Construction and validation of an 18F-FDG-PET/CT-based prognostic model to predict progression-free survival in newly diagnosed multiple myeloma patients

OBJECTIVE

To investigate the relationship between 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) related parameters and the prognosis of multiple myeloma and to establish and validate a prediction model regarding the progression-free survival (PFS) of multiple myeloma.

METHODS

A retrospective analysis of 126 newly diagnosed multiple myeloma patients who attended Nanjing Drum Tower Hospital from 2014-2021. All patients underwent PET/CT before treatment and were divided into a training cohort (n = 75) and a validation cohort (n = 51). Multivariate Cox proportional hazard regression analysis incorporated PET/CT-related parameters and clinical indicators. A nomogram was established to individually predict PFS in MM patients. The model was evaluated by calculating the C-index and calibration curve.

RESULTS

Here, 4.2 was used as the cut-off value of SUVmax to divide patients into high and low groups. PFS significantly differed between patients in the high-SUVmax group and low-SUVmax group, and SUVmax was an independent predictor of PFS in newly diagnosed multiple myeloma (NDMM) patients. Univariate and multivariate cox regression analysis suggested that lactate dehydrogenase (LDH), bone marrow plasma cell (BMPC), and SUVmax affected PFS. These factors were incorporated to construct a nomogram model for predicting PFS at 1 and 2 years in NDMM patients. The C-index and calibration curves of the nomogram exhibited good accuracy and consistency, and the DCA curves suggested that the model had good clinical utility.

CONCLUSION

The PET/CT parameter SUVmax is closely related to the prognosis of myeloma patients. The nomogram constructed in this study based on PET/CT-related parameters and clinical indicators individually predicts the PFS rate of NDMM patients and enables further risk stratification of NDMM patients.

Effect of sacral neuromodulation on bowel dysfunction in patients with neurogenic bladder

AIM

The aim of this retrospective study was to evaluate the clinical effect of sacral neuromodulation (SNM) on bowel dysfunction in patients with neurogenic bladder using the neurogenic bowel dysfunction (NBD) score.

METHOD

Between July 2012 and July 2019, 41 patients with both neurogenic bladder and bowel dysfunction underwent permanent SNM implantation. The NBD score was used to evaluate the bowel symptoms before the testing phase and at follow-up. The first follow-up was at the time of discharge after permanent implantation. The second follow-up was conducted by telephone after discharge.

RESULTS

The mean NBD score before the testing phase was 11.0 ± 5.83, whilst it significantly decreased to 5.2 ± 5.32 (n = 41, P < 0.05) at the first follow-up (32 ± 3.9 days). Before the testing phase, there were 9 patients with very minor NBD, 10 with minor NBD, 13 with moderate NBD and 9 with severe NBD. At the first follow-up, there were 26 patients with very minor NBD, 7 with minor NBD, 4 with moderate NBD and 4 with severe NBD (P < 0.05). Twenty-six patients were interviewed in the long-term follow-up (34 ± 30.9 months). The NBD score in these 26 patients was 5.6 ± 5.18, which was not significantly different from the NBD score (5.5 ± 5.33) at the first follow-up (n = 26, P > 0.05).

CONCLUSION

SNM facilitates a significant reduction in NBD score in patients with neurogenic bladder and bowel dysfunction. The improvement in NBD symptoms can also be used as a future indicator to determine the clinical efficacy of permanent SNM implantation in the treatment of neurogenic bladder.

iTRAQ-based quantitative proteomics analysis reveals inhibitory mechanismsof the antimicrobial peptide MDAP-2 against Salmonella gallinarum

MDAP-2 is a new AMP with high inhibitory activity on Salmonella gallinarum, which may be developed as an antimicrobial agent in the agricultural industry and food preservation. To investigate the underlying the action mechanism of MDAP-2 on Salmonella gallinarum, impacts of MDAP-2 on the growth curve and bacterial morphology of Salmonella gallinarum were studied. iTRAQ-based proteomics analysis was also performed on proteins extracted from treated and untreated Salmonella gallinarum cells. The differentially expressed proteins were then analyzed using the KEGG and GO databases. Finally, the function of some differentially expressed proteins was verified. The results showed that 150 proteins (41 up-regulated and 109 down-regulated) were found differentially expressed (fold > 1.8, p⟨0.05). The results indi- cate that MDAP-2 kills Salmonella gallinarum mainly through two mechanisms: (i) direct inhibi- tion of cell wall/ membrane/ envelope biogenesis, energy production/ conversion, carbohydrate transport/ metabolism, and DNA transcription/ translation through regulation of special protein levels; (ii) indirect effects on the same pathway through the accumulation of Reactive oxygen species (O2 ▪-, H2O2 and OH▪-).

Salidroside Reduces Inflammation and Brain Injury After Permanent Middle Cerebral Artery Occlusion in Rats by Regulating PI3K/PKB/Nrf2/NFκB Signaling Rather than Complement C3 Activity

Salidroside, an active constituent of Rhodiola rosea, is neuroprotective after transient middle cerebral artery occlusion (tMCAO). However, its effects in other experimental stroke models are less understood. Here, we investigated the effect of daily intraperitoneal injections of salidroside in rats after permanent MCAO (pMCAO). Cerebral infarct volumes at 1 day after pMCAO were significantly reduced by treatment with 100 mg/kg/day salidroside, but not by 25 or 50 mg/kg/day, and this benefit of salidroside increased significantly over at least 7 days of treatment, when it was also accompanied by decreased neurological deficit scores. These observations led us to investigate the underlying mechanism of action of salidroside. 100 mg/kg salidroside for 1 day increased NeuN, Nrf2, and its downstream mediator HO-1, while it reduced nuclear NFκB p50, IL-6, and TNFα. Brusatol, a Nrf2 inhibitor, blocked the actions of salidroside on Nrf2, NFκB p50, IL-6, and TNFα. Salidroside also increased the ratio of p-PKB/PKB at 1 day after pMCAO even in the presence of brusatol. LY294002, a PI3K inhibitor, prevented all these effects of salidroside, including those on NeuN, p-PKB/PKB, Nrf2, HO-1, and pro-inflammatory mediators. In contrast, salidroside had no significant effect on the level of cerebral complement C3 after pMCAO, or on the activity of C3 as measured by the expression of cerebral Egr1. Our findings therefore suggest that salidroside reduces neuroinflammation and neural damage by regulating the PI3K/PKB/Nrf2/NFκB signaling pathway after pMCAO, and that this neuroprotective effect does not involve modulation of complement C3 activity.

Biological characteristics of a new antibacterial peptide and its antibacterial mechanisms against Gram-negative bacteria

MDAP-2 is a new antibacterial peptide with a unique structure that was isolated from house- flies. However, its biological characteristics and antibacterial mechanisms against bacteria are still poorly understood. To study the biological characteristics, antibacterial activity, hemolytic activi- ty, cytotoxicity to mammalian cells, and the secondary structure of MDAP-2 were detected; the results showed that MDAP-2 displayed high antibacterial activity against all of the tested Gram-negative bacteria. MDAP-2 had lower hemolytic activity to rabbit red blood cells; only 3.4% hemolytic activity was observed at a concentration of 800μg/ml. MDAP-2 also had lower cytotoxicity to mammalian cells; IC50 values for HEK-293 cells, VERO cells, and IPEC-J2 cells were greater than 1000 μg/ml. The circular dichroism (CD) spectra showed that the peptide most- ly has α-helical properties and some β-fold structure in water and in membrane-like conditions. MDAP-2 is therefore a promising antibacterial agent against Gram-negative bacteria. To deter- mine the antibacterial mechanism(s) of action, fluorescent probes, flow cytometry, and transmis- sion electron microscopy (TEM) were used to study the effects of MDAP-2 on membrane perme- ability, polarization ability, and integrity of Gram-negative bacteria. The results indicated that the peptide caused membrane depolarization, increased membrane permeability, and destroyed membrane integrity. In conclusion, MDAP-2 is a broad-spectrum, lower hemolytic activity, and lower cytotoxicity antibacterial peptide, which is mainly effective on Gram-negative bacteria. It exerts its antimicrobial effects by causing bacterial cytoplasm membrane depolarization, increas- ing cell membrane permeability and disturbing the membrane integrity of Gram-negative bacte- ria. MDAP-2 may offer a new strategy to for defense against Gram-negative bacteria.

A retrospective study of neurocombing for the treatment of trigeminal neuralgia without neurovascular compression

BACKGROUND

Microvascular decompression (MVD) is the most effective and non-ablative treatment for trigeminal neuralgia (TN). However, it is not possible when neurovascular compression (NVC) is absent. Neurocombing is a possible treatment option for TN patients without NVC.

AIM

To evaluate and describe the clinical outcome of neurocombing for the treatment of TN when NVC was absent.

METHODS

We retrospectively reviewed the clinical data of the 37 patients of Type 1 TN without NVC who underwent neurocombing in our department between January 2013 and November 2014. The Barrow Neurological Institute (BNI) Pain Intensity scale, the numerical rating scale (NRS) and the quality of life scale (QOL) were evaluated in four stages-presurgical, immediate, at 1 and at 3 years. Pain recurrence was statistically evaluated with Kaplan-Meier analysis.

RESULTS

All the 37 enrolled patients were proved to have no NVC by imaging or exploration in surgery. The mean follow-up duration was 29.50 months. After the procedure, 35 patients (94.6%) experienced immediate pain relief (BNI I) and 2 patients (5.4%) had occasional pain without any medication (BNI II). At 1 year and 3 years, the rates of successful pain relief (BNI I&II) were 86.5 and 83.3%, respectively. 34 patients (91.9%) suffered from mild facial numbness, while it did not exert a harmful impact on their quality of life.

CONCLUSIONS

This study demonstrated that neurocombing is an attractive, effective, safe and durable treatment option for TN when NVC is absent. Further study is needed to explain the complicated and exact mechanism of pain relief by neurocombing.

Effects of green tea or green tea extract on insulin sensitivity and glycaemic control in populations at risk of type 2 diabetes mellitus: a systematic review and meta-analysis of randomised controlled trials

BACKGROUND

Although the regular consumption of green tea or green tea extract has been considered to improve insulin sensitivity, the reported results are inconsistent. Therefore, we conducted a meta-analysis to evaluate the effect of green tea or green tea extract on insulin sensitivity and glycaemic control in populations at risk of type 2 diabetes mellitus (T2DM).

METHODS

Electronic databases, including PUBMED, The Cochrane Library, EMBASE, ISI Web of Knowledge, Chinese Biomedical Literature Database and Chinese Scientific Journals Fulltext Database, were systematically searched to identify randomised controlled trials (RCTs) up to December 2011, supplemented by the Clinicaltrials.gov websites and the reference lists of identified studies. Two reviewers independently selected trials, extracted data, and evaluated the methodological qualities and evidence levels.

RESULTS

Seven RCTs involving 510 participants were identified. There was no statistically significant difference between green tea or green tea extract group and placebo group with regard to fasting plasma glucose [standardised mean difference (SMD) 0.04; 95% confidence interval (CI) -0.15 to 0.24], fasting serum insulin (SMD -0.09; 95% CI -0.30 to 0.11), 2-h plasma glucose in the oral glucose tolerance test (OGTT-2 h) (SMD -0.14; 95% CI -0.63 to 0.34), haemoglobin A₁c (SMD 0.10; 95% CI -0.13 to 0.33) and homeostasis model of insulin resistance (HOMA(IR)) index (SMD -0.06; 95% CI -0.35 to 0.23) in participants at risk of T2DM.

CONCLUSIONS

The consumption of green tea did not decrease the levels of fasting plasma glucose, fasting serum insulin, OGTT-2 h glucose, haemoglobin A₁c and HOMA(IR) in populations at risk of T2DM. Larger, longer-term and high-quality RCTs are needed to further definitely determine the effect of green tea or green tea extract on insulin sensitivity and glycaemic control in populations at risk of T2DM.

Laparoscopic versus open surgery for rectal cancer: a clinical comparative study

OBJECTIVE

To compare short-term surgical outcomes and long-term survival following laparoscopic or open resection for rectal cancer.

METHODS

A total of 381 patients undergoing laparoscopic surgery and 276 undergoing open surgery for curative resection of rectal cancer were included. Long-term survival and peri- and postoperative data were retrospectively reviewed from a prospectively-collected database.

RESULTS

Surgical groups were comparable regarding age, gender, tumour stage and preoperative comorbidities. Laparascopic surgery was associated with significantly longer duration of surgery, less intraoperative blood loss and fewer postoperative infections than open surgery. Patients who underwent laparoscopic resection had significantly earlier recovery of gastrointestinal function than those who underwent open surgery. There were no significant between-group differences in number of lymph nodes excised, specimen length or distal margin. The 3- and 5-year survival rates and overall survival were similar in the two groups, and survival was not influenced by tumour location.

CONCLUSION

Laparoscopic surgery can achieve the same oncological results as open resection in patients with rectal cancer, supporting its continued use in the management of this disease.

Immunodiagnostic value of combined detection of autoantibodies to tumor-associated antigens as biomarkers in pancreatic cancer

Previous studies demonstrated that cancer sera contain antibodies, which react with a unique group of autologous cellular antigens called tumour-associated antigens (TAAs). This study determines whether a panel of TAAs would enhance antibody detection and be a useful approach in pancreatic cancer (PC) detection and diagnosis. The panel of TAAs was composed of six TAAs including p53, p16, p62, survivin, Koc and IMP1 full-length recombinant proteins. Enzyme-linked immunosorbent assay (ELISA) was used to detect antibodies against these six TAAs in 23 sera from patients with PC and also 23 sera from normal individuals. Antibody frequency to any individual TAA in PC was variable and ranged from 14.7% to 30.4%. With the successive addition of TAAs to a final total of six antigens, there was a stepwise increase in positive antibody reactions reaching a sensitivity of 60.9% and a specificity of 87.0% in PC. Positive and negative likelihood ratio were 4.685 and 0.449, respectively. Positive and negative predictive values were, respectively, 82.4% and 69.0%. Agreement rate and Kappa value were 73.9% and 0.478, respectively. The data from this study support our previous hypothesis that using a panel of appropriately selected TAAs can enhance autoantibody detection in immunodiagnosis of PC. In 15 PC sera with carbohydrate antigen 19-9 (CA19-9) negative, 6 (40%) were found to have anti-TAA (anti-tumour associated antigens) antibodies. When CA19-9 and anti-TAAs were used together as markers in PC detection, the diagnostic sensitivity could be raised from 60.9% to 69.6%. Anti-TAA and CA19-9 were independent markers, and the simultaneous use of these two markers could raise the sensitivity of PC detection.

Con A-binding protein Zn-α2-glycoprotein on human sperm membrane is related to acrosome reaction and sperm fertility

Fertilization, the recognition and fusion between spermatozoa and oocyte, involves various molecules on the spermatozoa and oocyte membranes. Concanavalin A (ConA)-binding proteins may be one of the molecules involved in mammal spermatozoa fertilization; however, their structure and function remain largely unknown. Here, we initially identified a ConA-binding protein, Zn-α2-glycoprotein (ZAG), involved in regulating the acrosome reaction (AR) of human spermatozoa. ZAG is localized on the pre-equatorial region covering the acrosome, neck and tail (some parts of middle piece and principal piece respectively) regions of the acrosome intact human spermatozoa, and disappears in the acrosomal region of the acrosome-reacted spermatozoa. Polyclonal antibodies against human recombinant ZAG significantly reduced the AR and sperm capability binding to human zona pellucida or penetration into zona-free hamster oocytes. Furthermore, assessment of the signaling pathways regulated by ZAG revealed that ZAG affects sperm AR through both the cAMP/PKA and PKC pathways. These results indicate that ZAG, which is present on the human sperm membrane, plays a critical role in the AR and subsequently, may be involved in sperm fertility.

Association between Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and Components of Metabolic Syndrome in Young Chinese Men

BACKGROUND

To investigate the prevalence of metabolic syndrome (MetS) in young Chinese population and assess the association between HOMA-IR and different components of MetS in young Chinese men.

METHODS

Overall 5576 young Chinese subjects (age range [19-44 yr], 3636 men) were enrolled in, who visited our Health Care Center for a related health checkup from March to December 2008. The international diabetes federation (IDF) definition for MetS was used. The SPSS statistical package, version 11.5 was used for the statistical analysis.

RESULTS

The prevalence of MetS was 21.81% in young men and 5.62% in young women. According to suffering from different numbers of MetS components, the male subjects were divided into four groups. Numbers of MetS components were more and HOMA-IR values were significantly higher. In this male population, the quartile of HOMA-IR was higher, values of triglyceride (TG), fasting plasma glucose (FBG), systolic blood pressure(SBP), diastolic blood pressure(DBP) and waist circumference (WC) were all significantly higher, as well as high density lipoprotein cholesterol (HDL-C) value was significantly lower (P= 0.000). In Spearman's correlation analysis, HOMA-IR was positively correlated with TG, FBG, SBP, DBP and WC, and negatively correlated with HDL-C (r= 0.460, 0.464, 0.362, 0.346, 0.586, -0.357, respectively, all P value= 0.000).

CONCLUSION

The prevalence of MetS in these young Chinese men was obviously high. Insulin resistance played an important role in occurrence and development of MetS. Waist circumference was the best correlation with HOMA-IR among all components of MetS.

Abstract P5-13-06: Survival Benefit of Bisphophonates in Early Breast Cancer: A Meta-Analysis

Objectives: Bone is one of the most common metastatic sites of breast cancer. Recent date from randomized clinical studies suggested that the use of bisphophonates affect bone metastasis and survival in early breast cancer patients. Results from some of these trials are encouraging but somewhat contradictory. We conducted a meta analyses to assess the effect of bisphosphonates on bone metastasis and survival in primary breast cancer patients.

Methods: Trials were retrieved by searching the PubMed database, Cochrane Library and major cancer scientific conferences up to January 2010. All tirals randomized patients to receive any bisphosphonate versus non-use or placebo. Hazard ratios (HR) and its 95% CIs for bone metastasis free survival and overall survival were estimated.

Results: 8 eligible trials including 6132 patients entered the analysis. 3049 patients were treated with bisphosphonates and 3083 received either placebo or no treatment. Compared with no use, bisphophonates in the adjuvant setting improved the overall survival (HR=0.808; 95%CI 0.708-0.923; P = 0.022). However, the reduction of bone metastasis was failure to be seen (HR = 1.011; 95% CI 0.996-1.027; P = 0.667). Conclusion: Our meta-analysis provides additional evidence that adjuvant breast cancer treastment with bisphosphonates brought a survival benefit. However, the result should be carefully interpreted for that the statistical significance was not consistent in the bone benefit. Results of new clinical trials were awaited.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-13-06.

[Relationship between maternal nutritional stetus and intrauterine growth retardation with neonatal visual development disorder]

OBJECTIVE

To investigate the relationship between the maternal nutritional stetus and the occurrence of intrauterine growth retardation (IUGR) with neonatal visual development disorder.

METHODS

Sixty pregnant women closed to expected date of confinement were randomly divided into 2 groups: IUGR and normal control group, each were with 30 cases. Eight kinds of nutritional foods taken by the pregnant women were investigated and scored. The vitamin A concentrations of maternal and umbilical blood were measured with fluorometer method. The concentrations of iron, copper and zinc in maternal and umbilical blood were detected by spectrophotometer. The results of examination with Flash-visual evoked potentials (F-VEP) were recorded by an experienced technician in neonates at 3-7 days after birth and 10 months after follow-up.

RESULTS

Compared with the normal control, the IUGR group had taken less eggs, animal liver and fat pork during pregnancy (P < 0.05), had remarkable lower concentrations of vitamin A and iron in maternal and umbilical blood (P < 0.01), and had a lower umbilical blood zinc concentration (P < 0.05). Meanwhile, neonates with IUGR had obvious delay of the latent period of F-VEP's main positive component (P100) (P < 0.05) and an attenuation of the P100 with when it was measured at 3-7 days after birth and at 10th month after fellow-up (P < 0.01).

CONCLUSION

The decreased intake of foods rich in vitamin A, iron, zinc and other nutritional components was closely correlated with IUGR occurrence and resulted in retardation of neonate visal development.

Trapping of 1,8-biradical intermediates by molecular oxygen in photocycloaddition of naphthyl-N-(naphthylcarbonyl)carboxamides; formation of novel 1,8-epidioxides and evidence of stepwise aromatic cycloaddition

The photocycloaddition reaction of naphthyl-N-(naphthylcarbonyl)carboxamides (1) was examined under argon and oxygen atmospheres. In addition to the [2 + 2] and [4 + 4] cycloadducts, 3 and 4, respectively, novel 1,8-epidioxides (5) were formed under oxygen atmosphere. The transient absorption at lambda max of 360 nm with the lifetime of 360 ns was observed by laser flash photolysis of 1c and was interpreted as the absorption of biradical intermediate 2. On the basis of the anti stereochemistry of 5, which was different from that of the major [4 + 4] cycloadducts, syn-4, it was deduced that equilibrium between biradical intermediates syn-2 and anti-2 would exist. Retro [2 + 2] cycloaddition of 3 was responsible for the efficient trapping of the biradical intermediate with molecular oxygen. The photocycloaddition of the anthryl derivatives, 9-anthryl-N-(methylethyl)-N-(naphthylcarbonyl)carboxamides (7), afforded the [4 + 4] cycloadducts (8) exclusively in a quantitative yield even under oxygen atmosphere. The absence of trapping with molecular oxygen was interpreted to be due to the lack of retro [4 + 4] cycloaddition of 8.

Amperometric ultramicrosensors for peroxynitrite detection and its application toward single myocardial cells

The research studied the concentration variation of peroxynitrite anion (O=N-O-O-) released from cultured neonatal myocardial cells induced by ischemia/reperfusion and studied the protective effect of melatonin on the injury. For this purpose, amperometry peroxynitrite ultramicrosensors (UMS) were fabricated and constructed by electropolymerizing inorganic macromolecular film of tetraaminophthalocyanine manganese(II) and coating chemically with poly(4-vinylpyridine). Under optimum conditions, the UMS showed high selectivity and sensitivity to peroxynitrite determination with a calculated detection limit of 1.8 x 10(-8) mol/L (S/N of 3). The detection of peroxynitrite was based on electrocatalytic reduction of peroxynitrite. The mechanism of catalysis was also discussed. The UMS should be promising for in vivo measurement of peroxynitrite without interference or fouling. Peroxynitrite released from myocardial cells both in the ischemic period and in the reperfusion period was measured directly. This approach may lead to important information for myocardial cells on the mechanism of injury and prospective treatments of medicine such as melatonin.

[The study of induced circular dichroism of phenylalanine bridged metal bis-porphyrin]

L- and D-phenylalanine bridged zinc bis-porphyrin with the connecting chain at ortho and para position of two phenyl rings [o,o-C2-Phe-C2-(TPP)2Zn2 and p,p-C2-Phe-C2-(TPP)2Zn2] have been synthesized and characterized. o,o-C2-Phe-C2-(TPP)2Zn2 exhibited strong induced circular dichroism (ICD). While p,p-C2-Phe-C2-(TPP)2Zn2 exhibited no significant ICD. The ICD of present complexes were mainly determined by the pi-pi interaction and chiral excition coupling between two porphyrin moieties of the molecules. Our results also indicated that the existence of chiral center in a porphyrin molecule does not mean it would surely exhibit ICD.

Measurement of nitric oxide released in the rat heart with an amperometric microsensor

Nitric oxide (NO) plays an important role in various physiological processes, acting either as an intra- and intercellular messenger or as a toxic agent. The detection and quantification of NO have been accomplished by a variety of methodologies. In the present study, real-time production of NO in the rat heart was continuously measured by using a novel copper-platinum microparticle-modified NO electrochemical microsensor. The linearity range of the microsensor is between 8.0 x 10(-8) and 4.8 x 10(-6) mol L-1 and the detection limit is 3.0 x 10(-8) mol L-1. NO release from the rat heart stimulated by the agonists L-arginine and acetylcholine was observed, and the responses were decreased by the NO synthase inhibitor L-N omega-nitroarginine. In addition, the effect of sodium nitroprusside (SNP), a NO donor, was also studied. SNP increases the concentration of NO in the rat heart. The experiments showed that electrochemical detection is suitable for detecting and quantifying NO in biological systems.

[Ca(2+)](i) oscillations regulate type II cell exocytosis in the pulmonary alveolus

Pulmonary surfactant, a critical determinant of alveolar stability, is secreted by alveolar type II cells by exocytosis of lamellar bodies (LBs). To determine exocytosis mechanisms in situ, we imaged single alveolar cells from the isolated blood-perfused rat lung. We quantified cytosolic Ca(2+) concentration ([Ca(2+)](i)) by the fura 2 method and LB exocytosis as the loss of cell fluorescence of LysoTracker Green. We identified alveolar cell type by immunofluorescence in situ. A 15-s lung expansion induced synchronous [Ca(2+)](i) oscillations in all alveolar cells and LB exocytosis in type II cells. The exocytosis rate correlated with the frequency of [Ca(2+)](i) oscillations. Fluorescence of the lipidophilic dye FM1-43 indicated multiple exocytosis sites per cell. Intracellular Ca(2+) chelation and gap junctional inhibition each blocked [Ca(2+)](i) oscillations and exocytosis in type II cells. We demonstrated the feasibility of real-time quantifications in alveolar cells in situ. We conclude that in lung expansion, type II cell exocytosis is modulated by the frequency of intercellularly communicated [Ca(2+)](i) oscillations that are likely to be initiated in type I cells. Thus during lung inflation, type I cells may act as alveolar mechanotransducers that regulate type II cell secretion.

alpha(v)beta(3) integrin induces tyrosine phosphorylation-dependent Ca(2+) influx in pulmonary endothelial cells

The endothelial alpha(v)beta(3) integrin occurs luminally, where its ligation by soluble agents may induce inflammatory signaling. We tested this hypothesis in bovine pulmonary artery endothelial cell monolayers with the use of vitronectin and cross-linking antibodies to ligate and aggregate the integrin. We quantified the endothelial cytosolic Ca(2+) concentration ([Ca(2+)](i)) according to the Fura 2 ratio imaging method in single cells of confluent monolayers. At baseline, endothelial [Ca(2+)](i) levels remained steady at 86 nmol/L for >20 minutes. Cross-linking of the alpha(v)beta(3) integrin through the sequential exposure of monolayers to anti-alpha(v)beta(3) monoclonal antibody LM609 and secondary IgG resulted in a [Ca(2+)](i) increase of 100% above baseline. This increase commenced in <0.5 minute, peaked in <2 minutes, and decayed to baseline in approximately 5 minutes. Similar responses occurred after the addition of vitronectin (400 microg/mL). In contrast, external Ca(2+) depletion blunted the cross-linking-induced [Ca(2+)](i) increase by 60%, a response that was completely inhibited when the monolayers were also pretreated with thapsigargin. Thus, the [Ca(2+)](i) increase was attributable in part to the release of Ca(2+) from endosomal stores but mostly to Ca(2+) influx across the plasma membrane. Induced aggregation of the alpha(v)beta(3) integrin enhanced tyrosine phosphorylation of phospholipase C-gamma1 and increased the accumulation of inositol-1, 4,5-trisphosphate. Genistein, a broad-spectrum tyrosine kinase inhibitor, abrogated both of these effects, as well as the alpha(v)beta(3)-induced [Ca(2+)](i) increases. We conclude that aggregation of the endothelial alpha(v)beta(3) integrin induces a rapid tyrosine phosphorylation-dependent increase in [Ca(2+)](i). This response may subserve the inflammatory role of alpha(v)beta(3) integrin in blood vessels.

A single high dose of vitamin C counteracts the acute negative effect on microcirculation induced by smoking a cigarette

Cigarette smoking is associated with marked acute changes in microcirculation including reduced blood flow. We tested the hypothesis that the reduced blood flow velocity is due to the imbalance between prooxidants and antioxidants that occurs as a consequence of smoking and that it can be reduced by an antioxidant. The effect of smoking a single cigarette on nail-fold microcirculation was analyzed in 24 healthy subjects with varying smoking habits. Vital capillary microscopy was used and the blood cell flow velocity in the capillaries was evaluated before and 1-30 min after smoking. Smoking induced a marked decrease in microcirculatory blood flow in 23 of the 24 subjects (40-50% decrease 1-5 min after smoking). This change was reduced by more than 50% in the same subjects after intake of 2 g of vitamin C 2 h before smoking (P < 0.0001 by ANOVA test) with smokers responding similarly to nonsmokers in these experiments. Intake of 1 g of vitamin C had no significant effect on the smoking-induced changes in most of the subjects tested (n = 11). Pretreatment with aspirin had little or no effect on the response to smoking (n = 9). Our results show that treatment with a single high dose of vitamin C can reduce and in some individuals even completely abolish the negative acute effect on microcirculation induced by smoking a single cigarette. This effect of vitamin C is not likely to be mediated by the cyclooxygenase system.

Pressure is proinflammatory in lung venular capillaries

Endothelial responses may contribute importantly to the pathology of high vascular pressure. In lung venular capillaries, we determined endothelial [Ca(2+)](i) by the fura-2 ratioing method and fusion pore formation by quantifying the fluorescence of FM1-43. Pressure elevation increased endothelial [Ca(2+)](i). Concomitantly evoked exocytotic events were evident in a novel spatial-temporal pattern of fusion pore formation. Fusion pores formed predominantly at vascular branch points and colocalized with the expression of P-selectin. Blockade of mechanogated Ca(2+) channels inhibited these responses, identifying entry of external Ca(2+) as the critical triggering mechanism. These endothelial responses point to a proinflammatory effect of high vascular pressure that may be relevant in the pathogenesis of pressure-induced lung disease.

[The relation between placental pathologic changes and serum nitric oxide levels of maternal and umbilical blood in intrauterine growth retardation]

OBJECTIVE

To study the relation between placental pathologic changes and levels of maternal and umbilical serum nitric oxide (NO) in intrauterine growth retardation (IUGR).

METHODS

38 patients with IUGR (IUGR group) and 30 healthy pregnant women in their late trimester (control group) were studied from Nov. 1997 to Oct. 1998. The placenta and the appendages of fetus were studied after delivery. The concentration of serum NO were determined with cortas' method.

RESULTS

Placental pathological changes were found in 26 cases of IUGR group (68.42%), and the main pathological changes were growth retardation of villi and villositis. In the control group, 5 out of 30 cases had placental pathological findings (16.67%). There was statistically significant difference between the 2 groups (P < 0.01). In IUGR group, the maternal and umbilical NO concentration in the 26 cases with placental pathological changes decreased significantly when compared with that in 12 cases without obvious pathological findings of placenta (P < 0.05, P < 0.05); NO levels of umbilical cord were higher than that of maternal serum in both groups(P < 0.01, P < 0.05); There was correlation about serum NO concentration between mother and her fetus in both groups (r = 0.5475, r = 0.8506); but umbilical serum NO level was not related to the weight of the newborn (r = 0.2838).

CONCLUSION

The obvious placental pathologic changes occurred in patient with IUGR caused noticeably lower NO levels in maternal and umbilical serum.

Vitamin C reduces cholesterol-induced microcirculatory changes in rabbits

The microcirculation was studied for 10 weeks in untreated rabbits (n = 12) and in rabbits treated with vitamin C in their drinking water (0.5 g/d; n = 6), a 1% cholesterol diet (n = 12), or a combination of the two treatments (n = 11). The studies were performed by direct intravital microscopic imaging of the conjunctiva of both eyes to evaluate blood flow velocity, microvessel diameter, and microhemorheologic conditions. As we reported previously, changes occurred in all of the aforementioned variables as a consequence of cholesterol feeding. After 3 and 6 weeks of feeding, there was a marked and significant (P < .0001) decrease in blood flow velocity in third-order arterioles, which was accompanied by stasis and erythrocyte aggregation in the smaller conjunctival vessels. When cholesterol treatment was combined with vitamin C, blood flow was almost identical to that of controls and significantly (P < .0001) higher than that of rabbits treated with cholesterol alone. All other changes were also significantly reduced by the addition of vitamin C treatment to the cholesterol diet. Cholesterol-treated rabbits developed macroscopic arterial lesions that were not significantly reduced by vitamin C treatment. Neither circulating oxysterol levels nor atheromas were reduced by vitamin C treatment, which also had no significant effect on lipid or circulating vitamin E levels. We have previously shown that the lipid-soluble antioxidant BHT is able to prevent both cholesterol-induced microcirculatory changes and the development of arterial lesions in rabbits. This phenomenon is compatible with a critical oxidation step occurring in the lipid phase that is common to both processes. The finding that microcirculatory changes can be prevented by a water-soluble antioxidant is compatible with a role for water-soluble oxidants in this context. The possibility is discussed that vitamin C might also be important for the microcirculation in humans.

Ca2+ waves in lung capillary endothelium

Although cytosolic Ca2+ importantly regulates organ function, lung microvascular [Ca2+]i regulation remains poorly understood because of the lack of direct in situ quantification. In the present study, we report the first endothelial [Ca2+]i quantification by the fura 2 method in microscopically imaged venular capillaries of the isolated blood-perfused rat lung. Sequential images indicated the presence of intercellular Ca2+ waves that spontaneously originated from pacemaker endothelial cells and then spread for short distances along the capillary wall, inducing synchronous endothelial [Ca2+]i oscillations. Fast Fourier analyses of the oscillations revealed a dominant wave component with an amplitude of 37 nmol/L, frequency of 0.4 min-1, and velocity of 5 microns/s. The intracellular Ca2+ wave was unaffected by blood flow stoppage or by infusions of Ca(2+)-containing or Ca(2+)-free dextran. Inhibition of the wave by thapsigargin in Ca(2+)-free dextran and by the gap junction uncoupler, heptanol, indicated that it was generated by endosomal Ca2+ release in the pacemaker cell and was propagated by gap junctional communication. In the presence of histamine, enhancement of the wave accounted for a significant component of the coordinated [Ca2+]i increase in the capillary segment. No intercellular Ca2+ waves were evident in adjoining alveolar epithelial cells. Our findings indicate a novel mechanism of [Ca2+]i regulation in the lung capillary under both resting and stimulated conditions. Pacemaker-induced Ca2+ waves, generated intracellularly by unknown initiating mechanisms, communicated to adjoining cells to determine [Ca2+]i profiles in short interbranch segments of capillary walls.

Ligation of endothelial alpha v beta 3 integrin increases capillary hydraulic conductivity of rat lung

Complement-mediated pulmonary edema results from increases in lung capillary hydraulic conductivity (Lp), possibly by receptor-mediated mechanisms. We considered the Lp effects of vitronectin and the vitronectin-containing complement complex SC5b-9, which ligate the integrin alpha v beta 3. Vitronectin, SC5b-9, and SC5b-9-enriched zymosan-activated serum all rapidly increased Lp, as determined by the split-drop technique in single lung capillaries of rat lung. The Lp increases were inhibited by a monospecific (LM609) and a polyclonal (R838) antibody against the alpha v beta 3 integrin but not by an irrelevant monoclonal antibody isotype matched with LM609, by a monoclonal antibody against the alpha v beta 5 integrin, or by preimmune rabbit serum. Vitronectin monomers failed to increase Lp. The tyrosine kinase blockers genistein and methyl 2,5-dihydroxycinnamate caused significant concentration-dependent inhibitions of Lp increases due to vitronectin and zymosan-activated serum. By contrast, the protein kinase C blocker calphostin C had no major effect. We conclude that (1) multivalent ligation of the luminally located alpha v beta 3 integrin of lung capillary endothelium increases transcapillary liquid flux, and (2) the dominant signal transduction pathway for this effect occurs through tyrosine kinase activation.

Improvement of fusing ability of human sperm to zona-free hamster eggs by conditioned media

A conditioned medium (CM) was prepared by culturing human sperm at 3.0 x 10(6) sperm/ml for 12 h. The fusion index increased significantly when the sperm penetration assay (SPA) was performed with CM (0.6 without CM to 2.0 with CM). The conditioned medium was also effective on the sperm from 11 patients who showed a low or zero value in SPA and who's in vitro fertilization treatment failed. When CM from the sperm of healthy donors was added to these patients' sperm, the fusing ability to zona free hamster eggs was significantly restored.

Removal of albumin microinjected in rat lung perimicrovascular space

We used a microinjection approach to assess hydraulic properties of lung perimicrovascular adventitia (interstitial cuff surrounding microvessels). Isolated blood-perfused rat lungs held at constant airway pressure were microscopically viewed to identify subpleural venules (20 microns diam). Venular adventitia were microinjected with 20 nl of fluorescent albumin (4 g/dl), and then adventitial fluorescence was quantified at the injection site by either photometery or imaging. Nonlinear decay of adventitial fluorescence indicated liquid flux from the injection site into normal interstitium. In some experiments, we determined that the adventitial fluorescence flowed longitudinally along the venule length and filled single lymphatics. The fluorescence decay at the injection site was best described by equations of convective but not diffusive transport. The decay time constant (time to 37% initial), which relates inversely to hydraulic conductivity, increased 10-fold above baseline on lung expansion with airway pressure from 5 to 15 cmH2O (P < 0.05). However, presence or absence of blood flow, increase in filtration pressure, and tissue edema were all without effect on the time constant. Our estimate of the lower limit of baseline adventitial hydraulic conductivity was 5 x 10(-6) ml.cm-2.s-1.cmH2O-1. We conclude that hydraulic conductivity of perimicrovascular adventitia is not augmented by edema but that it is decreased by lung expansion.

Diameters of juxtacapillary venules determined by oil-drop method in rat lung

We report a new method for precise quantification of lung microvascular diameter. Isolated blood-perfused rat lungs (500-g Sprague-Dawley rats) at constant inflation pressure [alveolar pressure (PA)] and stopped blood flow were viewed by microscopy and video. Subpleural venules of the second and third postcapillary generations were microinjected with oil colored with Sudan Black. Vascular pressure (Pvas) was varied in steps, and at each step the horizontal diameter (DH) and the length of the oil-filled segment were determined by microcaliper measurements of the replayed video image. At PA = 5 cmH2O, a decrease in Pvas from 25 to 0 cmH2O decreased DH in the second-generation venules from 55 +/- 2 (SE) to 41 +/- 1 microns (n = 13) and in the third-generation venules from 96 +/- 6 to 73 +/- 6 microns (n = 6). The constant-volume oil-filled segment conformed to the cylinder formula in that decreases in DH correlated linearly with 1/ square root of length, thereby indicating that at all Pvas values venular geometry was constant and probably circular in cross section. The decrease in Pvas to -5 cmH2O did not further decrease DH. At Pvas = 10-25 cmH2O, an increase in PA to 15 cmH2O did not significantly increase DH, although the increase in PA did diminish the slope (compliance) of the DH-Pvas relationship in second- but not third-generation venules. We conclude that 1) lung expansion decreases compliance of juxtacapillary venules, 2) venules retain circular cross sections at Pvas between -5 and 25 cmH2O, and 3) venules are patent at subzero Pvas.

The antioxidant butylated hydroxytoluene prevents early cholesterol-induced microcirculatory changes in rabbits

Microcirculation was studied during 10 wk in untreated rabbits (n = 13) and in rabbits treated with dietary addition of 1% cholesterol (n = 13), 1% cholesterol + 1% of the antioxidant BHT (butylated hydroxytoluene) (n = 11), or 1% BHT (n = 5). The studies were performed by direct intravital microscopic imaging of the left and right conjunctivae with the use of a stereo microscope and a high resolution television camera. Microvessel diameter, erythrocyte flow velocity, and microhemorheologic conditions were evaluated quantitatively via a computer-assisted digital image processing system. Significant and marked changes occurred in all the above variables as a consequence of cholesterol feeding. After 3 wk of feeding there was a dramatic decrease (approximately 30%) in blood flow velocity in arterioli of the third order (P < 0.0001), accompanied by aggregation of cells in 40-50% of the smaller conjunctival vessels (P < 0.0001). These changes were enhanced further during the following 7 wk of treatment. All the above changes in the microcirculation were markedly reduced by the addition of BHT treatment. The diameter of the above arterioli decreased in the purely cholesterol-fed group (P < 0.005), whereas this did not occur in the group fed both cholesterol and BHT. In rabbits fed BHT in the absence of cholesterol, there was no significant effect on any assessed microcirculatory variable. In conclusion, the results demonstrate that the antioxidant BHT prevented early cholesterol-induced microcirculatory changes. This prevention occurred in the absence of a reduction of blood lipid levels. The results provide strong support for the hypothesis that a considerable part of the effects on microcirculation in hypercholesterolemia may be due to cholesterol-induced oxidations and not to cholesterol itself. The results are discussed in relation to the previously demonstrated antiatherogenic effect of BHT and the possible use of antioxidants in the therapy and prophylaxis of atherosclerosis.