Molecular cloning and expression of Cu/Zn-containing superoxide dismutase from Fasciola hepatica

The cytosolic superoxide dismutase (SOD) of Fasciola hepatica, a causative agent of fascioliasis, was purified and characterized. The enzyme consists of two identical subunits, each with an apparent molecular mass of 17.5 kDa. An analysis of the enzyme's primary structure and inhibition studies revealed that the enzyme is a copper/zinc-containing SOD (Cu/Zn-SOD). The enzyme activity was relatively stable in a broad pH range, from pH 7.0 to 10.0, and the enzyme showed maximum activity at pH 7.5. This enzyme also displayed strong antigenicity against sera of bovine and human subjects with fascioliasis. The SOD gene fragment was amplified by PCR with degenerate oligonucleotide primers derived from amino acid sequences conserved in the Cu/Zn-SODs of other organisms. An F. hepatica cDNA library was screened with the SOD gene fragment as a probe. As a result, a complete gene encoding the Cu/Zn-SOD was identified, and its nucleotide sequence was determined. The gene had an open reading frame of 438 bp and 146 deduced amino acids. Comparison of the deduced amino acid sequence of the enzyme with previously reported Cu/Zn-SOD amino acid sequences revealed considerably high homologies. The coding region of the F. hepatica Cu/Zn-SOD was cloned and expressed in Escherichia coli. Staining of native polyacrylamide gel for SOD activity of the expressed protein revealed SOD activity that was inactivated by potassium cyanide and hydrogen peroxide but not by sodium azide. This means that the presence of the recombinant fusion protein is indicative of Cu/Zn-SOD. The expressed protein also reacted with sera of bovine and human subjects with fascioliasis, but it did not react with sera of uninfected bovine and human subjects.

Augmentation of antitumor immunity by genetically engineered fibroblast cells to express both B7.1 and interleukin-7

Mouse fibroblasts (H-2(b)) were genetically engineered to express a costimulatory B7.1 and an interleukin-7 (IL-7; Fb/B7.1/IL7). The Fb/B7.1/IL7 cells were then pulsed with an ovalbumin (OVA) epitope (amino acids 257-264, SIINFEKL, H-2 K(b) restricted; Fb/B7. 1/IL7/OVA) and tested for the induction of OVA-specific cytotoxic T lymphocytes (CTLs) in C57BL/6 mice (H-2(b)). The genetically engineered fibroblasts lacking either B7.1 or IL-7 were constructed and used as controls. Immunization with the Fb/B7.1/IL7/OVA cells induced strong cytotoxic activities against OVA-expressing EL4 (EG7) tumor cells. The magnitude of the cytotoxic response in mice with the Fb/B7.1/IL7/OVA cells was significantly higher than the response in mice immunized with any other cell constructs. CD8(+) T cells were a major effector cell-type of antitumor response in the immunized mice with the Fb/B7.1/IL7/OVA cells. Furthermore, immunization with the Fb/B7.1/IL7/OVA cells significantly prolonged the survival period of mice when the mice were injected with EG7 tumor cells one week after the immunization. These results suggest that fibroblasts can be genetically modified to an efficient cell vaccine for the induction of antitumor response.

Injection with interleukin-4-secreting fibroblasts efficiently induces T helper type 2 cell-dominated immune response

To determine whether the paracrine secretion of interleukin-4 (IL-4) can efficiently induce T helper type 2 (Th2) cell-dominated immune response, BLK fibroblasts were stably transfected to secrete IL-4 (750 units/10(6) cells/48 h). Their effects on T helper cell-mediated immune response were investigated in ovalbumin (OVA)-primed C57BL/6 mice, and were compared with those of free recombinant IL-4. Injection with IL-4-secreting fibroblasts (BLK/IL-4) significantly increased anti-OVA IgG1 production in OVA-primed mice. In addition, the BLK/IL-4 cells were more effective than free recombinant IL-4 in decreasing OVA-specific IFN-gamma production and in increasing OVA-specific IL-4 production by splenic CD4(+) T cells. This work suggests that IL-4-secreting fibroblasts can efficiently induce Th2 cell-dominated immune response and may be beneficial in the treatment of diseases caused by undesired Th1 cell-dominated responses.

Efficient induction of an antigen-specific, T helper type 1 immune response by interleukin-12-secreting fibroblasts

To determine whether the paracrine secretion of interleukin (IL)-12 can efficiently convert immune responses characterized by high levels of synthesis of IL-4 and immunoglobulin E (IgE) into T helper 1 (Th1)-dominated responses, 3T3 fibroblasts were stably transfected to secrete IL-12 (480 units/10(6) cells/48 hr). Their effects on the T helper cell-mediated immune response were investigated in ovalbumin (OVA)-primed mice. Free mouse recombinant IL-12 was included as a control group. IL-12-secreting fibroblasts (3T3/IL-12) were more effective than free recombinant IL-12 at increasing OVA-specific interferon-gamma (IFN-gamma) production and decreasing OVA-specific IL-4 production in CD4+ T cells. In addition, injection with 3T3/IL-12 cells significantly increased anti-OVA immunoglobulin G2a (IgG2a) levels and decreased anti-OVA IgE levels in OVA-primed mice. This work suggests that IL-12-secreting fibroblasts can efficiently induce an antigen-specific Th1 response and may be beneficial in the treatment of diseases caused by undesirable T helper 2 (Th2)-dominated responses, including allergic diseases.

Genetically engineered fibroblasts with antigen-presenting capability: efficient induction of an antigen-specific cytotoxic T-lymphocyte response and protection against tumor development in vivo

BLK mouse fibroblasts (H-2b) were genetically engineered to express costimulatory B7.1 and interleukin-2 (BLK/IL2/B7.1). The BLK/IL2/B7.1 cells were then pulsed with an ovalbumin (OVA) epitope as a model antigen (Ag) (BLK/IL2/B7.1/OVA), and tested for the induction of OVA-specific cytotoxic T lymphocytes (CTLs) in C57BL/6 mice (H-2b). The genetically engineered fibroblasts lacking one or two of three factors (interleukin-2, B7.1, and OVA) were constructed and used as controls. Immunization with the BLK/IL2/B7.1/OVA cells induced strong cytotoxic activities against OVA-expressing EL4 (EG7) tumor cells, but not against other H-2b tumor cells, such as EL4, C1498 and B16F1 cells. The magnitude of the cytotoxic response in mice with the BLK/IL2/B7.1/OVA cells was significantly higher than the response in mice immunized with any other cell constructs. CD8+ T cells with OVA-specific cytotoxic activities were predominant in mice immunized with the BLK/IL2/B7.1/OVA cells. Furthermore, immunization with the BLK/IL2/B7.1/OVA cells significantly prolonged the survival of mice, compared with any other cell constructs, when the mice were challenged with EG7 tumor cells at 2 weeks postimmunization. Induction of antitumoral CTL immunity by the BLK/IL2/B7.1/OVA cells was independent of host Ag-presenting cells and of CD4+ T-cell and natural killer 1.1+ cell help. These results suggest that fibroblasts can be genetically modified to efficient Ag-presenting cells for the induction of an Ag-specific CTL response.

Retinoid-mediated inhibition of interleukin-12 production in mouse macrophages suppresses Th1 cytokine profile in CD4(+) T cells

Interleukin-12 (IL-12) plays a central role in the immune system by driving the immune response towards T helper 1 (Th1) type responses characterized by high IFN-gamma and low IL-4 production. In this study we investigated whether retinoid-mediated inhibition of interleukin-12 production in mouse macrophages could regulate cytokine profile of antigen (Ag)-primed CD4(+) Th cells. Pretreatment with retinoids (9-cis-RA, all-trans-RA, TTNPB) significantly inhibited IL-12 production by mouse macrophages stimulated with lipopolysaccharide (LPS) or heated-killed Listeria monocytogenes (HKL). Retinoid-pretreated macrophages reduced their ability to induce IFN-gamma and increased the ability to induce IL-4 in Ag-primed CD4(+) T cells. Addition of recombinant IL-12 to cultures of retinoid-pretreated macrophages and CD4(+) T cells restored IFN-gamma production in CD4(+) T cells. The in vivo administration of 9-cis-RA resulted in the inhibition of IL-12 production by macrophages stimulated in vitro with either LPS or HKL, leading to the inhibition of Th1 cytokine profile (decreased IFN-gamma and increased IL-4 production) in CD4(+) T cells. These findings may explain some known effects of retinoids including the inhibition of encephalitogenicity, and point to a possible therapeutic use of retinoids in the Th1-mediated immune diseases such as autoimmune diseases.

Guided tissue regeneration with bioabsorbable barriers: intrabony defects and class II furcations

BACKGROUND

The aim of this study was to compare the effects of guided tissue regeneration (GTR) using 2 different bioabsorbable barriers (control: polylactide acetyltributyl citrate; test: polydioxanon). The polydioxanon barrier is an experimental membrane for GTR therapy that consists of a continuous occlusive barrier that has a layer of slings on the side that is meant to face the mucoperiosteal flap.

METHODS

In 21 patients with 22 pairs of similar contralateral defects (30 intrabony and 14 Class II furcation lesions), each defect was randomly assigned for treatment with either control (c) or test (t) devices. At baseline and 12 months after surgery, clinical measurements, plaque index (PI) gingival index (GI), probing depth (PD), and vertical and horizontal clinical attachment loss (CAL-V; CAL-H) and standardized radiographs were obtained.

RESULTS

Barrier exposure was commonly observed in both groups. Four weeks after surgery 61% of all barriers were exposed to some extent. However, both treatments revealed a significant GI reduction (P <0.005), PD reduction (-3.08 +/- 2.29 mm [t]; -3.52 +/- 2.67 mm [c]; P <0.001) and CAL-V gain (2.44 +/- 2.29 mm [t], 2.80 mm +/- 2.21 [c]; P <0.001) 12 months after surgery in all defects. Within the intrabony defects significant bony fill (2.03 +/- 1.70 mm [t]; 1.91 +/- 1.20 mm [c]; P = 0.001), and within the furcations a significant but small CAL-H gain (0.79 +/- 0.68 mm [t]; 1.13 +/- 1.44 mm [c]; P <0.05), was observed.

CONCLUSIONS

Regarding GI and PD reduction as well as CAL-V and CAL-H gain, this study failed to reveal statistically significant or clinically relevant differences between test and control 12 months postsurgically. Thus, the use of both bioabsorbable barriers in GTR therapy may be recommended.

Absence of mRNA encoding estrogen receptor in the rat cochlea

Based on changes in hearing thresholds and tinnitus that are co-related with the menstrual cycle, it has been suggested that the cochlea may respond directly to estrogen. For this to occur, the cochlea should express estrogen receptors. In situ mRNA hybridization was performed on normal female rat cochleas, using radiolabeled RNA probes complementary to mRNA encoding estrogen receptor, to determine whether estrogen receptors are present in the cochlea. Strong hybridization of the riboprobes to sections of uterus and hypothalamus indicated that the technique detected estrogen receptor mRNA. No hybridization to any cochlear tissues was observed. The results indicate that estrogen receptors are not expressed on cochlear cells, at least in rats. This in turn suggests that variation in cochlear responses during the estrus cycle are not the result of the direct effect of estrogen on the cochlea. Such variation may, however, be caused by systemic changes in fluid regulation induced by estrogen receptors at a distant site, or by other hormone receptors.

Anti-allergic and anti-inflammatory triterpenes from the herb of Prunella vulgaris

The activity-guided fractionation of the extract of the herb of Prunella vulgaris (Labiatae) led to the isolation of four triterpenes, i.e., betulinic acid, ursolic acid, 2 alpha,3 alpha-dihydroxyurs-12-en-28-oic acid, and 2 alpha-hydroxyursolic acid. One of these compounds, 2 alpha,3 alpha-dihydroxyursolic acid, demonstrated significant inhibition on the release of beta-hexosaminidase from the cultured RBL-2H3 cells in a dose-dependent manner; the IC50 value was calculated to be 57 microM. When the isolated compounds were tested for their effects on the production of nitric oxide from cultured murine macrophages, RAW 264.7 cells, ursolic acid and 2 alpha-hydroxyursolic acid exhibited strong inhibitory activities (IC50 values, 17 and 27 microM, respectively).

Characterization of the murine homolog of C1qR(P): identical cellular expression pattern, chromosomal location and functional activity of the human and murine C1qR(P)

Human C1qR(P) is a highly glycosylated transmembrane protein that is the human C1q receptor/receptor component that in vitro mediates enhancement of Fc- and C3b-mediated phagocytosis. A human genomic clone and a murine genomic clone that is 73% identical in sequence with the coding region for human C1qR(P) cDNA have been isolated. Chromosomal localization of the human and murine gene demonstrates that these genes are syntenic. Murine cell lines of diverse myeloid origins are shown to respond to interaction of C1q with the enhancement of phagocytosis similar to that seen previously in human peripheral blood monocytes. Northern blot, RT-PCR, Western blot and FACS analyses demonstrated that mC1qR(P) is expressed in these murine myeloid cell lines, but not in a mouse epithelial cell line, similar to the cell type expression of the human gene product. A polyclonal antibody to a peptide sequence common to the deduced sequence from the both murine and human C1qR(P) inhibited the enhancement of phagocytosis response to C1q when cells were permeabilized to permit access of the antibody to the intracellular milieu. These data support the postulate that the identified murine and human genes are homologs, confirm the previously predicted intracellular location of the C-terminus of the molecule, and indicates the necessary role of this intracellular domain in transducing the signal that leads to enhancement of phagocytic function.

Cloning and expression of a cysteine proteinase gene from Paragonimus westermani adult worms

A gene encoding a cysteine proteinase from Paragonimus westermani has been cloned and expressed in Escherichia coli. The cysteine proteinase cDNA fragment was amplified by reverse transcription-polymerase chain reaction (RT-PCR) using degenerate oligonucleotide primers derived from the conserved active site of the cysteine proteinase. The 5' and 3' regions of the gene were amplified using a PCR technique for the rapid amplification of cDNA ends. The cloned gene has an open reading frame of 687 bp and deduced amino acid sequence of 229. Sequence analysis and alignment showed significant homologies with the eukaryotic cysteine proteinases and conservation of the Cys, His, and Asp residues that form a catalytic triad. Analysis of the expressed protein on sodium dodecyl sulfate polyacrylamide gel electrophoresis showed that the molecular weight of the protein was approximately 28.5 kDa. The expressed protein reacted with the sera of patients with paragonimiasis but not with the sera of fascioliasis and clonorchiasis. These results suggest that the expressed protein may be valuable as a specific diagnostic material for the immunodiagnosis of paragonimiasis.

General pharmacology of the new antiviral agent SK 1899

The general pharmacological properties of 2-amino-9-(3-acetoxymethyl-4-isopropoxycarbonyloxybut-1-yl)purine (CAS 247081-81-8, SK 1899), a new potential antiviral agent, were investigated in mice, rats, guinea pigs, rabbits, and dogs. The oral administration of 50, 150, and 500 mg/kg of SK 1899 had no effects on the central nervous system except that it slightly increased the spontaneous locomotor activity in mice at a dose of 500 mg/kg. SK 1899 did not disturb either the spontaneous motility or contractor-induced contraction of the isolated organs such as guinea pig ileum, rat uterus, guinea pig vas deferens, and guinea pig trachea at concentrations up to 10(-4) mol/l. It slightly increased the contractile force in the isolated guinea pig atrium at a concentration of 10(-4) mol/l. Following intravenous infusion of 5, 15, and 50 mg/kg of SK 1899 to anesthetized dogs, it did not change the mean arterial pressure, heart rate, left ventricular systolic pressure (LVSP), and respiratory rate, while it slightly increased the left ventricular positive dP/dtmax (LV + dP/dtmax) at a dose of 50 mg/kg. SK 1899 did not induce any significant changes in the intestinal charcoal meal transit in mice, basal gastric juice secretion in rats, and renal function in rats. It did not affect the blood coagulation system and phenolsulfonphthalein secretion in rats. These findings suggest that SK 1899 has a very low potential to induce any adverse pharmacological effects at the doses showing antiviral activity.

Current surgical results of retrosigmoid approach in extralarge vestibular schwannomas

BACKGROUND

Vestibular schwannomas (VS) are common tumors that can be cured; they are reported to comprise 6 approximately 8% of all intracranial tumors. The primary objective in the surgery of extralarge VS is total removal of the tumor mass while preserving the facial nerve. In extralarge tumors, complete excision of the tumor carries a significant risk of injuring the facial nerve and adjacent vital brain structures. The authors are reporting the techniques and results of operation on extralarge VS.

METHODS

The material consisted of 30 patients during the last 6 years with surgically treated VS that had a maximal extrameatal diameter exceeding 4 cm. Suboccipital craniotomy and tumor removal was performed with patients in the lateral position. Results and complications of the surgical technique will be reviewed.

RESULTS

Average age of patients was 45.2 years; there was a slight female predominance (1.5:1). Size of the mass ranged from 41 to 70 mm; all were removed by the retrosigmoid transmeatal approach. Peritumoral edema on MRI was seen in 50% (15/30). Total removal was achieved in 73.3% (22/30) with no significant relationship to peritumoral edema. In the cases of total removal, the facial nerve preservation rate was 86.4% (19/22). There was no mortality. Surgical complications were hemorrhage and CSF leakage in 1 case (3%) and 8 cases (26.7%), respectively, but in most of these cases, conservative treatment was adequate. In patients in whom anatomic preservation of the facial nerve was achieved, facial nerve function improved progressively within a year. In all cases except for one with gait disturbance, a good outcome was achieved.

CONCLUSIONS

Our surgical techniques, including the prediction of facial nerve displacement, not using retractors, and replacement of bone, contributed to good surgical results in a series of extralarge VS.

Muscle fiber type disproportion with an autosomal dominant inheritance

Congenital muscle fiber type disproportion (CFTD) has been described as a form of congenital myopathy characterized by the smallness and marked predominance of type 1 fibers in a muscle biopsy. Clinical manifestations include hypotonia, nonprogressive muscle weakness, joint contractures, and skeletal deformities. However, it has also been noted that the same pathologic alterations appeared in clinically diverse conditions. Recently, we experienced a family, a mother and two children, in which a muscle biopsy showed the mother to have muscle fiber type disproportion. This case was unusual in that there was a significant progression of weakness, an absence of neonatal hypotonia, and other commonly associated musculo-skeletal deformities. In this report, we describe the clinicopathologic features of the family with a brief review about muscle fiber type disproportion.

Sporadic inclusion body myositis correlates with increased expression and cross-linking by transglutaminases 1 and 2

Sporadic inclusion body myositis (SIBM) is characterized by vacuolar degeneration of muscle fibers and intrafiber clusters of paired helical filaments with abnormal amyloid deposition. Because of their potential involvement in other degenerative disorders, we have examined the expression of transglutaminases (TGases) in normal and SIBM tissues. We report that at least two different enzymes, the ubiquitous TGase 2 as well as the TGase 1 enzyme, are present in muscle tissues. However, in comparison with normal tissue, the expression of TGases 1 and 2 was increased 2.5- and 4-fold in SIBM, accompanied by about a 20-fold higher total TGase activity. By immunohistochemical staining, in normal muscle, TGase 2 expression was restricted to some endomysial connective tissue elements, whereas TGase 1 and beta-amyloid proteins were not detectable. In SIBM muscle, both TGases 1 and 2 as well as amyloid proteins were brightly expressed and co-localized in the vacuolated muscle fibers, but none of these proteins colocalized with inflammatory cell markers. Next, we isolated high molecular weight insoluble proteins from SIBM muscle tissue and showed that they were cross-linked by about 6 residues/1000 residues of the isopeptide bond. Furthermore, by amino acid sequencing of solubilized tryptic peptides, they contain amyloid and skeletal muscle proteins. Together, these findings suggest that elevated expression of TGases 1 and 2 participate in the formation of insoluble amyloid deposits in SIBM tissue and in this way may contribute to progressive and debilitating muscle disease.

Cerebral infarction with ICA occlusion after Gamma Knife radiosurgery for pituitary adenoma: A case report

Cranial irradiation may lead to accelerated atherosclerotic changes to small or medium sized arteries, but stroke associated with pituitary irradiation is not frequent. A patient treated with Gamma Knife radio-surgery (GKRS) for a pituitary adenoma suffered a cerebral infarction with internal carotid artery occlusion 4 years after radiosurgery. The patient was a 35-year-old male presenting with a visual disturbance. Endocrinological tests were normal. MRI revealed a 4.3 by 4.3 cm diameter invasive macroadenoma of the pituitary, projecting toward the suprasellar region and with cavernous sinus involvement with encasement of both internal carotid arteries (ICAs). GKRS was performed for residual tumor after a transcranial resection. The maximum dose was 40 Gy and the dose to the right carotid artery was below 20 Gy. The delayed hemiparesis was accompanied by a right capsular lacunar infarct shown on MRI. The images also showed a marked reduction in tumor size. Total, right ICA occlusion was confirmed by Doppler ultrasound. The patient had no history or signs of heart disease or metabolic disorder which could predispose to cerebrovascular

Semiinvasive pulmonary aspergillosis: CT and pathologic findings in six patients

OBJECTIVE

We describe the chest CT and pathologic findings of semiinvasive pulmonary aspergillosis in six patients.

CONCLUSION

Semiinvasive pulmonary aspergillosis should be considered in the mildly immunocompromised patient with CT findings that reveal persistent parenchymal abnormalities. Patterns include consolidation and mass.

Regenerative periodontal surgery in interproximal intrabony defects with biodegradable barriers

AIM

The comparison of the effects of guided-tissue regeneration (GTR) using 2 different biodegradable barriers (polylactide acetyltributyl citrate; polydioxanon) in 3- and 2-wall intrabony defects.

METHOD

The polydioxanon barrier is an experimental membrane for GTR therapy that consists of an continuous occlusive barrier that has a layer of slings on the side that is meant to face the mucoperiosteal flap. 15 patients provided 15 pairs of similar contralateral periodontal defects: 12 predominantly 2-wall and 18 predominantly 3-wall intrabony defects. Each defect was randomly assigned to treatment with either polylactide acetyltributyl citrate (control [c]) or polydioxanon (test [t]) devices. At baseline and 6 months after surgery, clinical measurements (P1I, GI, PPD, PAL-V) were performed.

RESULTS

Barrier exposure was commonly observed in both groups (control/test): 5/4 after 7 days, 9/11 after 14 days and 11/12 after 28 days postsurgically. 4 weeks after surgery, 77% of all barriers were exposed to some extent. However, both treatments revealed a significant GI reduction (p<0.05), PPD reduction [-4.63+/-1.85 mm (t), -4.17+/-1.89 mm (c); p<0.001] and PAL-V gain [3.97+/-1.17 mm (t), 3.40 mm+/-1.40 (c); p<0.001] 6 months after surgery. Regarding GI and PPD reduction as well as PAL-V gain, there were neither statistically significant nor clinically relevant differences between test and control: similar clinical results were found 6 months after surgical treatment using both biodegradable barriers.

CONCLUSIONS

Based on the results of the present study, the use of both biodegradable barriers in GTR therapy may be recommended.

Induction of in vivo persistent anti-mycobacterial activity by interferon-gamma-secreting fibroblasts

To determine whether the paracrine secretion of interferon-gamma (IFN-gamma) can efficiently stimulate the resistance to Mycobacterium avium complex (MAC) infection, 3T3 fibroblasts were stably transduced to secrete IFN-gamma (500 units/10(6) cells/48 h) and their effects on MAC infection were investigated in genetically susceptible BALB/c mice, compared with that of free recombinant IFN-gamma (rIFN-gamma). Immunization with IFN-gamma-secreting fibroblasts (3T3-IFN-gamma) during intranasal infection with MAC resulted in a significant decrease in bacterial load of lung during the entire 8-week observation period, while rIFN-gamma reduced the bacterial load at initial 1 week but not by 8 weeks postinfection. Furthermore, immunization with the 3T3-IFN-gamma cells induced and maintained significantly higher levels of cytotoxic activity and nitric oxide production by lung cells than those of rIFN-gamma immunization. This work suggest that IFN-gamma-secreting fibroblasts may serve as a vehicle for paracrine secretion of IFN-gamma in immunotherapy of MAC infection.

Cytomegalovirus pneumonia: high-resolution CT findings in ten non-AIDS immunocompromised patients

OBJECTIVE

To describe the HRCT findings of cytomegalovirus (CMV) pneumonia in non-AIDS immunocompromised patients

MATERIALS AND METHODS

This retrospective study involved the ten all non-AIDS immunocompromised patients with biopsy-proven CMV pneumonia and without other pulmonary infection encountered at our Medical Center between January 1997 and May 1999. HRCT scans were retrospectively analysed by two chest radiologists and decisions regarding the findings were reached by consensus.

RESULTS

The most frequent CT pattern was ground-glass opacity, seen in all patients, with bilateral patchy (n = 8) and diffuse (n = 2) distribution. Other findings included poorly-defined small nodules (n = 9) and consolidation (n = 7). There was no zonal predominance. The small nodules, bilateral in eight cases and unilateral in one, were all located in the centrilobular region. Consolidation (n = 7), with patchy distribution, was bilateral in five of seven patients (71%). Pleural effusion and bilateral areas of thickened interlobular septa were seen in six patients (60%).

CONCLUSION

CMV pneumonia in non-AIDS immunocompromised patients appears on HRCT scans as bilateral mixed areas of ground-glass opacity, poorly defined centrilobular small nodules, and consolidation. Interlobular septal thickening and pleural effusion are frequently associated.

B-cell lymphoma of bronchus-associated lymphoid tissue (BALT): CT features in 10 patients

PURPOSE

The purpose of this work was to describe the CT findings of pathologically confirmed bronchus-associated lymphoid tissue (BALT) lymphoma in 10 patients.

METHOD

The CT examinations of 10 patients with pathologically proven BALT lymphoma were reviewed retrospectively by two radiologists. Evaluated findings included number and distribution of lesions. We also assessed other CT findings such as presence of airspace consolidation, nodules, ground-glass attenuation, bubble-like radiolucencies, air bronchogram, bronchial dilatation, and lymphadenopathy.

RESULTS

Pulmonary lesions were revealed as airspace consolidation in six patients (60%) and nodule(s) in six (60%). Multiplicity of disease was seen in seven patients (70%) and bilateral lung lesions in six (60%). Areas of ground-glass attenuation were seen in seven patients (70%). Bubble-like radiolucencies were present in five patients (50%) and air bronchogram in nine (90%). Findings of bronchial dilatation and lymphadenopathy were seen in three patients (30%).

CONCLUSION

BALT lymphomas usually appear as airspace consolidation or nodules with air bronchogram or adjacent ground-glass attenuation at CT. These findings are similar to previous descriptions of pseudolymphomas. Multiple bilateral lesions are common in BALT lymphoma. Bubble-like radiolucencies have not been described previously and can be an additional finding of BALT lymphoma.

Adsorption of a mixture of Thiobacillus thiooxidans and Thiobacillus ferrooxidans onto copper-containing furnace dust

The Langmuir adsorption parameter X(Am) of a mixture of culture of Thiobacillus ferrooxidans and Thiobacillus thiooxidans indicates that these bacteria have preferential and competitive adsorption sites on furnace dust. The constant K(A) of the mixture significantly larger than that of each component, suggesting that a synergistic effect may occur in the binding of these bacteria to the dust.

Two new genotypes of Plasmodium vivax circumsporozoite protein found in the Republic of Korea

The gene encoding Plasmodium vivax circumsporozoite protein (PvCSP) exhibits polymorphism in many geographical isolates. The present study was designed to investigate polymorphism in PvCSP gene of P. vivax isolates in Korea. Thirty isolates, obtained from indigenous cases in Yonchon-gun, Kyonggi-do in 1997, were subjected for sequencing and RFLP analysis of the repeat and post-repeat regions of PvCSP gene and two genotypes (SK-A and SK-B) were identified. The genotype of 19 isolates was SK-A and that of 11 isolates was SK-B. Although the number of 12-base repeats present in SK-A was three while two were found in a Chinese strain CH-5, the repeat sequence of SK-A was identical to that of CH-5 except for one base substitution. Compared with known data there was no identical isolates with SK-B, but the sequence of SK-B was similar to that of a North Korean (NK) isolate. These results indicate that two genotypes of PvCSP coexist in the present epidemic area of Korea and the present parasite may originate from East Asia. RFLP would be useful to classify genotypes of P. vivax population instead of gene sequencing.

Inhibition of interleukin-12 production in lipopolysaccharide-activated macrophages by curcumin

Pharmacological control of interleukin-12 production may be a key therapeutic strategy for modulating immunological diseases dominated by type-1 cytokine responses. In this study we investigated the effects of curcumin (1,7-bis[4-hydroxy-3-methoxyphenyl]-1, 6-heptadiene-3,5-dione) on the production of interleukin-12 from mouse macrophages stimulated with lipopolysaccharide. Curcumin potently inhibited the production of interleukin-12 in a dose-dependent manner. The effect of curcumin on interleukin-12 p40 promoter activation was analyzed by transfecting RAW264.7 monocytic cells with p40 promoter/reporter constructs. The repressive effect mapped to a region in the p40 promoter containing a binding site for nuclear factor kappaB (p40-kappaB). Furthermore, activation of macrophages by lipopolysaccharide resulted in markedly enhanced binding activity to the kappaB site, which significantly decreased upon addition of curcumin. These results suggest that curcumin-induced inhibition of interleukin-12 production in macrophages may explain some of the biological effects of curcumin including its anti-inflammatory activity.

Chloromethyl ketones inhibit interleukin-12 production in mouse macrophages stimulated with lipopolysaccharide

Interleukin-12 (IL-12) plays a pivotal role in the development of T-helper type 1 (Th1) immune response, which may be involved in the pathogenesis of chronic inflammatory autoimmune disorders. In this study, we investigated the effects of N-alpha-tosyl-L-phenylalanine chloromethyl ketone (TPCK) and N-alpha-tosyl-L-lysine chloromethyl ketone (TLCK), serine protease inhibitors, on the production of IL-12 from macrophages stimulated with lipopolysaccharide (LPS). TPCK and TLCK potently inhibited this LPS-induced IL-12 production in a dose-dependent manner. The effect of TPCK and TLCK on the IL-12 p40 promoter activation was analyzed by transfecting monocytic RAW264.7 cells with p40 promoter-reporter constructs. The repressive effect maps to a region in the p40 promoter containing a binding site for NFkappaB (p40-kappaB). A linker scan mutant of the p40-kappaB site abrogates the inhibitory effect on the p40 promoter, confirming the functional relevance of the NFkappaB site. Our results show that TPCK and TLCK inhibit NFkappaB-mediated IL-12 production in macrophages. reserved.

mRNA expression of glomerular basement membrane proteins and TGF-beta1 in human membranous nephropathy

Immunogold densities for the 'classical' and 'novel' alpha chains of type IV collagen, laminin, and fibronectin are increased in the spikes in human membranous nephropathy (MN). To investigate the molecular mechanisms which underlie these changes in glomerular basement membrane (GBM) components, alpha1(IV) collagen, alpha4(IV) collagen, S-laminin, fibronectin, transforming growth factor (TGF)-beta1 and TGF-beta2 mRNA expression was examined in 12 renal biopsy specimens with MN and six renal biopsies with no detectable abnormality by RNA in situ hybridization. In controls, there were relatively low signals of alpha1(IV) collagen, alpha4(IV) collagen, S-laminin, and TGF-beta1 mRNAs, but there were no fibronectin or TGF-beta2 transcripts in glomerular cells. In MN, the number of alpha4(IV) collagen, alpha1(IV) collagen, S-laminin or TGF-beta1 mRNA-expressing cells per glomerular cross-section was significantly larger than in controls (p< 0.05), and fibronectin mRNA was occasionally expressed in glomerular visceral epithelial cells (GECs). No message for TGF-beta2 was seen in MN. The number of TGF-beta1 mRNA-expressing cells per glomerular cross-section significantly correlated with that of alpha1(IV) mRNA-expressing cells (p< 0.01). The MN patients with positivie signal for fibronectin mRNA exhibited more severe GBM thickening than those without (p< 0.05). These results indicate that the increased presence of GBM proteins in spikes of MN is associated with enhanced mRNA expression of these proteins. They also suggest that subepithelial deposits in MN stimulate GECs to produce TGF-beta1, which in turn could mediate the expression of GBM protein genes by GECs.

Changes of telomerase and telomere lengths in paired normal and cancer tissues of breast

To attain the immortal phenotype, cancer cells must overcome the mitotic clock. Telomerase activity has been identified to be activated in malignant tumors including breast cancer. Telomerase activity was evaluated in 71 breast cancer tissues and paired normal tissues with the TRAP (telomerase repeat amplification protocol) assay. Telomerase activity was calculated and translated into arbitrary units by computer-assisted densitometry with the control of telomerase activity in the 293 control cell line. In 59 paired breast tissues with telomerase activity, terminal restriction fragment (TRF) lengths were measured using Southern blotting. Relative inhibition (RI), the ratio of inhibited telomerase activity in each tumor tissue compared to that of the 293 control cell line after pre-treatment with 150 microg/ml of RNAse A, was measured. Sixty-three of 71 cancer tissues showed telomerase activity (88.7%) with 75.3+/-17.9 units in densitometry, while no telomerase activity was detected in their paired normal tissues. Telomerase activity was correlated to node metastasis (p=0.02) and stage (p=0.005), but not to tumor size or the hormonal receptor status. TRF lengths were 11. 0+/-4.7 kb in 59 tumor tissues and 11.7+/-2.2 kb in paired normal tissues. TRF lengths did not correlate to any of the clinical parameters. However changes of TRF lengths in tumor tissues compared to those of normal tissues correlated to telomerase activity. RI in the tumor tissues was proportional to telomerase activity without RNAse A pre-treatment. In breast cancer, telomerase activity was specific to tumor tissues and increased with tumor progression. Telomerase activity and changes in TRF lengths can be used as guidelines in detecting candidates for the telomerase inhibitor.

Nonspecific interstitial pneumonia with fibrosis: serial high-resolution CT findings with functional correlation

OBJECTIVE

We assessed serial changes in high-resolution CT findings and pulmonary function in patients with nonspecific interstitial pneumonia with fibrosis.

MATERIALS AND METHODS

Serial high-resolution CT findings in 13 patients with biopsy-proven nonspecific interstitial pneumonia with fibrosis (mean follow-up period, 11 months) and pulmonary function tests (mean follow-up period, 11 months) were retrospectively analyzed. On CT, the presence and extent of ground-glass opacity, irregular linear opacity, honeycombing, and consolidation were assessed.

RESULTS

On initial CT, all patients had areas of ground-glass opacity (mean +/- SD, 21.6% +/-14.4) and irregular linear opacity (5.0% +/- 5.2). The areas of ground-glass opacity decreased significantly on follow-up CT (13.5% +/- 10.5, p = .003). The areas of irregular linear opacity decreased slightly (4.2% +/- 5.2, p > .05). Initial forced vital capacity (69.4% +/- 16.0) improved significantly on follow-up examination (83.9% +/- 16.5) (p = .003). The decrease in the extent of ground-glass opacity on CT correlated significantly with changes in forced vital capacity (r = -.702, p = .007) and diffusing capacity for carbon monoxide (r = - .597, p = .031).

CONCLUSION

In patients with nonspecific interstitial pneumonia with fibrosis, areas of ground-glass opacity decrease on follow-up high-resolution CT, and the extent of decrease correlates significantly with that of functional improvement.

Sulfasalazine prevents T-helper 1 immune response by suppressing interleukin-12 production in macrophages

Interleukin-12 (IL-12) plays a pivotal role in the development of T-helper 1 (Th1) immune response, which may be involved in the pathogenesis of chronic inflammatory autoimmune disorders. In this study we investigated the effects of sulfasalazine, a drug for treating inflammatory bowel disease and rheumatoid arthritis, on the production of IL-12 from mouse macrophages stimulated with lipopolysaccharide (LPS). Sulfasalazine potently inhibited the production of IL-12 in a dose-dependent manner, in part through the down-regulation of nuclear factor kappaB (NFkappaB) activation in IL-12 p40 gene. Activation of macrophages by LPS resulted in markedly enhanced binding activities to the kappaB site, which significantly decreased upon addition of sulfasalazine as demonstrated by an electrophoretic gel shift assay. Importantly, macrophages pretreated with sulfasalazine either in vitro or in vivo reduced their ability to induce interferon-gamma (IFN-gamma) and increased the ability to induce IL-4 in antigen-primed CD4+ T cells. From these results, sulfasalazine may induce the Th2 cytokine profile in CD4+ T cells by suppressing IL-12 production in macrophages, and sulfasalazine-induced inhibition of IL-12 production in macrophages may explain some of the known biological effects of sulfasalazine.

Squalene-induced extrinsic lipoid pneumonia: serial radiologic findings in nine patients

PURPOSE

The purpose of this work was to demonstrate the initial and follow-up radiologic findings of squalene-induced extrinsic lipoid pneumonia.

METHOD

Follow-up chest radiographs (n = 9) and high-resolution CT scans (n = 3) as well as initial radiographs (n = 9) and CT scans (n = 8) were obtained in nine patients with squalene-induced extrinsic lipoid pneumonia. The serial radiologic findings were analyzed retrospectively by three chest radiologists, focusing on the pattern and distribution of parenchymal abnormalities.

RESULTS

The most frequent pattern of parenchymal abnormalities on chest radiograph was areas of ground-glass opacity (n = 9, bilateral 6), followed by consolidation (n = 7, bilateral 3) and poorly defined small nodules (n = 4, bilateral 2). The abnormalities were distributed in the right lower lung (n = 9), left lower lung (n = 6), and right middle lung (n = 6) zones. Initial CT scans (n = 8) demonstrated bilateral areas of ground-glass attenuation (n = 8), poorly defined centrilobular nodules (n = 8), crazy paving (n = 6), and consolidation (n = 3). The abnormalities were distributed in the right middle lobe (n = 8) and in both lower lobes (n = 5). Follow-up chest radiograph (n = 9) showed complete disappearance (n = 2) and decrease (n = 7) in the extent of the parenchymal abnormalities. Follow-up CT scans (n = 3) demonstrated decrease (n = 2) and no change (n = 1) in the extent of the abnormalities.

CONCLUSION

Squalene-induced extrinsic lipoid pneumonia most commonly appears as areas of ground-glass attenuation mixed with poorly defined centrilobular nodules and crazy paving on CT, being distributed mainly in the right middle and both lower lobes. The lesions are indolent and remain after cessation of squalene ingestion.

Curcumin inhibits Th1 cytokine profile in CD4+ T cells by suppressing interleukin-12 production in macrophages

1 Interleukin-12 (IL-12) plays a central role in the immune system by driving the immune response towards T helper 1 (Th1) type responses which are characterized by high IFN-gamma and low IL-4 production. In this study we investigated the effects of curcumin, a natural product of plants obtained from Curcuma longa (turmeric), on IL-12 production by mouse splenic macrophages and the subsequent ability of these cells to regulate cytokine production by CD4+ T cells. 2 Pretreatment with curcumin significantly inhibited IL-12 production by macrophages stimulated with either lipopolysaccharide (LPS) or head-killed Listeria monocytogenes (HKL). 3 Curcumin-pretreated macrophages reduced their ability to induce IFN-gamma and increased the ability to induce IL-4 in Ag-primed CD4+ T cells. Addition of recombinant IL-12 to cultures of curcumin-pretreated macrophages and CD4+ T cells restored IFN-gamma production in CD4+ T cells. 4 The in vivo administration of curcumin resulted in the inhibition of IL-12 production by macrophages stimulated in vitro with either LPS or HKL, leading to the inhibition of Th1 cytokine profile (decreased IFN-gamma and increased IL-4 production) in CD4+ T cells. 5 These findings suggest that curcumin may inhibit Th1 cytokine profile in CD4+ T cells by suppressing IL-12 production in macrophages, and points to a possible therapeutic use of curcumin in the Th1-mediated immune diseases.

Mucoepidermoid carcinoma of the tracheobronchial tree: radiographic and CT findings in 12 patients

PURPOSE

To determine the radiographic and computed tomographic (CT) findings and clinical features of mucoepidermoid carcinoma of the tracheobronchial tree.

MATERIALS AND METHODS

Chest radiographic and CT findings and clinical features of 12 histopathologically proved mucoepidermoid carcinomas in 12 consecutive patients (five male, seven female; age range, 9-72 years; mean age, 36 years) were reviewed retrospectively.

RESULTS

The tumors were located at the distal trachea (n = 1) or at a main (n = 2), lobar (n = 1), or segmental (n = 8) bronchus. On chest radiographs, the tumors appeared as central masses with post-obstructive pneumonia or peripheral atelectasis in four patients and as solitary pulmonary or endotracheobronchial nodules in eight. At CT, the tumors were all smoothly oval (n = 6) or lobulated (n = 6) in shape (ranging 9-40 mm in diameter), adapting to the branching features of the airways. Punctate calcification within the tumor was seen in six patients. Neither metastasis nor recurrence was seen after the surgical resection (follow-up of 8-103 months; mean, 30 months).

CONCLUSION

Mucoepidermoid carcinoma of the tracheobronchial tree, usually located in a segmental bronchus, appears at CT as a smoothly oval or lobulated airway mass. It adapts to the branching features of the airways.

Fetal mouse selenophosphate synthetase 2 (SPS2): biological activities of mutant forms in Escherichia coli

A novel gene, sps2, detected in mouse embryo at the early stages of development has been identified as an analog of the E. coli selenophosphate synthetase gene. Unlike the E. coli enzyme, the presence of selenocysteine in the mouse enzyme is indicated by a TGA codon in the open reading frame of the cDNA. Using an N-FLAG monoclonal antibody, it was shown that the full length N-FLAG-sps2 gene product was expressed in COS-7 cells. To investigate the biological activity of the sps2 gene product in vivo, the mutated sps2 gene, which contains cysteine in the place of the TGA encoded selenocysteine in the wild type, was expressed in the E. coli selD deficient mutant, MB08. Like the E. coli wild type selD gene, the mutant sps2 gene complemented the selD mutation. However, replacement of Cys with either Ala, Ser, or Thr resulted in a loss of ability to complement the selD mutation. The SPS2-CYS protein expressed in E. coli was purified and its catalytic activity was determined. The Km value for ATP was 0.75 mM and Vmax was 9.23 nmole/min/mg protein. These results confirm that the mouse embryonic sps2 gene encodes an eukaryotic selenophosphate synthetase, and that availability of selenophosphate as a selenium donor compound is widespread.

Antigen-specific cytotoxicity and cell number of adoptively transferred T cells are efficiently maintained in vivo by re-stimulation with an antigen/interleukin-2 fusion protein

In order to maintain in vivo anti-tumor efficacy of antigen (Ag)-specific T cells in adoptive immunotherapy for a prolonged period, we constructed a fusion protein (OVA/IL-2) containing ovalbumin (OVA) as a model tumor Ag, co-valently linked to murine interleukin-2 (IL-2). The OVA/IL-2 protein produced in a baculovirus expression system displayed potent IL-2 bio-activity. Immunization with the OVA/IL-2 protein after adoptive transfer of OVA-specific T cells maintained the OVA-specific cytotoxicity and cell number of adoptively transferred T cells long term in vivo, while a simple mixture of recombinant OVA (rOVA) and rIL-2 did not. The response was dependent on the injection doses and times of the OVA/IL-2 protein. Furthermore, weekly re-stimulation of adoptively transferred OVA-specific T cells with the OVA/IL-2 protein cured 70% of tumor-bearing mice. In contrast, re-stimulation with a mixture of rOVA and rIL-2 could not significantly prolong the survival period of tumor-bearing mice. These studies suggest that the co-valent linkage between IL-2 and antigen confines the effect of IL-2 to antigen-specific T cells, leading to efficient maintenance of the anti-tumor activity of adoptively transferred T cells.

Modulation of biological phenotypes for tumor growth and metastasis by target-specific biological inhibitors in gastric cancer

For tumor progression, a cascade of linked sequential biological events is essential. We tried to test whether biological therapy can modulate specific biological phenotypes and increase the anti-tumor effect when combined with chemotherapy. Five human gastric cancer cell lines (YCC-1, YCC-2, YCC-3, YCC-7, AGS) were used in these studies. Pentosan polysulfate (PPS) as a heparin-binding growth factor inhibitor, Tranexamic acid as a plasmin inhibitor, Lovastatin as an adhesion inhibitor and Adriamycin as a chemotherapeutic agent were selected. The effects of each drug on colony formation and tumor cell proliferation were evaluated by soft agar assay and cell proliferation assay, respectively to test direct anti-tumor effect. The expression of uPA, PAI-1 was determined by ELISA, while MMPs activity was evaluated by zymography. PPS suppressed the colony-forming activity as much as Adriamycin did, but it showed only cytostatic effects in cell proliferation assay. Migration capacity using Boyden chamber assay was more closely correlated with adhesive capacity than uPA or MMP-2 expression. The motility inhibitory effect of Tranexamic acid was observed in the YCC-7 cell line, which expressed all the required biological phenotypes for migration. In AGS, with high cell motility and adhesiveness, the adhesion was inhibited by Lovastatin and most of the inhibitory effect was recovered by Mevalonate. When PPS was combined with Adriamycin on the Adriamycin-resistant, midkine (MK) gene expressing YCC-7 cell line, the growth inhibition rate increased up to 84%, while that for a single treatment of PPS or Adriamycin was 40% and 22%, respectively (p=0.001). When we combined Tranexamic acid and Adriamycin, we observed the synergistic effect in YCC-3 and YCC-7, while no combined effect was found in YCC-1. The combination of Lovastatin and Adriamycin did not show any combined effects in any of the cell lines. In conclusion, a synergistic anti-proliferative effect (chemo-sensitization) with combined chemo-biotherapy was found in cancer cells with specific biological target, MK. The anti-motility effect was the greatest when the gastric cancer cells expressed all the specific biological phenotypes.

An intervention study to enhance medication compliance in community-dwelling elderly individuals

OBJECTIVE

To determine whether daily videotelephone or regular telephone reminders would increase the proportion of prescribed cardiac medications taken in a sample of elderly individuals who have congestive heart failure (CHF).

METHODS

The authors recruited community-dwelling individuals age 65 and older who had the primary or secondary diagnosis of CHF into a randomized controlled trial of reminder calls designed to enhance medication compliance. There were three arms: a control group that received usual care; a group that received regular daily telephone call reminders; and a group that received daily videotelephone call reminders. Compliance was defined as the percent of therapeutic coverage as recorded by Medication Event Monitoring System (MEMS) caps. Subjects were recruited from 2 sources: a large urban home health care agency and a large urban ambulatory clinic of a major teaching hospital. Baseline and post-intervention MOS 36-Item Short-Form Health Survey (SF-36) scores and Minnesota Living with Heart Failure (MLHF) scores were obtained.

RESULTS

There was a significant time effect during the course of the study from baseline to post-intervention (F[2,34] = 4.08, p < .05). Over time the elderly individuals who were called, either by telephone or videotelephone, showed enhanced medication compliance relative to the control group. There was a trend, but no significant difference between the two intervention groups. Both SF-36 and MLHF scores improved from baseline to post-intervention for all groups. There was no significant change in the SF-36 scores for the sample, but there was a significant change for the MLHF scores (p < .001). The control group had a significant fall off in the medication compliance rate during the course of the study, dropping from 81% to 57%.

CONCLUSIONS

Telephone interventions are effective in enhancing medication compliance and may prove more cost effective than clinic visits or preparation of pre-poured pill boxes in the home. Technologic advances which enable clinicians to monitor and enhance patient medication compliance may reduce costly and distressing hospitalization for elderly individuals with CHF.

Interferon-gamma- and interleukin-4-targeted gene therapy for atopic allergic disease

Two cytokines, interferon-gamma (IFN-gamma) and interleukin-4 (IL-4), which play critical roles in the regulation of serum IgE level by directing the interplay of T helper (Th)1 and Th2 cells, were chosen as targets for gene therapy. Anti-allergic activity was evaluated by determining the serum IgE level, and the functional status of each helper T cell was monitored by the serum concentrations of IgG1 and IgG2a. Experimental animals (BALB/c mice) were divided into four groups: the control group; the ovalbumin (OVA) group; the IFN-gamma group; and the IL-4 group. The control group was injected with saline and the OVA group with OVA-alum. The IFN-gamma and IL-4 groups were treated with OVA-alum plus the cDNAs of mouse IFN-gamma and IL-4 in an expression vector. These treatments were applied intramuscularly on a monthly basis for 4 months. OVA-alum treatment significantly increased the serum IgE and IgG1 concentrations, but did not affect IgG2a. Concomitant treatments with the cDNA of IFN-gamma or IL-4 returned the serum IgE almost to the control level and significantly suppressed the OVA-induced increase of IgG1. IFN-gamma cDNA increased the serum IgG2a but IL-4 cDNA had no affect. These results suggest that IFN-gamma inhibited the OVA-induced IgE production by suppressing the Th2 pathway and by enhancing the Th1 pathway. Administration of IL-4 cDNA suppressed the OVA-induced enhancement of IgE production by inhibiting the Th2 pathway rather than by potentiating it.

Interleukin-12-secreting fibroblasts are more efficient than free recombinant interleukin-12 in inducing the persistent resistance to Mycobacterium avium complex infection

To determine whether the paracrine secretion of interleukin-12 (IL-12) can efficiently stimulate the resistance to Mycobacterium avium complex (MAC) infection, 3T3 fibroblasts were stably transfected to secrete IL-12 (480 U/106 cells/48 hr) and their effect on MAC infection was investigated in genetically susceptible BALB/c mice, compared with that of free recombinant IL-12 (rIL-12). Injection with IL-12-secreting fibroblasts (3T3-IL-12) during intranasal infection with MAC resulted in a significant decrease in the bacterial load of the lung during the entire 10-week observation period, while rIL-12 reduced the bacterial load initially, at 2 weeks, but not by 10 weeks postinfection. Lung CD4+ T cells in mice injected with the 3T3-IL-12 cells showed a persistent T helper type 1 (Th1) response throughout the 10-week period. Furthermore, immunization with the 3T3-IL-12 cells induced and maintained significantly higher levels of cytotoxic activity and nitric oxide production by lung cells than did rIL-12 immunization. This work suggests that IL-12-secreting fibroblasts may serve as a vehicle for paracrine secretion of IL-12 for immunotherapy of MAC infection.

Spectral indices of cardiac autonomic function in obstructive sleep apnea

Spectral analysis of heart rate variability (HRV) is useful as a noninvasive means of assessing autonomic function in patients with obstructive sleep apnea (OSA). However, standard spectral measures, such as the ratio of low-frequency to high-frequency power (LHR) and normalized high-frequency power (NHFP), can be confounded by the abnormal breathing patterns that occur during sleep. To circumvent this limitation, we employed an autoregressive modeling approach to partition the RR time-series into a component that is correlated with respiration and a respiration-independent component. From these components, we derived two new spectral indices: the modified LHR (MLHR) and the average gain relating respiration to RR changes (GRSA). Six normals and seven OSA patients were studied in relaxed wakefulness and stage 2 sleep; during sleep, the OSA patients were studied without and with continuous positive airway pressure (CPAP) therapy. All four spectral indices showed significant differences between OSA patients and normals in both wakefulness and sleep, although the changes in MLHR and GRSA were substantially larger and less variable: MLHR (p < 0.0003) and GRSA (p < 0.0001) vs. LHR (p < 0.005) and NHFP (p < 0.004). However, in the OSA subjects, LHR and NHFP were unchanged by CPAP. By contrast, CPAP produced a highly significant increase in GRSA (p < 0.0004), as well as a decrease in MLHR (p < 0.03). Thus, by compensating for the effects of breathing pattern differences, MLHR and GRSA unmasked the effects of CPAP therapy, which has been shown in previous studies to reduce sympathetic activity and increase vagal cardiac modulation.

Ring-down artifacts posterior to the right hemidiaphragm on abdominal sonography: sign of pulmonary parenchymal abnormalities

The aim of our study was to verify whether ring-down artifacts posterior to the right hemidiaphragm on abdominal sonography reflected pulmonary parenchymal abnormalities. Forty patients (group 1) with abdominal diseases and 32 patients (group 2) with proved various pulmonary abnormalities involving the right lung base underwent abdominal sonography with 2-4 MHz transducers. In these two groups, the presence and number of ring-down artifacts were assessed and correlated with peridiaphragmatic lung findings on chest radiographs or computed tomographic scans. In 21 patients (group 3) with multiple (more than five) or numerous (10 or more) ring-down artifacts, chest radiographs were reviewed to see if any peridiaphragmatic pulmonary abnormalities were present. In group 1, one or several (less than five) ring-down artifacts were shown in 27 of 40 (68%) patients. In these patients, computed tomography showed insignificant focal intra- and interlobular septal thickening in the peridiaphragmatic right lung. In group 2, 31 of 32 (97%) patients showed multiple or numerous ring-down artifacts. In group 3, chest radiographs showed various pulmonary abnormalities in 20 of 21 (95%) patients, including emphysema, idiopathic interstitial pneumonia, bronchopneumonia, and interstitial edema. Although nonspecific, ring-down artifacts posterior to the right diaphragm on abdominal sonography may be used to predict pulmonary abnormalities when encountered on abdominal sonography in patients without specific pulmonary symptoms.

Correlation between expression of matrix metalloproteinase-2 (MMP-2), and matrix metalloproteinase-9 (MMP-9) and angiogenesis in colorectal adenocarcinoma

Matrix metalloproteinases-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9), which degrade extracellular matrix, are believed to play a crucial role in tumor invasion and metastasis. Angiogenesis is also perceived as an important step in tumor growth and metastasis. To investigate the expression of MMPs and the correlation between the expression of MMPs and angiogenesis in colorectal adenocarcinoma, we studied 72 cases of colorectal adenocarcinoma in Inha University Hospital from 1996 to 1997. We evaluated the expression of MMPs by immunohistochemistry and angiogenesis by counting the microvessels. The expression of MMP-2 was increased according to the Astler-Coller stage (p< 0.05). Angiogenesis in the metastatic group was higher than that of the localized one (p<0.05). The expression of MMP-2 positively correlated with angiogenesis (p<0.05), and marked expression of MMP-9 positively correlated with angiogenesis (p<0.05). The present results suggest that the expression of MMP-2 provides clues for tumor progression and angiogenesis provides significant information to predict whether metastasis is present in colorectal adenocarcinoma.

Spectrum of neurogenic tumors in the thorax: CT and pathologic findings

Neurilemomas and neurofibromas appear as round soft tissue masses at CT. Variable enhancement with either homogeneity or heterogeneity is seen in neurilemomas. Attenuation of the tumors on enhanced CT depends on histology: the extent of Antoni A or B tissue and the amount of myxoid or cystic degeneration or hemorrhage. Neurofibromas are usually homogeneous low attenuation lesions on unenhanced CT. They show homogeneous enhancement or early central blush on enhanced scan. The extent of enhancement depends on the proportions of tumor components: nerve sheath cells, collagen bundles, and areas of myxoid degeneration. Malignant nerve sheath tumors show variable attenuation. Bony destruction, pleural effusion, and metastatic pulmonary nodules may also occur. Ganglioneuromas appear as oblong homogeneous low attenuation lesions on both enhanced and unenhanced CT. This low attenuation is due to their pathologic components, with an abundant amount of myxoid matrices and a relatively small amount of ganglion cells. Neuroblastomas appear as aggressive soft tissue lesions with calcification. Ganglioneuroblastomas may appear with features in between those of ganglioneuromas and neuroblastomas. The typical location of the posterior mediastinum or the aortopulmonary window and high enhancement with administration of contrast medium at CT suggest the diagnosis of paragangliomas.

Studies on the synthesis and in vitro antitumor activity of the isoquinolone derivatives

3-Arylisoquinolin-1(2H)-ones (2) are possible bioisosteres of the 5-[4'-(piperidinomethyl)phenyl]-2,3-dihydroimidazo[2,1-a]iso quinoline (1) which is in clinical evaluation for the treatment of cancer. Structure-activity relationship studies of 3-arylisoquinolin-1(2H)-ones (2) led to the synthesis of 3-arylquinolin-2(1H)-ones (3). A number of 3-phenyl substituted quinolin-2(1H)-ones were synthesized and tested for their in vitro antitumor activity against four different human tumor cell lines and 3-phenyl-N-benzyl-3,4-dihydroquinolin-2(1H)-one (12) showed the most potent activity.

Retinoids inhibit interleukin-12 production in macrophages through physical associations of retinoid X receptor and NFkappaB

Lipopolysaccharide (LPS) increases the production of interleukin-12 (IL-12) from mouse macrophages via a kappaB site within the IL-12 p40 promoter. In this study, we found that retinoids inhibit this LPS-stimulated production of IL-12 in a dose-dependent manner. The NFkappaB components p50 and p65 bound retinoid X receptor (RXR) in a ligand-independent manner in vitro, and the interaction interfaces involved the p50 residues 1-245, the p65 residues 194-441, and the N-terminal A/B/C domains of RXR. Activation of macrophages by LPS resulted in markedly enhanced binding activities to the kappaB site, which significantly decreased upon addition of retinoids, as demonstrated by the electrophoretic mobility shift assays. In cotransfections of CV-1 and HeLa cells, RXR also inhibited the NFkappaB transactivation in a ligand-dependent manner, whereas a mutant RXR lacking the AF2 transactivation domain, which serves as ligand-dependent binding sites for transcription integrators SRC-1 and p300, was without any effect. In addition, coexpression of increasing amounts of SRC-1 or p300 relieved the retinoid-mediated inhibition of the NFkappaB transactivation. From these results, we propose that retinoid-mediated suppression of the IL-12 production from LPS-activated macrophages may involve both inhibition of the NFkappaB-DNA interactions and competitive recruitment of transcription integrators between NFkappaB and RXR.

Anterior cervical spinal epidural abscess in an infant

Spinal epidural abscess (SEA) is rare in children, especially in newborns and infants, groups in which only very few cases have been reported. Because of the nonspecificity of presenting symptoms in children the diagnosis may be delayed, resulting in major permanent neurological deficits. In this paper, we report a case of cervical SEA in a 6-week-old infant who initially presented with fever and developed quadriparesis 19 days prior to admission. After emergency anterior decompression of the abscess the neurological function was improved immediately. Five months after surgery the neurological status was normal, an MR study showing disappearance of the epidural abscess and spinal cord indentation, and progressive fusion of the C3, C4 and C5 vertebral bodies. Anterior decompression without bone graft can provide an excellent prognosis in case of an anterior cervical SEA in infants.

Enzyme histochemical study of germanium dioxide-induced mitochondrial myopathy in rats

The purpose of this study were 1) to determine the earliest pathological changes of germanium dioxide (GeO2)-induced myopathy; 2) to determine the pathomechanism of GeO2-induced myopathy; and 3) to determine the minimal dose of GeO2 to induce myopathy in rats. One hundred and twenty five male and female Sprague-Dawley rats, each weighing about 150 gm, were divided into seven groups according to daily doses of GeO2. Within each group, histopathological studies were done at 4, 8, 16, and 24 weeks of GeO2 administration. Characteristic mitochondrial myopathy was induced in the groups treated daily with 10 mg/kg of GeO2 or more. In conclusion, the results were as follows: 1) The earliest pathological change on electron microscope was the abnormalities of mitochondrial shape, size and increased number of mitochondria; 2) The earliest pathological change on light microscope was the presence of ragged red fibers which showed enhanced subsarcolemmal succinate dehydrogenase and cytochrome c oxidase reactivity; 3) GeO2 seemed to affect the mitochondrial oxidative metabolism of muscle fibers; 4) GeO2 could induce mitochondrial myopathy with 10 mg/kg of GeO2 for 4 weeks or less duration in rats.

Papillary adenocarcinoma of the lung: radiologic and pathologic findings

We describe the radiologic and pathologic findings of papillary adenocarcinoma of the lung in three patients. The tumor appeared as a peripheral lung nodule (n = 1) or a mass (n = 2) on chest radiographs. On CT, the tumor appeared as a solitary pulmonary nodule, as a mass containing internal bubble lucencies with surrounding ground-glass opacity and satellite micronodules, and as a triangular mass with satellite micronodules. On pathology, all tumors showed distinct histologic features with papillary architecture, distortion and/or destruction of normal pulmonary architecture, and nuclear atypism.

Diffuse micronodular lung disease: HRCT and pathologic findings

PURPOSE

The purpose of our study was to compare the findings seen on HRCT with those from pathologic examination in patients with diffuse micronodular lung disease (DMLD).

METHOD

Forty consecutive patients with biopsy-proven DMLD (each nodule being <5 mm in diameter and occupying more than two-thirds of lung volume on chest radiograph) were included. High resolution CT (HRCT) scans were analyzed with particular attention to the location of nodules in and around the secondary pulmonary lobule (centrilobular, perilymphatic, and random) and the zonal distribution. The findings were compared to pathology.

RESULTS

CT scans showed centrilobular nodules in the patients with diffuse panbronchiolitis (n = 4), infectious bronchiolitis [n = 4; Hemophilus influenzae (n = 3) and Mycoplasma pneumoniae (n = 1)], hypersensitivity pneumonia (n = 3), bronchogenic disseminated tuberculosis (n = 3), pneumoconiosis (n = 1), primary lymphoma of the lung (n = 1), and foreign body-induced necrotizing vasculitis (n = 1). They demonstrated perilymphatic nodules in the patients with pneumoconiosis (n = 5), sarcoidosis (n = 2), and amyloidosis (n = 2). They demonstrated micronodules of random distribution in the patients with miliary tuberculosis (n = 9) and pulmonary metastasis (n = 5). Upper and middle zonal predominance was seen in two of two patients with sarcoidosis and in two of six patients with pneumoconiosis. The CT location of nodules in the secondary pulmonary lobule represented the location and nature of the lesion on pathologic examination.

CONCLUSION

By showing the distribution of micronodules in and around the secondary pulmonary lobule, HRCT enables the narrowing of the differential diagnosis of DMLD. CT findings reflect gross morphologic features of pathologic examination.

Pulmonary tuberculosis presenting as acute respiratory failure: radiologic findings

PURPOSE

The purpose of this work was to describe the radiologic findings of pulmonary tuberculosis in patients who presented with acute respiratory failure.

METHODS

We included patients who had newly diagnosed active pulmonary tuberculosis and who presented with acute respiratory failure. Initial chest radiographic (n = 17) and high-resolution CT (n = 11) findings of each patient were analyzed retrospectively.

RESULTS

Of 1,010 patients with active pulmonary tuberculosis, 17 patients (1.7%) presented with acute respiratory failure. Nine (53%) of the 17 patients died. The most common initial chest radiographic findings were small nodular lesions (16/17; 94%), consolidation (13/17; 76%), and ground-glass opacity (12/17; 70%). Eleven (69%) of 16 nodular lesions, 9 of 13 (69%) consolidations, and 10 of 12 (83%) ground-glass opacities were bilateral. On HRCT (n = 11), miliary micronodular lesions were seen in 6 patients (55%), whereas bronchogenic spread of tuberculosis with disseminated centrilobular nodules and tree-in-bud appearance was seen in 5 patients (45%). Diffuse areas of ground-glass attenuation were seen in all six patients with miliary nodules and four of five patients with bronchogenic spread of tuberculosis.

CONCLUSION

Patients with pulmonary tuberculosis occasionally present with acute respiratory failure. In this condition, chest radiograph most commonly shows bilateral small nodular lesions mixed with consolidation or ground-glass opacity, whereas HRCT demonstrates findings of miliary or bronchogenic disseminated tuberculosis with diffuse areas of ground-glass attenuation.