Evaluation of different dietary alterations in their ability to mitigate the incidence and severity of woody breast and white striping in commercial male broilers

The following study was conducted to define how multiple nutritional strategies affect broiler performance, meat yield, and the presence and severity of white striping (WS) and woody breast (WB) in high-yielding broilers. Relative to a commercial set of reference broiler diets (Commercial reference diet; Trt 1) that were fed in a 4-phase program, the following nutritional strategies were investigated: increasing the ratio of digestible arginine: digestible lysine (dArg: dLys ranged from 113 to 126; Trt 2), supplementing Trt 1 with 94.4 mg vitamin C/kg feed (Trt 3), doubling the vitamin pack inclusion rate (Trt 4), reducing the digestible amino acid density (dAA) of only the grower phase by 15% and feeding the same Trt 1 starter, finisher, and withdraw diets (Trt 5), and combining the 4 strategies just mentioned (Trt 6). There was no difference in performance at the end of the starter phase (P = 0.066); however, at the end of the grower and finisher phases, feeding lower dAA grower diets suppressed BW (Trts 5 and 6; P < 0.001) and increased FCR. Differences in performance amongst all treatments disappeared at day 49 (P = 0.220). No differences were observed in average breast weight (P = 0.188); however, breast yield (as a % of live weight) was greatest for Trt 1 and least for Trt 6 (P = 0.041). The WB score dropped from 1.83 in Trt 1 to 1.49, 1.27, 1.74, 1.53, and 1.43 in treatments 2 to 6, respectively (P = 0.018). These changes were the result of a shift in WB score, where the WB class that contained scores of 2 and 3 shifted from 61.3% in Trt 1 to 49.3, 35.9, 60.0, 50.8, and 38.7 in treatments 2 to 6, respectively. Given the FCR, breast weight data and the fact that high WB scores result in a devaluation of breast meat, feeding a higher ratio of dArg: dLys, higher vitamin C, or lower dAA in the grower phase results in better breast meat quality and value.

Evaluation of novel micronized encapsulated essential oil-containing phosphate and lactate blends for growth inhibition of Listeria monocytogenes and Salmonella on poultry bologna, pork ham, and roast beef ready-to-eat deli loaves

Essential oils and their constituents are reported to possess potent antimicrobial activity, but their use in food processing is limited because of low solubility in aqueous systems and volatilization during processing. Two proprietary noncommercial essential oil-containing phosphate blends were evaluated for antimicrobial activity against Salmonella enterica cocktail (SC)-and Listeria monocytogenes (Lm)-inoculated deli meat products made from pork, poultry, or beef. Four treatments were tested on restructured cured pork ham, emulsified chicken bologna, and restructured beef loaf: nonencapsulated essential oil with phosphate version 1 at 0.45% of final batch (EOV145; chicken and pork, or EEOV245 beef), micronized encapsulated essential oil with phosphate version 2 at 0.60% of final batch (EEOV260), a 2.0% potassium lactate (PL) control, and a negative control (CN) with no applied antimicrobial agent. Compared with the CN, none of the antimicrobial agents (EEOV260, EOV145, PL) successfully limited Lm or SC growth to <2.0 log cycles over 49 days or 35 days of refrigerated storage, respectively. The PL and EEOV260-treated ham loaves did show Lm growth limiting ability of up to 1 log cycle by days 35 and 42. On formed roast beef, the EEOV260 was able to extend the lag phase and inhibited the growth of Lm in the same manner as the PL. For SC-treated samples, the following effects were observed: in poultry bologna treated with EEOV260, a lag-phase extension was observed through 35 days of storage compared with the other samples. For pork deli loaves, the EEOV260 inhibited growth of SC at days 21 and 28 to the same level of efficacy as PL (0.5 log cycle). In roast beef samples, on day 35, the SC growth was inhibited ca. 0.5 log CFU/g by EEOV260 when compared with the CN. In conclusion the EEOV260 can function to replace PL to limit Salmonella and Lm growth in ready-to-eat deli products. Further testing is needed to ensure consumer acceptability.

Evaluation of Dentaport ZX and Raypex 6 electronic apex locators: an in vivo study

INTRODUCTION

Raypex 6 is an electronic apex locator (EAL) that has not yet been tested in vivo. The purpose of this in vivo study was to compare the accuracy of two EALs: the Dentaport ZX and the Raypex 6.

METHODS

The study involved 36 straight single-rooted teeth. A 10-K file was advanced until the EAL detected the major foramen. The file was fixed in a replaceable pattern of light-cured composite. The apical part of each canal was trimmed to expose the file tip. The distances from the file tips to the major foramen were measured.

RESULTS

Wilcoxon's signed Rank test found no significant differences between the Dentaport ZX and Raypex 6 in terms of their abilities to detect the major foramen (P = .52) The Dentaport ZX was accurate 82.35% of the time to ± 0.5 mm and 97.05% of the time to ± 1 mm, whereas the Raypex 6 was accurate 88.22% of the time to ± 0.5 mm and 100% of the time to ± 1 mm.

CONCLUSIONS

No statistically significant differences were observed between the performance of the Dentaport ZX and Raypex 6 EALs under the in vivo clinical conditions used in this study.

2D 1H and 13C NMR conformational studies of thienopyridines and carboline biarylic compounds

In this paper, we report on conformational studies of biarylic compounds, as prepared through the well-known aza-Wittig methodology. The conformational studies were mainly realized by bidimensional (2D) nuclear magnetic resonance spectroscopy (NMR) and NOESY experiments. The conformational behavior showed that these biarylic compounds display an orthogonal symmetry and adopt a characteristic arrangement around the pivotal bond. Molecular modeling calculations were performed to support structure conformations.

Androgen receptor CAG repeat length contraction in diseased and non-diseased prostatic tissues

To investigate contraction of CAG repeats within the androgen receptor gene (AR) as shorter CAG repeats have been implicated as a possible risk factor in prostate cancer (PCa). AR CAG repeat lengths were analyzed in DNA from microdissected diseased prostates, leukocytes from matched peripheral blood, and control non-diseased prostates. Consistently, all prostatic tissues, whether from benign or cancerous areas of diseased prostates, or from control prostates, showed multiple AR CAG repeat contractions. Germline DNA from blood leukocytes had single CAG repeat lengths in the normal range. AR CAG repeat length contraction may be involved in prostate carcinogenesis and may precede the pathological process.

Nutritional evaluation of commercial dry dog foods by near infrared reflectance spectroscopy

Near infrared reflectance spectroscopy (NIRS) was used to predict the nutritional value of dog foods sold in Chile. Fifty-nine dry foods for adult and growing dogs were collected, ground and scanned across the visible/NIR range and subsequently analysed for dry matter (DM), crude protein (CP), crude fibre (CF), total fat, linoleic acid, gross energy (GE), estimated metabolizable energy (ME) and several amino acids and minerals. Calibration equations were developed by modified partial least squares regression, and tested by cross-validation. Standard error of cross validation (SE(CV)) and coefficient of determination of cross validation (SE(CV)) were used to select best equations. Equations with good predicting accuracy were obtained for DM, CF, CP, GE and fat. Corresponding values for and SE(CV) were 0.96 and 1.7 g/kg, 0.91 and 3.1 g/kg, 0.99 and 5.0 g/kg, 0.93 and 0.26 MJ/kg, 0.89 and 12.4 g/kg. Several amino acids were also well predicted, such as arginine, leucine, isoleucine, phenylalanine-tyrosine (combined), threonine and valine, with values for and SE(CV) (g/kg) of 0.89 and 0.9, 0.94 and 1.3, 0.91 and 0.5, 0.95 and 0.9, 0.91 and 0.5, 0.93 and 0.5. Intermediate values, appropriate for ranking purposes, were obtained for ME, histidine, lysine and methionine-cysteine. Tryptophan, minerals or linoleic acid were not acceptably predicted, irrespective of the mathematical treatment applied. It is concluded that NIR can be successfully used to predict important nutritional characteristics of commercial dog foods.

Food-associated lactic acid bacteria with antimicrobial potential from traditional Mexican foods

This work was conducted to identify indigenous LAB capable of antimicrobial activity, present in traditional Mexican-foods with potential as natural preservatives. A total of 27 artisan unlabeled Mexican products were evaluated, from which 94 LAB strains were isolated, and only 25 strains showed antimicrobial activity against at least one pathogen indicator microorganism. Most of the inhibitory activity showed by the isolated LAB strains was attributed to pH reduction by organic acids. Lactobacillus and Lactococcus strains were good acid producers, depending on the substrate, and may enhance the safety of food products. Cell free cultures of Leuconostoc mesenteroides CH210, and PT8 (from chorizo and pulque, respectively) reduced the number of viable cells of enteropathogenic E. coli in broth system. Lb. plantarum CC10 (from "madre" of vinegar) showed significant inhibitory effect against S. aureus 8943. E. faecium QPII (from panela cheese) produced a bacteriocin with wide anti-L. monocytogenes activity. Selected LAB from traditional Mexican foods showed good potential as bio-preservatives.

Randomized, active-controlled study of denosumab (AMG 162) in breast cancer patients with bone metastases not previously treated with intravenous (IV) bisphosphonates (BP)

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Background: Receptor activator of NF-κB ligand (RANKL) is a key mediator of osteoclast formation, function, and survival. Denosumab, a fully human monoclonal antibody, binds and inhibits RANKL, thus suppressing excess osteoclastic activity associated with bone metastases. We report interim efficacy and safety results of an ongoing, phase 2 study of denosumab in IV BP treatment-naïve women with advanced breast cancer and bone metastases (BM). Methods: Eligible patients (pts; age ≥ 18 yrs with breast cancer; confirmed BM; naive to IV BP therapy) were stratified by chemo- or hormonal therapy and randomized to 1 of 6 cohorts (5 denosumab [double blind]; 1 IV BP [open label]; see table ). The primary endpoint was the % change from baseline (BL) to week 13 in the resorption marker, urinary N-telopeptide (uNTx), corrected for creatinine. Also evaluated were % of pts with ≥ 65% decrease in uNTX from BL, time to a 65% reduction in uNTx, % of pts with ≥ 1 skeletal-related event (SRE), and safety. Results: In total, 255 pts (∼40/cohort) were enrolled. Mean age was 57 to 59 yrs (denosumab cohorts) vs 52 yrs (BP). Most pts had > 2 sites of BM (denosumab, 74%; BP, 81%); 51% and 49% received concurrent chemo- or hormonal therapy, respectively. As shown in the efficacy table , the 120 mg Q4W dose resulted in the greatest % decrease from BL in uNTx. At data cutoff, the % of all denosumab pts with ≥ 1 SRE was 9% (20/212) vs 16% (7/43) of BP pts. Commonly reported adverse events (AE) among all pts included nausea, vomiting, asthenia, diarrhea, and bone pain. Of 198 denosumab pts tested, none developed anti-denosumab antibodies. Conclusion: In this interim analysis, denosumab resulted in rapid and sustained suppression of bone turnover and was at least as effective as IV BP at reducing the risk of SREs, with a safety profile similar to that seen in advanced breast cancer pts receiving cancer treatment.

[Table: see text]

[Table: see text]

Improvement of leukocyte functions in young prematurely aging mice after a 5-week ingestion of a diet supplemented with biscuits enriched in antioxidants

In our previous studies, diet supplementation with therapeutic thiolic antioxidants improved the function of peritoneal leukocytes from mice, especially in adult prematurely aging mice (PAM). In the present work, we have studied the effects of ingestion during 5 weeks of a diet supplemented with 20% (wt/wt) of biscuits enriched with antioxidants (vitamin C, vitamin E, beta-carotene, zinc, and selenium) on several immune functions of peritoneal leukocytes from young PAM. The results show that, in macrophages, chemotaxis and phagocytosis as well as the intracellular free radical levels, which are depressed in PAM in comparison with the control nonprematurely aging mice (NPAM), increase after supplementation, especially in the PAM. An increase also occurs in lymphocyte chemotaxis, proliferative response to the mitogen concanavalin A, and interleukin-2 release, as well as in natural killer cell activity. However, the release of tumor necrosis factor-alpha, which increases with aging, decreases after 5 weeks of supplementation. As a well preserved function of the immune system is an excellent marker of health and longevity, the improvement of leukocyte functions after ingestion of the present diet suggests that this antioxidant supplementation may be useful for the preservation of health and functional longevity in aging populations.

Anti-Listeria monocytogenes Bacteriocin-Like Inhibitory Substances From Enterococcus faecium UQ31 Isolated from Artisan Mexican-Style Cheese

Artisan fresh Mexican-style cheeses are commonly made from raw milk that provides not only rich flavors, but also a diversity of associated lactic acid bacteria (LAB) strains. Enterococcus faecium UQ31 was isolated from panela cheese and produced bacteriocin-like inhibitory substances (BLIS) with a strong anti-Listeria activity. A modified pH-mediated adsorption-desorption purification process resulted in (after SDS-PAGE) two bands showing antimicrobial activities, where most of the activity corresponded to the band with an estimated molecular weight of 7.5 kDa. The BLIS produced by E. faecium UQ31 were heat resistant, stable at ambient storage conditions, and active in the pH range 5--9. The BLIS antimicrobial activities were detected during logarithmic growth phase and remained constant until the end of incubation time (19 h). These BLIS showed a wide anti-Listeria monocytogenes spectra. The E. faecium UQ31 strain or their BLIS represent a promising potential as antimicrobial food preservatives.

Changes with age in peritoneal macrophage functions. Implication of leukocytes in the oxidative stress of senescence

The age-related deterioration of the immune cells contributes to the increased morbidity and mortality of the aged populations. Since ageing is the result of oxidative stress and macrophages are an important source of oxidation, which is produced in order to carry out many of their functions, the changes with age of several macrophage functions as well as of oxidative stress parameters (oxidants, inflammatory mediators and antioxidants) of peritoneal leukocytes have been investigated using young (4 months), adult (7 months), mature (12 months) and old (20 months) female ICR (CD-1) mice. With age the macrophage functions suffer deterioration. Thus, chemotaxis, phagocytosis and intracellular superoxide anion production decrease in old animals. Moreover, the levels of antioxidant defenses, such as superoxide dismutase activity, decrease with ageing. However, the adherence capacity and the release of oxidant and inflammatory mediators, such as extracellular superoxide anion, TNF-alpha and PGE2, as well as oxidized glutathione/ reduced glutathione ratio, increase with age. These results show that these cells suffer oxidative stress with ageing, which results in an increase of the oxidative damage to nuclear DNA. These changes in peritoneal immune cells could contribute to the chronic oxidative stress state linked to senescence.

Reconciliation of FDA and societal guidelines for endoscope reprocessing

Chemical sterilants are used to high-level disinfect semicritical medical devices such as flexible endoscopes. For the chemosterilant to obtain a high level disinfection claim, The Food and Drug Administration requires demonstration of a 6-log reduction of myobacterial inoculum under worst case conditions (2% horse serum added to test sterilant). This testing requirement has led to label product claims of 45 minutes immersion times at 25 degrees C. Review of the scientific data suggests that at least an 8-log reduction in contamination with thorough instrument cleaning, followed by chemical disinfection for 20 minutes immersion at 20 degrees C will achieve high-level disinfection.

Pleuropulmonary blastoma and ovarian teratoma

We report a patient with pleuropulmonary blastoma who had a benign teratoma as a second primary tumor. The radiology, clinical course, and the biological importance of this rare neoplasm are discussed.

Prognostic significance of age, MYCN oncogene amplification, tumor cell ploidy, and histology in 110 infants with stage D(S) neuroblastoma: the pediatric oncology group experience--a pediatric oncology group study

PURPOSE

Although a high rate of spontaneous regression is observed in infants with stage D(S) neuroblastoma (NB), survival is not uniform. To determine the prognostic relevance of age at diagnosis, therapy, and tumor biology in infants with stage D(S) NB, we reviewed the Pediatric Oncology Group (POG) experience.

PATIENTS AND METHODS

A review of patients diagnosed with stage D(S) NB registered on POG protocols was performed. Survival according to age at diagnosis, treatment, and tumor biology was determined.

RESULTS

Between 1987 and 1996, 110 infants with stage D(S) NB had an estimated 3-year survival rate of 85% +/- 4%; survival rate was 71% +/- 8% for infants 2 months of age or younger, and 68% +/- 12%, 44% +/- 33%, and 33% +/- 19% for patients with diploid, MYCN-amplified, and unfavorable histology tumors, respectively. Survival rates were similar for patients who received adjuvant chemotherapy versus those who did not (82% +/- 5% v 93% +/- 6%, respectively; P = .187). Furthermore, there was no statistical difference in survival rate for patients who underwent complete resection of their primary tumor compared with those who underwent partial resection or biopsy only (90% +/- 5% v 78% +/- 7%, respectively; P = .083).

CONCLUSION

Our review confirmed that the survival of infants with stage D(S) NB is excellent. However, subsets of patients with poor prognosis can be identified by young age and unfavorable biologic factors. More effective therapy is needed for the group of stage D(S) infants who show unfavorable clinical and biologic features.

Spinobulbar muscular atrophy: polyglutamine-expanded androgen receptor is proteolytically resistant in vitro and processed abnormally in transfected cells

The neuronotoxicity of genes with expanded CAG repeats is most likely mediated by their respective polyglutamine (Gln)-expanded gene products. Gln- expanded portions of these products may be sufficient, or necessary, for pathogenesis. We tested whether a Gln-expanded human androgen receptor (AR) is structurally altered, so that it allows for the proteolytic generation of a potentially pathogenic portion that may be resistant to further degradation. We found, in vitro , that a Gln-expanded AR is more proteolytically resistant than normal, and that it yields a distinct set of Gln-expanded fragments even after extended proteolysis in the presence of 2 M urea. Furthermore, COS cells transfected with CAG-expanded AR cDNA generate an aberrant, nuclear-associated 75 kDa derivative containing the Gln-expanded tract. They are also twice as likely to die by 24 h apoptotically than those transfected with normal AR cDNA. Our data support the notion that an unconventional derivative of the Gln- expanded AR is a component of the proximate motor neuronopathic agent in spinobulbar muscular atrophy. They also focus attention on two ways in which neuronotoxic derivatives may originate from various Gln-expanded proteins: (i) generation of an unusual derivative that is pathogenic de novo ; and (ii) the toxic accumulation of a normal derivative because of an inability to dispose of it.

Protein degradation in red cells exposed to 2,2'-azo-bis(2-amidinopropane) derived radicals

Extensive proteolysis is observed when red blood cells are exposed to free radicals produced in the thermolysis of 2,2'-azo-bis(2-amidinopropane). It is evaluated that nearly one amino terminal group is produced by each free radical introduced into the system. These groups are considered to arise mainly from band 3 fragmentation due to the action of red cell proteinases. Protein fragmentation takes place prior to significant hemolysis or lipid peroxidation, as evaluated by thiobarbituric acid-reactive substances measurements.

Participation of the Bcl-2 and Fas molecules in experimental apoptosis of spleen B lymphocytes

BACKGROUND

Homeostasis in the immune system is based on equilibrium between rates of cell renewal and cell death. Failure of elimination of undesirable autoreactive B cell clones may lead to autoimmune disorders.

OBJECTIVE

To assess the participation of the Bcl-2 and Fas molecules in the regulation of B lymphocyte death.

METHODS

We used two strains of mice known to have deficient mechanisms of apoptosis, namely the transgenic C57BL/6-E mu-bcl-2-22 expressing the bcl-2 transgene on B cells, and the C57BL/6-lpr/lpr mutant, lacking the expression of a functional Fas molecule. Both strains develop a systemic lupus erythematosus-like disease with serum autoantibodies and splenomegaly. We induced apoptosis by three different treatments: dexamethasone,gamma irradiation and hyperthermia. The proportion of cells in apoptosis was determined with the TUNEL method.

RESULTS

Radiation or hyperthermia induced apoptosis was inhibited more effectively by having the lpr mutation than the proto-oncogene bcl-2, but the latter conferred higher resistance to apoptosis by dexamethasone.

CONCLUSIONS

Our findings suggest that the role of molecules regulating cell death may relate to the stimuli used to induced apoptosis, and that both the lpr mutation and the overexpression of the proto-oncogene bcl-2 protect B cells from apoptosis induced by the three treatments tested.

Autoantibody production in healthy elderly people is not promoted by interleukin-10 although this cytokine is expressed in them by a peculiar CD8+CD3+ large granular cell subpopulation

Healthy elderly people tend to have autoantibodies in their sera. These antibodies, not being associated with any clinical manifestation, have been considered as natural autoantibodies. In systemic lupus erythematosus, as well as in rheumatoid arthritis, the presence of autoantibodies characteristic of these disease (anti-dsDNA and rheumatoid factor, respectively) depends on the endogeneous production of IL-10. The same could hold true for autoantibodies found in healthy elderly individuals. In the present work, the authors analysed whether an increased production of IL-10 contributed to the production of autoantibodies in elderly people. The authors found that there is neither increased in vivo gene expression nor augmented production of IL-10 by peripheral blood mononuclear cells from elderly women even if they do produce autoantibodies. The authors further sought to determine if the production of autoantibodies is inhibited in vitro by adding an anti-IL-10 MoAb to cell cultures and found that it is not. Despite these negative findings of a role for IL-10 in the production of autoantibodies in elderly people, the authors investigated which cells produce IL-10. In so doing they found that intracellular IL-10 expression occurred exclusively in monocytes in young female controls, but in elderly females it involved also CD8+CD3+ large granular cells. These results indicate that autoantibody production in healthy aged individuals is IL-10 independent.

Elevated Th1 cytokine mRNA in skin biopsies and peripheral circulation in patients with erythema nodosum

It is generally believed that erythema nodosum is the result of an immunologic attack centered within the subcutaneous fat. This belief, however, is based on indirect evidence. The aim of this study was to analyze whether erythema nodosum could represent an example of a polarized Th1 or Th2 immune response. We have studied herein, by semiquantitative coupled reverse transcription-polymerase chain reaction the Th1 (IL-2, IFN-gamma) and Th2 (IL-4, IL-10) cytokine gene expression in skin biopsies and peripheral blood from eleven patients with erythema nodosum. As controls, we studied skin and peripheral blood from nine healthy subjects. We found expression of Th1 cytokines in most erythema nodosum skin lesions as well as in their peripheral blood. Both Th1 and Th2 cytokine gene expressions were scarcely or not detected in the skin and peripheral blood of control subjects. These results directly demonstrate that a polarized Th1 immune response occurs in the skin lesions of erythema nodosum patients regardless of the wide variety of provoking agents.

Characterization of normal and point-mutated human androgen receptors expressed in the baculovirus system

The baculovirus system is able to generate large amounts of a protein, permitting detailed analysis of structure-function relations. We have used this system to overexpress and characterize normal human androgen receptors (hAR) and mutant hARs from humans with complete or partial androgen insensitivity. Maximum specific binding of [3H]mibolerone (MB) in recombinant baculovirus-infected Spodoptera frugiperda (Sf9) cells varied from 15 to 40 pmol/mg protein, about 1000-fold higher than in genital skin fibroblasts, and peaked 48-72 h after infection. In contrast, Coomassie blue staining and Western blotting revealed maximum accumulation of 100-120 kDa hAR proteins 96 h post-infection. Normal and mutant hARs were specifically photo-affinity-labeled with [3H]methyltrienolone (MT), and had normal steroid-binding selectivity: the order of competition was androgen > estrogen > progestin > glucocorticoid. Normal hAR was phosphorylated in Sf9 cells, reacted with antibodies against phosphoserine and phosphothreonine after purification using testosterone-biotin, and transactivated a transfected androgen response element-luciferase reporter in infected Sf9 cells. Two mutant hARs had increased rates of dissociation from MB and MT that were in accord with the associated degree of clinical androgen insensitivity: complete, Pro903Ser > partial, Leu820Val; the third, Ile663Asn, was not abnormal. Our data extend the characterization of normal hAR produced by baculovirus-infected Sf9 cells, and demonstrate, for the first time, that point-mutated hARs so produced can display distinctive biochemical phenotypes.

Effect of CD28 antibody on T cells from patients with systemic lupus erythematosus

CD28 is a 44-kDa glycoprotein that contributes to T cell activation and proliferation. To elucidate the functional role of CD28 in T cell proliferation and IL-2 production in SLE, we studied its effects in cells from untreated patients with active (n = 10) or inactive disease (n = 10) as compared with normal subjects. Mean percentages of CD4+ CD28+ and CD8+ CD28+ T cells were decreased in SLE patients (P < 0.01). SLE patients had significantly decreased absolute CD8+ CD28+ T cells. To investigate whether CD28 antibody affects T cell proliferation, we stimulated peripheral blood T cells from SLE patients and normal controls with anti-CD28, anti-CD3 and/or Interleukin-2 (IL-2) during 3 days of culture. We found that T cells from SLE patients had significantly higher responses to CD28 than did cells from normal controls. This effect was higher in cells from patients with active disease than in those with inactive disease. Conversely, IL-2 had no significant effect on the proliferative response of SLE T cells. However, when it was used for co-stimulating with anti-CD28, there was an increase in the secretion of IL-2 which was greater in the cells of patients with active disease. Thus, on average, there was an 81% increase in the production of IL-2 in T cells from patients with active SLE, 48% in those from patients with inactive disease and 40% in T cells from healthy controls, as compared with the production in response to stimulus by anti-CD3 or with anti-CD3 and anti-CD28. Lymphocytes from patients with active disease showed increased gene expression of CD28 when compared with normal subjects. These data suggest that CD28 might play a central role in the defective immune response observed in SLE patients.

Complete androgen insensitivity due to mutations in the probable alpha-helical segments of the DNA-binding domain in the human androgen receptor

We describe different single-amino acid aberrations in the DNA-binding domain (DBD) of the human androgen receptor (hAR) in three families with complete androgen insensitivity. No additional alteration was found in the translated portion of each mutant gene. In one family, an in-frame 3 nt deletion removes codon 581-(or 582) and, thereby, one of two phenylalanines that invariably occupy adjacent positions in the N-terminal alpha-helical region of the DBD in the steroid/thyroid/vitamin D receptor superfamily. In the second, an in-frame 3 nt loss deletes Arg614, an invariant residue in the C-terminal alpha-helix of the DBD. In the third, a G-->A transition causes Arg614His. Following transient transfection of COS cells with each mutant AR plasmid, there is a normal concentration of specific androgen-binding activity that has a reduced ability to bind two types of androgen response element (ARE), and to transregulate an androgen-responsive human growth hormone reporter gene. In genital skin fibroblasts with delta Phe581 or Arg614His, androgen-binding, AR protein and AR mRNA are markedly reduced; in gonadal fibroblasts with delta Arg614, AR mRNA may be reduced. Our data substantiate the primary contributions of Phe581 and Arg614 to normal hAR-ARE binding, and expose important secondary effects of the mutations affecting each residue.

Androgen resistance due to mutation of the androgen receptor

The androgen receptor (AR) is a 'one-stop' signal transduction system that is the core of the intracellular androgen-response apparatus. It is an androgen-regulated, DNA-binding protein that regulates the expression of certain target genes, primarily at the transcriptional level. Mutations at the X-linked AR locus cause deficient or defective AR activity and, thereby, an extraordinarily wide spectrum of clinical androgen resistance. At one extreme, the affected 46,XY person is an infertile phenotypic female; at the other, he is a phenotypic male who may even be fertile, yet have gynecomastia or other focal signs of postpubertal subvirilization. We have identified 32 proven or putatively pathogenic alterations in the AR gene of 38 androgen-resistant families. This permits heterozygote detection and prenatal diagnosis whenever relevant. Most of the mutations affect the AR's androgen-binding domain, partly because our search has been targetted on those whose genital skin fibroblasts have impaired androgen-binding activities. The AR is a prototypic member of a subfamily that includes the receptors for progesterone, glucocorticoid, and mineralocorticoid. Observations that correlate AR genotype with clinical and receptor phenotypes of androgen resistance will help to generate a fine structure-function map of the AR and its close relatives. Constitutional variation in androgen sensitivity, that may be restricted to an organ (or organ system), could contribute to the pathogenesis of certain diseases whose sex ratio departs significantly from one.

The t(1;22) (p13;q13) is nonrandom and restricted to infants with acute megakaryoblastic leukemia: a Pediatric Oncology Group Study

We report the nonrandom occurrence and frequency of the t(1;22)(p13;q13) in acute myeloid leukemia (AML) and its close association with the French-American-British M7 subtype of AML in infants (less than 1 year). This chromosomal abnormality occurred in 6 of 252 (2.4%) children and adolescents with AML (6 of 28 infants, 22%; 6 of 18 M7 AML cases overall, 33%; and 6 of 6 M7 cases in infants). Infants with AML of M7 subtype and the t(1;22) often presented with prominent abdominal masses. Two of these infants were not treated and died early. Three of four treated infants entered complete remission with therapy for AML; the remaining infant died of hemorrhage on day 8. Of the three infants who entered remission, only one remains alive and disease free at 5+ months. The other two infants relapsed in the bone marrow at 5 and 2 months from the start of therapy, respectively. We conclude that M7 AML with the t(1;22) usually presents in infants with extensive infiltration of abdominal organs by leukemic cells and may confer a poor prognosis despite intensive AML-directed treatment. Identification of this nonrandom translocation exclusively in infants with acute megakaryoblastic leukemia (AMkL) implies that it may serve as an additional diagnostic marker for this disease and links it to the pathogenesis of AMkL in infants.

[Interstitial nephritis syndrome and uveitis]

A nine year old male patient was admitted to a metropolitan general hospital at Santiago, Chile, because of unexplained severe anemia (hematocrit 18%) and redness of the right eye. Uveitis was confirmed by ophthalmological examination. Laboratory work up showed an erythrocyte sedimentation rate of 101 mm.h, marked nitrogen retention (BUN 91 mg/dl), creatinine clearance was 9 ml/min.1,73 sq m, serum IgG and IgM immune globulin concentrations were 2,368 mg/dl and 263 mg/dl respectively, over the normal range for age, with almost absent serum IgA and reduced T cell populations. Negative rheumatoid factor, antinuclear antibodies and anti smooth muscle antibodies reactions were obtained, together with normal levels of C3 and C4 fractions of complement and normal urine sediment. Renal biopsy specimen included 25 glomerular, one of them was wholly sclerotic, another two had periglomerular fibrosis and the remainder showed only slightly increased mesangial matrix. Heavy mononuclear inflammatory interstitial infiltration, with granulomatous structures including giant multinuclear cells as those seen in foreign body reactions (fig 1) and PAS positive intraluminal tubular crystals were also observed. In spite of steroidal treatment, which was complicated by an inflammatory brain granuloma that healed in coincidence with parenteral antibiotic therapy, the patient evolved toward chronic renal failure. We think that the available evidence strongly suggests an immunological disorder as a very likely explanation for this case.

Toxicity of high-dose cytosine arabinoside in the treatment of advanced childhood tumors resistant to conventional therapy. A Pediatric Oncology Group study

Experience with high-dose cytosine arabinoside (HDAC) in pediatric solid tumors is limited. Sixteen children with solid tumors resistant to conventional therapies were registered in a pilot Pediatric Oncology Group (POG) study that required the administration of HDAC at 3 g/m2 every 12 hours for four doses. There were four cases of rhabdomyosarcoma, two cases of fibrosarcoma, four cases of neuroblastoma, and one case each of germ cell tumor, Wilm's tumor, retinoblastoma, hepatocellular carcinoma, Ewing's sarcoma, and Burkitt's lymphoma. All eligible patients had advanced diseases and had previously received extensive chemotherapy. Thirteen patients received one course of HDAC and three patients received two courses of HDAC. Due to prior treatments, patients had less than normal marrow reserves. Short-term toxicity included nausea, vomiting, suppression of hemopoiesis, drug fever, and increased blood urea nitrogen (BUN), creatinine, and liver enzymes. All evaluable patients recovered from their toxicities. There were no drug-related deaths. None of the patients had neurologic problems, including the only patient with prior irradiation to the skull. With the above schedule, HDAC appears to have manageable toxicity.

Transfers of frozen-thawed human embryos in cycles stimulated by HMG

A total of 130 transfers of frozen-thawed (F-T) human embryos was carried out after moderate ovarian stimulation with human menopausal gonadotrophin (HMG). Embryos were replaced 3 days after the spontaneous luteinizing hormone (LH) surge or 4 days if ovulation was induced by human chorionic gonadotrophin (HCG). Embryos were thawed a few hours prior to transfer. One-hundred-and-twenty-three transfers were effective and 23 pregnancies were achieved. The rate of ongoing pregnancies per transfer was 17.9% (22/123). The survival rate of embryos originating from cycles stimulated by a combination of an LHRH analogue and HMG in a long protocol (LA-HMG protocol) was significantly lower when compared with the rate of embryos retrieved from clomiphene citrate-HMG (CC-HMG protocol) stimulated cycles (52 versus 67%, P less than 0.05). When fresh embryos originated from cycles stimulated with an LHRH analogue and HMG in a short protocol (SA-HMG protocol), the survival rate was not affected (59 versus 67%, NS). Although the difference was not significant, the ongoing pregnancy rate per transfer according to the three protocols from which the embryos originated seemed to be better with the SA-HMG protocol: 16% with the CC-HMG protocol, 14.5% with the LA-HMG protocol versus 27.6% with the SA-HMG protocol. The success rate was independent of the number of F-T transferred embryos if at least one embryo with 100% intact blastomeres was replaced.

Natural killer cells in children with acute leukemia. The effect of interleukin-2

The purpose of this study was to determine (1) the number and activity of natural killer (NK) cells in children with acute leukemia at different stages of their disease; and (2) the effect of interleukin-2 (IL-2) in enhancing NK activity of these patients' cells. The mean percentage of Leu 11+ NK cells in patients at diagnosis (5% of peripheral blood (PB) mononuclear cells) was significantly lower than for patients on maintenance (23%), post-treatment (21%) and for normal children (20%). The mean PB NK cell cytotoxicity for patients at diagnosis (16% lysis versus K562) and during maintenance (20%) was significantly lower than for post-treatment (41%) and normal controls (40%). After NK cells were incubated for 5 days with IL-2, NK cells from 82% (36/44) of patients showed enhanced cytotoxicity toward K562 and several acute leukemia cell lines as well as toward autologous leukemic cells. Cytotoxicity toward autologous cells was very low (0% to 5%, 16 hour assay) before IL-2 stimulation, and significantly increased (23% to 69%) after stimulation, suggesting that IL-2 may be a useful agent for enhancing the antileukemic immune response.

Double-bagging of items from isolation rooms is unnecessary as an infection control measure: a comparative study of surface contamination with single- and double-bagging

In many hospitals, waste materials and used linens from the rooms of patients in isolation or the clinical laboratories are routinely double-bagged to reduce contamination of the external surface of the bag that could be transmitted to hospital personnel subsequently handling them. No studies have prospectively examined the value, if any, of double-bagging. We randomly assigned waste and linens from the rooms of 42 patients in contact isolation to be transported in single bags or double bags. Shortly after a single (or double) bag had been set outside the patient's room, the surface was cultured quantitatively in two locations near the knot; over 2 months, 209 bags were cultured. Surface contamination by Staphylococcus aureus (3% to 5%), enteric gram-negative bacilli (6% to 7%), or either (9% to 12%) was infrequent and comparable in both groups; moreover, quantitative levels of contamination in the two groups were almost identical (mean, 27 and 29 colony forming units [cfu] per bag). These data suggest that there is no advantage, as regards asepsis, to double-bagging potentially contaminated items from isolation rooms or clinical laboratories as compared with using a single bag. The use of a single-bag system with a heavy-duty bag, as compared with double-bagging, saved our hospital $9,400 in 1985.

Sequential testicular biopsies in childhood acute lymphocytic leukemia

Between August 1978 and November 1981, 33 boys with acute lymphocytic leukemia (ALL) (26 non-T, 7 T-cell) younger than 16 years underwent bilateral wedge testicular biopsies at the time of initial diagnosis. Seven (4 non-T, 3 T-cell) demonstrated focal leukemic infiltrates. Rebiopsy after successful induction therapy without testicular irradiation showed eradication of leukemic infiltrates in five, persistent focal infiltrates in one, and a diffuse infiltrate in one. The two patients who had persistent leukemic involvement had a T-cell phenotype, and in one of them overt testicular disease developed 2 years later. All 33 patients were followed prospectively for a minimum of 3 years. Fifteen (14 non-T, 1 T-cell) remained in remission for 3 years and underwent another testicular biopsy before the cessation of therapy. Two patients, both non-T and both of whom were free of testicular involvement at diagnosis, showed testicular infiltrates at that time. Of the seven boys with positive specimens at diagnosis, only two remained disease-free for 3 years and showed no testicular involvement upon the completion of chemotherapy. In this study, microscopic testicular involvement by lymphoblasts occurred in 21% of newly diagnosed boys with ALL; this occurred only if the leukocyte count exceeded 25,000/microliter. These patients in general had a poor prognosis, probably reflecting the overall heavy tumor burden. However, it was not possible to predict accurately those patients who would have leukemic testicular infiltrates at the cessation of chemotherapy by performing biopsy of the testes at the time of initial diagnosis or after induction therapy.