicating that 2B1 binds effector cells through the CD16-binding site derived from parental antibody 3G8 rather than through its Fc portion. Variable inhibition of 2B1-mediated lysis was observed when autologous polymorphonuclear leukocytes from different donors were added to mononuclear effector cells at a 2:1 ratio; this inhibition was overcome at higher antibody concentration. 2B1 bispecific monoclonal antibody was also able to mediate targeted cytolysis using whole human blood as a source of effector cells or using effector or target cells derived from ovarian cancer patients.

Neurologic improvement in pure motor hemiparesis: implications for clinical trials

Knowledge of the natural history of certain stroke subtypes is essential for the proper analysis and interpretation of clinical trials of stroke therapy. We evaluated the degree of weakness on admission and again 7 to 10 days later in 62 patients with pure motor hemiparesis (PMH) and 280 patients with motor deficits from other stroke syndromes (OSS). During the 7-to-10-day study interval, we found that the OSS group worsened slightly in motor function, whereas the PMH group improved (p = 0.01). Among those who improved in both groups, those in the PMH group improved to a greater extent than did those in the OSS group (p = 0.02). This occurred despite a greater frequency of worsening during the first 12 hours after stroke onset in the PMH group. By the fourth day following PMH onset, a majority of patients had improved, and this improvement was sustained until day 10. The two groups did not differ significantly in age, race, sex, history of cardiac disease, hematocrit, anticoagulation treatment, blood glucose, or medical complications in hospital. Lacunar infarcts occurred in 84% of PMH and 23% of OSS. Patients with PMH show significant spontaneous improvement in weakness within 7 to 10 days of admission, compared with patients with OSS. Stratification by admission stroke syndrome in clinical trials may be necessary before judging the efficacy, or lack thereof, of a therapeutic agent.

Selection of hybrid hybridomas by flow cytometry using a new combination of fluorescent vital stains

A new combination of fluorescent dyes (rhodamine 123 and hydroethidine) was used to internally label hybridoma fusion partners. Murine hybridoma 520C9 (recognizing human c-erbB-2) was labeled with hydroethidine. Murine hybridoma 3G8 (recognizing human Fc gamma receptor III) was labeled with rhodamine 123, and verapamil was used to block rhodamine efflux via P-glycoprotein. Viability assays showed little cytotoxicity from these dyes at the concentrations used. The labeled cells were fused with polyethylene glycol, sorted for dual fluorescence on an Epics V cell sorter, and cloned. Hybrid hybridomas producing bispecific antibodies were selected for ability to promote lysis of SK-Br-3 breast cancer cells by human mononuclear cells. Several positive clones were obtained and shown to have a double content of DNA. Bispecific antibody produced by subclone 2B1 was purified by anion exchange chromatography and shown to bind both tumor cells and Fc gamma R III bearing cells. Using two parameter flow cytometric analysis, we were able to measure a 'bridging' effect of this bispecific antibody, which caused formation of complexes between PMNs and SK-Br-3 cells. Either parental antibody could compete with bispecific antibody to block such complexing. This fusion method provides several advantages over other techniques presently used (speed, convenience, low toxicity and automatic exclusion of dead cells) and can be applied to produce other hybrid hybridomas.

Activated Langerhans cells release tumor necrosis factor

Langerhans cells act as antigen-presenting cells in immune reactions in the skin. What other roles they may play in inflammation is less well defined. We have tested whether these cells can produce TNF-alpha, an important mediator of inflammation. Resting Langerhans cells produce less than 0.1 U TNF-alpha/ml. Langerhans cells stimulated with phorbol myristate acetate (PMA) and lipopolysaccharide (LPS) release 4-5 U TNF-alpha/ml. Specificity of the released TNF-alpha in an L929 cytotoxicity assay was confirmed by using neutralizing anti-TNF-alpha monoclonal antibodies, and the identity of TNF-alpha was further confirmed by Northern blot hybridization with an TNF-alpha oligomer DNA probe. Activated Langerhans cells may contribute to inflammation in the skin by releasing TNF-alpha, which is known to effect fibroblast growth, endothelial cell activation, and lymphocyte function.

Delta-9-tetrahydrocannabinol during pregnancy in the rat: I. Differential effects on maternal nutrition, embryotoxicity, and growth in the offspring

Either 15 or 50 mg/kg of delta-9-tetrahydrocannabinol (THC) in sesame oil was administered by gastric intubation to gravid rats during the last two weeks of gestation. A pair-fed control group was administered the vehicle alone and allowed to eat and drink only the amount consumed by the 50 mg/kg group on the same gestation days. A nontreated control group was left undisturbed during pregnancy. All treated and control litters were fostered at birth to untreated dams. Among the dams receiving 50 mg/kg of THC, food and water intake was initially reduced to 75-80% of nontreated controls but then recovered over 3-4 days to approximately a 15-20% reduction until term. Compared with the nontreated dams, both THC dose-level groups and pair-fed control dams gained significantly less body weight from conception to term. Offspring mortality did not differ between the nontreated and pair-fed controls but was significantly higher among both dose-level THC exposed groups. In addition, there was a dose-related increase in the sex-ratio of live male to female offspring as well as significant effects on rate of growth for both sexes. The results are discussed with respect to published animal and clinical studies of cannabinoid exposure during pregnancy.

Delta-9-tetrahydrocannabinol during pregnancy in the rat: II. Effects on ontogeny of locomotor activity and nipple attachment in the offspring

Either 15 or 50 mg/kg delta-9-tetrahydrocannabinol (THC) in sesame oil was administered by gastric intubation to gravid rats during the last two weeks of gestation. A pair-fed control group was administered the vehicle alone and allowed to eat and drink only the amount consumed by the 50 mg/kg group on the same gestation days. A nontreated control group was left undisturbed during pregnancy. All treated and control litters were fostered at birth to untreated dams. Intact litters from the two THC treated and the two control groups were tested at 3-day intervals from birth to 32 days of age for differences in locomotor activity. In addition, pups were tested for nipple attachment on days 2, 5, 8, 11, and 14 of age. There were no differences in locomotor activity among any of the groups although activity level varied during development. Pups from dams exposed to 50 mg/kg of THC, as well as the pair-fed controls, displayed significantly longer latencies to attach to a nipple. These results suggest that the impaired nipple attachment observed among the high-dose offspring was not a primary effect of THC, but rather was secondary to the significant reduction of food and water intake among the dams. The behavioral findings are discussed with respect to other animal and clinical reports of prenatal cannabinoid exposure.

Fibrosarcoma complicating irradiated pituitary adenoma

Eight years after radiation therapy (5000 rads of 60Co) for a pituitary adenoma, a patient developed a sellar fibrosarcoma. The tumor had an aggressive growth pattern: it infiltrated the optic nerve, sphenoidal air sinus, hypothalamus, and both cavernous sinuses, where compression of the left internal carotid artery resulted in a massive hemispheric infarction. Surgery was ineffective in arresting rapid growth of the lesion; death occurring 5 months after onset of symptoms.