Apoptotic photoreceptor cell death after traumatic retinal detachment in humans

OBJECTIVE

To determine the mechanism of photoreceptor cell death after traumatic retinal detachment in humans.

DESIGN

Clinical records from 1975 to 1993 of 75 patients, whose eyes were enucleated after traumatic retinal detachment, were reviewed for age, sex, previous ocular or systemic medical history, interval from initial trauma to enucleation, visual acuity, and types of trauma. The patients were divided into five groups of 15 cases each, based on the interval from initial trauma to enucleation. The retinal tissue was examined for two markers of apoptosis: (1) nicked nuclear DNA in situ by the terminal deoxynucleotidyl transferase-mediated biotinylated deoxyuridine triphosphate nick end labeling (TUNEL) technique and (2) apoptotic bodies by light and electron microscopy.

RESULTS

Of the 75 cases of ruptured globe and traumatic retinal detachment that were evaluated, 19 eyes (25.3%) showed TUNEL-positive labeling of photoreceptor cells. Nicked nuclear DNA was detected in photoreceptor cells of detached retinas as early as 8 hours after trauma. The detached retinas in seven of 15 eyes enucleated within 2 days after ocular trauma showed TUNEL-positive photoreceptor nuclei. The number of cases showing TUNEL-positive photoreceptor nuclei decreased as the interval between initial trauma and enucleation increased. The TUNEL-positive photoreceptor cells could still be seen in the detached retinas of two eyes enucleated 22 days after trauma. Light microscopy disclosed condensation and fragmentation of photoreceptor nuclei in the detached retinas. Electron microscopy showed structures resembling apoptotic bodies phagocytosed by neighboring cells in the TUNEL-positive retinas.

CONCLUSIONS

Apoptosis is an important mechanism of photoreceptor cell degeneration in the early stage after traumatic retinal detachment in humans.

Oral vanadyl sulfate improves hepatic and peripheral insulin sensitivity in patients with non-insulin-dependent diabetes mellitus

We examined the in vivo metabolic effects of vanadyl sulfate (VS) in non-insulin-dependent diabetes mellitus (NIDDM). Six NIDDM subjects treated with diet and/or sulfonylureas were examined at the end of three consecutive periods: placebo for 2 wk, VS (100 mg/d) for 3 wk, and placebo for 2 wk. Euglycemic hyperinsulinemic (30 mU/m2.min) clamps and oral glucose tolerance tests were performed at the end of each study period. Glycemic control at baseline was poor (fasting plasma glucose 210 +/- 19 mg/dl; HbA1c 9.6 +/- 0.6%) and improved after treatment (181 +/- 14 mg/dl [P < 0.05], 8.8 +/- 0.6%, [P < 0.002]); fasting and post-glucose tolerance test plasma insulin concentrations were unchanged. After VS, the glucose infusion rate during the clamp was increased (by approximately 88%, from 1.80 to 3.38 mg/kg.min, P < 0.0001). This improvement was due to both enhanced insulin-mediated stimulation of glucose uptake (rate of glucose disposal [Rd], +0.89 mg/kg.min) and increased inhibition of HGP (-0.74 mg/kg.min) (P < 0.0001 for both). Increased insulin-stimulated glycogen synthesis (+0.74 mg/kg.min, P < 0.0003) accounted for > 80% of the increased Rd after VS, and the improvement in insulin sensitivity was maintained after the second placebo period. The Km of skeletal muscle glycogen synthase was lowered by approximately 30% after VS treatment (P < 0.05). These results indicate that 3 wk of treatment with VS improves hepatic and peripheral insulin sensitivity in insulin-resistant NIDDM humans. These effects were sustained for up to 2 wk after discontinuation of VS.

Clinical significance of urinary ferritin excretion in patients with transitional cell carcinoma

1. The serum ferritin level provides a valuable index of the body iron store. An increase in serum ferritin has often been observed in patients with neoplastic disease and correlates well with the stage of cancer. A few studies have suggested the potential of urinary ferritin as a marker for transitional cell carcinoma. The rationale of the measurement, however, has not been investigated in detail. 2. Urinary ferritin levels were evaluated in patients with diverse urological diseases to investigate their potential clinical implications. 3. Analysis of logarithmic transformed values (ng/mg creatinine) showed that patients with both neoplastic and non-neoplastic urological diseases had significantly higher ferritin levels than normal control subjects (P = 0.02). There was no apparent difference between subgroups of patients with urological disease (P > 0.5). For patients with urothelial carcinoma, univariate analysis revealed a strong positive relationship between urinary ferritin levels and the density of lymphoid cells in tumour stroma (P = 0.0001), while no important association was observed with tumour grade (P = 0.32), stage (P = 0.29) or urinary cytology detection (P = 0.33). Patients with muscle-invasive tumour had significantly higher ferritin levels than those with papillary, superficial cancer (P < 0.05). For patients with non-neoplastic urological disease (n = 19), urinary ferritin levels tend to correlate with the severity of tissue inflammation (P = 0.03). 4. The results suggest that urinary ferritin may reflect the degree of local inflammatory reaction in the urinary tract.(ABSTRACT TRUNCATED AT 250 WORDS)

Autoregulated induction of the acute-phase response transcription factor gene, agp/ebp

AGP/EBP (C/EBP beta) is a key transcription factor responsible for transcriptional induction of many acute-phase protein genes. To characterize the regulation of this gene, we have isolated the mouse genomic DNA and sequenced the 5'-regulatory region. Using nuclear extracts from lipopolysaccharide (LPS)-stimulated or unstimulated mouse liver, three protein factor-binding motifs, UF1(-376 to -352), UF2(-254 to -223), and UF3(-220 to -190), as well as two Sp1 motifs (-309 to -277, and -264 to -241) were identified by DNase I footprinting assays. Biochemical analysis has shown that the AGP/EBP protein can bind to UF1 and UF2 sites, whereas an ubiquitous factor of unknown identity can bind to the UF3 site. Functional characterizations indicate that all of these factors play a major role in AGP/EBP induction. Thus, the agp/ebp gene is autoregulated during the acute-phase response.

Randomly amplified polymorphic DNA analysis of Xylella fastidiosa Pierce's disease and oak leaf scorch pathotypes

Randomly amplified polymorphic DNA analysis was conducted with 14 primers to 17 strains of Xylella fastidiosa. There was a high degree of similarity among the seven Pierce's disease (PD) strains (Sxy > 0.93) and the seven oak leaf scorch (OLS) strains (Sxy > 0.96). However, the two groups were different, with a similarity index of 0.67, confirming the presence of a PD DNA cluster and suggesting the presence of a new OLS cluster. The control plum leaf scald strains (two strains) together with the periwinkle wilt strain had a much smaller similarity index (0.44) compared with the PD and OLS clusters.

Antiproliferative activity of gossypol and gossypolone on human breast cancer cells

Gossypol is a polyphenolic aldehyde occurring naturally in cottonseed that produces antisteroidogenic activity in vivo, has been extensively investigated as a male contraceptive agent, and has demonstrated anticancer activity. Gossypolone, the major metabolite of gossypol, also prossesses antisteroidogenic activity but has not been examined for its anticancer properties. The objectives of these investigations are to compare the effects of gossypolone with those of gossypol on cell proliferation of hormone-dependent and hormone-independent human breast carcinoma cells, i.e., MCF-7, MCF-7 Adr and MDA-MB-231 cells. Gossypol and gossypolone were examined at concentrations up to 10 microM, and cellular DNA synthesis was monitored by 3H-thymidine incorporation. Gossypol and gossypolone produced dose-dependent suppression of DNA synthesis in all of the human breast cell lines examined. Gossypol produced potent antiproliferative activity in MCF-7 cells at doses as low as 30 nM. Co-incubation of MCF-7 cells with gossypol (5 microM) and estradiol (10 nM) did not alter the effects of gossypl. Treatment of human breast cancer cells with 2.5 microM of gossypol resulted in alterations in cell shape and attachment to the surface of the culture dishes. At gossypol doses of 10 microM, pericytoplasmic globuation and cytoplasmic swelling were observed in the majority of breast cancer cells. These changes in cellular morphology indicate a loss of ability of the cells to maintain normal cell membrane permeability, resulting in subsequent disorganization and loss of cytoplasmic organelles. Gossypolone is less potent than gossypol in producing these effects in the human breast cancer cell lines, whereas it possesses equipotent antisteroidogenic and antireproductive activities with gossypol. These investigations suggest that gossypol and gossypol analogs may have therapeutic potential for human breast cancer.

The effects of apolipoprotein E polymorphism on the distribution of lipids and lipoproteins in the Chinese population

The effects of apolipoprotein E (apo E) polymorphism on the distribution of serum levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were studied in 546 unrelated Chinese in Taiwan. By isoelectric focusing and immunoblotting, three common alleles were demonstrated. The frequencies of the epsilon 2, epsilon 3 and epsilon 4 alleles were 0.076, 0.875 and 0.049, respectively. The relative frequency of the epsilon 3 allele was higher than that in Caucasians, whereas the frequency of epsilon 4 was lower in the Chinese population. Individuals with apo E4/4 phenotype had the highest serum TC and LDL-C concentrations, while the lowest levels were associated with apo E2/2 phenotype. There was a trend for individuals carrying the epsilon 2 allele to have a higher HDL-C level. No relationship between apo E phenotype and TG level was observed in this study. These data indicated that a given apo E allele acted in a relatively similar way in determining individual differences between Chinese and Caucasian populations in serum lipid and lipoprotein.

Meliavolkenin, a new bioactive triterpenoid from Melia volkensii (Meliaceae)

Meliavolkenin, a new triterpene with an apotirucallane skeleton, has been isolated from the root bark of Melia volkensii (Meliaceae) by bioactivity-directed fractionation using the brine shrimp lethality test. The structure has been elucidated using spectral and chemical data. The relative stereochemistries were determined by reduction and acetonide derivations, and the ring conformations were analyzed using the results of NOESY experiments. Meliavolkenin was bioactive in the brine shrimp lethality test and gave moderate cytotoxicities against three human solid tumor lines.

Decreased tobacco-glycoprotein-induced lymphocyte proliferation in vitro in pulmonary eosinophilic granuloma

Pulmonary eosinophilic granuloma is a disorder caused by localized collections of proliferating histiocytes in the lung. Little is known about its etiology except that the majority (58 to 97%) of patients are current or ex-smokers, making the potential etiologic role of tobacco products an important area for research. Tobacco glycoprotein (TGP) is a potent immunostimulator that has been isolated from cigarette smoke. TGP-specific lymphocyte proliferation, and cytokine production in vitro, were measured in three patients with pulmonary eosinophilic granuloma in remission and in three closely matched normal subjects with similar smoking histories. One patient with eosinophilic granuloma of bone and a matched control subject were also studied. Peripheral blood mononuclear cells were cultured with TGP, the recall antigen streptokinase (SK), and the mitogen concanavalin A (Con A). All three of the patients with pulmonary eosinophilic granuloma exhibited significant decreases in lymphocyte stimulation to TGP, despite normal responses to SK and Con A. In contrast, the response of the patient with eosinophilic granuloma of bone was higher than her matched control. The mean responses of the patients with pulmonary eosinophilic granuloma to TGP was significantly lower than the mean of nondiseased smokers or of normal nonsmokers. Twenty-four-hour culture supernatants were collected and assayed for cytokine levels (IL-1, IL-2, and IL-6). TGP-stimulated IL-2 production was significantly lower in the patients with pulmonary eosinophilic granuloma than in the normal subjects, confirming the reduced T-cell proliferative response.(ABSTRACT TRUNCATED AT 250 WORDS)

[Epidemiological study of anemia in the elderly aged over 65 years in Taiwan]

We investigated the prevalence rate of anemia in a study of the health of the elderly population in four Taiwan urban communities. A total of 2,518 noninstitutionalized persons aged 65-93 were evaluated in 1989-1991. The age-adjusted prevalence rates of anemia (hemoglobin < 12.5 g/dl in men and < 11.5 g/dl in women) were 6.5% in men and 8.3% in women. Prevalence rates increased significantly with age in women, while they were not so prominent in men. The men with anemia had higher creatinine and thyroid stimulating hormone levels, but had lower bilirubin and albumin level than men without anemia. Compared with the non-anemic female group, the anemic women had higher creatinine and lower bilirubin and albumin levels. Regardless of sex, anemic elderly had significantly higher rates of high serum creatinine. Hence, high serum creatinine may be one of the important factors of anemia in the elderly.

Frozen preservation of human amnion and its use as a burn wound dressing

A method of freezing and sterilizing the human amnion enabled it to be stored at -60 degrees C for more than six months. The membranes were obtained from twenty-four cesarean section mothers without a history of endometritis, premature rupture of their membranes or a positive serology. The elongation and break strength of the membranes were evaluated before and after storage. The membranes as prepared have been utilized on twenty-two wounds of ten burn patients. The results indicate that amnion is quite safe and effective as a biological dressing using this preservation method.

The role of tobacco, alcohol use, and body mass index in oral and pharyngeal cancer

BACKGROUND

Although tobacco smoking and alcohol drinking are well-established risk factors for oral cancer, relatively few studies have addressed the comparative effect of filter versus non-filter cigarettes, the nature of the reduction in risk following cessation, and the joint effects of tobacco and alcohol. In addition, recent studies suggest an inverse association of body mass index with oral cancer. We used data from a large, hospital-based case-control study to investigate these issues.

METHODS

The data set consisted of 1097 male and 463 female oral cancer cases and 2075 male and 873 female controls. Unconditional logistic regression was used to estimate the effect of risk factors in the presence of covariates.

RESULTS

Among male current smokers, users of filter cigarettes (whether lifetime users or those who switched to filter cigarettes) had a significantly reduced risk of oral cancer which approached 50%. Among female current smokers, only those who switched to filter cigarettes 10+years previously showed a significantly reduced risk. Those who quit smoking experienced a marked decrease in risk compared to current smokers. Smoking and alcohol consumption showed a significant interaction on a multiplicative model. After adjustment for covariates, leanness was significantly associated with oral cancer among male current and ex-smokers.

CONCLUSIONS

The results of this study: 1) indicate that smokers of filter cigarettes and those who quit smoking are at substantially reduced risk of oral cancer, 2) demonstrate interaction between smoking and drinking, and 3) suggest that leanness preceding diagnosis may be associated with oral cancer.

Cytotoxic cyclolignans from Koelreuteria henryi

Chemical investigation of the cytotoxic fraction of Koelreuteria henryi resulted in the isolation of three cyclolignans. A new cyclolignan, named koelreuterin-1 was elucidated as furo[3',4':6,7]naphtho[2,3-d]-1,3-dioxol-6(8H)-one,5-(7-methoxy-1, 3- benzodioxol-5-yl)[1]. Two known cyclolignans were characterized as austrobailignan-1 [2] and austrobailignan-2 [3]. The structure elucidation of 1 was based on extensive 1H- and 13C-nmr spectral analyses. Further chemical conversion of 2 to 3 and oxidative transformation of 2 to 1 unambiguously confirmed the structure of 1. The cytotoxicity and tubulin polymerization inhibitory activity of 1-3 are discussed.

Recovery of epinephrine response but not hypoglycemic symptom threshold after intensive therapy in type 1 diabetes

PURPOSE

Patients with intensively treated insulin-dependent diabetes mellitus (IDDM) exhibit more severe defects in counterregulatory hormone secretion and symptom recognition during hypoglycemia than do conventionally treated patients. In this prospective study in patients with preexisting defects in counterregulation, we examined the induction and reversibility of impaired symptomatic and adrenomedullary responses to hypoglycemia in 5 patients with IDDM (diabetes duration of 2 to 16 years; aged 19 to 36 years; 3 women, 2 men) who were receiving intensive therapy.

METHODS

Counterregulatory responses were assessed by using a single-step (approximately 2.8 mmol/L plasma glucose) and multiple-step (from approximately 5 mmol/L to 2.2 mmol/L plasma glucose) clamped hypoglycemia procedure. Patients were first studied after a stable period of conventional insulin therapy (glycosylated hemoglobin [HbA1c] 9.5 +/- 1.2%), then after 3 to 5 months of intensive therapy (HbA1c 6.6 +/- 0.2%), and a third time after resuming conventional therapy (HbA1c 8.7 +/- 0.9%).

RESULTS

Intensive therapy was associated with a 44% decline (P < 0.01) in the average plasma epinephrine increase during hypoglycemia, and the plasma glucose level required to stimulate epinephrine secretion fell from 3.7 +/- 0.2 to 3.0 +/- 0.1 mmol/L (P < 0.01). The threshold, but not the magnitude, of the plasma norepinephrine response was similarly altered. Hypoglycemic symptoms also decreased in intensity (by 67%, P < 0.01), and the glucose level required for symptom activation fell from 3.4 +/- 0.3 to 2.7 +/- 0.2 mmol/L, P < 0.01). When conventional therapy was resumed, the abnormalities in the epinephrine response due to intensive therapy were almost completely reversed. However, the reduction in symptoms and the altered thresholds for plasma norepinephrine were not reversed.

CONCLUSIONS

There is dissociation between the treatment-associated defects in hypoglycemia counterregulation in IDDM, and an increase in average glycemia produced by a return to conventional insulin therapy is not sufficient to reverse hypoglycemia unawareness worsened by intensive therapy.

Presence of antitumor activities in the milk collected from gossypol-treated dairy cows

Two human breast carcinoma cell lines (MCF-7, MCF-7 Adr) and a rat esophageal cancer cell line (RE-B2T) were used to evaluate the antiproliferative potential of gossypol (GP)-containing milk (GP-Milk), which was collected from Brown Swiss dairy cows treated daily with federally allowable 450 ppm of GP for 6 days. Treatment of the cultured cancer cells with GP-Milk for 24 h significantly inhibited the rates of 3H-thymidine incorporation during the ensuing 3-h period in all three tumorigenic cell lines. The inhibitory effects of GP-Milk occurred in a dose-dependent manner in all cases, but the calculated ED50 varied with cell lines. ED50 for GP-Milk was estimated at 10% for wild-type MCF-7 human breast cancer cells, 15% for multidrug-resistant MCF-7 Adr human breast cancer cells and 50% for RE-B2T rat esophageal carcinoma cells. The potential of GP-Milk as a dietary supplement for the prevention and/or treatment of human breast cancer is discussed in this paper.

Maxillary involvement in central craniofacial fractures with associated head injuries

From January 1983 through December 1990, we treated 703 patients with central craniofacial fractures. Among them 177 had maxillary fractures, with or without frontonasoethmoidal involvement. Of the 177, 151 patients were diagnosed in the acute stage. Using the Glasgow Coma Scale, these 151 patients were divided into three groups: group I (GCS score 13-15), 100 patients; group II (GCS score 9-12), 33 patients; group III (GCS score 3-8), 18 patients. The patterns of facial fractures were analyzed and surgically corrected after the following average postadmission lags: group I, 7.1 days; group II, 11.5 days; group III, 13.3 days. The average hospital stay for each group was: group I, 15.6 days; group II, 19.5 days; and group III, 27.2 days. The mean follow-up period was 12 months. The physiologic, functional and esthetic outcomes were assessed. Regardless of initial head injury severity, the outcomes in each group showed almost no statistically significant differences, and unnecessary extended hospital stays may be avoided by early surgical management.

The osmotic lysis of Spiroplasma cells and its use in enzyme studies

A simple and efficient osmotic lysis method was developed for enzyme studies in spiroplasmas. Log phase cells in R2 medium were harvested by centrifugation (19,600 x g for 30 min). Wash buffer supplemented with 0.23 M sucrose maintained the helicity of spiroplasma cells during washing. Osmotic lysis of spiroplasmas was achieved in H buffer that contained no sucrose. Sucrose at concentrations as low as 0.004 M dramatically increased the resistance of the spiroplasmas to osmotic lysis. NADH oxidase, lactate dehydrogenase, and malate dehydrogenase were detected in cell lysates of Spiroplasma floricola (23-6), Spiroplasma citri (R8A2), Spiroplasma apis (SR 3), and Spiroplasma melliferum (AS 576). Citrate synthase, aconitase, isocitrate dehydrogenase, alpha-ketoglutarate dehydrogenase, succinyl coenzyme A synthetase, succinate dehydrogenase, and fumarase were not detected in cell lysates of S. floricola (23-6). NADH oxidase and malate dehydrogenase were found in the cytosol whereas lactate dehydrogenase was loosely associated with the cytomembrane.

Study on the children of Kaohsiung with acute viral infection of lower respiratory tract by direct immunofluorescence assay

This study retrospectively reviewed those pediatric patients of acute lower respiratory tract infection with positive virus identification by direct immunofluorescence assay (Direct IF) from Jan, 1992 to Dec, 1993. One hundred and eighteen patients with 133 positive Direct IF results (107 cases with single virus identified, and 11 cases with more than one) were included. The sex ratio was 1.6:1 with males predominant; age, 22.1 (1 approximately 154.8) (months); duration of admission, 5.7 (1 approximately 69) (days); peripheral white blood cell count, 10,600 +/- 3,800/mm3; C-reactive protein, 17.0 (0 approximately 163.3) mu/ml; body temperature, 37.1 +/- 1.1 degrees C in those cases with single virus. The symptoms were cough 105 cases (98.1%), rhinorrhea 46 cases (43.0%), dyspnea and/or tachypnea 43 cases (40.2%) and diarrhea 15 cases (14.0%). The viruses identified were: Adenovirus (52 cases, 39.1%). Influenza B (45 cases, 33.8%), Parainfluenza 1 (28 cases, 20.1%), Parainfluenza 3 (19 cases 14.3%), Respiratory Syncytial virus (17 cases, 12.8%), and Influenza A (9 cases, 6.8%). The seasonal incidence rates were spring (49 cases, 36.8%), summer (46 cases, 34.6%), autumn (23 cases, 17.3%), and winter (15 cases, 11.3%). The results showed much similarity with others, except the commonest viral type (Adenovirus in this study; Respiratory Syncytial virus in others) and the seasonal incidence rate (higher in spring and summer in this study but not in others). In conclusion, most children with acute viral lower respiratory tract infection had an uneventful course and Direct IF is a reliable method for viral detection in that disease.

Hyperammonemic encephalopathy due to essential amino acid hyperalimentation

Hyperammonemic encephalopathy has occasionally been reported in uremic patients receiving hyperalimentation with essential amino acid (EAA) as a source of nitrogen as one of the remaining treatment options when the enteric routes were prohibited. We encountered this complication in a patient with normal renal function. A rat animal model was designed to elucidate the mechanism of hyperammonemia resulting from hyperalimentation with EAA as a source of nitrogen. Sixty-four male Long-Evan rats were divided into eight groups receiving feeds ad libitum or different formula of hyperalimentation. Hyperammonemia was found in every rat given hyperalimentation with EAA as the only nitrogen source. Using the Tukey honestly significant difference test, the results were significantly higher (p < 0.001) than that of the control group which were given feeds ad libitum and those groups given hyperalimentation for the same number of days but with mixed amino acid (MAA) as the nitrogen source. Adding arginine to EAA for a further four days after initial administration of EAA hyperalimentation for three days only slightly lowered the mean serum ammonia level. When compared to that of the three-day EAA hyperalimentation group, the difference was not statistically significant. Adding arginine, citrulline, and ornithine to EAA for a further four days significantly lowered the mean serum ammonia level. When we changed EAA hyperalimentation to MAA hyperalimentation for a further four days, the mean serum ammonia level decreased dramatically to nearly normal. Hyperalimentation using EAA as the exclusive source of nitrogen resulted in hyperammonemia. A deficiency of arginine or other amino acids of the urea cycle failed to account completely for the hyperammonemia observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Altered body composition and increased frequency of diverse malignancies in insulin-like growth factor-II transgenic mice

The physiological role of insulin-like growth factor (IGF) II (IGF-II) in adult humans is poorly understood. Rather high levels of IGF-II persist in adult human serum, whereas, in rodents, IGF-II levels are very low. To investigate the physiological and carcinogenic effects of persistently elevated IGF-II in adults, we have produced two lines of transgenic mice in which high levels of IGF-II (20- or 30-fold increase above normal) are persistently maintained in the blood. The transgene is driven by the major urinary protein promoter, and it is highly expressed in the liver and perputial glands in both lines. The adult transgenic mice are smaller than controls, and their body composition is altered. Their lean body mass is reduced by 5-8%, whereas fat mass is reduced between 44 and 77%. The mice expressing the highest level of IGF-II (30x) develop hypoglycemia and hypoinsulinemia and IGF-I levels are normal. Mice in the lower expression line (20-fold elevated IGF-II) develop hypoglycemia progressively over their lifetime. Mice from both lines also develop a diverse spectrum of tumors at a higher frequency than controls after 18 months of age, and the most frequent types of tumors are hepatocellular carcinomas and lymphomas. Squamous cell carcinoma, sarcoma, and thyroid carcinomas also occurred in our test group. The long latent period before tumors arise and the wide spectrum of tumor types suggest that IGF-II may function primarily as a tumor progression factor in mice via autocrine and endocrine mechanisms of action.

A 12-month study of the effects of oral zidovudine on neurodevelopmental functioning in a cohort of vertically HIV-infected inner-city children

OBJECTIVE

To examine the effects of oral zidovudine on the neurodevelopmental functioning of HIV-infected children.

METHODS

Oral zidovudine was administered to 54 symptomatic children with vertically transmitted HIV infection (Centers for Disease Control and Prevention class P2). All children were recruited from an inner-city pediatric HIV/AIDS outpatient clinic and ranged in age from 2 months to 12 years and 11 months (mean age, 3 years) at entry. Neurodevelopmental functioning, height and weight, and lymphocyte subpopulation data were ascertained for all the children pretherapy, and 6 and 12 months post-therapy initiation.

RESULTS

Analysis of the 6- and 12-month post-initiation drug data found no significant change in neurodevelopmental functioning. Height and weight percentiles remained the same or improved in the majority of children. CD4+ cell counts declined over the treatment period with CD4+ counts < 500 x 10(6)/l observed in 15% of the children pre-therapy, and 33% after 1 year.

CONCLUSION

In contrast with previously published data, the present study observed no improvement in neurodevelopmental functioning in HIV-infected children treated with oral zidovudine.

Apoptosis leads to photoreceptor degeneration in inherited retinal dystrophy of RCS rats

PURPOSE

To determine the pathogenetic mechanism of photoreceptor cell degeneration in the inherited retinal dystrophy in Royal College of Surgeons (RCS) rats.

METHODS

The dystrophic retinas of the pink-eyed RCS (RCS-rdy-p) rats were examined for DNA fragmentation by agarose gel electrophoresis of retinal DNA and by TdT-mediated biotin-dUDP nick-end labeling (TUNEL) in paraffin sections. Rats ranging in age from 3 to 60 days were examined.

RESULTS

Agarose gel electrophoresis of retinal DNA isolated from animals 25, 30, 35, and 40 days old showed a ladder pattern of degradation with bands corresponding to multiples of 180 to 200 base pair subunits. TUNEL study showed increasing labeling of photoreceptor cells with progression of the retinal dystrophy of the RCS rats.

CONCLUSIONS

Apoptosis is the dominant mechanism of photoreceptor degeneration in the RCS rat, which has a genetic defect in the phagocytic activity of retinal pigment epithelium. The onset of the degeneration appeared to vary between rod cells in the different regions of the eye.

The use of severe combined immunodeficiency mice to study the metabolism of human immunoglobulin G

BACKGROUND

Although the four human immunoglobulin G (IgG) isotypes are similar in structure, they exhibit significant differences in effector function and catabolic half-life. With advent of structurally engineered antibodies, there is the potential to design antibody constructs with desired half-lives; however, it is first necessary to discover the structures and mechanisms that control immunoglobulin metabolism.

METHODS

Radioiodinated chimeric antibodies, consisting of a mouse antidansyl variable region and the four human IgG constant regions, were injected intravenously into Balb/c and severe combined immunodeficiency (SCID) mice, and their half-lives were determined by whole body and whole blood counting. Dependence of the rate of immunoglobulin catabolism on immunoglobulin concentration, a normal regulatory phenomenon specific to IgG, was evaluated by the introduction of large amounts of human gamma-globulin intraperitoneally.

RESULTS

Whole body and blood half-lives were statistically indistinguishable. The four IgG isotypes were eliminated from the whole animals in a predominantly single-phasic manner, with the half-life being dependent on the isotype studied. In Balb/c mice, immune elimination frequently occurred after 6 days, although this was not observed in SCID mice. Relevance of the model was confirmed by the demonstration of the presence of the concentration-catabolism phenomenon, a relationship unique to normal IgG regulation.

CONCLUSIONS

SCID mice provide an adequate initial animal model for the study of human-mouse chimeric antibodies. Further understanding of the factors governing immunoglobulin catabolism can be probed by study of recombinant human constant regions in this animal system.

Determination of taxanes in Taxus brevifolia extracts by tandem mass spectrometry and high-performance liquid chromatography

A tandem mass spectrometric (ms/ms) method using desorption chemical ionization is described for the quantitation of taxol [1], cephalomannine [2], and baccatin III [3] found in Taxus brevifolia bark and needle extracts. A parent ion scan was used to simultaneously determine the weight percentages of 1-3 in bark and needle samples by the method of standard addition. In an alternative experiment, the concentration of 1 in the same samples was determined by ms/ms using trideuterated 10-acetyltaxol [7a] as an internal standard. High-performance liquid chromatography (hplc) was also used to determine the weight percentages of 1-3 in the same T. brevifolia bark and needle extracts with an external standard. The ms/ms method of quantitation by internal standard is the best overall method of analysis examined. With this method, 1 was quantitated in the T. brevifolia extracts at the low picomole level with a relative standard deviation of 17% or better for all samples analyzed with an analysis time of less than five min per sample. The precision, level of quantitation, and speed of analysis of the three methods of taxane quantitation are compared.

An assessment of immunoreactive epidermal growth factor in urine of patients with urological diseases

To examine the excretion of urinary epidermal growth factor (EGF) in urological diseases and the relationship of EGF urine levels with transitional cell carcinoma (TCC), we measured the concentration of EGF by radioimmunoassay. The series comprised patients with active TCC (n = 52), others in tumor-free status (n = 29) and with non-neoplastic inflammatory diseases (n = 43), and normal controls (n = 50). Urinary EGF values were lower in patients with urological diseases of different etiologies than in normal controls (P < 0.005). Mean EGF levels of patients who had previous bladder tumor resection (n = 21) were not statistically different from normal controls (P = 0.2). For patients with active TCC, EGF urine levels showed a significant inverse relationship to increasing tumor grade (P = 0.02). In addition, subjects who had received nephrectomy for pelvic carcinoma (n = 8) showed significantly lower mean EGF values than those with intact kidneys (n = 21), irrespective of sex (P < 0.05). Immunostaining of EGF on non-neoplastic kidney (n = 9) revealed reactivity in the distal convoluted tubules and thick ascending limbs of Henle. Our results suggest that the kidney is the major source of urinary EGF. Its excretion in urine is decreased in both inflammatory and neoplastic diseases of the urinary tract. EGF may play an important part in the biological activity of TCC. Further study is indicated to investigate the monitoring of EGF urine levels as a marker of recurrence for EGF receptor-positive TCC.

Detection of keratinocyte growth factor (KGF) transcripts from normal human and archival canine benign prostatic hyperplastic tissues

This study examined the expression of keratinocyte growth factor (KGF) gene in human and canine prostatic tissues. KGF transcript was detected in normal human prostatic tissues by reverse transcription and polymerase chain reactions (RT-PCR). PCR-generated human KGF complementary DNA (cDNA) clone was confirmed by restriction enzyme digestion analysis and partial DNA sequencing. Expression of KGF in archival canine benign prostatic hyperplastic tissues was also examined. In a pilot experiment, RNAs isolated from formalin-fixed (FF) and formalin-fixed and paraffin-embedded (FFPE) canine prostatic tissues were shown to be of sufficient quality to permit amplification of KGF mRNA by RT-PCR. The transcript of a housekeeping gene, glucose-6-phosphate dehydrogenase (G6PD), was detected by RT-PCR indicating the quality of RNAs to be more than adequate for RNA expression analysis. Later, total RNA from two archival canine FF prostate tissue types, benign prostatic hyperplasis and mild glandular hyperplasia, were used to amplify canine KGF transcripts. Southern hybridization analysis using rat and human KGF cDNAs as probes confirmed the fidelity of the amplified PCR product and it was indeed canine KGF.

[One year follow-up study of the recovery of adrenal insufficiency induced by formulated herb drugs]

Previous studies have found that taking formulated herb drugs may reduce the serum cortisol level which may result in an adrenal insufficiency. We suspect that this effect is induced by corticosteroids artificially mixed in formulated herb drugs. The objectives of this study were to determine the time course of serum cortisol and plasma ACTH (adrenocorticotropic hormone) levels, and whether pituitary-adrenal function recovers after quitting formulated herb drugs for a period of one year. Forty eight subjects with an initial serum cortisol level smaller than 10.7 micrograms/dL due to the intake of formulated herb drugs were recruited. They were tested for serum cortisol and plasma ACTH levels at 08:00 6, 9 and 12 months after quitting formulated herb drugs, respectively. The diagnosis of adrenal insufficiency was confirmed by an ACTH test at 9 months and 12 months after quitting the formulated herb drugs. The follow-up rates ranged from 63% to 71%. The 08:00 serum cortisol levels at the initial test, 6 months, 9 months, and 12 months were 4.4 +/- 0.5 micrograms/dL, 6.6 +/- 0.8 micrograms/dL, 6.6 +/- 0.7 micrograms/dL, 6.2 +/- 0.8 micrograms/dL, respectively, (interpersonal p = 0.0001, intrapersonal p = 0.0004, repeated measures ANOVA test.) The 08:00 plasma ACTH levels at the initial test, 6 months, 9 months and 12 months were 33.8 +/- 6.4 pg/mL, 67.6 +/- 16.8 pg/mL, 21.0 +/- 3.2 pg/mL, 16.3 +/- 2.2 pg/mL, respectively (interpersonal P = 0.0001, intrapersonal P = 0.0003, repeated measures ANOVA test.) The statistical significance was the same after logarithmic transformation of the ACTH levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Differences in precision of dietary estimates among different population subgroups

Populations vary in consistency of diets. The precision of estimates (E) of nutrient intake depends both on the ratio (R) of intraindividual to interindividual variances, as well as on the number of days of dietary intake recorded (k). We present baseline data from 872 participants in the Trial of Antihypertensive Interventions and Management (TAIM), a randomized clinical trial of diet and drug treatment for mild hypertension. There is wide variation in R among different demographic groups and for different nutrients. This has implications for the ability to estimate the correlations between the nutrient and a physiologic variable such as blood pressure, as well as for power calculations to compare group means on nutrient intake. For example, to achieve the same degree of precision (E = 0.80) in estimating the correlation between sodium intake and blood pressure for whites in New York, 7 days of food records would be required, compared to 2 days for whites in Alabama. Tables are presented indicating within- and between-person variances for different groups and different nutrients. Methods of calculating E, determining k, and calculating samples size are provided. Investigators designing nutritional epidemiologic studies should take into account ratios of intraindividual to interindividual variances of different population subgroups and different nutrients in order to determine the number of daily food records that must be obtained and the sample size for group comparisons.

Dopamine metabolism and free-radical related mitochondrial injury during transient brain ischemia in gerbils

Regional extracellular release of dopamine (DA) and its metabolites, 3,4-dihydroxy-phenylacetic acid (DOPAC), homovanillic acid (HVA) and 3-methoxytyramine (3-MT) was measured in gerbils (with or without pargyline pretreatment) subjected to bilateral carotid artery occlusion (15 min) and various periods of recirculation (up to 6 hr), utilizing intracerebral microdialysis and high-performance liquid chromatography (HPLC) with electrochemical detection. Mitochondrial monoamine oxidase (MAO) and superoxide dismutase (SOD) activities and in vitro stimulated lipid peroxidation (TBARM) were determined in separate experimental groups of animals. The ischemically induced DA release, decrease of MAO-derived DA metabolites DOPAC and HVA, and accumulation of 3-MT were potentiated and prolonged by pargyline pretreatment. Mitochondrial MAO and SOD activities were significantly reduced during ischemia alone and up to 1 hr of reperfusion, whereas TBARM was enhanced during reflow only. The data suggest that reduced activity of mitochondrial antioxidative enzyme(s) but not DA metabolism by MAO may contribute to free radical-mediated injury of (mitochondrial) membranes.

Kinase inhibitors from Polygonum cuspidatum

Bioassay-directed fractionation of a medicinal plant, Polygonum cuspidatum (Polygonaceae), has led to the discovery of a hydroxystilbene, resveratrol [1], as an inhibitor of a protein-tyrosine kinase (p56lck) partially purified from bovine thymus. Both trans and cis isomers of resveratrol possess comparable protein-tyrosine kinase inhibitory activity. Comparison of the IC50 values of resveratrol for protein-tyrosine kinase inhibitory activity with those of piceid (resveratrol-O3-beta-glucoside) [2] and resveratrol-O4'-beta-glucoside [3] shows the requirement of free hydroxyl groups on both phenyl rings for the protein-tyrosine kinase inhibition. Protein kinase C inhibitory analysis suggests the requirements of two free hydroxyl groups on one phenyl ring only.

The effect of shift system on sleep quality, sleep quantity, psychological disturbance, and family function of workers in Taiwan

This study was designed to examine whether there were any differences in sleep quality and quantity between rotating shift workers and permanent day workers. The subjects of this study consisted of 419 rotating shift workers and 468 permanent day workers. The Chinese Health Questionnaire (CHQ-12) and Family APGAR Index were used to collect information concerning psychological disturbances and family dysfunctions. The results showed that, compared to the permanent day workers, sleep quality and quantity were poorer for the rotating shift workers. The rotating shift workers often had more psychological disturbances and family dysfunctions than permanent day workers.

Lumbosacral kinematics in the sagittal plane: a radiographic study in vivo

Lateral functional radiographs of flexion and extension using Putto's method were examined in 89 normal subjects. A specially-designed radiopaque ruler was placed on each film for calibration. A computer-assisted method was used for digitization and analysis. There were weak negative correlations between age and range of motion, especially at the L4-L5 level (r = 0.437). No significant correlation was noted between age and translation. For flexion-extension rotation, although large variations may limit its usefulness in judging instability in some clinical settings, the data still provide a good diagnostic basis. For translation changes, 2 mm is regarded as acceptable in most cases at levels from L1 to L5, but not at the level of L5-S1 where the average translation change was only 0.4 mm. The differences in the absolute translation value among different positions were not statistically significant (p = 0.064).

Selective inhibition of the growth of ras-transformed human bronchial epithelial cells by emodin, a protein-tyrosine kinase inhibitor

Emodin (3-methyl-1,6,8-trihydroxyanthraquinone), a naturally occurring protein-tyrosine kinase inhibitor, selectively blocked the growth of v-ras-transformed human bronchial epithelial cells. Half-maximal inhibition of cell growth occurred at a concentration of 4 micrograms/ml. In contrast, emodin at a concentration of 100 micrograms/ml had little effect on the growth of normal human bronchial epithelial cells. Cell cycle analyses indicated that treatment with emodin arrested the v-ras-transformed cells in the G2/M phase of their cell cycle. Immunoblotting experiments using anti-phosphotyrosine antibodies indicated that ras-transformed cells, as compared to their normal counterparts, exhibited elevated levels of phosphotyrosine-containing proteins. Treatment with emodin resulted in a decrease in intracellular protein-tyrosine phosphorylation. These results suggest that compounds that inhibit the ras-dependent elevation in the level of tyrosine phosphorylated proteins may prove to be useful chemotherapeutic agents and may exhibit selective cytotoxicity against cancer cells with an activated ras oncogene.

Oral health conditions among people visiting a medical center for health checkups

The purpose of this study was to evaluate the oral health conditions of subjects in a southern Taiwan health checkup program. One half of the examinees were selected randomly for oral examination during a two-year period. There were 537 subjects, including 286 men and 251 women with mean ages of 49.7 +/- 13.5 years and 50.2 +/- 12.1 years, respectively. Oral examinations included periodontal condition and existence of dental caries. The periodontal treatment needs of all examinees were evaluated using the Community Periodontal Index of Treatment Needs system and the World Health Organization periodontal probe. Dental caries examination was performed by the visual-tactile method with a mouth mirror and explorer. No radiographs were taken. All clinical evaluations were performed by the first author, who has experience in all of the indices. The results showed that only 0.7% of the subjects had no need of periodontal treatment, 6.7% had bleeding after gentle probing, and 75.2% presented with calculus, overhanging restorations, or pockets of 4 or 5 mm. The remaining 17.3% had pocket depths of 6 mm or deeper. There was no statistically significant difference between males and females in periodontal treatment needs and the mean number of decayed teeth (D). According to this hospital-based observation, most of the people in the health checkup program were in need of periodontal treatment, including oral hygiene instruction, prophylaxis and root planing. Approximately one-fifth of the subjects needed complex periodontal treatment; there were no differences in the treatment needs of males and females.(ABSTRACT TRUNCATED AT 250 WORDS)

Flavonoids from Koelreuteria henryi and other sources as protein-tyrosine kinase inhibitors

The EtOH extract of Koelreuteria henryi was investigated in a search for natural products with potential protein-tryrosine kinase (PTK) inhibitory activity. The PTK inhibitory activity of the crude fractions was determined by measuring their inhibition of p56lck partially purified from bovine thymus using angiotensin I as a substrate. Analysis of those fractions that exhibited significant activity led to the isolation of kaempferol and quercetin, in addition to two kaempferol glycosides, kaempferol-O3-alpha-rhamnopyranoside [1] and kaempferol-O3-alpha-arabinopyranoside [2]. This study represents the first report on the isolation of flavonols and their PTK inhibitory activities from the genus Koelreuteria. Eight other flavonoids were also examined to study the role of the hydroxy groups on the B ring on PTK inhibitory activity.

Effects of cerebral ischemia on regional dopamine release and D1 and D2 receptors

To expand on the nature of regional cerebral vulnerability to ischemia, the release of dopamine (DA) and dopaminergic (D1 and D2) receptors were investigated in Mongolian gerbils subjected to bilateral carotid artery occlusion (15 min) alone or with reflow (1-2 h). Extracellular cortical and striatal content of DA and its metabolites was measured by microdialysis using HPLC with electrochemical detection. The kinetic properties of D1 and/or D2 receptor binding sites were determined in cortical and striatal membranes with the use of radiolabeled ligands (125I-SCH23982 and [3H]YM-09151-2, respectively). The ischemic release of DA from the striatum was greater (400-fold over preischemic level) than that from the cortex (12-fold over preischemic content). The affinity for the D1-receptor ligand was lower (KD = 1.248 +/- 0.047 nM) after ischemia than that for sham controls (KD = 0.928 +/- 0.032 nM, p < 0.001). The number of binding sites for D2 receptors decreased in striatum (Bmax = 428 +/- 18.4 fmol/mg of protein) after ischemia compared with sham controls (Bmax = 510 +/- 25.2 fmol/mg of protein, p < 0.05). D1 or D2 binding sites were not changed either in the ischemic cortex or postischemic striatum and cortex. The findings strongly suggest that the ischemic release of DA from striatum is associated with early transient changes in D1- and D2-mediated DA neurotransmission.

Antiproliferative and antimetastatic effects of gossypol on Dunning prostate cell-bearing Copenhagen rats

Gossypol, a polyphenolic aldehyde naturally present in cottonseed, has long been recognized as a male contraceptive and recently as a potential anticancer agent. Our study used a rodent model to evaluate gossypol's potential for the treatment of human prostatic carcinoma. Two-month-old Copenhagen male rats received subcutaneous implants of a subpassage of MAT-LyLu prostatic cancer line, a highly metastatic, androgen-independent Dunning prostate tumor subline that specifically metastasizes to lymph nodes and lungs of recipients. After 2 weeks of gossypol treatment (0 or 12.5 mg/kg B.W./day S.C.) initiated immediately after transplantation, the rats were sacrificed and evaluated for prostate tumor growth and metastasis. Testosterone and gossypol levels in tumor tissue and various reproductive organs and serum potassium level were measured by radioimmunoassay (RIA), high pressure liquid chromatography (HPLC) and atomic emission spectroscopy (AES), respectively. Gossypol-treated rats exhibited weight reductions in developed MAT-LyLu prostate tumor mass and prostate of 24% (p < 0.05) and 31% (p < 0.05), respectively; whereas testicular and epididymal weights were not significantly affected. Few metastases (20%) were observed in either lymph nodes or lungs of gossypol-treated recipients. The control rats, however, had a much higher rate of lung (60%) and lymph node metastasis (40%). Testicular testosterone levels, as measured by RIA, were significantly lower in gossypol-treated rats than in controls (p < 0.05), but serum testosterone levels were not different. Extractable gossypol content in the prostate tumor, as measured by HPLC, reached 19.67 ng/gm and was 1.28 times higher than in liver, 1.98 times higher than in testes, but was 3.3% of that in prostate. Moreover, serum had the highest gossypol content (10.7 micrograms/ml). Serum potassium levels, as measured by AES, were significantly higher in gossypol-treated individuals than controls (p < 0.05). Our results indicate for the first time that gossypol has antiproliferative and antimetastatic effects on MAT-LyLu prostate cancer cells and can be explored as a potential therapeutic agent for androgen-independent human prostatic carcinoma.

Solid-state nuclear magnetic resonance (NMR) spectra of pharmaceutical dosage forms

Solid-state 13C NMR spectra of tablets or capsules of prednisolone, enalapril maleate, lovastatin, simvastatin, ibuprofen, flurbiprofen, mefenamic acid, indomethacin, diflunisal, sulindac, and piroxicam were obtained in the CP/MAS mode at 50 MHz. These studies show that (1) solid-state NMR spectroscopy can detect the active ingredients in low-dose tablets and capsules; (2) the use of interrupted decoupling often results in suppression of resonances due to excipients, thereby allowing better detection of resonances from the drug; and (3) the technique permits discrimination between two prednisolone polymorphs present in tablets obtained from various manufacturers even though the tablets contain only approximately 5% (w/w) of the drug.

Gossypol inhibits basal and estrogen-stimulated DNA synthesis in human breast carcinoma cells

Estrogen stimulates the growth of hormone-dependent human breast cancer. Failure of chemotherapy frequently results from the development of multidrug resistance. Gossypol (GP), a naturally occurring toxin, inhibits the growth of various carcinoma cells. Thus, the effects of GP on 17 beta-estradiol (E2)-stimulated DNA synthesis were studied in two hormone-dependent human breast carcinoma cell lines: the wild-type MCF-7 and the multidrug-resistant MCF-7 Adr cells. Cells (5 x 104/well) were cultured for 24 hrs in a chemically-defined, serum-free medium consisting of 1:1 mixture of Dulbecco's Modified Eagle's medium and Ham's nutrient mixture F12 (DMEM/F12) supplemented with insulin (5.0 micrograms/ml), transferrin (5.0 micrograms/ml), epidermal growth factor (EGF; 10.0 ng/ml) and antibiotics E2 (0 or 10.0 nM), GP (0, 2.5, 5.0, 10.0 or 20.0 microM) and bovine serum albumin (BSA; 0 or 0.1 mg/ml) were used as treatments in a factorial experimental design. Cells were treated for 24 hrs and finally pulsed with 3H-thymidine (5.0 microCi/ml) for 3 hrs. E2 significantly stimulated 3H-thymidine incorporation in both MCF-7 and MCF-7 Adr cells. GP at 10.0 and 20.0 microM inhibited both basal and E2-stimulated DNA synthesis in human breast cancer cells. The inhibitory effects of GP at 10.0 microM, but not at 20.0 microM, were blocked by BSA treatment. Results from the present study indicate that GP treatment was antiproliferative in both drug-sensitive and multidrug-resistant cancer cells and that the antiproliferative effects of GP on human breast cancer cells were mediated through mechanisms independent of estrogenic responses. Thus, GP could be potentially very useful for treatment of human breast cancer patients, especially those who have developed multidrug resistance.

The antitachycardia pacing ICD: impact on patient selection and outcome

Implantable cardioverter defibrillators (ICD) currently undergoing clinical investigation incorporate antitachycardia pacing capabilities, but little is known about their effect on patient selection and outcome. The Bilitch registry database was reviewed to compare the 1,553 patients who initially received standard devices with the 242 patients initially implanted with antitachycardia pacing ICDs (ANT). Baseline characteristics including mean age, ejection fraction, sex, type of cardiac disease, and percent presenting with sudden cardiac death were reviewed. Cumulative first shock occurrence and survival from arrhythmic and all cause mortality were calculated for the two groups.

RESULTS

Patient characteristics were similar in the two groups except that the ANT population had a greater male predominance and initially presented with a lower sudden cardiac death incidence (P < 0.05). Cumulative occurrence of first shock was significantly lower in the ANT group up to 24 months of follow-up (28% vs 36%, P < 0.05). ANT group survival from arrhythmic death (99% vs 96%) and all cause mortality (89% vs 94%) was significantly higher at 24 months of follow-up (P < 0.05).

CONCLUSIONS

The addition of antitachycardia pacing to ICD therapy appears to significantly limit the occurrence of first ICD shock without adversely affecting mortality in a patient population similar to those implanted with standard ICDs.

Development of macrovascular diseases in NIDDM patients in northern Taiwan. A 4-yr follow-up study

OBJECTIVE

To assess the development of macrovascular diseases and explore major associative factors in NIDDM.

RESEARCH DESIGN AND METHODS

A total of 479 NIDDM patients > or = 40 yr of age were recruited from four community primary care health centers of northern Taiwan in July 1986 for a cohort study with a 4-yr follow-up. No patient required insulin therapy within 1 yr of diagnosis nor had a history of diabetic ketoacidosis. All were able to participate independently in the activities of daily living. BP and ECG were measured, and a structured questionnaire was asked of each patient. Venous blood after overnight fasting was collected every year to measure cholesterol, HDL cholesterol, plasma glucose, and HbA1c.

RESULTS

The duration of diabetes was associated with the development of stroke with a relative risk of 1.063 for every 1-yr increment (P = 0.07). As for HVDs, the significant risk factors were serum cholesterol and HbA1c. For every 1-mg/dl increase in mean total cholesterol level, the relative risk of developing HVD increased 1.016-fold (P = 0.04). For every 1% increase in HbA1c, the relative risk of developing HVD increased 1.170-fold (P = 0.01). With regard to leg VDs, sex and cigarette smoking were significant risk factors. Women diabetic subjects had a higher relative risk than men. Cigarette smoking was significantly associated with leg VD with a relative risk of 6.9 for smokers compared with nonsmokers. The most significant risk factor for LVD was the total cholesterol level. For every 1-mg/dl increase in mean serum cholesterol level, the relative risk of LVD increased 1.013-fold.

CONCLUSIONS

In the prevention of macrovascular diseases, effective intervention of the nondiabetic cardiovascular risk factors may be as important as or even more important than the good control of diabetes.

Evidence for a phosphoenolpyruvate dependent sugar-phosphotransferase system in the mollicute Acholeplasma florum

In order to confirm the presence of a phosphoenolpyruvate (PEP)-dependent sugar-phosphotransferase system (PTS) in the mollicute Acholeplasma florum we studied the ability of cell free extracts of this organism to phosphorylate glucose and/or fructose in the presence of PEP. We also cloned and sequenced a DNA fragment coding for a putative polypeptide showing significant similarity with the enzyme II of the beta-glucoside PTS of Escherichia coli. Taken together, these results show that A florum possesses a fructose-PTS, but not a glucose-PTS, and that the amino acid sequence deduced from the DNA fragment is related to beta-glucoside and sucrose enzymes II of PTS from various bacteria.

Prevalence and risk factors of diabetic retinopathy among noninsulin-dependent diabetic subjects

In a population-based study in Taiwan, 11,478 subjects aged 40 years or older were screened for diabetes in one urban and five rural areas. Among the 715 subjects proven to have diabetes, 527 subjects underwent ophthalmoscopy. Diabetic retinopathy was present in 184 of the 527 subjects (35.0%), including background diabetic retinopathy in 157 subjects (30.0%), preproliferative diabetic retinopathy in 15 subjects (2.8%), and proliferative diabetic retinopathy in 12 subjects (2.2%). Diabetic retinopathy was correlated with the duration of diabetes and age at onset of diabetes, type of diabetes treatment, higher serum creatinine levels, and lower serum cholesterol levels. Several other factors, including gender, age, residential area, family income, educational level, control and family history of diabetes, body mass index, physical activity, exercise, cigarette smoking, stroke, ischemic heart disease, leg vessel disease, hypertension, and proteinuria, had no significant association with retinopathy. By multiple logistic regression analysis, duration of diabetes was the most important risk factor related to retinopathy. Diabetic subjects treated with insulin had a higher risk of developing retinopathy than those treated with dietary control (relative risk, 1.57; .05 < P < .10). The univariate analysis disclosed that proliferative diabetic retinopathy was related to older age at examination, older age at onset of diabetes, type of diabetes treatment, and presence of leg vessel disease. Insulin-treated diabetic subjects also had a higher risk of proliferative diabetic retinopathy than patients in whom diabetes was controlled by diet, with a relative risk of 2.51 (.05 < P < .10) in the multiple logistic regression analysis.

Influence of central obesity and obesity level on the prevalence of NIDDM and impaired glucose tolerance

The purpose of this study was to determine the association of the prevalence of non-insulin-dependent diabetes (NIDDM) with central obesity, obesity, and family history of diabetes. This survey consisted of 1590 subjects (646 men, 944 women) aged 30 years or more from the Sun-Ming district of Kaoshiung city. Glucose tolerance status was ascertained by both medical history and a 75-g oral glucose tolerance test according to World Health Organization criteria. In men and women with central obesity (WHR > or = 0.92 in men and > or = 0.85 in women) or obesity (BMI > or = 27.6 kg/m2 in men and > or = 28.3 kg/m2 in women) (WHR: waist-hip ratio; BMI: body mass index), the prevalence of impaired glucose tolerance (IGT) and diabetes was significantly higher, except the prevalence of diabetes in both sexes with obesity and the prevalence of IGT in women with central obesity were not statistically different, as compared with nonobese subjects. The prevalence of diabetes in men significantly increased from the first quartile to the fourth quartile of BMI and the waist-hip ratio (WHR) (4.48% to 9.21% in BMI, 3.67% to 13.61% in WHR), while the prevalence in women also significantly increased from the first to fourth quartile (2.45% to 11.76% in BMI, 2.04% to 13.49% in WHR). Multiple logistic regression analyses revealed similar increase in the prevalence of diabetes among both men and women for every 1 kg/m2 increase in BMI and every 0.05 increase in WHR (1.07-fold and 1.09-fold in BMI, 1.34-fold and 1.32-fold in WHR, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Morphometric analysis of renal cortex changes induced by diethylstilbestrol (DES) in Syrian hamsters

Estrogen-induced renal adenocarcinoma usually can be readily detected in castrated hamsters after 9 to 12 months of DES treatment. In the present study, we examined the morphological characteristics of the renal cortices of castrated hamsters that had received 3 months of DES treatment in order to describe early histological evidence of carcinogenesis induction. Twelve Syrian Golden hamsters, 8 to 9 weeks of age, were first castrated and then subjected to either subpannicular implantation of a 20 mg DES pellet (experiment group), or sham operation (controls). Morphological and 2-D morphometric evaluations were conducted sequentially on kidney histological sections. Numbers (N's) or area fractions (AF's) of renal components in the juxta-medullary junction of each kidney section were processed for morphometric evaluation. The DES treatment caused a 15% increase in kidney weight, but not body weight. Dysplastic foci associated with hyperplastic tubules were present in 67% of the left kidneys or 17% of the right kidneys of hamsters in the test group, but were absent in kidneys of controls. DES treatment decreased glomeruli N by 33% and increased the vasculature AF by 169% per examination field. DES also increased AF's of glomeruli, proximal tubules, distal tubules, and vasculature by 17, 81, 53 and 346% per nephron, respectively. Our results showed that, after the first three months of DES-treatment, hamster kidneys developed dysplastic foci and their masses were greater than controls. Increased renal components in the juxta-medullary junction region included glomeruli, tubules, and vasculature. The dysplastic foci may be sites of subsequent malignancies, whereas the increased renal mass might be a result of functional adaptation/expression to exogenous estrogen which might contribute to the carcinogenic process.

Structure and expression of mouse alpha 1-acid glycoprotein gene-3 (AGP-3)

The genome of Mus domesticus has multiple genes of the alpha 1-acid glycoprotein (AGP). Two cDNA clones were identified corresponding to AGP-1 and AGP-2. Moreover, two alleles of AGP-1 exist in inbred mice. The genomic DNA of the AGP-2 gene has been cloned and studied. Here we report the genomic organization of three M. domesticus AGP genes, the sequence analysis of the AGP-3 genomic DNA, and the expression of the AGP-3 gene. The major structural differences between AGP-2 and AGP-3 genes are located in introns 1 and 5. The low level of AGP-3 mRNA can be detected by the polymerase chain reaction (PCR). The molecular basis of the low level expression of AGP-3 and the possible classification of AGP-3 as a pseudogene are discussed.

Emodin, a protein tyrosine kinase inhibitor from Polygonum cuspidatum

Bioassay-directed fractionation of a Chinese medicinal plant, Polygonum cuspidatum (Polygonaceae), has led to the discovery of an anthraquinone, emodin [1], as a strong inhibitor of a protein tyrosine kinase (p56lck) partially purified from bovine thymus. Comparison of the IC50 values of emodin for protein tyrosine kinase inhibitory activity with physcion [2] and emodin-O8-D-glucoside [3], also isolated from the same plant, reveal the importance of the hydroxyl groups at C-6 and C-8 for the observed activity.