Occurrence of Fusarium mycotoxins in freshly harvested highland barley (qingke) grains from Tibet, China

Highland barley, also called "qingke" in Tibetan, is mainly cultivated in the Tibetan Plateau of China and has been used as a major staple food for Tibetans. Recently, Fusarium head blight (FHB) of qingke was frequently observed around the Brahmaputra River in Tibet. Considering the importance of qingke for Tibetans, the assessment of Fusarium mycotoxin contamination is essential for food safety. In this study, a total of 150 freshly harvested qingke grain samples were obtained from three regions around the Brahmaputra River in Tibet (China) in 2020. The samples were investigated for the occurrence of 20 Fusarium mycotoxins using high-performance liquid chromatography-tandem mass spectrometry (HPLC‒MS/MS). The most frequently occurring mycotoxin was enniatin B (ENB) (46%), followed by enniatin B₁ (ENB₁) (14.7%), zearalenone (ZEN) (6.0%), enniatin A₁ (ENA₁) (3.3%), enniatin A (ENA) (1.3%), beauvericin (BEA) (0.7%), and nivalenol (NIV) (0.7%). Due to the increase in altitude, the cumulative precipitation level and average temperature decreased from the downstream to the upstream of the Brahmaputra River; this directly correlated to the contamination level of ENB in qingke, which gradually decreased from downstream to upstream. In addition, the level of ENB in qingke obtained from qingke-rape rotation was significantly lower than that from qingke-wheat and qingke-qingke rotations (p < 0.05). These results disseminated the occurrence of Fusarium mycotoxins and provided further understanding of the effect of environmental factors and crop rotation on Fusarium mycotoxins.

Compact thermal imager: a flight demonstration of infrared technology for Earth observations

During 2019, an infrared camera, the compact thermal imager (CTI), recorded 15 million images of the Earth from the International Space Station. CTI is based on strained-layer superlattice (SLS) detector technology. The camera covered the spectral range from 3 to 11 µm in two spectral channels, 3.3-5.4 and 7.8-10.7 µm. Individual image frames were 26×21km² projected on the ground, with 82 m pixel resolution. A frame time of 2.54 s created continuous image swaths with a 13% along-track image overlap. Upper limits determined on the ground and in flight for the electronic offset, read noise, and dark current demonstrated the stability of the SLS detector and camera over many months. Temperature calibration was established using a combination of preflight and in-flight measurements. A narrowband approximation of temperature as a function of photon counts produced an analytic relationship covering a temperature range of 0°-400°C. Examples of CTI images illustrate temperature retrievals over sea ice, urban and agricultural areas, desert, and wildfires.

Long non-coding RNA AFAP1-AS1 facilitates prostate cancer progression by regulating miR-15b/IGF1R axis

BACKGROUND

Prostate cancer (PCa) is a commonly diagnosed malignant cancer and is the second highest cause of cancer related death in men worldwide. Enzalutamide is the second-generation inhibitor of androgen receptor signaling and is the fundamental drug for the treatment of advanced PCa. However, the disease will eventually progress to metastatic castration-resistant prostate cancer (CRPC) and aggressive neuroendocrine prostate cancer (NEPC) because of androgen-deprivation therapy (ADT) resistance. The aim of the study was to investigate the role of long non-coding RNA (lncRNA) AFAP1-AS1 in ADT resistance.

METHODS

Quantitative real-time PCR analysis (qPCR) was used to assess the expression of AFAP1-AS1 in PCa cell lines and tissues. Cell proliferation and invasion were assessed after AFAP1-AS1 knockdown using Cell Counting Kit (CCK)-8 and Transwell assay, respectively. A dual-luciferase reporter gene assay was carried out to validate the regulatory relationship among AFAP1-AS1, microRNA (miR)-15b, and insulin-like growth factor1 receptor (IGF1R).

RESULTS

AFAP1-AS1 level was markedly increased in castration-resistant C4-2 cells and NE-like cells (PC3, DU145, and NCI-H660), compared with androgen-sensitive LNCaP cells. Enzalutamide treatment increased the expression of AFAP1-AS1 in vitro and in vivo. Functionally, AFAP1-AS1 knockdown repressed tumor cell proliferation and invasion. Mechanistically, AFAP1-AS1 functioned as an oncogene in PCa through binding to miR-15b and destroying its tumor suppressor function. Finally, we identified that AFAP1-AS1 up-regulated IGF1R expression by competitively binding to miR-15b to de-repress IGF1R.

CONCLUSION

AFAP1-AS1 facilitates PCa progression by regulating miR-15b/IGF1R axis, indicating that AFAP1-AS1 may serve as a diagnostic biomarker and therapeutic target for PCa.

Kallikrein-related peptidase 4 promotes migration and invasion of endometrial stromal cells in endometriosis by inducing epithelial-mesenchymal transition

Endometriosis is a gynecological health problem for women of reproductive stage. Kallikrein 4 is a proliferative factor and has important roles in cancer development and progression. To explore the role of Kallikrein 4 in endometriosis, we detected the expression of Kallikrein 4 in ectopic and normal control endometriosis tissues. Moreover, the underlying influence of Kallikrein 4 on migration and invasion of endometrial stromal cells was investigated. Furthermore, the correlations between this gene and E-cadherin and N-cadherin were also evaluated. The results demonstrated that the expression level of Kallikrein 4 in endometrial tissues was significantly increased compared to normal endometrial tissues, and over-expression of Kallikrein 4 up-regulated expression of N-cadherin but down-regulated E-cadherin in endometrial stromal cells. The ability of migration and invasion of endometrial stromal cells in vitro was increased by up-regulating Kallikrein 4 expression, suggesting that Kallikrein 4 might be involved in the development of ovarian endometriosis.

[Yun's optimized pelvic floor training therapy for idiopathic moderate overactive bladder with sexual dysfunction in young and middle-aged women]

OBJECTIVE

To explore the efficacy and safety of Yun's optimized pelvic floor training (OPFT) therapy for idiopathic moderate overactive bladder (OAB) with female sexual dysfunction (FSD) in young and middle-aged women.

METHODS

Eighty 25－45 years old women with idiopathic moderate OAB companied by FSD were randomized into an experimental and a control group of equal number, the former treated by 6 weeks of Yun's OPFT therapy, followed by a 2-week washout period and then another 6 weeks of traditional pelvic floor muscle exercises (PFME), while the latter by 6 weeks of traditional PFME, followed by a 2-week washout period also and then another 6 weeks of Yun's OPFT. At 0, 6 and 14 weeks, we recorded the scores on overactive bladder symptoms (OABS), patient perception of bladder condition (PPBC), Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7), pelvic floor muscle strength, voided volume (VV), average urinary flow rate (Qavg), maximum urinary flow rate (Qmax) and postvoid residual urine volume (PVR), female sexual function index (FSFI), sexual satisfaction of the male partners and adverse events, and compared the parameters obtained between the two groups of patients.

RESULTS

Thirty-eight of the patients in the experimental group and 29 controls completed the experiment. There were no statistically significant differences in the baseline data between the two groups (P > 0.05). After 6 and 14 weeks of treatment, the effectiveness rate was decreased from 71% to 58% in the experimental group, but increased from 45% to 72% in the control. Significant improvement was achieved in the experimental group in the OABS, PPBC, UDI-6 and IIQ-7 scores, pelvic floor muscle strength, VV, Qavg, Qmax, FSFI and sexual satisfaction of the male partners at 6 weeks as compared with the baseline (P < 0.05), and even more significant at 14 weeks than at 6 (P < 0.05), and so was it in the control group in the PPBC and IIQ-7 scores, VV, Qmax and sexual satisfaction of the male partners at 6 weeks (P < 0.05), and more significant in the OABS, PPBC, UDI-6 and IIQ-7 scores, pelvic floor muscle strength, FSFI and sexual satisfaction of the male partners at 14 than at 6 weeks (P < 0.05). The patients of the experimental group showed remarkably more improvement than the controls in the OABS, PPBC, UDI-6 and IIQ-7 scores, pelvic floor muscle strength, FSFI and sexual satisfaction of the male partners at 6 weeks (P < 0.05), while the control group exhibited significantly better improved OABS, PPBC, UDI-6 and IIQ-7 scores, pelvic floor muscle strength, VV, Qmax, PVR and FSFI than the experimental group at 14 weeks (P < 0.05). No serious adverse reactions were observed during the treatment.

CONCLUSIONS

Yun's OPFT therapy can improve the symptoms of moderate OAB with FSD in young and middle-aged women, with significantly better effects than traditional pelvic floor muscle exercises.

KDM5C is transcriptionally regulated by BRD4 and promotes castration-resistance prostate cancer cell proliferation by repressing PTEN

Prostate cancer (PCa) is one of the leading causes of cancer-related death worldwide, and it is almost incurable once it has developed into castration-resistance prostate cancer (CRPC). However, the mechanisms underlying the oncogenesis of PCa and CRPC remain elusive. Lysine-specific histone demethylase 5C (KDM5C) is an important member of lysine demethylase family and has recently been found highly expressed in multiple cancer types. In this study, we reported that KDM5C was highly expressed in PCa and CRPC specimens, and the high expression promoted CRPC cell proliferation through repressing phosphatase and tensin homolog (PTEN) gene epigenetically. Moreover, KDM5C was transcriptionally upregulated by bromodomain-containing protein 4 (BRD4), and knockdown KDM5C sensitized the therapeutic effects of CRPC cells to the bromodomain and extraterminal (BET) inhibitor. Taken together, our study uncovers that the BRD4-KDM5C-PTEN may be a new oncogenic pathway in CRPC development, and KDM5C is a critical protein and could be an ideal target for CRPC treatment in this oncogenic pathway.

Sumoylation Negatively Regulates CSR1-Dependent Prostate Cancer Cell Death

BACKGROUND/AIMS

SUMOylation is a dynamic process and reversed by the activity of SUMO-specific proteases (SENPs) family. SENP1, a member of this family, is highly expressed and plays oncogenic roles in diverse cancers including prostate cancer. However, the SENP1-transgenic mice exhibit aberrant transformation of the mouse prostate gland but do not develop cancer. Cellular Stress Response 1 (CSR1) is a tumor suppressor gene and frequently deleted in prostate cancers. Overexpression of CSR1 in prostate cancer cells inhibits colony formation, anchorage-independent growth and induces cell death.

METHODS

The relationship between CSR1 and SENP1 were determined by immunoprecipitation-based proteomics screen and verified by GST-pull down assay. In vivo SUMOylation assay was used to detect the direct effect of SENP1 in the regulation of CSR1. Clustered regularly interspaced short palindromic repeats (CRISPR)-based gene editing was used to generate Senp1-/- and CSR1-/- PC3 cells. FACS assay was used to determine the apoptosis ratio of cells after transfection.

RESULTS

CSR1 is SUMOylated at K582 and rapid ubiquitinated and degradated in prostate cancer cells. SENP1 interacts with and deSUMOylates CSR1 to prevent its degradation and enhances CSR1-dependent prostate cancer cell death.

CONCLUSION

Thus, our data indicates that CSR1 is a critical SUMOylated substrate of SENP1 that might partially explain the controversial roles of SENP1 in prostate cancer development.

[Effects of different computed high b-values on diffusion weighted imaging scores in Prostate Imaging Reporting and Data System version 2 of prostate cancer in peripheral zone]

Objective: To determine the effects of different computed high b-value on diffusion weighted imaging (DWI) scores in Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) of prostate cancer in peripheral zone. Methods: A retrospective study of 104 cases of prostate cancer in peripheral zone was conducted, all of the patients were histopathologically confirmed by transrectal ultrasound guided saturation biopsy or radical prostatectomy in Tongji Hospital of Tongji University from January 2012 to December 2015.All MRI imaging examinations were performed by using a 3.0T Siemens Verio MRI scanner.The imaging protocol consisted of high-resolution axial and sagittal T(2) weighted imaging (T(2)WI), axial acquired diffusion weighted imaging (aDWI) with b=0, 50, 1 000 s/mm(2) and dynamic contrast-enhanced (DCE) scans.Computed diffusion weighted imaging (cDWI) images with b=1 000, 1 400, 2 000 s/mm(2) were processed by Matlab.These three groups of cDWI images were analyzed according to the PI-RADS v2 criteria, and signal intensity of ratio (SIR) of lesions were analyzed by independent t test and one-way ANOVA in each group. Results: The numbers of cases with a DWI score of 2 and 5 were similar among three groups.Nine cases (33.3%) in all 27 cases with a DWI score of 3 on b=1 000 s/mm(2) upgraded to score 4 when b-value rose to 1 400 and 2 000 s/mm(2).The ratios of SIR of lesions in cases upgraded from DWI score 3 to 4 to those unchanged cases on b=1 400 and 2 000 s/mm(2) were 1.86±0.21 to 1.61±0.27 and 2.18±0.26 to 1.75±0.30, respectively (t=2.486, t=3.671, both P<0.05). In these 9 cases who upgraded to DWI score 4, SIRs of the lesion were significantly different between groups when b=1 000, 1 400 and 2 000 s/mm(2) (F=10.907, 33.768, 8.043, all P<0.05), and their SIRs increased with the rising of b-value. Conclusions: The computed high b-value (b≥1 400 s/mm(2)) mainly affects cases with a DWI score of 3, but DWI scores would not change neither in b=1 400 s/mm(2) nor in 2 000 s/mm(2) cases. For DWI score in PI-RADS v2 of prostate cancer in peripheral zone, b=1 400 s/mm(2) is probably of more scoring value than b=1 000 or 2 000 s/mm(2).

Intermediate-Term Outcomes and Complications of Long Segment Urethroplasty with Lingual Mucosa Grafts

PURPOSE

We evaluated outcomes and donor site complications in male patients with complex urethral strictures who underwent urethroplasty using with long strip oral mucosal grafts. We also analyzed whether a lingual mucosa graft is a good substitute for repairing long segment urethral strictures.

MATERIALS AND METHODS

This retrospective study was done in 81 male patients with complex urethral strictures who underwent oral mucosal graft urethroplasty. Patients with long segment (8 cm or greater) anterior urethral strictures who were considered candidates for long strip lingual mucosa graft urethroplasty were included in study.

RESULTS

Oral mucosal graft urethroplasty was performed in 81 patients with complex urethral strictures between August 2006 and December 2014. Mean urethral stricture length was 12.1 cm (range 8 to 20). A single 9 to 12 cm long strip lingual mucosa graft was used in 52 patients, a lingual mucosa graft greater than 12 cm was placed in 17 and a lingual mucosa graft combined with a buccal mucosal graft was used in 12. Mean followup was 41 months (range 15 to 86) postoperatively. The overall urethroplasty success rate was 82.7%. Urethral complications developed in 14 patients (17.3%), including urethral strictures in 10 and urethrocutaneous fistulas in 4. At 12 months 5 patients (6.2%) reported minimal difficulty with fine motor movement of the tongue.

CONCLUSIONS

Lingual mucosa harvested from the ventrolateral surface of the tongue can provide a wide and long graft that is an excellent urethral substitute. Donor site complications are primarily limited to postoperative year 1. Our study confirms that the lingual mucosa graft is a good substitute for urethral reconstruction and lingual mucosa graft urethroplasty is a valuable procedure to treat long anterior urethral strictures.

Emergence of a Novel Bluetongue Virus Serotype, China 2014

One hundred and twenty-six blood samples were collected from healthy sheep and goats in Xinjiang, China, during July 2014. Seventy-three samples (57.93%) were bluetongue virus (BTV) serology-positive, and 39 samples (30.95%) were BTV NS1 gene-positive. BTV strain XJ1407 was isolated from the blood of BTV NS1 gene-positive animals and sequenced. Analysis of its genome sequence suggests that XJ1407 is a novel BTV serotype.

Molecular characterization of the gene checkpoint homolog 1 in Daphnia carinata during different reproductive phases

Full-length cDNA of the gene checkpoint homolog 1 (Chk1) was cloned from Daphnia carinata and designated DcarChk1. DcarChk1 cDNA was 1817 bp in length and encoded a 497-amino acid polypeptide. Phylogenetic analyses revealed that DcarChk1 was most closely related to Chk1 of Daphnia pulex, followed by homologous genes of insects. Expression of DcarChk1 was higher in adult Daphnia than in larvae, and significantly higher in males than females, as determined by real-time polymerase chain reaction analysis. Using whole-mount in situ hybridization techniques, DcarChk1 in parthenogenetic females was found to be expressed mainly on the head surface, capillus, and carapace valve edge. In contrast, in sexual females, DcarChk1 was expressed mainly in the joint of the second antenna, and in the thoracic limbs and capillus. These results suggest that DcarChk1 plays a significant role in both the growth and development, as well as in regulating reproductive plasticity, in D. carinata.

Prevalence and risk factors of urinary incontinence among Chinese women in Shanghai

OBJECTIVE

A group of healthy females were randomly sampled in Shanghai for the purpose of evaluating the prevalence of urinary incontinence (UI) among Chinese women and its associated risk factors.

METHODS

5,467 registered female residents aged from 20 years were randomly sampled from four communities in Shanghai, and the Bristol Female Lower Urinary Tract Symptoms Questionnaire (the International Consultation Incontinence Questionnaire) was adopted. Detailed information regarding pregnancy, menstruation, and several demographic variables was also collected. Data were subsequently analyzed using McNemar's test, univariate analysis, multinomial logistic regression models, and binary logistic regression models.

RESULTS

The prevalence rate of UI was estimated to be 23.3%. The rate of stress UI (SUI) was 14.0% (761/5433), which was more prevalent than the rate of urgency UI (UUI) and mixed UI (MUI), which were 3.0% (164/5433) and 6.3% (341/5433), respectively. The risk factors associated with developing UI included aging, lack of education, poor living environment (specifically in the rural area), intense manual labor, the absence of physical exercise, hyperlipemia, diabetes, nocturia, consumption of greasy food, divorce or widowing, chronic pelvic pain (CPP), pelvic organ prolapse (POP), frequent urinary tract infection, and vaginal delivery without episiotomy. We also observed that most Chinese women were not aware of UI, which prevented them from seeking early treatment.

CONCLUSIONS

Urinary incontinence is a common disorder among Chinese women in Shanghai, and many risk factors contribute to the development of UI. Most Chinese women were not aware of UI, which prevented them from seeking early treatment.

[Diagnosis and treatment of yolk sac tumor of the testis with hydrocele in children: report of 7 cases]

OBJECTIVE

To study the clinical characteristics of yolk sac tumor of the testis with concomitant testicular hydrocele in children and the association between the two conditions in order to improve the diagnosis and treatment of the disease.

METHODS

We retrospectively analyzed the clinical data of 7 cases of stage-I yolk sac tumor of the testis with concomitant testicular hydrocele. The patients ranged in age from 6 to 14 (mean 11) months. As treatment, we performed radical high spermatic cord orchiectomy after diagnosis established on intraoperative frozen sections, and conducted follow-up visits by medical examination, serum alpha-fetoprotein (AFP) detection, chest X-ray, ultrasonography and CT for 3-41 (mean 17) months, every month in the first year, every 3 months in the second year and every 6 months in the third year after surgery.

RESULTS

Postoperative pathology confirmed yolk sac tumor in all the cases, with negative incisal margin. The level of serum AFP were decreased to normal in 6 cases within 1 month after surgery, all diagnosed as at stage I, and cured without chemotherapy. The other 1 case, with the serum AFP level of 116 microg/L at 1 month after operation, was diagnosed as at stage II and received PVC chemotherapy, but lost to follow-up at 3 months post-operatively.

CONCLUSION

Yolk sac tumor of the testis with concomitant testicular hydrocele is easily misdiagnosed in children. Ultrasonography is necessitated as routine examination in its diagnosis. Radical high spermatic cord orchiectomy can be performed for patients in stage I, and chemotherapy should follow for those in stage II. Its prognosis is similar to that of other yolk sac tumors. Hitherto, there has been no evidence for a definitive correlation between yolk sac tumor of the testis and hydrocele in children.

Early responses of the STAT3 pathway to platinum drugs are associated with cisplatin resistance in epithelial ovarian cancer

Cisplatin resistance remains one of the major obstacles when treating epithelial ovarian cancer. Because oxaliplatin and nedaplatin are effective against cisplatin-resistant ovarian cancer in clinical trials and signal transducer and activator of transcription 3 (STAT3) is associated with cisplatin resistance, we investigated whether overcoming cisplatin resistance by oxaliplatin and nedaplatin was associated with the STAT3 pathway in ovarian cancer. Alamar blue, clonogenic, and wound healing assays, and Western blot analysis were used to compare the effects of platinum drugs in SKOV-3 cells. At an equitoxic dose, oxaliplatin and nedaplatin exhibited similar inhibitory effects on colony-forming ability and greater inhibition on cell motility than cisplatin in ovarian cancer. Early in the time course of drug administration, cisplatin increased the expression of pSTAT3 (Tyr705), STAT3α, VEGF, survivin, and Bcl-X_L, while oxaliplatin and nedaplatin exhibited the opposite effects, and upregulated pSTAT3 (Ser727) and STAT3β. The STAT3 pathway responded early to platinum drugs associated with cisplatin resistance in epithelial ovarian cancer and provided a rationale for new therapeutic strategies to reverse cisplatin resistance.

Pathogenicity and distribution of highly pathogenic porcine reproductive and respiratory syndrome virus in pigs

The pathogenesis of highly pathogenic porcine reproductive and respiratory syndrome virus (PRRSV) strain (HuN4) is poorly understood. Therefore, highly pathogenic PRRSV strain (HuN4) and its derivative strain (HuN4-F112) (obtained by propagation in MARC145 cells for 112 passages) were inoculated into a total of 48 PRRSV-sero-negative pigs (age: 4-5 weeks) by the intranasal route. Virological, pathological and in situ hybridization analyses were performed. The results exhibited that pigs infected with HuN4 showed a loss of appetite, decrease in body weight, raised body temperature and respiratory symptoms, along with interstitial pneumonia lesions. In the HuN4 group, multifocal interstitial pneumonia with macrophage infiltration was found in the lung. The lesions in the lymph node were characterized by collapsed follicles, depletion of germinal centres and reduction in lymphocytes. Perivascular cuffing and glial nodules were observed in the brains of some pigs. By comparison, the HuN4-F112 group had milder lesions. PRRSV was detected in macrophages, alveolar epithelial cells and vascular endothelial cells in the tonsil and lymph nodes. The PRRSV amounts in the pigs infected with HuN4 were 10(5) -10(9) copies/ml in the blood and 10(10) -10(11) copies/g in the lung tissues, whereas the virus amounts with HuN4-F112 were 10(2.15) -10(3.13) copies/ml in the blood and 10(3.0) -10(3.6) copies/g in the lung. Our results demonstrate that the PRRS HuN4 virus infects alveolar epithelial cells, macrophages and vascular endothelial cells causing diffuse alveolar damage and lymph node necrosis. Its higher pathogenicity compared with HuN4-F112 virus may be explained in part by higher replication rate in the previously mentioned organs.

[Penoplasty with scrotal flap for the treatment of buried penis in children]

OBJECTIVE

To investigate the therapeutic effect of penoplasty with scrotal skin flap for the treatment of buried penis in children.

METHODS

The narrow ring was cut vertically at the ventral side of penis and the prepuce inner plate was circularly cut 0.5 cm from the coronary sulcus. The prepuce was degloved to the base of penis. The abnormal aponeurosis was removed completely. The prepuce was designed to cover the coronary sulcus. The scrotal flaps at both sides were formed and advanced to cover the penile base. Then the prepuce was sutured to reconstruct penile-scrotal angle and scrotum plasty was completed.

RESULTS

From March 2009 to July 2011, 24 children with buried penis were treated with scrotal flaps. Adhesion at external orifice of urethra was happened in two cases which recovered after urethra expansion. There was one case of necrosis at the distal end of prepuce. All the cases were followed up for 6 months to 2 years with no penile shrinkage. The penile appearance was good without rotation or lateral curvature during erection.

CONCLUSIONS

The buried penis can be best corrected with scrotal flap. It is an ideal method with less complication.

Reducing nocturia in the elderly: a randomized placebo-controlled trial of staggered furosemide and desmopressin

AIMS

The purpose of this study was to investigate efficacy, safety, and impact on quality of sleep of staggered furosemide and desmopressin in the treatment of nocturia in the elderly.

METHODS

Patients aged >60 years with nocturia at least two voids per night were screened for enrollment into the study. A 3-week dose-titration phase established the optimum desmopressin dose (0.1, 0.2, or 0.4 mg). After a 1-week "washout" period, patients who showed sufficient response during the dose-titration period were randomized to receive staggered furosemide and the optimal dose of desmopressin or placebo in a double-blind design for 3 weeks. Voiding diaries were assessed before and after the treatment.

RESULTS

In all, 82 patients were randomized to either staggered furosemide and desmopressin (n=41) or placebo (n=41). In the study group, most patients reported a good response with both reduced nocturnal voids (3.5 vs. 2.0, P<0.01) and urine volume (919.6 ml vs. 584.2 ml, P<0.01). The mean duration of the first sleep period was improved by 70 min (133.6 vs. 203.2, P<0.01). Compared to placebo, staggered furosemide and desmopressin resulted in a significant reduction in the mean number of nocturnal voids (43% vs. 9%; P<0.01), nocturnal urine volume (37% vs. 5%; P<0.01), and increase in the mean duration of the first sleep period (52% vs. 19%, P<0.01). Adverse events were mild.

CONCLUSIONS

Staggered furosemide and desmopressin provide an effective and well-tolerated treatment for nocturia in the elderly.

Evaluation of erectile function after urethral reconstruction: a prospective study

We conducted a prospective study of erectile dysfunction (ED) after urethral reconstructive surgery, using the 5-item International Index of Erectile Function (IIEF-5), the Sexual Life Quality Questionnaire (SLQQ) and the Quality of Life Questionnaire (QoLQ). Between January 2003 and July 2007, 125 male patients with urethral strictures underwent urethroplasty, and pre- and post-surgery erectile function was assessed using these three questionnaires. A formula to predict the probability of ED after urethroplasty was derived. At 3 months post-operatively, there was a significant decrease in IIEF-5 (16.57 +/- 7.98) and SLQQ scores (28.71 +/- 14.84) compared with pre-operative scores (P < 0.05). However, the IIEF-5 scores rebounded at 6 months post-operatively (17.22 +/- 8.41). Logistical regression analysis showed that the location of the urethral stricture, the recurrence of strictures and the choice of surgical technique were predictive of the post-operative occurrence of ED. This study identified the clinical risk factors for ED after urethroplasty. Posterior urethral stricture and end-to-end anastomosis were found to have a strong relationship with erectile function. The logistical model derived in this study may be applied to clinical decision algorithms for patients with urethral strictures.

[Reconstructive surgery for male urethral stricture affects erectile function and sexual life quality]

OBJECTIVE

To evaluate the influence of reconstructive surgery for male urethral stricture on erectile function and sexual life quality.

METHODS

We analyzed retrospectively the clinical data of 326 male patients who underwent urethroplasty for urethral stricture in our department and evaluated their erectile function and sexual life quality.

RESULTS

A total of 172 groups of valid data were collected, with the mean follow-up of 28.5 months. The mean scores on IIEF-5 (P=0.002) and sexual life quality (P=0.026) were statistically significantly reduced after surgery. Erectile dysfunction was found in 88 (51.2%) of the patients after urethroplasty, as compared with 56 (32.6%) preoperatively.

CONCLUSION

The location of urethral stricture, surgical method and urethral stricture recurrence may affect the erectile function and sexual life quality of the patient, but both can be gradually improved with the time after urethroplasty.

Ileal ureteric replacement with an ileo-psoas muscle tunnel antirefluxing technique for the treatment of long segment ureteric strictures

OBJECTIVES

To develop and report our initial experience with a novel antirefluxing technique for segmental ileal ureteric replacement for the treatment of long ureteric strictures.

PATIENTS AND METHODS

Between January 2000 and January 2007, 12 cases of ureteric strictures (nine bilateral and three unilateral) were treated using a novel surgical technique in which the ureter was replaced with a segment of ileum using an end-to-side anastomosis. An antireflux valve was constructed by fixing the distal part of upper ureter (4 cm) between the psoas muscle and ileal segment (the ileo-psoas tunnel technique). The distal ileum was connected to the urinary bladder with an end-to-side anastomosis.

RESULTS

The 12 cases were followed-up for a mean (range) of 39.42 (12-64) months. There were no cases of pyelonephritis or signs of renal failure after surgery. There was dramatic improvement in hydronephrosis, as assessed by intravenous urography, in the 4-9 months after surgery. Cystography showed no evidence of ileo-ureteric reflux. Mild hyperchloraemic acidosis was detected in two patients and was successfully treated with oral alkalization.

CONCLUSIONS

In our initial experience, ileal ureteric replacement combined with the ileo-psoas tunnel antirefluxing technique is a highly effective procedure for the treatment of ureteric strictures.

Proteomic Evaluation of Urine from Renal Cell Carcinoma Using SELDI-TOF-MS and Tree Analysis Pattern

There is no useful marker in screening and early diagnosis for renal cell carcinomas (RCCs), especially in the urine. To screen for specific markers in the urine of RCCs patients, surface enhanced laser desorption and ionization time of flight mass spectrometry (SELDI-TOF-MS) was used and coupled with a tree analysis pattern to develop SELDI protein profiling of urine. Urine samples from 58 RCC patients, 45 healthy volunteers, and 56 patients with other urogenital diseases were analyzed using IMAC-Cu ProteinChip capable of specifically binding metal interesting proteins. Proteomic spectra were generated by mass spectrometry. Bioinformatic calculations were performed with Biomarker Wizard software 3.0 (Ciphergen). Four differentially expressed potential biomarkers from urine were identified with the relative molecular weights of 4020, 4637, 5070, and 5500. The discriminatory classifier with a panel of the four biomarkers determined in the training set could precisely detect 24 of 30 (sensitivity, 80.0%) RCC and 52 of 58 (specificity, 89.6%) non-RCC samples. Furthermore, a sensitivity of 67.8% (19/28) and a specificity of 81.4% (35/43) for the blinded test were obtained when comparing the RCC vs. non-RCC. So SELDI-TOF combined with a tree analysis pattern could potentially serve as a useful tool for diagnosis of RCC by urine samples.

Reduced semen quality in chronic prostatitis patients that induce the release of apoptotic protein Omi/HtrA2 from spermatozoa

The relationship between chronic prostatitis and fertility has been disputed for many years. Several groups have shown infection and autoimmune response against prostate antigens could have a deleterious effect on semen quality and fertility. This study was conducted to test the hypothesis that Omi/HtrA2-induced apoptosis in chronic prostatitis could be a mechanism underlying the observed clinical benefit. The Omi/HtrA2 serine protease is a nuclear-encoded mitochondrial protein, which can be released from mitochondria into the cytosol after apoptosis stimuli, inducing apoptosis in caspase-dependent and independent manners. Forty-one patients diagnosed as suffering from chronic prostatitis were included. Healthy normal individuals were included as controls. Human spermatozoa in the semen were purified by Percoll-gradient technique to separate the seminal plasma and other round cells. Measurements for sperm concentration, motility, morphology, proinflammatory cytokines, Omi/HtrA2 mRNA and protein levels in spermatozoa of chronic protatitis patients, were performed accordingly. Significantly increased levels of proinflammatory cytokines were detected in seminal plasma from these prostatitis patients. Omi/HtrA2 mRNA and protein levels were significantly higher in prostatitis men than in normal men. This study shows that chronic prostatitis patients present important alterations in their semen quality parameters, Omi/HtrA2 mRNA and protein levels of spermatozoa. We speculate that the inflammatory process involved may affect male fertility by release of proapoptotic protein Omi/HtrA2.

An evaluation of surgical approaches for posterior urethral distraction defects in boys

PURPOSE

We present our preliminary experience with operative approaches in the treatment of complex posterior urethral distraction defects in children.

MATERIALS AND METHODS

A total of 24 boys 7 to 14 years old with obliterative complex posterior urethral distraction defects were treated with 1 of 3 surgical approaches between January 1998 and December 2002. A perineal approach was used in 5 cases, a transperineal-inferior pubic approach including distal urethral mobilization, corporeal body separation and inferior pubectomy in 10, and a combined transpubic-perineal approach in 9.

RESULTS

Patients were followed 1 to 5 years postoperatively. A successful result of no recurrence of stricture was achieved in 19 of 24 patients (79.2%), including 3 of 5 (60%) treated with a perineal approach, 9 of 10 (90%) with a transperineal-inferior pubic approach and 7 of 9 (77.8%) with a transpubic-perineal approach. Complications included 1 combined false passage, which was resolved using a transperineal-inferior pubic approach, 2 urethrocutaneous fistulas, which were resolved using a perineal approach in 1 and a transpubic-perineal approach in 1, and 3 rectourethral fistulas, which were resolved using a transpubic-perineal approach in 1 and a transperineal-inferior pubic approach in 1. Of the 9 patients treated with the transpubic-perineal approach 3 walked with an abnormal gait postoperatively.

CONCLUSIONS

The transperineal-inferior pubic approach fully exposes the space behind the pubis, does not damage pelvic stability and yields better results compared to the perineal and transpubic-perineal approaches. We recommend it as first line operative treatment for complex posterior urethral distraction defects in boys.

Staged pendulous-prostatic anastomotic urethroplasty followed by reconstruction of the anterior urethra: an effective treatment for long-segment bulbar and membranous urethral stricture

OBJECTIVES

To describe a novel surgical technique for male long-segment urethral stricture after pelvic trauma using the intact and pedicled pendulous urethra to replace the bulbar and membranous urethra, followed by reconstruction of the anterior urethra.

METHODS

Two patients with long-segment post-traumatic bulbar and membranous urethral strictures with short left pendulous urethras who had undergone several failed previous surgeries were treated with staged pendulous-prostatic anastomotic urethroplasty followed by reconstruction of the anterior urethra. This procedure was divided into three stages. First-stage surgery was mobilization of the anterior urethra down to the coronary sulcus and then rerouted to the prostatic urethra followed by pendulous-prostatic anastomotic urethroplasty with transposition of the penis to the perineum. Second-stage surgery was transecting the anterior urethra at the revascularised coronary sulcus 6 mo later, followed by straightening of the penis and urethroperineostomy. Third-stage surgery was reconstruction of the anterior urethra 6 mo later.

RESULTS

Postoperatively, the two patients reported satisfactory voiding. For patient 1, retrograde urethrography showed that the urethra was patent, and that the mean maximal flow rate (MFR) was 18.4 ml/s with no postvoiding residual urine after the third-stage surgery and at 3-yr follow-up. For patient 2, a 22F urethral catheter could pass smoothly through the urethra, and the MFR was 19.5 ml/s with no postvoiding residual urine at 2-yr follow-up.

CONCLUSIONS

This procedure was an effective surgical option for men with complex long-segment post-traumatic bulbar and membranous urethral strictures, especially for those who had undergone failed previous surgical treatments.

Tree analysis of mass spectral urine profiles discriminates transitional cell carcinoma of the bladder from noncancer patient

BACKGROUND

Recent advances in proteomic profiling technologies, such as surface-enhanced laser desorption/ionization mass spectrometry (SELDI), have allowed preliminary profiling and identification of tumor markers in biological fluids in several cancer types and establishment of clinically useful diagnostic computational models. We developed a bioinformatics tool and used it to identify proteomic patterns in urine that distinguish transitional cell carcinoma (TCC) from noncancer.

METHODS

Proteomic spectra were generated by mass spectroscopy (surface-enhanced laser desorption and ionization). A preliminary "training" set of spectra derived from analysis of urine from 46 TCC patients, 32 patients with benign urogenital diseases (BUD), and 40 age-matched unaffected healthy men were used to train and develop a decision tree classification algorithm that identified a fine-protein mass pattern that discriminated cancer from noncancer effectively. A blinded test set, including 38 new cases, was used to determine the sensitivity and specificity of the classification system.

RESULTS

The algorithm identified a cluster pattern that, in the training set, segregated cancer from noncancer with sensitivity of 84.8% and specificity of 91.7%. The discriminatory pattern correctly identified. A sensitivity of 93.3% and a specificity of 87.0% for the blinded test were obtained when comparing the TCC vs. noncancer.

CONCLUSIONS

These findings justify a prospective population-based assessment of proteomic pattern technology as a screening tool for bladder cancer in high-risk and general populations.

[Screening urine markers of renal cell carcinoma using SELDI-TOF-MS]

OBJECTIVE

To screen relatively specifical markers in urines from renal cell carcinoma patients using surface-enhanced laser desorption and ionization time of flight mass spectrometry (SELDI-TOF-MS) ProteinChip technology.

METHODS

Urine samples from 40 renal cell carcinoma (RCC) patients, 40 healthy volunteers and 40 patients with other urogenital diseases were analyzed using IMAC-Cu-3 PoteinChip, which can specifically bind the metal-combining-proteins. Proteomic spectra were generated by mass spectrometry.

RESULTS

Four differentially expressed potentially biomarkers were identified with the relative molecular weights of 4020, 4637, 5070, and 5500. The sensitivity for diagnosing RCC was 57.5%, 66.7%, 63.7%, 65%, and specificity was 86.2%, 95%, 82.5% and 75% when the critical points were 2.0, 5.0, 5.0 and 5.0 respectively.

CONCLUSIONS

SELDI-TOF-MS ProteinChip technology is a quickly, easy and convenient, and high-throughput analyzing method capable of screening several relatively specific, potential biomarkers from the urines of RCC patients and had better clinical value.

1-stage urethral reconstruction using colonic mucosa graft for the treatment of a long complex urethral stricture

PURPOSE

We investigated the possibility of urethroplasty with a free graft of colonic mucosa for long, complex urethral strictures. We report our initial experience with colonic mucosa graft urethroplasty for such urethral strictures in 16 patients.

MATERIALS AND METHODS

Between September 2000 and December 2002, 16 patients with a long, complex urethral stricture were treated with colonic mucosal graft urethroplasty. Patients had undergone an average of 2.5 previous unsuccessful repairs. Urethral reconstruction was done with a 10 to 17 cm (median 13) graft of colonic mucosa

RESULTS

Patients were followed 6 to 33 months postoperatively. Meatal stenosis that developed in 1 patient 3 months postoperatively needed reoperation. The patient was voiding well with a urinary peak flow of 28.7 ml per second during 9-month followup after reoperation. Hyperplasia of the verumontanum was observed during urethroscopy and transurethral colliculectomy was performed in 1 patient more than 14 months postoperatively. Uroflowmetry showed a urinary peak flow of 46.5 ml per second postoperatively. The other patients were voiding well with a urinary peak flow of greater than 15 ml per second. Urethrogram revealed a patent urethra with an adequate lumen and no significant graft sacculation.

CONCLUSIONS

This initial experience in 16 patients indicates that colonic mucosa graft urethroplasty is a feasible procedure for long, complex anterior urethral strictures. The technique may be considered for urethral reconstruction when more conventional procedures have failed.

One-stage urethral reconstruction using colonic mucosa graft: An experimental and clinical study

AIM: To investigate the possibility of urethral reconstruction with a free colonic mucosa graft and to present our preliminary experience with urethral substitution using a free graft of colonic mucosa for treatment of 7 patients with complex urethral stricture of a long segment.

METHODS: Ten female dogs underwent a procedure in which the urethral mucosa was totally removed and replaced with a free graft of colonic mucosa. A urodynamic study was performed before the operation and sacrifice. The dogs were sacrificed 8 to 16 wk after the operation for histological examination of urethra. Besides, 7 patients with complex urethral stricture of a long segment were treated by urethroplasty with the use of a colonic mucosal graft. The cases had undergone an average of 3 previous unsuccessful repairs. Urethral reconstruction with a free graft of colonic mucosa ranged from 10 to 17 cm (mean 13.1 cm). Follow-up included urethrography, urethroscopy and uroflowmetry.

RESULTS: Urethral stricture developed in 1 dog. The results of urodynamic studies showed that the difference in the maximum urethral pressure between the pre-operation and pre-sacrifice in the remaining 9 dogs was not of significance (P > 0.05). Histological examination revealed that the colonic free mucosa survived inside the urethral lumen of the 10 experimental dogs. Plicae surface and unilaminar cylindric epithelium of the colonic mucosa was observed in dogs sacrificed 8 wk after the operation. The plicae surface and unilaminar cylindric epithelium of the colonic mucosa was not observed, and metaplastic transitional epithelium covered a large proportion of the urethral mucosa in dogs sacrificed 12 wk after the operation. Clinically, the patients were followed up for 3-18 mo postoperatively (mean 8.5 mo). Meatal stenosis was developed in 1 patient 3 mo postoperatively and needed reoperation. The patient was voiding very well with urinary peak flow 28.7 mL/s during the follow-up of 9 mo after reoperation. The other patients were voiding well with urinary peak flow greater than 15 mL/s. Urethrogram revealed a patent urethra with an adequate lumen with no significant graft sacculation. Neither necrosis of neourethral mucosa nor stenosis at the anastomosis sites has been observed on urethroscopy in 4 patients over 6 mo after operation.

CONCLUSION: Urethral mucosa can be replaced by colonic mucosa without damaging the continence mechanism in female dogs. Colonic mucosa graft urethral substitution is a feasible procedure for the treatment of complex urethral stricture of a long segment. The technique may be considered when more conventional options have failed or are contraindicated.

Malignant lymphoepithelial lesion of the parotid gland: a case report and review of the literature

Malignant lymphoepithelial lesions are rare tumors of the major salivary glands. They most often occur in Asians and Greenland Eskimos and are strongly associated with Epstein-Barr virus infection. We report a case of a malignant lymphoepithelial lesion of the parotid gland that developed in an Italian-American woman whose serology was positive for Epstein-Barr virus antibody. The patient underwent a left total parotidectomy and upper neck dissection, followed by radiation therapy. At the 2-year follow-up, she remained free of disease.

[Studies on the chemical constituents from Chrysanthemum morifolium Ramat]

OBJECTIVE

To study the chemical constituents of Chrysanthemum morifolium.

METHOD

Separated the constituents by means of chromatography and identified their structures by chemical and spectroscopic analysis.

RESULT

Three compounds of flavonoid were identified as acacetin-7-O-beta-D-glucoside, apigenin-7-O-beta-D-glucoside and luteolin-7-O-beta-D-glucoside.

CONCLUSION

These compounds were obtained from C. morifolium for the first time.

Genetic polymorphism of RhD-negative associated haplotypes in the Chinese

The Rh blood group is the most polymorphic human blood group system, and is clinically significant in transfusion medicine. Individuals are classified as Rh-positive and Rh-negative depending on the presence or absence of the D antigen on the red cell surface. The RhD-negative trait could be generated by multiple genetic mechanisms, which have been shown to be ethnic group-dependent. In this study, we evaluated the status of seven RHD-specific exons (exons 3, 4, 5, 6, 7, 9, and 10) and RH intron 4 in 119 Chinese blood donors, using the sequence-specific primers polymerase chain reaction (SSP-PCR). Of the 87 individuals who were RhD-negative, 52 with the ce/ce, ce/cE, or Ce/ce genotype (60%) lacked the above seven RHD exons; 22 with the Ce/Ce or Ce/ce genotype (25%) had all the RHD exons examined; 13 with the Ce/ce genotype (15%) carried at least one RHD exon. Antigen association analysis suggested the existence of a novel class of RhD-negative associated haplotypes in the Chinese, tentatively denoted D(nf)Ce. The D(nf)Ce haplotype consisted of a normal RHCe allele and a nonfunctional RHD gene, which vary depending on the structure of the RHD gene. Among the RhD-negative Chinese, the estimated frequencies of the dce, dCe, and D(nf)Ce haplotypes were 0.7500, 0.0465, and 0.2035, respectively. No statistically significant deviation from Hardy-Weinberg equilibrium was observed using this genetic model.

Acute esotropia may be a presenting sign of intracranial neoplasm

Here we report eight consecutive patients with intracranial neoplasm at different ages clinically presenting with acute esotropia. Among these patients, two had divergent paresis, four had bilateral abducens paresis and the other two had unilateral abducens nerve paresis. All of these patients have intracranial neoplasm demonstrated by neuroimaging studies. Besides of acute esotropia, four had papilledema, one had optic atrophy, and three had associated other neurological signs. Of the eight patients, three patients are children, and the other five are adults. In the adult group, four patients are less than 45 years old. In conclusion, acute esotropia may be an early presenting sign of brain tumor and careful evaluation of associated clinical symptoms/signs is mandatory, especially in the young age group.

Further analysis of the phenotype and distribution of tumor cells in sporadic B-cell and T-cell lymphomas in the lymph node and spleen of cattle

Immunohistologic studies were performed to identify the phenotype and distribution of neoplastic lymphocytes in the spleens of BLV-negative animals examined by PCR and diagnosed as having sporadic bovine leukosis. Tumor cells from three cases of sporadic bovine leukosis were identified as of B-cell lineage. Tumor cells from three additional cattle were identified as CD3+ CD4- CD8+, CD3+ CD4- CD8-, and CD3+ CD4- WC1+, respectively. The last case was diagnosed as a gamma/delta T-cell lymphoma. Differences in morphology proliferative characteristics were recognized between B- and T-cell type lymphomas. The tumor cells in B-cell type lymphoma were characterized as follows: medium or large in size, round or polymorphic nucleus with rough chromatin with some tumor cells containing a convoluted nucleus. These tumor cells of B-cell type lymphoma were present in the red pulp and periarteriolar lymphoid sheath. Tumor cells of the T-cell type lymphoma were uniformly smaller than B-cell type and present around arteries or replaced red pulp of the spleen.

Opioid modulation of fetal glucose homeostasis: role of receptor subtypes

Opioids have long been known to influence glucose homeostasis in the adult. However, their role in modulating glucose regulation in the fetus is not known. The objectives of this study were to determine the effects of morphine on fetal plasma glucose levels and to ascertain the role of opioid receptor subtypes in fetal glucose homeostasis. The studies were carried out in 38 unanesthetized fetal sheep (123-142 days) (term being approximately 145 days). Intravenous infusion of morphine to the fetus resulted in dual actions on fetal plasma glucose, with hypoglycemia after 1.2 mg/hr (F3,16 = 6.02; P = .006; n = 5) and hyperglycemia after 5.0 mg/hr (F3,16 = 5.58; P = .008; n = 5). Significant increase in plasma lactate concentration also was found after 5.0 mg/hr (F3, 16 = 5.25; P = .010). Both hypoglycemia and hyperglycemia were antagonized by i.v. naloxone, indicating both were mediated by specific opioid receptors. The mu-selective agonist, [D-Ala2,N-Me-Phe4,Gly5-ol]-enkephalin (100 micrograms/hr i.c.v., n = 6), resulted in a significant increase in both plasma glucose (F3,20 = 11.50; P = .001) and lactate (F3,20 = 3.77; P = .007) concentrations. In contrast, the delta-selective agonists, [D-Pen2,D-Pen5]-enkephalin (30 and 100 micrograms/hr i.c.v.) and [D-Ala2]-deltorphin I (0.3 and 1.0 micrograms/hr i.c.v.) had no effect on plasma glucose or lactate levels. Similarly, Dynorphin A(1-13) (160 and 480 micrograms/hr i.c.v.) and U50,488H [trans-(+/-)-3,4-dichloro-N-methyl-[2-(1-pyrrolidinyl)-cyclohexyl] benzeneacetamide] (200 micrograms/hr i.c.v.) also had no effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Lack of relationship between opioid-induced changes in fetal breathing and plasma glucose levels

The mechanisms by which opioids increase or decrease fetal breathing remain unclear. Fetal plasma glucose is known to modulate breathing activity, and opioids have been reported to alter glucose regulation in the adult. In this study, we investigated whether alterations in fetal breathing by opioids may be explained by changes in plasma glucose levels. We compared the effects of morphine (nonselective), [D-Ala2,N-Me-Phe4,Gly5-ol]enkephalin (DAMGO, mu-selective), and [D-Pen2,D-Pen5]enkephalin (DPDPE, delta-selective) on fetal breathing and plasma glucose in unanesthetized fetal sheep. Whereas morphine at 1.2 and 5.0 mg/h iv resulted in an increase in breath number (P < 0.01), plasma glucose was decreased after 1.2 mg/h (P = 0.006) but increased after 5.0 mg/h (P = 0.008). DAMGO (100 micrograms/h icv) increased plasma glucose (P = 0.001) but reduced fetal breathing (P < 0.001). In contrast, DPDPE (30 micrograms/h icv) increased fetal breathing (P = 0.026) but had no effect on plasma glucose concentration. These data demonstrate that the actions of opioids on fetal glucose regulation and breathing are dependent on dose and receptor selectivity. However, there is no relationship between the effects of opioids on fetal breathing and plasma glucose concentration.

Effects of the delta-opioid agonist, [D-Pen2,D-Pen5]-enkephalin, on fetal lamb EEG

Opiates are known to exert biphasic effects on level of arousal, with excitation at low doses and depression at higher doses. It has been suggested that this dual excitatory and depressant actions of opiates may be mediated by different receptor subtypes. We have previously shown that activation of mu 1-opioid receptors evoked EEG activation in the fetal lamb. The purpose of the present study was to quantitate the effects of DPDPE, a highly selective delta-opioid agonist, on fetal EEG. When infused ICV (4.6-154 nmol/h), DPDPE elicited dose-dependent activation of fetal EEG, with a reduction in power distribution in the delta (1-4 Hz) band, and an increase in the beta (15-32 Hz) band. This activation was reflected by an increase in the spectral edge frequency. This EEG activation was greatly attenuated at DPDPE doses greater than 154 nmol/h, resulting in a U-shaped dose-response curve. The EEG activation was completely blocked by naloxone or naltrindole (delta antagonist), but not by naloxonazine (mu 1 antagonist). These results indicate that the activation of delta-opioid receptors will evoke EEG activation in the fetal lamb.

Maternal marijuana smoking alters respiratory timing in the fetal lamb

The effect of single and repeated maternal marijuana smoke exposure on fetal breathing movements (FBMs) was investigated in 13 fetal lambs in the third trimester. These animals were surgically instrumented for long-term intrauterine recording of diaphragmatic electromyogram (EMG). Maternal inhalation of marijuana smoke [1.84% tetrahydrocannabinol (THC)] increased FBMs and resulted in a more continuous and regular breathing pattern. There was a significant increase in the number of breaths/h (p < 0.01) and the incidence of FBMs (p < 0.001) in the second hour. Breathing activity returned to presmoke level by the third hour. Duration of the longest breathing epoch was significantly increased from 16.8 +/- 3.3 min to 31.9 +/- 5.2 min (p < 0.005). Instantaneous breathing rate was much more stable in the second hour after marijuana exposure (p < 0.01). Inhalation of placebo smoke did not result in any significant change in either overall breathing activity or continuity and stability of the breathing rate. The effects of marijuana smoke on fetal breathing were not observed after repeated smoke exposure. These results suggest that tolerance develops rapidly to the respiratory stimulating effect of marijuana smoke in the fetus.

Central opioid modulation of breathing dynamics in the fetal lamb: effects of [D-Pen2,D-Pen5]-enkephalin and partial antagonism by naltrindole

The effects of opiates on fetal breathing movements (FBM) have been shown to be complicated, with stimulation at low doses and suppression at higher doses. Recent studies have shown that morphine-induced stimulation of FBM can be blocked by naloxonazine (NALZ), suggesting action at the mu 1 opioid receptor. To examine the role of delta receptors in modulating FBM, the effects of [D-Pen2,D-Pen5]-enkephalin (DPDPE) on breathing dynamics were studied in fetal lambs with chronically implanted diaphragmatic electromyographic electrodes. DPDPE given i.c.v. (4.6-465 nmol/hr) caused significant time and dose-related increases in the number of breaths/hr and the incidence of fetal breathing movements, without significant changes in blood pH, PCO2 or PO2. Higher doses resulted in an attenuation of the responses, with a significant decrease in breaths/hr at 465 nmol/hr. DPDPE also induced a much more continuous and regular breathing pattern. All DPDPE effects were completely abolished by pretreatment with i.v. naloxone, but were unaffected by naloxonazine pretreatment. Naltrindole did not alter the effects of DPDPE on breath number or incidence of FBM, but blocked the effects on continuity and regularity of the breathing pattern. These results demonstrate that DPDPE stimulates breathing activity as well as alters breathing dynamics in the fetal lamb. The differential sensitivity of these two actions to naltrindole suggest that they may be mediated by different delta receptor subtypes, and that the mu 1 receptor is not involved.

Fractal properties in fetal breathing dynamics

The dynamic pattern of fetal breathing was studied in 17 fetal lambs with chronically implanted electromyographic electrodes in the diaphragm. The instantaneous breathing rate time series appeared similar on different time scales, with clusters of faster breathing rates interspersed with periods of relative quiescience, suggesting self-similarity. Distribution histograms of the interbreath intervals (IBIs) showed log-normal distribution for IBIs less than 1 s and inverse power-law distribution for IBIs greater than 1 s. The ratio of log-normal distribution to power-law distribution varied from approximately 2 at 102 days to approximately 30 by 130 days of gestation. Fast Fourier transform of the breathing rate time series revealed 1/f beta power spectra for all animals, with beta increasing linearly from 0.43 to 0.88 between 102 and 139 days. Studies in the newborn lamb showed further maturation in both the distribution characteristics of the IBIs, as well as in the 1/f power spectra, with beta approaching 1.0 at 2 days after birth. The inverse power-law relationship in the distribution of the IBIs, together with the 1/f beta power spectra, indicate scale invariance and suggest that fractal mechanisms are involved in the regulation of fetal breathing.

Developmental changes in continuity and stability of breathing in the fetal lamb

Developmental changes in the continuity and stability of fetal breathing patterns were studied in 27 fetal lambs with chronically implanted electromyographic electrodes in the diaphragm throughout the third trimester (102-140 days). The results showed that there was a progressive decrease in the incidence of fetal breathing movements throughout the third trimester (P less than 0.001). This reduction in incidence of fetal breathing movements was due, in part, to a 20% decrease in the total number of breathing bursts at approximately 125 days (P = 0.05). The breathing patterns in both immature (less than 120 days) and mature fetal lambs were fragmented by a large number of pauses (interburst interval 6-10 s) and apneas (interburst interval greater than 10 s). Increase in gestational age was associated with a decrease in the number of pauses and apneas but longer apnea durations. The breathing pattern in fetuses less than 120 days old was more continuous than that in those greater than 120 days old, as demonstrated by significantly longer epoch durations (P = 0.013). There was no significant change in the continuity of the breathing pattern after 120 days. However, there was a significant increase in the stability of the instantaneous breathing rates throughout the third trimester. This was indicated by a significant increase in the percent of breathing bursts that occurred in stable clusters (P = 0.046), the number of bursts per cluster (P = 0.013), and cluster duration (P = 0.018). Thus an increase in stability appears to be the major developmental change in breathing control in late gestation.

Sinus automaticity and sinoatrial conduction in severe symptomatic sick sinus syndrome

Electrophysiologic studies with recordings of sinus node electrograms were performed in 38 patients with severe symptomatic sick sinus syndrome. Thirty-two of the 38 patients had episodic tachyarrhythmias and 17 presented with syncope. The clinically documented sinus or atrial pause was 5.6 +/- 2.8 s (mean +/- SD). Patients were divided into three groups according to electrophysiologic findings. Group I consisted of nine patients with complete sinoatrial block. Sinus node electrograms were recorded during the episodes of long pauses. Seven patients had unidirectional exit block, with the atrial impulse being capable of retrograde penetration to the sinus node causing suppression of sinus automaticity; two had bidirectional sinoatrial block. Group II consisted of 22 patients with either 1:1 sinoatrial conduction (group IIa = 13 patients) or second degree sinoatrial exit block (group IIb = 9 patients) during spontaneous sinus rhythm. Sinoatrial exit block, ranging from 1 to greater than 14 sinus beats, was observed during postpacing pauses that ranged from 1,650 to 37,000 ms (mean 7,286 +/- 6,989). The maximal sinus node recovery time ranged from 770 to 5,580 ms (mean 3,004 +/- 1,686) and was normal in 5 patients and prolonged in 17. Group III consisted of seven patients with no recordable sinus node electrogram, reflecting either a technical failure or a quiescence of sinus activity. The sinus node recovery time in these seven patients ranged from 1,190 to 4,260 ms (mean 2,949 +/- 1,121). Thus, abnormalities in both sinus node automaticity and sinoatrial conduction are responsible for the long sinus or atrial pauses in the sick sinus syndrome. However, complete sinoatrial exit block can occur and cause severe bradycardia with escape rhythm; repetitive sinoatrial exit block plays a major role in producing posttachycardia pauses.

Effects of single and repeated marijuana smoke exposure on fetal EEG

The effect of single and repeated marijuana smoke exposure on fetal EEG was investigated in the chronic fetal lamb model using power spectral analysis. Maternal inhalation of marijuana smoke (n = 9) resulted in a significant reduction in total power and power distribution in the delta (1-4 Hz) band, and an increase in power distribution in the faster frequencies in the first h after smoke inhalation. These EEG changes were not observed following maternal inhalation of placebo smoke (n = 5), nor in animals with 3-5 prior exposures to marijuana smoke (n = 5). These results suggest that the effects of marijuana smoke exposure on fetal EEG is short-lived and tolerance develops rapidly with repeated exposure.

Morphine-induced stimulation of fetal breathing: role of mu 1-receptors and central muscarinic pathways

The mechanism of action of low doses of morphine on breathing dynamics in the fetus was studied in 16 fetal lambs with chronically implanted electromyographic electrodes in the diaphragm. Morphine (0.15-2.5 mg/h) caused a significant dose-dependent increase in the number of diaphragmatic bursts per hour, with either an increase or no change in instantaneous breathing rate. There was also a significant dose-related increase in the continuity of the breathing pattern, as indicated by a decrease in the number of apneas per hour, and an increase in epoch duration. Morphine also had a significant effect on the stability of the breathing pattern, with an increase in the percentage of bursts that occurred in stable clusters. All of these effects were completely abolished by concurrent intracerebroventricular administration of either methylnaloxone or methylatropine or by pretreatment with intravenous naloxonazine. These results suggest that stimulation and stabilization of ventilatory activity in the fetal lamb by low doses of morphine are mediated via mu 1-receptors and involve central muscarinic pathways.

The effects of selective mu1 opiate receptor blockade on breathing patterns in the fetal lamb

The effects of naloxone and naloxonazine (an irreversible mu1 antagonist) administration on fetal breathing movement (FBM) patterns under control, physiologic conditions were studied in 10 fetal lambs with chronically implanted electromyogram electrodes in the diaphragm. Neither naloxone (6 mg/h) nor naloxonazine (34 mg) had any effect on the total number of diaphragmatic electromyogram bursts per hour, mean instantaneous breathing rate, or incidence of breathing. However, naloxonazine caused a more fragmented FBM pattern, as indicated by a significant increase in both the number of apneas and pauses per hour, along with decreased epoch duration. In addition, naloxonazine caused a significant reduction in the stability or regularity of the breathing rate. Naloxone had no effects on the dynamic pattern of the FBM. These results suggest that endogenous opiate peptides play a tonic role at the mu1, receptor to maintain both the continuity and stability of the FBM pattern in late gestation.

Immunogold labelling of the intermediate filament-lamina-nuclear matrix system in HeLa and BHK-21 cells

Whole-mount, sequentially extracted cells combined with immunogold electron microscopy were developed to demonstrate the intermediate filaments, lamina, and nuclear matrix (IF-L-NM) and to identify their protein components. The IFs of HeLa cells were reacted both with keratin and vimentin monoclonal antibodies; meanwhile, the IF network of BHK-21 cell was reacted only with vimentin monoclonal antibody. The lamina and nuclear matrices of both HeLa and BHK-21 cell were labelled, respectively, with lamin monoclonal antibody-gold complex and 280 Kd nuclear matrix protein monoclonal antibody-gold complex. The monoclonal antibody to keratin could cross-react with the lamina both of HeLa and BHK-21 cells.