Incident Cardiovascular Diseases Among Survivors of High-Risk Stage II–III Colorectal Cancer: A Cluster-Wide Cohort Study

Background: The incidence and survival of colorectal cancer (CRC) are increasing. There is an increasing number of long-term survivors, many of whom are elderly and have comorbidities. We conducted a population-based study in Hong Kong to assess the long-term cardiovascular disease (CVD) incidence associated with adjuvant fluoropyrimidine-based chemotherapy among CRC survivors. Patients and Methods: Using the population-based electronic medical database of Hong Kong, we identified adults who were diagnosed with high-risk stage II–III CRC and treated with radical surgery followed by adjuvant fluoropyrimidine-based chemotherapy between 2010 and 2019. We evaluated the cause-specific cumulative incidence of CVD (including ischemic heart disease, heart failure, cardiomyopathy, and stroke) using the flexible parametric competing risk modeling framework. The control group without a history of CVD was selected from among a noncancer random sample from primary care clinics in the same geographic area. Results: We analyzed 1,037 treated patients with CRC and 5,078 noncancer controls. The adjusted cause-specific hazard ratio (HR) for CVD in the cancer cohort compared with the control group was 2.11 (95% CI, 1.39–3.20). The 1-, 5-, and 10-year cause-specific cumulative incidences were 2.0%, 4.5%, and 5.4% in the cancer cohort versus 1.2%, 3.0%, and 3.8% in the control group, respectively. Age at cancer diagnosis (HR per 5-year increase, 1.16; 95% CI, 1.08–1.24), male sex (HR, 1.40; 95% CI, 1.06–1.86), comorbidity (HR, 1.88; 95% CI, 1.36–2.61 for 1 comorbidity vs none, and HR, 6.61; 95% CI, 4.55–9.60 for ≥2 comorbidities vs none), diabetes (HR, 1.38; 95% CI, 1.04–1.84), hypertension (HR, 3.27; 95% CI, 2.39–4.50), and dyslipidemia/hyperlipidemia (HR, 2.53; 95% CI, 1.68–3.81) were associated with incident CVD. Conclusions: Exposure to adjuvant fluoropyrimidine-based chemotherapy was associated with an increased risk of CVD among survivors of high-risk stage II–III CRC. Cardiovascular risk monitoring of this group throughout cancer survivorship is advisable.

Determination of Lipids in Fish Meal

Lipids were extracted from a series of twelve menhaden meals by six methods, and results were compared. The chloroformmethanol extraction method developed by Smith, et al., extracts approximately the same amount of lipids as the official AOAC method, 22.037. The Torry-TNO method with chloroform-methanol extraction, and acid and alkaline hydrolysis methods extract lesser amounts of lipids, but all methods extract more than the ethyl ether method, 22.032. The Smith-Ambrose-Knobl method, rather than AOAC method 22.037, is recommended for extraction of total lipids from fish meal because of its simplicity and efficiency.

Febrile neutropenia and its associated hospitalization in breast cancer patients on docetaxel-containing regimen: A retrospective cohort study on duration of prophylactic GCSF administration

PURPOSE

To compare febrile neutropenia (FN) incidence and hospitalization among breast cancer patients on docetaxel with no granulocyte colony-stimulating factors (GCSF) primary prophylaxis (PP), 4/5-day PP, or 7-day PP.

METHODS

We identified 3916 breast cancer patients using docetaxel-cyclophosphamide (TC), doxorubicin-cyclophosphamide then docetaxel (AC-T), fluorouracil-epirubicin-cyclophosphamide then docetaxel (FEC-T), docetaxel-carboplatin-trastuzumab (TJH), or docetaxel-doxorubicin-cyclophosphamide (TAC) from a hospital pharmacy dispensing database in Hong Kong between 2014 and 2016. Patients were offered GCSF within 5 days since administering docetaxel. Outcomes included FN incidence, time to first hospitalization, hospitalization rate, and duration.

RESULTS

In TC regimen, FN incidence (with odds ratio, OR) of patients with no PP, 4/5-day PP, and 7-day PP was 21.69%, 7.95% (OR 0.31, p < 0.001), and 5.33% (OR 0.20, p < 0.001), respectively. In TJH regimen, FN incidence of patients with no PP, 4/5-day PP, and 7-day PP was 38.26%, 8.33% (OR 0.15, p < 0.001), and 8.57% (OR 0.15, p < 0.001), respectively. FN incidence of patients on AC-T regimen with no PP and 4/5-day PP was 20.93% and 6.84%, respectively (OR 0.28, p = 0.005); with FEC-T regimen, the incidence was 9.91% and 4.77%, respectively (OR 0.46, p = 0.035). Only 3.27% FN cases were not hospitalized. Mean (±standard deviation, SD) time to first hospitalization was 8.21 ± 2.44 days. Mean (±SD) duration of hospitalization for patients with no PP, 4/5-day PP, and 7-day PP was 4.66 ± 2.60, 4.37 ± 2.85, and 5.12 ± 2.97 days, respectively.

CONCLUSION

GCSF prophylaxis in breast cancer patients on docetaxel could reduce FN incidence and hospitalization. 4/5-day PP demonstrated similar efficacy to 7-day PP with superior saving benefits on healthcare expenditure.

Respite Service to Family Caregivers by the Senior Companion Program: An Urban-Rural Comparison

The Senior Companion Program (SCP), a federally sponsored progrant, aims to enlist older volunteers to provide in-home services to the homebound elderly. A survey of 48 sample SCP projects providing family caregiver services reveals a distinctly different trajectory of urban and rural project development. In both environments, the longer a project has been in existence, the greater the number of volunteers in service. However, the number of clients served increases for urban projects, but not for rural projects. Relatedly, the unmet need for family care giver services, the number of referrals unserved by the project, is considerably greater in rural areas. These results suggest that because offactors unique to rural areas, the expansion of clientele may be more restricted in ruml settings compared to that in urban settings, thereby implying that rural-urban differences should be reflected in project planning and implementation.

Comparing EMG amplitude patterns of responses during dynamic exercise: polynomial vs log-transformed regression

The purposes of this study were to determine if (a) the log-transformed model can be applied to dynamic exercise and (b) the slope and y-intercept terms can provide additional information above and beyond the polynomial regression analyses. Eleven physically active individuals performed incremental cycle ergometry on a single occasion. Electromyographic electrodes were placed on the three superficial quadriceps muscles to record muscle activation during the exercise test. The patterns of responses for electromyographic amplitude vs power output were analyzed with polynomial and log-transformed regression models. The results of the polynomial regression for the composite data indicated that the best-fit model for the vastus lateralis muscle was linear (R(2) = 0.648, P < 0.0001), whereas the best-fit model for the rectus femoris (R(2) = 0.346, P = 0.013) and vastus medialis (R(2) = 0.764,P = 0.020) muscles was quadratic. One-way repeated measures analyses indicated no significant differences(P > 0.05) across the three superficial quadriceps muscles for the slope and y-intercept terms. These findings suggest that the log-transformed model may be a more versatile statistical approach to examining neuromuscular responses during dynamic exercise.

Dental diagnostic X-ray exposure and risk of benign and malignant brain tumors

BACKGROUND

This study evaluates the risk of benign brain tumors (BBTs) and malignant brain tumors (MBTs) associated with dental diagnostic X-ray, using a large population-based case-control study.

MATERIALS AND METHODS

We identified 4123 BBT cases and 16 492 controls without BBT (study 1) and 197 MBT cases and 788 controls without MBT (study 2) from Taiwan National Health Insurance claim data. The risks of both types of tumor were estimated in association with the frequency of received dental diagnostic X-ray.

RESULTS

The mean ages were ~44.2 years in study 1 and 40.6 years in study 2. Multivariable unconditional logistic regression analysis showed that the risk of BBT increases as the frequency of received dental diagnostic X-ray increases. The BBT odds ratio increased from 1.33 [95% confidence interval (CI) 1.22-1.44] for those with annual mean X-ray examination of less than one to 1.65 (95% CI 1.37-1.98) for those with three or more X-ray examinations, after controlling for comorbidities. No significant association was found between MBTs and dental diagnostic X-ray exposure.

CONCLUSIONS

Exposure to dental diagnostic X-rays in oral and maxillofacial care increases the risk of BBTs, but not MBTs.

A new risk classification rule for curve progression in adolescent idiopathic scoliosis

BACKGROUND CONTEXT

Prognostic factors for curve progression of adolescent idiopathic scoliosis (AIS) have been reported previously. There is only one existing rule that classifies AIS patients into two groups by a curvature of 25°.

PURPOSE

This study aimed to develop a more refined risk classification rule for AIS.

STUDY DESIGN

This was a retrospective cohort study.

PATIENT SAMPLE

We examined 2,308 untreated AIS patients, aged 10 years and older, who had a Risser sign of 2 and lesser and a curvature less than 30° at presentation.

OUTCOME MEASURES

Outcome was taken as the time to progression to 30°.

METHODS

Patients' clinical parameters were analyzed by Classification and Regression Tree analysis.

RESULTS

The new classification rule identified four risk groups of curve progression. Patients with a curvature of 26° and more and less than 18° constituted the highest and lowest risk groups, respectively. The two intermediate groups were identified by the age (11.3 years), menarcheal status, and body height (154 cm).

CONCLUSIONS

The risk classification rule only uses information at the first presentation and can aid physicians in deriving an efficient management.

Split-liver transplantation in 2 adults: significance of caudate lobe outflow reconstruction in left lobe recipient: case report

Split-liver transplantation is a well-known procedure for increasing the donor pool. The procedure is commonly used in 1 adult and 1 child, but is less commonly performed in 2 adults because of technical difficulty and poor outcome in left-lobe recipients. Preservation of caudate lobe function is important in recipients with borderline graft-recipient weight ratio to achieve better results. Herein, we report a case in which caudate lobe outflow was reconstructed in a left lobe with a caudate lobe graft in split-liver transplantation in 2 adults.

MODULATION OF MDR-1 GENE BY MIF AND GSTpi WITH DRUG RESISTANCE GENERATION IN HORMONE INDEPENDENT PROSTATE CANCER

The expression of MIF and GSTpi were upregulated in prostate cancer cells with mulitdrug resistant phenotype. The aim of this study is to determine the relationship between these genes and multidrug resistance (mdr-1) gene in acquired multidrug resistance of prostate cancer. The expression of MIF, GSTpi and gp-170 in multidrug resistant (MDR) subline or native cells were determined using flow cytometry and western blotting. The mRNA level of various genes was analyzed with RT-PCR method. The chemosensitivity of tumor cells and stable transfectants to paclitaxel was measured using MTT (tetrazolium bromide) assay. The protein levels of MIF, GSTpi and gp-170 increased in MDR sublines of prostate cancer when compared with their parental cells. The MIF and GSTpi stable transfectants expressed higher MIF and GSTpi protein levels than their parental cells in western blotting analysis, respectively. The expression of mdr-1 gene and the production of pg-170 were also increased in either MIF or GSTpi stable transfectants when compared with vector control by using RT-PCR and flow cytometric analysis. The MTT results demonstrated that the increased chemoresistance was correlated with the increased production of gp-170 protein in either MIF or GSTpi transfectants. The upregulation of MIF and GSTpi during the development of acquired drug resistance of hormone independent prostate cancer may simultaneously and partially modulate the activation of gp-170.

Devising an integrated methodology for analyzing energy use and CO2 emissions from Taiwan's petrochemical industries

Input-output modeling and multiplier analysis are used to assess Taiwan's five petrochemical industries, based upon their economic contribution and potential impacts on energy consumption and CO2 emission. In addition, a consolidated index system was developed for evaluating energy and economic efficiencies as well as targets for CO2 reduction. Results indicate that petrochemical materials (PM) make a major contribution to economic development, with lesser contributions from plastic materials (PL) and artificial fibres (AF). PM has the highest energy multiplier while PL has the largest induced potential for energy consumption. Plastic and rubber products (PP, RP) are relatively insignificant energy consumers. AF has the highest CO2 multiplier, and its induced potential for CO2 emission is the most significant. The consolidated index shows that the upstream petrochemical industries perform rather poorly in an integrated view of economic, energy, and CO2 emission, and should be seen as the primary targets for CO2 reduction. Investment of the petrochemical industries in Taiwan should be adjusted to improve energy efficiency, economic bases, and lower CO2 emissions.

Mitochondrial theory of aging matures--roles of mtDNA mutation and oxidative stress in human aging

Mitochondrial theory of aging, a variant of free radical theory of aging, proposes that accumulation of damage to mitochondria and mitochondrial DNA (mtDNA) leads to aging of humans and animals. It has been supported by the observation that mitochondrial function declines and mtDNA mutation increases in tissue cells in an age-dependent manner. Age-related impairment in the respiratory enzymes not only decreases ATP synthesis but also enhances production of reactive oxygen species (ROS) through increased electron leakage in the respiratory chain. Human mtDNA, which is not protected by histones and yet is exposed to high levels of ROS and free radicals in the matrix of mitochondria, is susceptible to oxidative damage and mutation in tissue cells. In the past decade, more than one hundred mtDNA mutations have been found in patients with mitochondrial disease, and some of them also occur in aging human tissues. The incidence and abundance of these mutant mtDNAs are increased with age, particularly in tissues with great demand for energy. On the other hand, recent studies have revealed that the ability of the human cell to cope with oxidative stress is compromised in aging. Comparative analysis of gene expression by microarray technology has shown that a number of genes related to oxidative stress response are altered in aging animals. We discovered that the transcripts of early growth response protein-1, growth arrest and DNA damage-inducible proteins and glutathione S-transferase genes are increased in response to oxidative stress in human skin fibroblasts. Moreover, the activities of Cu,Zn-SOD, catalase and glutathione peroxidase decrease with age, whereas Mn-SOD activity increases with age up to 65 years and slightly declines thereafter in skin fibroblasts. Such an imbalance in the function of antioxidant enzymes may result in excess production of damaging ROS in the cell. This notion is supported by the observation that intracellular levels of H2O2 and oxidative damage to DNA and lipids are significantly increased with age of the fibroblast donor. Furthermore, the mitochondrial pool of reduced glutathione declines and DNA damage is enhanced in aging tissues. Taken together, these observations and our previous findings that mtDNA mutations and oxidative damage are increased in aging human tissues suggest that mitochondrial theory of aging is mature.

Increases of mitochondrial mass and mitochondrial genome in association with enhanced oxidative stress in human cells harboring 4,977 BP-deleted mitochondrial DNA

In order to investigate the effect of aging- and disease-associated deletion of mtDNA on cellular functions, we used cytoplasm fusion to construct a series of the cybrids harboring varying proportions of mtDNA with 4,977 bp deletion from skin fibroblasts of a patient with chronic progressive external ophthalmoplegia. The cybrids were grown in the Dulbecco's modified Eagle medium supplemented with 5% fetal bovine serum, 100 microg/ml pyruvate and 50 microg/ml uridine. The population doubling time was longer for the cybrids containing higher proportions of 4,977 bp-deleted mtDNA. In addition, we found that the respiratory function was decreased with the increase of mtDNA with 4,977 bp deletion in the cybrids. Since impairment of the respiratory system of mitochondria increases the electron leak of the respiratory chain, we further determined the oxidative stress in these cybrids. The results showed that the specific contents of 8-hydroxy 2'-deoxyguanosine and lipid peroxides of the cybrids harboring > 65% of the 4,977 bp-deleted mtDNA were significantly increased as compared with those of the cybrids containing undetectable mutant mtDNA. On the other hand, we found that the mitochondrial mass and the relative content of the mitochondrial genome in the cybrids harboring 4,977 bp-deleted mtDNA were higher than those of the cybrids containing only wild type mtDNA. The relative content of mtDNA was increased 17% and 30%, respectively, in the cybrids harboring 17% and 56% of mtDNA with 4,977 bp deletion. Moreover, both mitochondrial mass and mtDNA content were concurrently increased by treatment of the cybrids with 180 microM of hydrogen peroxide. Taken these findings together, we conclude that increase of mitochondrial mass and mtDNA are the molecular events associated with enhanced oxidative stress in human cells with impaired respiratory function caused by mtDNA deletion.

Mediators and oxygen radicals in hyperpnea-induced airway constriction of guinea pigs

Leukotrienes (LTs), tachykinins (TKs), and oxygen radicals have been suggested to be important modulating factors for the hyperpnea-induced bronchoconstriction (HIB) of guinea pigs. In this study, we tested the hypothesis that LTs and oxygen radicals modulate HIB by triggering TK release. Eighty-five Hartley guinea pigs were divided into four groups: control, dimethylthiourea (DMTU), FPL 55712, and A63162. DMTU is the scavenger for hydroxyl radical. FPL 55712 is an antagonist of LT receptor, whereas A63162 is an inhibitor of lipoxygenase. Each group was further divided into three subgroups: baseline, hyperpnea, and recovery. Each animal was anesthetized, cannulated, paralyzed, and artificially ventilated. We measured dynamic respiratory compliance (Crs), maximal expiratory flow at 50% total lung capacity (V(max(50))), and forced expiratory volume in 0.1 s (FEV(0.1)) during the baseline and recovery periods. Hyperpnea caused significant decreases in Crs, V(max(50)), and FEV(0. 1), indicating HIB in the control group. Pretreatment with DMTU, FPL 5712, or A63162 attenuated HIB. Plasma substance P (SP) levels increased progressively during the experiment in all groups. However, both FPL 55712 and A63162, but not DMTU, significantly decreased SP levels. Similarly, lung malondialdehyde (MDA) contents increased progressively during the experiment in the control group. Neither FPL 55712 nor A63162 significantly affected the increase. On the contrary, DMTU significantly attenuated the increase in MDA during the recovery period. These results suggest that inhibition of LTs leads to suppression at SP levels and HIB, whereas DMTU attenuates HIB by means of other mechanisms.

DNA vaccination using the fragment C of botulinum neurotoxin type A provided protective immunity in mice

Botulinum neurotoxin (BoNT) is one of the most toxic substances known to produce severe neuromuscular paralysis. The currently used vaccine is prepared mainly from biohazardous toxins. Thus, we studied an alternative method and demonstrated that DNA immunization provided sufficient protection against botulism in a murine model. A plasmid of pBoNT/A-Hc, which encodes the fragment C gene of type A botulinum neurotoxin, was constructed and fused with an Igkappa leader sequence under the control of a human cytomegalovirus promoter. After 10 cycles of DNA inoculation with this plasmid, mice survived lethal doses of type A botulinum neurotoxin challenges. Immunized mice also elicited cross-protection to the challenges of type E botulinum neurotoxin. This is the first study demonstrating the potential use of DNA vaccination for botulinum neurotoxins.

The molecular biology of Schwanniomyces occidentalis klocker

This review describes the molecular studies of Schwanniomyces occidentalis (Debaryomyces occidentalis) concerning transformation, genome, gene cloning, gene structure, gene expression and its characteristics to application. Schw. occidentalis appears to have at least five or seven chromosomes and no native plasmid from the yeast has been reported. Four transformation systems based on complement of Schw. occidentalis auxotrophic mutants were established. Vectors with the replicon of 2-micron plasmid and autonomous replication sequences (ARS) of Saccharomyces cerevisiae and Schw. occidentalis ARS replicated extrachromosomally in Schw. occidentalis transformants, without modification of the transformed vector DNA. So far, at least 21 Schw. occidentalis genes encoding 14 different proteins have been cloned. Most of the Schw. occidentalis genes have shown homologies (45 to 91%) with the corresponding genes of other organisms, especially of S. cerevisiae. However, some Schw. occidentalis genes possess other unique structures for their operators, promoters, transcription initiation sites, and terminators. Some foreign genes were expressed in Schw. occidentalis, while Schw. occidentalis genes functioned in other yeasts and bacteria, Escherichia coli, and Streptomyces lividans. Due to a strong ability of secretion and low level of glycosylation, Schw. occidentalis might be a promising host to produce heterologous proteins.

Lac/Tet dual-inducible system functions in mammalian cell lines

The Escherichia coli Lac repressor (Lac system) and tetracycline responsive promoter (Tet system) systems have been used individually to regulate gene expression at the cellular as well as the organismal levels. In this study, these two systems were combined (designated Lac/Tet dual-inducible system) to regulate two inducible genes simultaneously in a single cell. The isopropyl-beta-D-thiogalactopyranoside (IPTG) and tetracycline (used for the operation of the Lac and the Tet systems) were non-cytotoxic to the cells when added together into the cells at around the optimal concentrations (IPTG: < or = 5 mM; tetracycline: < 1.5 micrograms). The rate and efficiency of induction and repression of two inducible genes regulated by the Lac/Tet dual-inducible system were similar to the results obtained when one inducible gene is regulated by one inducible system in a single cell. The Lac/Tet dual-inducible system could function in many cell lines, which was demonstrated by regulating the expression of beta-galactosidase and luciferase reporter genes in five tumor cell lines by transient transfection analysis. The feasibility of introducing a second inducible system into an already established inducible cell line was confirmed. Finally, we showed that the Lac/Tet dual-inducible system functions at translational and at functional levels in a stable cell line named 7-4-b, which contains the Ha-ras and bc1-2 inducible genes. In conclusion, this study extends the application of prokaryotic inducible systems from the regulation of a single gene to two genes and helps clarify the relationship between two genes and the effects of two genes on the cells.

Single dose pharmacokinetic study of lithium in Taiwanese/Chinese bipolar patients

OBJECTIVE

The purpose of this study is to investigate the single dose pharmacokinetics of lithium in Taiwanese/Chinese bipolar patients for future interracial comparisons.

METHOD

Eight bipolar patients took 900 mg of lithium carbonate after overnight fasting. Blood samples of 5 mL were taken after 15 min, 30 min, 45 min, 1 h, 2 h, 3 h, 4 h, 7 h, 9 h, 15 h, 25 h and 31 h after dosing. The computer programs CSTRIP and PCNONLIN were used for pharmacokinetic analysis.

RESULTS

The pharmacokinetic parameters obtained were as follows: Cmax, 0.970 +/- 0.170 (SD) mmol/L; Tmax, 1.59 +/- 0.78 h; AUC31 h = 548.9 +/- 135.4 mmol x m/L; AUC to infinity = 722.6 +/- 262.7 mmol x m/L; beta-half-life = 16.3 +/- 7.18 h; kappa-half-life = 0.613 +/- 0.442 h; Cl(oral) = 1.13 +/- 0.39 mL/min/kg; Vd/F = 1.43 +/- 0.387 L/kg. Most of the pharmacokinetic parameters were within the ranges reported in investigations of Caucasian subjects.

CONCLUSIONS

This study showed that racial differences in lithium pharmacokinetics might not exist. We suggest that methodological designs, including method of blood sampling, measurement of lithium, and pharmacokinetic and statistical calculations, be standardised if future cross-ethnic comparisons are to be conducted.

Epinephrine enhances glycogen turnover and depresses glucose uptake in vivo in rat heart

In vivo effects of epinephrine on glucose uptake and glycogen turnover in rat heart were studied and compared to liver and skeletal muscle. Fasted ketamine-anesthetized rats were intravenously infused with saline or epinephrine. Both the low and high doses of epinephrine resulted in hyperglycemia (40-50%) and hyperlactemia (threefold) at the end of infusion. Glucose uptake, determined by the phosphorylation of the intravenously injected [14C]2-deoxyglucose, was found to decrease in the heart and skeletal muscle of epinephrine-infused rats. Glycogen in livers, skeletal muscles, and hearts of the epinephrine-infused rats decreased to varying degrees relative to the saline-infused rats, indicating enhanced glycogenolysis in all three organs. Glycogen synthesis, determined by the incorporation of the co-infused [3-(3)H]glucose into glycogen, was found to decrease in liver and skeletal muscle. However, glycogen synthesis in the heart was found to increase 50% in Epi-1 and 280% in Epi-2 compared to the saline-infused rats. We conclude that glucose utilization in the in vivo heart may be preferentially channeled through glycogen turnover in the presence of epinephrine. That both synthesis and degradation of glycogen can be simultaneously activated appears to be unique to the heart and is protective against a loss of glycogen at a time of enhanced glucose utilization.

Synthesis and cytotoxic evaluation of substituted sulfonyl-N-hydroxyguanidine derivatives as potential antitumor agents

A series of sulfonyl-N-hydroxyguanidine derivatives was designed and synthesized for cytotoxic evaluation as potential anticancer agents on the basis of the lead compound LY-181984. Replacement of the ureido moiety of the lead compound with hydroxyguanidine provided a stable cytotoxic agent. The conformation of sulfonyl-N-hydroxyguanidine derivatives, such as N-(4-chlorophenyl)-N'-[(benzo[2,1,3]thiadiazol-4-yl)sulfonyl]-N"- hydroxyguanidine (4g), investigated utilizing HMBC NMR, theoretical calculations, and X-ray crystallography, indicated stacking of the two aromatic rings. The derivatives were evaluated for in vitro cytoxicity against five human tumor cell lines, including HepG2, TSGH 8302, COLO 205, KB, and MOLT-4. The cytotoxic activities of the derived compounds against the human tumor cell lines were equal to or greater than that of the lead compound. N-(4-Chlorophenyl)-N'-[[3,5-dichloro-4-(4-nitrophenoxy)phenyl]sulfonyl]- N"- hydroxyguanidine (4n) and N-(4-chlorophenyl)-N'-[[3,5-dichloro-4-(2-chloro-4-nitrophenoxy)phenyl] sulfonyl]-N"-hydroxyguanidine (4o) exhibited the greatest growth inhibition of solid tumor cell lines. Compound 4o was found to possess antitumor activity against murine K1735/M2 melanoma xenografts.

In vitro antitumor and antimicrobial activities of N-substituents of maleimide by adamantane and diamantane

New N-1-adamantylcitraconimide (compound 1) and N-1-diamantylcitraconimide (compound 2) were synthesized by reaction of citraconic anhydride with 1-aminoadamantane, and 1-aminodiamantane, respectively, followed by imidization with acetic anhydride and sodium acetate. Compound 1, N-1-adamantylmaleimide (compound 3) and N-1-diamantylmaleimide (compound 4) exhibited strong growth-inhibitory activity against four cancer cell lines (Colo 205, Hep G2, SK-BR-3 and Molt-4). Moreover, compound 1 showed relatively specific cytotoxicity against the test tumor cell lines. Compound 2 exhibited growth inhibitory activity against Colo 205, and SK-BR-3 cells, similar to 5-fluorouracil. It was noted that compound 2 showed relatively low cytotoxicity against Molt-4 cells, approximately 42 times lower than 5-fluorouracil. The N-substituents of imides with adamantly substituents have a more potent antitumor activity than the imides with diamantyl substituents. The imides with methyl substituents (compounds 1 and 2) showed relatively higher selectivity against the tested cancer cell lines than the imides without methyl substituents (compounds 3 and 4). Compounds 3 and 4 show good in vitro activities against Staphylococcus aureus and Trichophyton mentagrophytes. Compound 1 had weak antimicrobial activity against T. mentagrophytes.

2-Heteroaryl 2-substituted phenylketone derivatives and their inhibitory activity on platelet aggregation

R 68070 and CV-4151 are two compounds possessing both thromboxane synthetase inhibitory activity and thromboxane receptor antagonist properties. 2-Heteroaryl 2-substituted phenylketone derivatives with a partial structural similarity to R 68070 and CV-4151, i.e. possessing a phenyl and a heteroaryl moiety, have been prepared and found to have antiplatelet activity. The compound 2-thienyl 2'-hydroxyphenyl ketone (4) was shown to completely inhibit platelet aggregation induced by arachidonic acid at a concentration of 5.0 microM. Structure-activity analysis indicated that the presence of a ketone group is an important requirement for this inhibitory activity. An o-hydroxyl substitution on the phenyl ring, and a 2-thienyl of heteroaryl ring might increase inhibitory activity.

Circulatory regulation during supine and sitting intermittent isometric handgrip in a hot environment

We studied the circulatory regulation during intermittent isometric handgrip (IIHG, six seconds contraction + six seconds relaxation) in supine and sitting postures in a hot environment (40 degrees C, RH: 50%). Eight healthy male subjects performed thrice 5-minute period IIHG at three different work loads (10%, 20% and 30% MVC). The IIHG was performed with the right hand in the two postures. Heart rate (HR), cardiac output (CO), mean arterial blood pressure (MBP), forearm blood flow (FBF), skin blood flow (SBF), foot swelling (FSW) and tympanic temperature (Tty) were measured during IIHG, resting and recovery periods. During IIHG in a hot environment, HR, MBP, FSW and Tty showed higher values in the sitting than in the supine posture. FBF during relaxation showed higher values at high work load than at low work load in the two postures. FBF showed higher values in the sitting than in the supine posture, except during relaxation at 30% MVC. It was concluded that the decrements of blood volume of splanchnic organs might be greater in the sitting than in the supine posture due to sympathetic vasoconstrictor activity, and were responsible for the redistribution of blood flow. Posture had an effect on FBF because of hydrostatic pressure.

Amino acid sequences of trypsin inhibitors from the melon Cucumis melo

Two squash family trypsin inhibitors, CMeTI-A and CMeTI-B, were isolated from the melon (Cucumis melo) seeds, by ion exchange chromatography, gel filtration, affinity chromatography, and high-performance liquid chromatography, and their amino acid sequences were determined. All inhibitors contain 29 amino acid residues including 6 half-cystine residues. They differ by twelve amino acid residues. These polypeptides are strong inhibitors of bovine trypsin, with Ki values of 1.6 x 10(-10) M (CMeTI-A) and 4.7 x 10(-10) M (CMeTI-B). The products of CMeTI-A and CMeTI-B cleaved at their reactive sites by tryptic digestion during the purification by trypsin-Sepharose 4B affinity column chromatography are active against trypsin activity, but a molar ratio of inhibitor to trypsin of 2:1 for trypsin-treated CMeTI-B or 1:1 for trypsin-treated CMeTI-A is required.

Different behavior of forearm blood flow during intermittent isometric handgrip in a thermo-neutral and a hot environment

The purpose of the present study was to evaluate the different behavior of forearm blood flow (FBF) during intermittent isometric handgrip (IIHG, 6 seconds contraction +6 seconds relaxation) in a thermoneutral versus a hot environment. Six healthy men performed three times of 5-minute period IIHG at three different work loads (10%, 20% and 30% MVC). The IIHG was performed with the right hand. The experiments of IIHG were performed at two different air temperatures (25 degrees C and 40 degrees C, RH: 50%), and an experiment without work was also carried out at 40 degrees C (RH: 50%). The physiological responses measured involved heart rate (HR), cardiac output (CO), mean arterial blood pressure (MBP), FBF, and skin blood flow (SBF). HR, CO and SBF showed higher values during IIHG at 40 degrees C than at 25 degrees C. MBP had a tendency to increase with the intensity of work load at both 25 degrees C and 40 degrees C. Since intramuscular pressure might increase during contraction periods at 20% MVC and 30% MVC at 25 degrees C, FBF was significantly higher during relaxation periods than during contraction periods. FBF showed similar values between contraction and relaxation periods at 10% MVC at both temperatures. The present study suggested that FBF was sufficient for active muscles during IIHG at 10% MVC. FBF of contraction periods was close to that of relaxation periods at 40 degrees C due to the modulation of the sympathetic outflow to the muscles and/or the decreased efficiency of the muscle pump. It was suggested that FBF showed different behaviors during HHG at 25 degrees C versus at 40 degrees C.

The daily rhythm of tooth eruption

A video microscope system, which can resolve tooth movements to 1 to 2 microns, was used to monitor the eruption of 17 human maxillary second premolars in the prefunctional phase. Eruptive movement was detected by the change in position of an optical ruling on the erupting tooth relative to a reference ruling on the occluding adjacent teeth. Eruption was observed as the teeth erupted toward the occlusal plane over approximately a 41-hour period, from late Friday afternoon until Sunday noon. Half hourly observations were made during a 6 to 8-hour continuous laboratory session, which was during the day (9 AM to 5 PM) for nine of the subjects, and during the evening (5 to 11 PM) for eight. A similar pattern of eruption was seen for all subjects. The tooth intruded from before to after dinner on the first day, erupted significantly overnight, ceased eruption and approximately maintained its position during the next day, and erupted again during the second night. On the average, a slight intrusion was observed during the day, and statistically significant intrusion was associated with breakfast and dinner. Eruption occurred during the evening observation period, and the rate of evening eruption was significantly greater in children who were supine and relaxed than those who were upright and active. The 24-hour eruption rate was slower for teeth that were within 1.5 mm of the occlusal plane. The circadian eruption rhythm may be related to fluctuations of hormonal levels that affect metabolic activities within the periodontal ligament. It is also possible that a transient reduction in pressures by the cheeks, lips, and tongue during periods of rest allows eruption to occur then.

Synonymy of Candida methylica with Candida boidinii and of Candida methanolophaga with Candida succiphila

Some Candida species which can use methanol as a sole carbon source were studied by performing chemotaxonomic tests; we determined the ubiquinone systems of these organisms, their DNA base compositions, their electrophoretic karyotypes, and their DNA relatedness values. The type strains of Candida methanolophaga and Candida succiphila had similar DNA base compositions and exhibited 90% DNA relatedness. All Candida boidinii and Candida methylica strains had DNA G + C contents of 30.8 to 31.0 mol%, and these organisms exhibited 87 to 101% DNA relatedness to the type strain of C. boidinii. We propose that C. methanolophaga and C. methylica should be synonyms of C. succiphila and C. boidinii, respectively.

[Responses of electroencephalogram to different odors]

The responses of electroencephalogram (EEG) to different odors and their densities were studied on four men and two women at rest while sitting. The odors examined were citrus, floral and lavender, and their densities were 100 ppb and 200 ppb. The odors were released for ten minutes from a duct to fill the room completely. The subjective estimation indicated that citrus had a tendency to be the most comfortable odor in this study, but it was not significant. To evaluate changes of EEG, the power spectra of frequency-fluctuation of alpha wave (Fz) and the rate of alpha, beta, and beta/alpha wave (Oz, Fz) were calculated. The rate of alpha wave (Oz) in the period of giving out the citrus at 100 ppb was significantly (p < 0.05) higher than that of the lavender. The rate of beta wave (Oz) in the period of giving out the floral at 200 ppb was significantly (p < 0.05) higher than that of the lavender. The regression coefficient of the power spectra of frequency-fluctuation of alpha wave in the period of giving out the lavender at 100 ppb was significantly higher than those in the other periods of the experiment. The regression coefficient of the power spectra of frequency-fluctuation of alpha wave for lavender given out at 200 ppb was significantly (p < 0.01) higher than those for the other odors given out. It seems that the regression coefficient of the power spectra of frequency-fluctuation of alpha wave can be used for the evaluation of psychophysiological responses.

[Factors related to the choice of clinic between Chinese traditional medicine and Western medicine]

The study applied Andersen's health-service utilization model to analyze the basic demographic, enabling and need factors related to the choice of traditional Chinese medicine clinic or modern Western medicine clinic by single-method-treatment (i.e. traditional Chinese medicine or modern Western medicine only) patients. During the period from August 1989 to October 1989, systemic sampling was done and a structured questionnaire survey was carried out among patients from the Out-patient Departments of 13 teaching hospitals accepting reimbursement by Labor Medical Insurance in Taiwan. The total number of valid respondents was 579: 378 (65.3%) were visiting modern Western medicine clinics and 201 (34.7%), traditional Chinese medicine clinics. There were 339 (58.6%) males and 240 (41.4%) females, aged from 15 to 85 years old, with a mean of 40.7 years. Under univariate analysis, the significant variables (p < 0.05) related to visiting the two types of clinics were: nativity, religious belief, career, general health condition, severity of illness of this episode, types of disorder as neuromusculoskeletal, digestive, circulatory, endocrine-metabolic and sense-and-skin. By logistic regression analysis, the significant variables (p < 0.05) relating to visiting two types of clinics were religion, career, and two kinds of disorders. Folk-religion believers, farmers and businessmen favored traditional Chinese medicine; and patients who suffered from musculoskeletal, sense organs or skin disorders were also likely to visit traditional Chinese medicine clinics.

Prevalence of rheumatic diseases in Taiwan: a population study of urban, suburban, rural differences

OBJECTIVE

To determine the prevalence of symptomatic rheumatic disease in rural, urban and suburban areas of Taiwan by a 2-staged population survey.

METHODS

Nine thousand subjects over 20 years old were sampled proportional to age and sex for the area from 3 administrative areas in Taiwan. A pretested questionnaire to screen for potential rheumatic disorders and/or disability was administered in the communities by health workers. Subjects who screened positive were examined by a rheumatologist who assigned a final diagnosis based on established criteria.

RESULTS

A total of 8998 persons over age 20 residing in Hen-San (rural area), Sien-Dien (suburban), and Cu-Tien (urban) were studied. Twenty-five percent (2272) of the population indicated rheumatic problems: 1124 of 2271 were evaluated by a rheumatologist with serological and radiological testing. The response rates were 49.7% in Hen-San, 50.7% in Sien-Dien and 48.5% on Cu-Tien. After age and sex adjustment, the prevalence of rheumatic symptoms in Hen-San, Sien-Dien, and Cu-Tien was 24.3, 18.4 and 26.3% respectively. It was significantly higher in rural Hen-San and urban Cu-Tien than in Sien-Dien. The prevalence of rheumatoid arthritis (RA) in Hen-San, Sien-Dien, and Cu-Tien was 0.26, 0.78, and 0.93%, osteoarthritis (OA) was 6.3, 5.8, 5.1%, ankylosing spondylitis (AS) was 0.54, 0.19, 0.4%, gout was 0.16, 0.67, 0.67%, respectively. The prevalence of RA in Sien-Dien and Cu-Tien was significantly higher than in Hen-San (p < 0.05) but were not statistically different for OA, AS and gout among those 3 sites. Only one case of systemic lupus erythematosus (SLE) was found in urban Cu-Tien for a prevalence of 0.033%.

CONCLUSION

Our results suggest that the prevalence of RA and AS is similar to that reported in Caucasians. We could not confirm anecdotal reports that SLE was common or that it is more common than RA in people of Chinese ancestry. The prevalence of OA of the hip is comparatively uncommon in our population. The difference in prevalence of rheumatism, RA, OA and gout in these areas suggests areas of further study.

Screening for defects of branched-chain amino acid metabolism

Screening for defects of branched-chain amino acid metabolism is a sequential process involving clinical evaluation of the patient, plasma carnitine determination, urinary organic acid analysis, and enzyme studies in cultured or isolated peripheral cells. This report will summarize clinical and metabolite features and enzymological methods available for the diagnosis of the more common defects of branched-chain amino acid metabolism, including isovaleryl-CoA dehydrogenase deficiency, 3-methylcrotonyl-CoA carboxylase deficiency, 3-methylglutaconic aciduria due to 3-methylglutaconyl-CoA hydratase deficiency and other less well characterized defects, 3-hydroxy-3-methylglutaryl-CoA lyase deficiency, and 2-methylacetoacetyl-CoA thiolase deficiency. Newer enzymatic methodologies utilizing NaH14CO3 fixation coupled assays are described which allow for the estimation of six enzyme activities in the catabolic pathways of L-leucine and L-isoleucine catabolism. These coupled assays facilitate the rapid identification of five of the six enzyme abnormalities described above. Their ease of use should allow them to be implemented in any laboratory which screens for inborn errors of metabolism.

Comparative studies on thermoregulatory responses to heat between Japanese Brazilians and Japanese

Eight male Japanese Brazilians (20-32 yrs) and 11 male Japanese (22-24 yrs) volunteered for this study. The Brazilians had been staying for about 2-21 weeks in Japan. Their physical characteristics are not significantly different from those of the Japanese. Each one of them sat on a chair for 45 min at 40 degrees C (R.H. 50%) in a climatic chamber. Then, they exercised using a bicycle ergometer in a semi-reclining position for 45 min at 40% of maximal oxygen uptake. Forearm blood flow (FBF), oxygen uptake (VO2), heart rate (HR), skin temperature (Tsk), sweat rate (SR) at chest region and body weight loss (delta Wt) were measured. Thermal sensation and thermal comfort were also measured. Thermal and comfort sensation confirmed that Japanese Brazilians felt cooler and more comfortable in 40 degrees C environment than the Japanese. VO2, SR and delta Wt for both groups were not significantly different. FBF and HR for Brazilians were significantly lower than those for Japanese. Tsk at chest region for Brazilians was found to be significantly higher than that for Japanese. Thus the thermoregulatory responses observed in Japanese Brazilians may be largely attributed to the climate in their native places located on the Tropic of Capricorn.

A coupled assay detecting defects in fibroblast isoleucine degradation distal to enoyl-CoA hydratase: application to 3-oxothiolase deficiency

We developed a coupled NaH14CO3 fixation assay to detect 3-oxothiolase deficiency in extracts of cultured human fibroblasts. Cell extracts were incubated with tiglyl-CoA, NAD, CoASH, ATP and NaH14CO3. The enzymatic activities of tiglyl-CoA (enoyl-CoA) hydratase, 2-methyl-3-hydroxybutyryl-CoA dehydrogenase and 2-methylacetoacetyl-CoA thiolase (3-oxothiolase) were coupled to produce propionyl-CoA. Propionyl-CoA produced in the assay was estimated by fixation of NaH14CO3 into [14C]methylmalonyl-CoA employing endogenous propionyl-CoA carboxylase. The control activity was 32 +/- 23 pmol/min per mg protein (+/- 1 S.D., range 7-94; 28 cell lines). Five known cases of 3-oxothiolase deficiency had a mean activity of 2% of the control; a sixth case of 3-oxothiolase deficiency was significantly higher at 27% of the mean control value. Coupled assay activity was also low (3% of control) in the cells from a patient with propionyl-CoA carboxylase deficiency.

The effect of bead attachment systems on casting patterns and resultant tensile bond strength of composite resin veneer cast restorations

This study compared the difference in tensile bond strength between the composite resin veneer and the cast Ni-Cr disk when different bead adhesives were used to make the laboratory patterns. Visio-Gem, cyanoacrylate, and shellac were the adhesives tested. Fifty-six composite resin bonded Ni-Cr disks were prepared and tested to tensile failure with the Kemper-Kilian device. All tested samples showed a complex failure pattern. The results showed that the mean tensile bond strength of the cyanoacrylate group was significantly higher than the other two groups. No significant difference in the mean tensile bond strength was observed between the Visio-Gem and shellac groups. The higher tensile bond strength in the cyanoacrylate group is thought to be attributed to the low rheological property of the adhesive that allowed greater exposure of the bead for retention. Using different adhesives in the fabrication of composite resin veneered-castings may affect the bond strength in the composite resin-metal interface.

Maintenance lithium levels could be lowered: based on Taiwanese and Danish studies

Twenty-two patients, 8 males and 14 females, who had been lithium-free for at least 1 week were included in this study. All patients took 900 mg of Lithonate at 8:00 a.m. while in a fasting state. A 5 ml blood sample was taken at 9:00 a.m., 10 a.m., 12 noon, 3 p.m., 5 p.m., 11 p.m., and at 9 a.m. and 3 p.m. on the next day. Plasma was separated immediately, and the lithium level was measured by atomic absorption spectrophotometry. The pharmacokinetic parameters were as follows: K12 (microconstant) = 0.3455 +/- 0.5345 (mean +/- SD) h-1; K21 (microconstant) = 0.1691 +/- 0.1242 h-1; K10 (microconstant) = 0.1320 +/- 0.1112 h-1; Vl (volume of distribution of central compartment) = 16.9057 +/- 5.9384 1; Vss (volume of distribution at steady state) = 38.8917 +/- 11.4540 1; V-beta (volume of distribution of elimination phase) = 46.3809 +/- 13.8742 1; alpha (distribution rate constant) = 0.5932 +/- 0.7090; and beta (excretion rate constant) = 0.0361 +/- 0.0141. The mean elimination half-life, AUC (the area under the curve) and clearance were 22.5 +/- 9.9 h (range from 9.6 to 50.4 h), 16.33 +/- 5.52 mmoll-1h (8.69 to 31.81 mmoll-1 h), and 1.65 +/- 0.53 1h-1 (0.76 to 2.28 1h-1) or 28.59 +/- 9.58 ml/kg-1 h-1, respectively. There were no statistically significant differences in beta, AUC and clearance between Taiwanese/Chinese and Danish results. The possibility of lowering the traditional prophylactic therapeutic range of lithium to around 0.5-0.8 mmol/L is supported by the results of this study.

Video microscope observations of human premolar eruption

It is now possible to observe with an accuracy of 1-2 microns the pattern of eruptive movements of a human premolar as it moves from gingival emergence to the occlusal plane. This was accomplished by use of a video microscope to track the position of an optical ruling on the erupting tooth relative to a reference ruling mounted on adjacent teeth that were in occlusion. Net eruptive movements averaging 25-75 microns occurred from one day to the next until the tooth was almost in occlusion; then the eruptive rate slowed. Eruption occurred almost entirely at night. During the day, there was a marked slowing or cessation of eruption and often intrusion, which appeared to be related to masticatory activity.

Interferon production from peripheral blood, synovial fluid, and synovial tissue lymphocytes in patients with rheumatoid arthritis and ankylosing spondylitis

A previous study demonstrated that interferon was present in the serum of 30% of the patients with systemic lupus erythematosus (SLE), which was significantly higher than the 4.5% found in normal controls. We also recently reported that interferon production was deficient from SLE mononuclear cells, which has been attributed to immunodeficiency of the lymphocytes. In this study, interferon measurement included lymphocytes obtained from peripheral blood (PB), synovial fluid (SF) and synovial tissue (ST) in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). PB from normal subjects (NS) was used as a control. The results showed with PHA stimulation, that the interferon level in PBL (L = lymphocyte) in NS (70.0 +/- 67.5) was significantly higher when compared with PBL in RA (27.9 +/- 21.6). However, there was no difference between PBL in NS and AS. With ConA stimulation, the interferon level was significantly higher in the PBL of NS (130 +/- 59) and as compared with the PBL in RA (83.6 +/- 53.5). The SFL in RA (67.8 +/- 31.1) and the STL in RA (77.2 +/- 93.2) were also significantly different. It is concluded that interferon production was deficient not only in PBL in RA, but also in SF and STL in RA. The reduced interferon production from PB, SF and ST lymphocytes in RA patients may be due to previous release or immunodeficiency. Lymphocyte interferon production was normal in AS, which suggests that the lymphocyte abnormality between RA and AS may be different.

Steroid receptors in benign mastectomy tissue

Estrogen and progesterone receptors (ERs and PRs, respectively) were measured in both cancerous and noncancerous components of 104 modified radical mastectomy specimens. In addition, ER and PR levels were determined for 14 benign breast specimens obtained by reduction mammoplasty. The receptor levels were measured by scatchard method. Each of these groups--cancerous, corresponding noncancerous, and mammoplasty specimens--were divided into subgroups according to their receptor levels. Fourteen of the 104 noncancerous specimens were found to be ER positive (ER+). Most cases of ER+ noncancerous tissue (13 of 14 cases) were associated with ER+ tumors. The reverse was not true because only 13 of 64 cases of the ER+ tumors were associated with positive ER in their noncancerous counterparts. Comparable results were obtained for PR. The average ER-PR level of the noncancerous mastectomy tissue was significantly higher than that of the mammoplasty specimens despite the similar histologic findings in both groups.

Evaluation of an enzyme immunoassay for the detection of herpes simplex virus (HSV) antigen from clinical specimens in viral transport media

A total of 301 clinical specimens (229 culture positive and 72 culture negative) were assayed retrospectively by an enzyme immunoassay. Specimens were transported to the virus lab in viral transport media (VTM), and were inoculated into HF and A549 cell culture tubes for viral isolation with the remainder of the sample being saved at -70 degrees C. Specimens were thawed, vortexed and resuspended in 10 x Herptran concentrate and each sample was then added in duplicate to designated wells of a microtiter plate for the EIA assay. The EIA detected 147/150 (98%) culture positive specimens from symptomatic patients, 63/79 (79.7%) culture positive specimens from patients considered asymptomatic and 210/229 (91.7%) culture positive specimens overall. The EIA was negative for 70/72 (97.2%) culture negative specimens. These data suggest that the EIA test can be used with clinical specimens submitted in conventional VTM. However, VTM samples which are EIA negative, particularly with EIA values close to the EIA positive cutoff value, need to be cultured.

[The occurrence and clinical significance of antibodies to type II collagen in sera and synovial fluid of Chinese patients with rheumatoid arthritis]

Antibodies to type II collagen (Col II) in sera and synovial fluid (SF) were measured with an enzyme linked immunosorbent assay (ELISA) using a solid phase sandwich method. The subjects included: 42 patients with rheumatoid arthritis (RA); 31 cases of osteoarthritis (OA); 10 cases of gouty arthritis; 4 cases of ankylosing spondylitis (AS); 5 cases of systemic lupus erythematosus (SLE); and 44 normal controls. The antigens used to detect antibodies against Col II were in native and heat-treated denatured forms, both of which were purified from chicken sternal cartilage by limited enzyme digestion and differential precipitation with salt. The reactivity to native type II collagen was generally higher than the reaction to the denatured collagen. In sera, significant higher levels of Col II were detected in the different arthritis groups when compared with the normal control group, with the exception of AS. In SF, the Col II was significantly higher in RA than it was in OA (p less than 0.001), while no difference was present between gout and OA (p less than 0.05). When native Col II was simultaneously measured in sera and SF among arthritics, positive rates were both higher among RA (65% and 58%, respectively). Positive rates were only higher in sera among OA (59% in sera and 3% in SF) and were both lower among gouty arthritis. The above findings show that the measurement of Col II is more important in SF than in sera.

3-Hydroxy-3-methylglutaryl-CoA lyase deficiency as detected by radiochemical assay in cell extracts by thin-layer chromatography, and identification of three new cases

In this rapid radiochemical assay for 3-hydroxy-3-methylglutaryl-coenzyme A lyase (I) activity in cell extracts, DL-3[glutaryl-3-14C]hydroxy-3-methylglutaryl-coenzyme A is used as substrate and the radiochemical product, [3-14C]acetoacetic acid, is converted to the more stable [3-14C]-3-hydroxybutyric acid in the presence of added NADH and 3-hydroxybutyrate dehydrogenase. Substrate and product are separated and quantified by thin-layer chromatography on cellulose (solvent system: butanol/water/formic acid, 77:13:10 by vol). All reagents for the assay are commercially available. No detailed column chromatography or spectrophotometry is required. Thus the assay is suited for any clinical laboratory. Using this procedure, we studied cultured fibroblasts or lymphocytes isolated from whole blood from five patients in whom the urinary organic acid profile was suggestive of deficiency of I. Three patients had less than or equal to 18% of control I activity in fibroblast or lymphocyte extracts. The other two had activity within the normal range. In one of the latter cases, urinary excretion of three of the characteristic acids disappeared with age, and 3-hydroxyisovaleric acid excretion was within normal limits. The other case presented with urinary excretion of moderate amounts of all four metabolites and the characteristic absence of urinary ketone bodies. Evidently, confirmatory enzyme studies should be undertaken, even when the profile of urinary organic acids appears definitive for this deficiency.

3-Hydroxy-3-methylglutaryl-CoA lyase deficiency as detected by radiochemical assay in cell extracts by thin-layer chromatography, and identification of three new cases

In this rapid radiochemical assay for 3-hydroxy-3-methylglutaryl-coenzyme A lyase (I) activity in cell extracts, DL-3[glutaryl-3-14C]hydroxy-3-methylglutaryl-coenzyme A is used as substrate and the radiochemical product, [3-14C]acetoacetic acid, is converted to the more stable [3-14C]-3-hydroxybutyric acid in the presence of added NADH and 3-hydroxybutyrate dehydrogenase. Substrate and product are separated and quantified by thin-layer chromatography on cellulose (solvent system: butanol/water/formic acid, 77:13:10 by vol). All reagents for the assay are commercially available. No detailed column chromatography or spectrophotometry is required. Thus the assay is suited for any clinical laboratory. Using this procedure, we studied cultured fibroblasts or lymphocytes isolated from whole blood from five patients in whom the urinary organic acid profile was suggestive of deficiency of I. Three patients had less than or equal to 18% of control I activity in fibroblast or lymphocyte extracts. The other two had activity within the normal range. In one of the latter cases, urinary excretion of three of the characteristic acids disappeared with age, and 3-hydroxyisovaleric acid excretion was within normal limits. The other case presented with urinary excretion of moderate amounts of all four metabolites and the characteristic absence of urinary ketone bodies. Evidently, confirmatory enzyme studies should be undertaken, even when the profile of urinary organic acids appears definitive for this deficiency.

Preliminary evaluation of two experimental surgical adhesives in the rabbit cornea

We examined the clinical and histopathologic effects of the instillation of two surgical adhesives in the corneal stroma of rabbits. The adhesives examined in this study included a butyl-2-cyanoacrylate (CA) and a combination of a mussel-derived polyphenolic protein (MAP) with an enzyme polymerizer (COX). In this study, either one of the adhesives or balanced saline solution (as a control) was instilled directly into the corneal stroma following the surgical creation of a perilimbal intralamellar pocket. Animals were examined on a regular basis for a 60-day period following instillation and, at predetermined time points, sacrificed for histopathologic evaluation. The group of animals that received intracorneal instillations of CA consistently manifested early and progressive stromal neovascularization of the affected corneas. Histopathologic examination confirmed the progressive neovascularization, as well as a noticeable inflammatory response surrounding the adhesive. In contrast, instillation of the MAP-COX adhesive produced neovascular and inflammatory responses that were later in onset and milder in degree than those observed with CA. In this experimental model, the MAP-COX adhesive appeared to be better tolerated than did the CA.