GTP Cyclohydrolase Drives Breast Cancer Development and Promotes EMT in an Enzyme-Independent Manner

GTP cyclohydrolase (GCH1) is the rate-limiting enzyme for tetrahydrobiopterin (BH4) biosynthesis. The catalysis of BH4 biosynthesis is tightly regulated for physiological neurotransmission, inflammation, and vascular tone. Paradoxically, BH4 has emerged as an oncometabolite regulating tumor growth, but the effects on tumor development remain controversial. Here, we found that GCH1 potentiated the growth of triple-negative breast cancer (TNBC) and HER2+ breast cancer and transformed nontumor breast epithelial cells. Independent of BH4 production, GCH1 protein induced epithelial-to-mesenchymal transition by binding to vimentin (Vim), which was mediated by HSP90. Conversely, GCH1 ablation impaired tumor growth, suppressed Vim in TNBC, and inhibited EGFR/ERK signaling while activating the p53 pathway in estrogen receptor-positive tumor cells. GCH1 deficiency increases tumor cell sensitivity to HSP90 inhibition and endocrine treatments. In addition, high GCH1 correlated with poor breast cancer survival. Together, this study reveals an enzyme-independent oncogenic role of GCH1, presenting it as a potential target for therapeutic development.

SIGNIFICANCE

GTP cyclohydrolase functions as an oncogene in breast cancer and binds vimentin to induce epithelial-to-mesenchymal transition independently of its enzyme activity, which confers targetable vulnerabilities for developing breast cancer treatment strategies.

Commonalities and differences in the mutational signature and somatic driver mutation landscape across solid and hollow viscus organs

Advances in sequencing have revealed a highly variegated landscape of mutational signatures and somatic driver mutations in a range of normal tissues. Normal tissues accumulate mutations at varying rates ranging from 11 per cell per year in the liver, to 1879 per cell per year in the bladder. In addition, some normal tissues are also comprised of a large proportion of cells which possess driver mutations while appearing phenotypically normal, as in the oesophagus where a majority of cells harbour driver mutations. Individual tissue proliferation and mutation rate, unique mutagenic stimuli, and local tissue architecture contribute to this highly variegated landscape which confounds the functional characterization of driver mutations found in normal tissue. In particular, our understanding of the relationship between normal tissue somatic mutations and tumour initiation or future cancer risk remains poor. Here, we describe the mutational signatures and somatic driver mutations in solid and hollow viscus organs, highlighting unique characteristics in a tissue-specific manner, while simultaneously seeking to describe commonalities which can bring forward a basic unified theory on the role of these driver mutations in tumour initiation. We discuss novel findings which can be used to inform future research in this field.

Utility of Human Relevant Preclinical Animal Models in Navigating NAFLD to MAFLD Paradigm

Fatty liver disease is an emerging contributor to disease burden worldwide. The past decades of work established the heterogeneous nature of non-alcoholic fatty liver disease (NAFLD) etiology and systemic contributions to the pathogenesis of the disease. This called for the proposal of a redefinition in 2020 to that of metabolic dysfunction-associated fatty liver disease (MAFLD) to better reflect the current understanding of the disease. To date, several clinical cohort studies comparing NAFLD and MAFLD hint at the relevancy of the new nomenclature in enriching for patients with more severe hepatic injury and extrahepatic comorbidities. However, the underlying systemic pathogenesis is still not fully understood. Preclinical animal models have been imperative in elucidating key biological mechanisms in various contexts, including intrahepatic disease progression, interorgan crosstalk and systemic dysregulation. Furthermore, they are integral in developing novel therapeutics against MAFLD. However, substantial contextual variabilities exist across different models due to the lack of standardization in several aspects. As such, it is crucial to understand the strengths and weaknesses of existing models to better align them to the human condition. In this review, we consolidate the implications arising from the change in nomenclature and summarize MAFLD pathogenesis. Subsequently, we provide an updated evaluation of existing MAFLD preclinical models in alignment with the new definitions and perspectives to improve their translational relevance.

Novel therapeutic strategies: targeting epithelial-mesenchymal transition in colorectal cancer

Epithelial-mesenchymal transition (EMT) is a process during which cells lose their epithelial characteristics, for instance apical-basal cell polarity and cell-cell contact, and gain mesenchymal properties, such as increased motility. In colorectal cancer, EMT has an important role in tumour progression, metastasis, and drug resistance. There has been accumulating evidence from preclinical and early clinical studies that show that EMT markers might serve as outcome predictors and potential therapeutic targets in colorectal cancer. This Review describes the fundamentals of EMT, including biology, newly partial EMT, and associated changes. We also provide a comprehensive summary of therapeutic compounds capable of targeting EMT markers, including drugs in preclinical and clinical trials and those with repurpose potential. Lastly, we explore the obstacles of EMT bench-to-bedside drug development.

Extracellular K+ Dampens T Cell Functions: Implications for Immune Suppression in the Tumor Microenvironment

Background: Dying tumor cells release intracellular potassium (K⁺), raising extracellular K⁺ ([K⁺]_e) in the tumor microenvironment (TME) to 40-50 mM (high-[K⁺]_e). Here, we investigated the effect of high-[K⁺]_e on T cell functions. Materials and Methods: Functional impacts of high-[K⁺]_e on human T cells were determined by cellular, molecular, and imaging assays. Results: Exposure to high-[K⁺]_e suppressed the proliferation of central memory and effector memory T cells, while T memory stem cells were unaffected. High-[K⁺]_e inhibited T cell cytokine production and dampened antitumor cytotoxicity, by modulating the Akt signaling pathway. High-[K⁺]_e caused significant upregulation of the immune checkpoint protein PD-1 in activated T cells. Although the number of K_Ca3.1 calcium-activated potassium channels expressed in T cells remained unaffected under high-[K⁺]_e, a novel K_Ca3.1 activator, SKA-346, rescued T cells from high-[K⁺]_e-mediated suppression. Conclusion: High-[K⁺]_e represents a so far overlooked secondary checkpoint in cancer. K_Ca3.1 activators could overcome such "ionic-checkpoint"-mediated immunosuppression in the TME, and be administered together with known PD-1 inhibitors and other cancer therapeutics to improve outcomes.

Determinants of maternity length of stay: a Gamma mixture risk-adjusted model

With obstetrical delivery being the most frequent cause for hospital admissions, it is important to determine health- and patient-related characteristics affecting maternity length of stay (LOS). Although the average inpatient LOS has decreased steadily over the years, the issue of the appropriate LOS after delivery is complex and hotly debated, especially since the introduction of the mandatory minimum-stay legislation in the USA. The purpose of this paper is to identity factors associated with maternity LOS and to model variations in LOS. A Gamma mixture risk-adjusted model is proposed in order to analyze heterogeneity of maternity LOS within obstetrical Diagnosis Related Groups (DRGs). The determination of pertinent factors would benefit hospital administrators and clinicians to manage LOS and expenditures efficiently.

Laryngeal mask airway insertion in paediatric anaesthesia: comparison between the reverse and standard techniques

Sixty-seven children between one and 15 years of age were randomized to have Laryngeal Mask Airway (LMA) insertion using either the standard technique (Group A) as described by Brain or the "reverse technique" (involving a 180 degree turn after insertion with the cuff facing the palate) (Group B). A blinded observer using a fibreoptic bronchoscope assessed the final position of the LMA. The LMA had to be placed within 15 seconds for the procedure to be considered "successful". The success rate using the standard technique was 90.3% (28/31) and 100% (36/36) using the reverse technique (P value 0.06). The 95% confidence interval for the difference in success rates between Group B and A (B-A) was -0.73% to 20.1%. It is our opinion that the reverse technique of insertion of the LMA is an acceptable alternative to the standard technique.

A ten-year review of ruptured sinus of valsalva: clinico-pathological and echo-Doppler features

Rupture of the sinus of valsalva (RSOV) is an uncommon condition with a variety of manifestations ranging from an asymptomatic murmur to cardiogenic shock. This retrospective 10-year review (1985-1995) of 18 patients from a single institution revealed that 6 (33%) were female and 12 (67%) were male with a mean age of 37.6 +/- 13.4 years and that 72% were Chinese by ethnic descent with the remaining 28% being Malay. Eight patients (44.4%) presented with an asymptomatic murmur, 4 (22.2%) with acute chest pain, 4 (22.2%) with mild heart failure, 2 (11.1%) with severe heart failure, and 2 (11.1%) with cardiogenic shock. Rupture of the right aneurysmal coronary cusp (RCC) made up 15 (83.3%) while those of the non-coronary cusp (NCC) made up the remaining. Most of the RCC ruptures were directed into the right ventricle and all of the NCC ruptures were into the right atrium. Ventricular septal defects (VSDs) were found in 9 (50%) of the patients, (although detected by echocardiography in only one third of those patients), aortic regurgitation in 6 (33.3%) and aortic valve vegetations in 2 (11.1%). Echocardiography was found to be accurate in diagnosing RSOVs with 100% diagnostic accuracy after 1990 with four misdiagnoses before 1990. Of these four patients, two were misdiagnosed as having VSDs, one as having a coronary arteriovenous fistula and one as having a patent ductus arteriosus. The anatomical structure of the "windsock" was seen in 64% of the patients who were correctly diagnosed. The pattern of colour flow and spectral Doppler was seen in all patients and helped to localise the site of rupture and the direction of flow. In summary, echocardiography is a simple and accurate way of diagnosing and defining RSOVs and is the imaging modality of choice.

Long-term survivor mixture model with random effects: application to a multi-centre clinical trial of carcinoma

A mixture model incorporating long-term survivors has been adopted in the field of biostatistics where some individuals may never experience the failure event under study. The surviving fractions may be considered as cured. In most applications, the survival times are assumed to be independent. However, when the survival data are obtained from a multi-centre clinical trial, it is conceived that the environmental conditions and facilities shared within clinic affects the proportion cured as well as the failure risk for the uncured individuals. It necessitates a long-term survivor mixture model with random effects. In this paper, the long-term survivor mixture model is extended for the analysis of multivariate failure time data using the generalized linear mixed model (GLMM) approach. The proposed model is applied to analyse a numerical data set from a multi-centre clinical trial of carcinoma as an illustration. Some simulation experiments are performed to assess the applicability of the model based on the average biases of the estimates formed.

Argpyrimidine, a blue fluorophore in human lens proteins: high levels in brunescent cataractous lenses

PURPOSE

To determine whether the human lens contains argpyrimidine, a modification of arginine by methylglyoxal, to establish how argpyrimidine content relates to lens aging and cataract formation.

METHODS

A monoclonal antibody was used to measure argpyrimidine by a competitive ELISA in water soluble (WS) and insoluble (WI) lens fractions from young, aged, nuclear cataractous, and brunescent cataractous lenses. Brunescent cataractous lens proteins were digested by enzymes, the digest was subjected to HPLC, and the eluate was analyzed for argpyrimidine. Lens proteins from aged lenses (from donors 65 to 80 years of age) were fractionated on a Sephadex G-200 column, and the crystallins were tested for argpyrimidine.

RESULTS

The competitive ELISA showed two to three times as much argpyrimidine in water-insoluble proteins as in water-soluble proteins. Although no clear cut increase with the age of the lens donors in either the water-soluble or the insoluble protein fractions was found, the argpyrimidine levels in brunescent cataractous lenses were significantly higher (254.0 +/- 155 pmol/mg protein, P < 0.005) than in age-matched, aged (16.1 +/- 8 pmol/mg) or nuclear cataractous lenses (49.0 +/- 26 pmol/mg). Lenses from diabetic individuals showed a modest increase (50.3 pmol/mg) compared with age-matched normal lenses. HPLC results provided additional evidence that human lenses contain argpyrimidine. Western blotting experiments showed consistently stronger reactions with cataractous lens proteins than those from noncataractous lenses, and argpyrimidine was found in both crystallin monomers and polymers. All crystallins and several cross-linked high-molecular-weight aggregates reacted with the antibody to argpyrimidine, but a protein of approximately 28 kDa in the alpha-crystallin fraction displayed the greatest immunoreactivity.

CONCLUSIONS

Methylglyoxal modifies arginine within the human lens, and the changes occur at a much higher rate in brunescent lens proteins than in either nuclear cataractous or normal lenses. All crystallins contained argpyrimidine and covalently cross-linked aggregates. This is the first report of immunologic evidence for an arginine modification in the human lens by a physiologically important alpha-dicarbonyl compound.

Postoperative vomiting (POV) in the paediatric outpatient general surgical population

AIM

To determine the incidence of postoperative vomiting (POV) in the paediatric outpatient general surgical population, the factors affecting POV and the incidence of unplanned admissions contributed by POV.

METHOD

One hundred and ninety-nine children below 13 yeas of age undergoing elective outpatient general surgical procedures were enrolled into this prospective study. Anaesthesia was induced either intravenously or via the inhalational route. It was then maintained with nitrous oxide, oxygen and isoflurane or halothane. The age, sex, body weight, duration of fasting, administration of trimeprazine, type of general surgical procedure, maintenance technique for general anaesthesia, duration of general anaesthesia, the administration of opiods or local anaesthetics and the incidence of POV were noted. The results were analysed initially with chi-squared test and subsequently subjected to multivariate logistic regression analysis and stepwise variable selection method.

RESULTS

The incidence of POV was 8.5%. Duration of general anaesthesia greater than one hour was associated with a significantly higher incidence of POV. Postoperative emesis did not contribute to unplanned admissions in these day surgical patients.

Caudal morphine in paediatric patients: a comparison of two different doses in children after major urogenital surgery

We compared the duration of postoperative analgesia and the occurrence of side-effects of two different doses of caudal morphine in children undergoing major urogenital surgery. Fifty-two children aged between 1 and 12 years were randomly selected to receive caudal morphine, either 25 micrograms.kg-1 (Group A) or 50 micrograms.kg-1 (Group B) with 0.5 ml kg-1 of 0.25% plain bupivacaine immediately before surgery. They were monitored for 24 hours in a high dependency area for known complications of epidural morphine. There was no significant difference in postoperative analgesia between the two doses of caudal morphine. Clinically significant respiratory depression or sedation was not detected in either group. The occurrence of vomiting and pruritus was similar in both groups. Urinary retention was not recorded as all children had an indwelling catheter as required by the surgical procedure. We concluded that 25 micrograms.kg-1 of caudal morphine is as effective as 50 micrograms.kg-1 for providing postoperative analgesia in children undergoing urogenital surgery.

A questionnaire survey on practice of chest tube management

AIM

With the aim towards better education of junior medical staff on chest tube management, we designed a questionnaire to survey their practice and at the same time to assess their level of understanding of the physical principles of chest tube and its drainage system.

METHODS

The questionnaire was distributed to 130 junior medical staff (house officers, medical officers, trainee medical officers and specialist medical officers) from 7 Medical and Surgical Departments in Singapore General Hospital. Eighty-seven (66.9%) candidates responded. The mean age of the respondents was 27 +/- 2.1. They had an average of 3.2 +/- 1.9 years after basic medical qualification and 5 hospital postings. Nine respondents had obtained higher medical qualifications.

RESULTS

About a quarter of the respondents, and 40% of those with higher medical qualifications gave appropriate answers. Ninety percent indicated that they received no lectures on chest tube management. Incomplete response ranged from 0% to 6%.

CONCLUSION

To improve education on chest tube management, our results and the feedback we obtained from the respondents, suggest that lectures on important physical principles of chest tube and its drainage system should be delivered to all junior medical staff.

Oral premedications in paediatric day surgery

The degree of sedation in 191 day-stay children after oral premedication were compared. One hundred and forty-six were 1-5 years old (Group 1) and were randomised to receive either chloral 40 mg/kg, midazolam 0.2 mg/kg, promethazine 1 mg/kg, trimeprazine 3 mg/kg or placebo. Forty-five were 5-12 years old and were randomised to receive either trimeprazine 3 mg/kg, midazolam 0.2 mg/kg or placebo (Group 2). The children were assessed using four categories: asleep or drowsy, awake but calm, crying or anxious and oversedated or obstructed airway. They were assessed on leaving the ward, at separation from the parents, at induction, in the recovery room and one and two hours after returning to the ward. In Group 1, it was found that chloral and trimeprazine gave the best degree of sedation but the sedative effect of trimeprazine lasted longer into the post operative period. In Group 2, it was found that the children did not require deep sedation and the anxiolysis obtained with midazolam was adequate.

Inhibition of thrombin by peptides containing Lysyl-alpha-keto carbonyl derivatives

Several H-N-Me-D-Phe-Pro-Lysyl-alpha-keto carbonyl derivatives were shown to be potent thrombin inhibitors (Ki 0.2 to 27 nM). The inhibitory potencies of these compounds toward tissue plasminogen activator, plasmin and factor Xa were minimal; however, substantial cross-reactivity versus trypsin was observed (Ki values from 0.5 to 1500 nM). Inhibition of thrombin by alpha-keto carbonyl compounds appeared to occur via a one-step reversible reaction. The alpha-keto carbonyl inhibitors bound thrombin with a second order rate constant (k1 1-4 microM-1s-1) that was 10-100-fold slower than that expected for a diffusion-controlled reaction. Certain alpha-keto carbonyl inhibitors were as potent (on a weight basis) as hirudin when evaluated in a rat arterial thrombosis model. The modest oral bioavailability (10-19%) in rats demonstrated for three of the alpha-keto carbonyl thrombin inhibitors suggests the possibility that alpha-keto amide containing thrombin inhibitors may have utility as orally-active antithrombotic agents.

Amide and alpha-keto carbonyl inhibitors of thrombin based on arginine and lysine: synthesis, stability and biological characterization

We report structure-activity investigations in a series of tripeptide amide inhibitors of thrombin, and the development of a series of highly potent active site directed alpha-keto carbonyl inhibitors having the side chain of lysine at P1. Compounds of this class are unstable by virtue of reactivity at the electrophilic carbonyl and racemization at the adjacent carbon (CH). Modifications of prototype alpha-keto-ester 8a have afforded analogs retaining nanomolar Ki. Optimal potency and stability have been realized in alpha-keto-amides 11b (Ki = 2.8 nM) and 11c (Ki = 0.25 nM).

Pharmacokinetics of propofol infusion in Asian patients undergoing coronary artery bypass grafting

The pharmacokinetics of propofol was studied in 11 Asian patients with fentanyl-isoflurane anaesthesia during cardiopulmonary bypass (CPB) and undergoing elective coronary artery bypass grafting (CABG). Instead of the usual increments of morphine and a benzodiazepine, propofol (4 mg/kg/h) was initiated at the start of CPB and ceased at CPB separation. Whole blood propofol concentrations were determined during and postinfusion using high-performance liquid chromatography with fluorescence detection. Data from four patients seemed to fit a two-compartment model, whereas those from seven patients were significantly (F test, p < 0.05) better fitted to a three-compartment model. The pharmacokinetic parameters were as follows: The mean (SD) of the initial distribution phase t1/2 pi, intermediate distribution phase t1/2 alpha, and elimination phase t1/2 beta were 2.22 (1.04) min, 42.9 (16.4) min, and 370 (138) min, respectively. The mean clearance of 1.31 (0.50) L/min was lower than those reported from other studies, whereas the mean blood concentration of 2.2 (1.0) mg/L at the 1-h infusion period was higher. The mean calculated apparent Css was 3.9 (1.5) mg/L. The low clearance is likely to be due to hemodynamic changes during CPB and CABG, thereby affecting drug distribution and blood flow to the liver.

Inhibition of thrombin and other trypsin-like serine proteinases by cyclotheonamide A

Cyclotheonamide A (CA), a cyclic peptide isolated from the marine sponge of the genus Theonella was shown to be a slow-binding inhibitor of several trypsin-like serine proteinases. Values of 4.6 x 10(4), 4.8 x 10(4), 9.3 x 10(3), 2.1 x 10(3) and 2.7 x 10(2) M-1 s-1 were determined for the second-order rate constants for formation of CA complexes with thrombin, trypsin, plasmin, 2-chain t-PA and factor Xa, respectively. The equilibrium constant (Ki) was measured for dissociation of CA from the CA complex with human thrombin (Ki = 1.0 nM), bovine trypsin (Ki = 0.2 nM), human plasmin (Ki = 12 nM), human factor Xa (Ki = 50 nM) and human 2-chain tissue plasminogen activator (t-PA) (Ki = 40 nM). CA produces dose dependent increases in clotting time assays. The clotting time in the thrombin time, activated partial thromboplastin time and prothrombin time assays, were doubled by 1.5, 0.9 and 48 microM CA, respectively. A model for the binding of CA to the active site of thrombin is proposed.

Lipid screening in a volunteer population in Singapore

Coronary risk profile screening was performed in 1065 volunteers during the National Heart Week 1988 as part of the National Heart Association's campaign against the increasing incidence of ischaemic heart disease. Of particular importance was the use of a desktop analyser for lipid screening of total cholesterol and high density lipoprotein (HDL) cholesterol. It was found that the mean serum cholesterol was 211 +/- 39.5 mg/dl, with 62% of the participants having a total cholesterol greater than 200 mg/dl and 23.1% having a total cholesterol greater than 240 mg/dl. For HDL cholesterol, the mean was 48.4 +/- 17 mg/dl, with 18.7% of the participants having a low HDL cholesterol of less than 35 mg/dl. The male Indians had a significantly lower HDL cholesterol compared to male Malays. Three or more risk factors for coronary artery disease was present in 21.7% of Chinese, 41.2% of Malays and 50% of Indians. We conclude therefore that a proportion of this volunteer population, the majority of which have no overt heart disease, is at risk from coronary artery disease from an elevated cholesterol or low HDL cholesterol level. A follow-up of 90 participants who were initially detected to have an elevated cholesterol in 1986, however, showed that only 54.4% still had an elevated cholesterol of greater than 240 mg/dl, thus suggesting that early detection may help to reduce this risk.

Adrenocorticotropin- and beta-endorphin-like substances in brains of the freshwater snake Ptyas mucosa

Snake (Ptyas mucosa) brains (400 g) were extracted with a mixture of acetone, water, and hydrochloric acid. The precipitate (5.6 g) that formed upon addition of five volumes of acetone to the extract, designated acid-acetone powder, was subjected to gel filtration on Sephadex G-25. A large unretarded peak (SB-1) with molecular weight greater than 5000 and a small retarded peak (SB-2) with molecular weight smaller than 5000 were obtained. They were then separately subjected to ion-exchange chromatography on CM-cellulose. Adrenocorticotropic activity was detected in the fractions by their ability to stimulate isolated rat adrenal cells to produce corticosterone. Opiate activity was detected in the fractions by their ability to inhibit the binding of (D-Ala2,D-Leu5)-[tyrosyl-3,5-3H]enkephalin to rat brain membranes and their cross-reactivity in a beta-endorphin radioimmunoassay. Adrenocorticotropic and opiate activities were found to be concentrated in fractions strongly adsorbed on CM-cellulose, which were eluted by combined pH and ammonium acetate concentration gradients. There appeared to be a separation between adrenocorticotropic and opiate activities, suggesting that they were due to separate molecular entities.

Coronary risk profile screening during National Heart Week--1986

Coronary risk profile screening was performed in 1422 volunteer subjects during National Heart Week 1986. A great proportion (55%) of this study group had blood cholesterol above 200 mg/dl; 10% of the subjects were smokers. This study documents the coronary risk profile of 1422 subjects whose biodata provide a baseline for future follow up of the possible changes in any of the various risk factors. This study identifies modifiable risk factors, high blood cholesterol and smoking which should be the target of public education in the efforts to reduce coronary diseases in Singapore.

The presence of corticotropin-like and opiate-like activities in tissues of adult sea lamprey, Petromyzon marinus L

Sexually mature landlocked sea lamprey were captured during their upstream migration. Different tissues, including the brain, pituitary, heart, liver, gut, testis, and ovary, were dissected from the animals and an acetone powder was prepared from each tissue. The tissue acetone powders were subjected to heat treatment and were then extracted with an acidic medium in order to inactivate any proteases present. The resulting acid acetone powders were then tested for their ability to stimulate corticosterone production from isolated rat adrenal cells and to displace the binding of D-Ala2-D-Leu5-[tyrosyl-3,5-3H]-enkephalin to rat brain membranes. It was found that the brain and liver contained steroidogenic activity while opiate activity was detected in the heart, liver, gut, brain, and pituitary. No steroidogenic activity was found in the heart, ovary, testis, gut, and pituitary while ovary and testis did not contain assayable opiate activity. None of the tissues contained beta-endorphin-like immunoreactivity.

Systemic amyloidosis with severe amyloid heart disease--a case report

Cardiac Amyloidosis was first observed by Vichow in 1957. Since then many more cases have been documented, but there has been no case report of mortality from severe cardiac involvement in the local literature. We describe one such case seen in the Singapore General Hospital and review briefly the clinico-pathological data on this uncommon entity.

A C-terminal domain of GAP is sufficient to stimulate ras p21 GTPase activity

The cDNA for bovine ras p21 GTPase activating protein (GAP) has been cloned and the 1044 amino acid polypeptide encoded by the clone has been shown to bind the GTP complexes of both normal and oncogenic Harvey (Ha) ras p21. To identify the regions of GAP critical for the catalytic stimulation of ras p21 GTPase activity, a series of truncated forms of GAP protein were expressed in Escherichia coli. The C-terminal 343 amino acids of GAP (residues 702-1044) were observed to bind Ha ras p21-GTP and stimulate Ha ras p21 GTPase activity with the same efficiency (kcat/KM congruent to 1 x 10(6) M-1 s-1 at 24 degrees C) as GAP purified from bovine brain or full-length GAP expressed in E. coli. Deletion of the final 61 amino acid residues of GAP (residues 986-1044) rendered the protein insoluble upon expression in E. coli. These results define a distinct catalytic domain at the C terminus of GAP. In addition, GAP contains amino acid similarity with the B and C box domains conserved among phospholipase C-II, the crk oncogene product, and the non-receptor tyrosine kinase oncogene products. This homologous region is located in the N-terminal half of GAP outside of the catalytic domain that stimulates ras p21 GTPase activity and may constitute a distinct structural or functional domain within the GAP protein.

Bladder neck resection and transurethral resection of the prostate: a randomized prospective trial

Transurethral resection of the prostate and bladder neck incision are accepted methods in the treatment of obstructive prostatic hyperplasia. Bladder neck incision is particularly useful in cases of small prostates. We have modified the method of bladder neck incision to bladder neck resection. A randomized prospective trial was done to compare the results of conventional transurethral resection of the prostate (30 patients) and the new method of bladder neck resection. Bladder neck resection was comparable to transurethral resection of the prostate with respect to postoperative hospital stay, maximal flow rates and postoperative complications. Bladder neck resection was better than transurethral resection with respect to the operating time, transfusion requirement, volume of irrigation fluid and postoperative urinary infection. We conclude that bladder neck resection is the operation of choice in patients with a prostate of 30 gm. or less.

Patent ductus arteriosus in patients more than 50 years old

At the Mayo Clinic, from 1945 through 1983, a definitive diagnosis of patent ductus arteriosus was first made in 38 patients when they were more than 50 years old. Of the 29 patients who had cardiac catheterization, 14 had a small left-to-right shunt, 7 had a moderate shunt, and 8 had a large shunt. Five patients, including 2 with right-to-left shunts through the ductus, had pulmonary systolic pressures greater than 75 mm Hg. Thirty procedures were done in 29 patients: ductal ligation in 7, division and suture in 13, transaortic patch closure in 3, and closure via median sternotomy with extracorporeal circulation in 7. There was one intraoperative death (operative mortality, 3.3%). Although technically more challenging, surgical repair is associated with low mortality and excellent follow-up survival. The patients who benefit most from surgical correction are those with Qp/Qs greater than 1.5 and pulmonary artery systolic pressure less than 75 mm Hg.

Improved high-performance liquid chromatography method for quantitation of proline and hydroxyproline in biological materials

Numerous high-performance liquid chromatography systems have been described for the determination of hydroxyproline (Hyp) and proline (Pro) levels in biological materials. These methods are generally complicated and have shortcomings in applicability due to poor separation, low sensitivity or derivatization-associated problems. The large number of chemical components present in biological samples further complicates the analysis of Hyp which usually occurs in extremely low concentrations. The present investigation describes the development of a simple highly sensitive derivatization method which results in good separation of peaks and which is capable of quantitating less than 10 pmol of Hyp and Pro in complex test systems. The method is based on removal of o-phthalaldehyde (OPA) derivatives of primary amino acids using reversed-phase chromatography, pre-column derivatization with OPA and phenylisothiocyanate, and detection of derivatized Hyp and Pro using a UV detection system. The procedure yields good peaks and a 93% recovery of Hyp and Pro provided that the analysis is initiated within 5 min of completion of OPA derivatization. While a 93% recovery of Pro was obtained up to 100 min post-derivatization with OPA, the recovery of Hyp is decreased to approximately 80% within the same time interval.

Anticoagulant activity in cell-free peritoneal fluid of an experimental pancreatic ascites tumor

The ascitic form of a chemically-induced pancreatic ductal adenocarcinoma in the Syrian golden hamster was very bloody and indistinguishable from blood macroscopically. Unlike blood, the bloody fluid remained unclotted at room temperature. To explore the possibility of presence of anticoagulants, we mixed 40% cell-free fluid with 60% normal human plasma and tested the clottability of the mixture with standard techniques. Plasma containing the fluid showed markedly prolonged activated partial thromboplastin time (APTT), thrombin time (TT) and recalcification time (RCT), and normal prothrombin time (PT) and reptilase time (RT). Comparing the prolongation of APTT of samples containing the fluid to those containing a commercial heparin, the fluid contained an anticoagulant activity equivalent to 0.436 +/- 0.03 unit heparin per ml (mean +/- SEM, n = 14). In addition to prolonging the APTT, TT and RCT, the fluid also inhibited the clotting and amidolytic activities of thrombin. "Heparsorb" had nearly completely neutralized the anticoagulant activity in fluid samples, while protamine sulfate was only partially effective. Incubation of fluid with pronase or phospholipase did not affect its anticoagulant activity; incubation with heparinase had only a minimal effect. Electrophoresis of an alkali digested fluid on cellulose acetate revealed the presence of heparan sulfate. The native ascitic fluid also contained other hemostatic components including platelets, fibrinogen and antithrombin III, but their concentrations were much lower than in blood. Apparently, heparan sulfate in the neoplastic effusion is largely responsible for the bloody ascites tumor remaining unclotted.

2-Chloroadenosine, a permeant for the nucleoside transporter

Human erythrocytes were shown to possess a saturable uptake mechanism for 2-chloroadenosine (apparent Km 23 microM, 22 degrees). Uptake by this route was inhibited by nitrobenzylthioinosine, uridine and adenosine, but adenine had no effect. In addition, uridine caused the countertransport of 2-chloroadenosine and vice versa. 2-Chloroadenosine was also shown to be an apparent competitive inhibitor of uridine influx (apparent Ki value of 33 microM) and high-affinity nitrobenzylthioinosine binding (apparent Ki 0.18 mM). The apparent Ki value for inhibition of uridine influx was close to the apparent Km value for 2-chloroadenosine uptake. Previous studies [Jarvis et al., Biochem. J. 208, 83 (1982)] have demonstrated that dog erythrocytes do not possess a saturable transport system for uridine and adenosine. Similarly, in the present study, the entry of 2-chloroadenosine into dog erythrocytes was slow and linear with concentration. Nitrobenzylthioinosine (NBMPR) had no effect on the uptake of 2-chloroadenosine into dog erythrocytes. These results demonstrate that 2-chloroadenosine enters human erythrocytes by the same nucleoside carrier as other nucleosides. It is suggested from these data that the previous explanation that the inability of nucleoside transport inhibitors to potentiate the pharmacological effects of 2-chloroadenosine was due to the failure of the nucleoside carrier to accept 2-chloroadenosine as a permeant may have to be reassessed.

Flicker haloes observed with subjective borders

Subjective borders are known to behave quite similarly to real borders when the stimulus presents fragments of visually meaningful forms. There is less information on whether this also applies to unfamiliar stimulus elements. Thus, if a dark/bright stimulus border is presented intermittently at certain frequencies below flicker fusion, the bright border enhancement band increases greatly in width and takes on a textured appearance, resembling a halo streaming from the border. The percept is spontaneous and unlike anything experienced in real life. Preliminary observations showed that the effect occurs also at subjective borders. The extent of the halo from the border was measured for various flicker frequencies and compared with similar measurements obtained with real borders. It was found that the extent varies with frequency in an identical manner for real and virtual borders. Also, the halo was judged equal in qualitative appearance for both kinds of border. The striking similarity between virtual and real effects in this respect is best explained in terms of physiological border perception processes, possibly instigated by a cognitive mechanism.

Identification of the adenosine uptake sites in guinea pig brain

Nitrobenzylthioinosine (NBMPR), a potent and specific inhibitor of nucleoside transport, was employed as a photolabile probe of the adenosine transporter in guinea pig brain membranes. Reversible, high-affinity binding of [3H]NBMPR to a crude preparation of guinea pig brain membranes was demonstrated (apparent KD 0.075 +/- 0.012 nM; Bmax values of 0.24 +/- 0.04 pmol/mg protein). Adenosine, uridine, dipyridamole, and nitrobenzylthioguanosine inhibited high-affinity binding. Low concentrations of cyclohexoadenosine (10-300 nM) had no effect on NBMPR binding. These properties of the high-affinity NBMPR binding sites were consistent with NBMPR binding to the nucleoside transport protein. Exposure of brain membranes in the presence of [3H]NBMPR and dithiothreitol, a free-radical scavenger, to ultraviolet light resulted in covalent incorporation of 3H into polypeptides of apparent MW 66,000-45,000, a value similar to that for the human erythrocyte nucleoside transporter. Covalent attachment of [3H]NBMPR was inhibited by adenosine, dipyridamole, and nitrobenzylthioguanosine.

Anticoagulant Activity in Cell-Free Peritoneal Fluid of an Experimental Pancreatic Ascites Tumor

The ascitic form of a chemically-induced pancreatic ductal adenocarcinoma in the Syrian golden hamster was very bloody and indistinguishable from blood macroscopically. Unlike blood, the bloody fluid remained unclotted at room temperature. To explore the possibility of presence of anticoagulants, we mixed 40% cell-free fluid with 60% normal human plasma and tested the clottability of the mixture with standard techniques. Plasma containing the fluid showed markedly prolonged activated partial thromboplastin time (APTT), thrombin time (TT) and recalcification time (RCT), and normal prothrombin time (PT) and reptilase time (RT). Comparing the prolongation of APTT of samples containing the fluid to those containing a commercial heparin, the fluid contained an anticoagulant activity equivalent to 0.436 ± 0.03 unit heparin per ml (mean ± SEM, n = 14). In addition to prolonging the APTT, TT and RCT, the fluid also inhibited the clotting and amidolytic activities of thrombin. “Heparsorb” had nearly completely neutralized the anticoagulant activity in fluid samples, while protamine sulfate was only partially effective. Incubation of fluid with pronase or phospholi-pase did not affect its anticoagulant activity; incubation with heparinase had only a minimal effect. Electrophoresis of an alkali digested fluid on cellulose acetate revealed the presence of heparan sulfate. The native ascitic fluid also contained other hemostatic components including platelets, fibrinogen and antithrombin III, but their concentrations were much lower than in blood. Apparently, heparan sulfate in the neoplastic effusion is largely responsible for the bloody ascites tumor remaining unclotted.

Endochondral pseudocyst of the auricle in Chinese

Thirty-one patients with endochondral pseudocysts of the auricle were seen over a four-year period in the Department of Surgery at the University of Hong Kong. The lesions chiefly affected Chinese males (90.3%); 80.6% involved the scaphoid fossa on the anterior surface of the pinna. They were usually asymptomatic and static in size. Excision of the anterior wall, followed by contour pressure dressing, gave cosmetically satisfactory results in 90% of the patients, and there were no recurrences. Pathologic studies revealed the absence of an epithelial lining as well as multiple cystic spaces that contained abundant glycosaminoglycans (acid mucopolysaccharides). We postulate that the overproduction of glycosaminoglycans engendered by repeated minor trauma to the cartilage was the primary cause of the pseudocysts.

Distribution coefficients and in vitro human serum protein binding of spironolactone and its 7 alpha-carboxymethyl analog

The distribution coefficients of spironolactone (I) and its 7 alpha-carboxymethyl analog (II) were determined at 22-25 degrees in systems of n-octanol or chloroform and 0.1 M phosphate buffer at pH 7.4. The respective values for I in the two systems were 153.9 and 15.1, and those for II were 15.9 and 3.1. Protein binding studies of I and II were conducted with human serum albumin and human gamma-globulin via equilibrium dialysis at 37 degrees. The I fractions bound to 4% (w/v) albumin and to 1.16% (w/v) gamma-globulin were 66 and 18%, respectively. The corresponding II fractions bound to the two proteins were 46 and 12%. The greater protein binding of I agrees with its superior lipophilicity to that of II. The binding of both I and II to albumin increased with increasing albumin concentration, whereas the binding of I and II to albumin did not change significantly as the concentrations of I or II were varied from 50 to 1300 ng/ml. Cooperativity and/or multiple classes of binding sites appear to be associated with the binding of I and II to albumin.

Increased production of PGI2-like activity by frozen-thawed rat aorta

The effects of storage conditions, temperature, and time on the ability of the rat thoracic aorta to produce a platelet aggregation inhibitor were investigated. Aortic fragments were incubated in Tris buffer, aliquots of which were then tested for their ability to inhibit ADP-induced human platelet aggregation. The incubation fluid of samples that had been soaked in Tris buffer at 4 degrees C for 24 hours contained no inhibitor activity, whereas the incubation fluid of similar samples that had been kept at 4 degrees C but not soaked in buffer contained comparable inhibitor activity as that of fresh samples. The incubation fluid of samples that had been kept at -20 degrees C or -80 degrees C contained greater inhibitor activity than that of fresh samples, and was maintained in -20 degrees C samples for 7 days, and -80 degrees samples for 28 days. The aortic inhibitor had similar properties as PGI2.