Characteristics of male fertility after renal transplantation

We investigated factors such as time span between transplantation and having offspring, the dosage of immunosuppressive agents during fertilisation and the effects of fertilisation on recipient's renal allograft function in 212 male recipients registered at eight Chinese organ transplantation centres. Our results are as follows: the 212 male renal allograft recipients conceived with their wives between 15 and 204 months after transplantation. The wives who became pregnant at 15-24 months after the renal transplantation gave birth to a total of 20 babies with an average weight of 3115 ± 517 g, of which 3 (15.0%) were premature. The wives who became pregnant at 25-204 months after the renal transplantation gave birth to a total of 196 babies with an average weight of 3384 ± 438 g, of which 6 (3.1%) were premature. All recipients had normal renal function during the fertile period. In conclusion, the fertility capacity of male renal allograft recipients was associated with the time after transplantation and the dose of immunosuppressive agents used during fertilisation. It might be helpful to have a fertility capacity evaluation before fertilisation. There were no effects of fertility on renal allograft function.

[Effects of a new houttuyfonate derivative on proliferation of NIH3T3 cell and expression of syndecan-4 induced by tumor necrosis factor alpha]

OBJECTIVE

To investigate the effect of a new houttuyfonate derivative (NHD) on proliferation of NIH3T3 cell and expression of Syndecan-4 induced by TNF-alpha in vitro.

METHODS

NIH3T3 cells were cultured and exposed to TNF-alpha or NHD respectively, and then cotreated with TNF-alpha and NHD. All the groups were cultured for 24 hour in vitro, in addition to the untreated control group established for comparison. The ratio of proliferation of NIH3T3 cell was determined by non-radioactive MTS/PMS assay and the expression of Syndecan-4 was evaluated by western blot using anti-Syndecan-4 antibody.

RESULTS

Statistical analysis showed that, compared with the control group, NHD had no effect on VSMCs growth, but significantly inhibited NIH3T3 cell proliferation while induced by TNF-alpha. It also showed that compared with control group, NHD had no effect on the expression of Syndecan-4, but significantly inhibited its expression while induced by TNF-alpha (P < 0.05).

CONCLUSIONS

NHD can inhibit the proliferation of NIH3T3 cell and the expression of syndecan-4 protein induced by TNF-alpha in vitro.

Cloning and characterization of a novel neurotoxin from the sea anemone Anthopleura sp

A full-length cDNA of neurotoxin (Hk2a) was isolated by RT-PCR of total RNA isolated from tentacles of Anthopleura sp. using degenerate oligonucleotide primers and 3',5'-RACE. The cDNA sequence of Hk2a encoded a polypeptide of 47 amino acids, which lacks a typical N-terminal signal sequences commonly found in proteins that are secreted via endoplasmic reticulum-Golgi pathway, indicating the possibility of secretion via a non-classical pathway. The neurotoxin has a predicted molecular mass of 4.8 kDa and a pI value of 7.62. The amino acid sequence of Hk2a is very similar to Anthopleurin C (Ap-C) and Neurotoxin I (Af I), and shares 95% amino acid sequence similarity to Ap-C. The coding region for the matured Hk2a toxin was cloned into the thioredoxin (TRX) fusion expression vector (pTRX) for the fusion expression in Escherichia coli. The recombinant polypeptide of Hk2a (rHk2a) was purified by the affinity chromatography, 15 mg/l of rHk2a was obtained after the digestion with protease 3C and further purification. The molecular weight of rHk2a (5.078 kDa) obtained by MALDI-TOF was very close to that (5Da) calculated from the sequence. The results of the UV-circular dichroism spectra of rHk2a indicates that its secondary structure is similar to that of Ap-B (), having 61.7% beta-sheet and no alpha-helix. Investigation on pharmacological effects of rHk2a in vitro was undertaken, and it was found that LD(50) of rHk2a was 1.4 mg/kg on NIH mice (i.p.). The rHk2a was demonstrated to increase contracting activity on isolated SD rat atria with the enhancing degree reaching 343.5+/-160.5%. The increase in contractile amplitude reached a plateau value within 3-5 min after addition of this toxin.

Recombinant human interleukin-10 inhibits proliferation of vascular smooth muscle cells stimulated by advanced glycation end products and neointima hyperplasia after carotid injury in the rat

The purposes of this study was to determine the effects of recombinant human interleukin-10 (rhIL-10) on proliferation of vascular smooth muscle cells (VSMCs) stimulated by advanced glycation end products (AGE) and neointima hyperplasia after rat carotid arterial injury. Rat aortic VSMCs were cultured and treated with rhIL-10 or AGE respectively, and then co-treated with rhIL-10 and AGE. Proliferation of VSMCs was quantified by colormetric assay. Cell cycle analysis was performed by flow cytomertry. Sprague-Dawley rats were treated with recombinant human IL-10 (rhIL-10) for 3 d after carotid arteries injury. The ratio of neointima to media area at the site of arterial injury was measured 28 d after balloon injury. The p44/42 MAPK activity was evaluated by the immunoblotting technique using anti-p44/42 phospho-MAPK antibody. Compared to control, AGE stimulated VSMCs proliferation. rhIL-10 alone had no effect on VSMCs growth. With AGE stimulation, rhIL-10, at dose as low as 10 ng/ml, inhibited VSMCs growth (P<0.05). The cell number in G(0)/G(1) phase of AGE and rhIL-10 co-treatment group was higher than that of AGE treatment alone (P<0.01) by flow cytometry analysis. Compared with the control group of neointima hyperplasia in rats, the ratio of neointima to media area of recombinant human IL-10 group was reduced by 45% (P<0.01). The p44/42 MAPK activity was significantly enhanced by AGE. The AGE effects were opposed by rhIL-10. The anti-inflammatory cytokine rhIL-10 inhibits AGE-induced VSMCs proliferation. Recombinant human IL-10 also inhibited neointima hyperplasia after carotid artery injury in rats. The results suggest the possibility that recombinant human IL-10, as a potential therapeutic approach, prevents neointimal hyperplasia.

[The construction of cDNA expression library from the tentacles of Sagartia rosea]

A cDNA expression library of the tentacles of Sagartia rosea was constructed. The cDNA was cloned into eukaryotical expression plasmid pcDNA3. SMART protocol was used for cDNA library construction and bioinformatics analysis was carried out. 71 novel EST clones were obtained from 130 sequences in the library, of which there were 21 full-length clones, including cytolysin genes, flourescent protein, ubiquinol-cytochrome C reductase gene, elongation factor, ferritin gene riboflavin kinase gene, ribosomal protein. This provides a base for further investigating their biological activity and application.

[Mitochondrial permeability transition pore regulates the apoptosis in MGC-803 induced by the extract of glycyrrhiza uralensis Fisch]

In our previous studies, we have discovered that the extract of glycyrrhiza uralensis Fisch (EGUF) can induce obvious apoptosis in gastric cancer cell Line MGC-803. Here, further investigation was carried on about the time-lapse changes of mitochondria transmembrane potential, intracellular free calcium ions, DNA electrophoresis, plasma membrane permeability and chromatin condensation during the apoptotic process of MGC-803 induced by EGUF and the influences of MPT-specific inhibitor Cyclosporin A(CsA) on these changes. Enhancement of plasma membrane permeability with PI staining, increase of intracellular free calcium ion and decrease of mitochondria transmembrane potential are early events in apoptotic cascades, prior to the appearances of apoptotic peak, chromatin condensation and DNA ladder. CsA significantly inhibited enhancement of plasma membrane permeability, change of intracellular free calcium ions and decrease of mitochondria transmembrane potential, also greatly delayed the progress of apoptosis. Thus, our results suggest that calcium and CsA-sensitive MPT is involved in the apoptosis of MGC-803 induced by EGUF.

Analysis of T cell receptor Vbeta gene usage during the course of disease in patients with chronic hepatitis B

The T cell receptor (TCR) is a heterodimeric molecule expressed on the surface of T cells and recognizes foreign peptides presented by the major histocompatibility complex on the surface of antigen-presenting cells or virus-infected cells. Analysis of TCR usage by T cells which recognize hepatitis B virus (HBV) provides further insight into the participation of T cell populations during the course of disease. In this study, we examined the T-cell-proliferative response and the TCR Vbeta gene usage of peripheral blood mononuclear cells in 3 patients with clinical evidence typical of chronic hepatitis B. All 3 patients had significant T-cell proliferative responses against HBV core antigen (HBcAg) during the remission stage, while no responses were detected during the acute exacerbation stage. In addition, the TCR Vbeta7 gene was utilized more frequently in T cells recognizing HBcAg during remission, while TCR Vbeta1 and Vbeta2 were utilized at a higher percentage during acute exacerbation. On the contrary, the T cell proliferative response against HBV surface antigen was undetectable and no specific Vbeta gene was utilized more frequently by all 3 patients, regardless of disease state. Our longitudinal studies, although based on a small sample of patients, demonstrate that the population of HBcAg-activated T cells alters during the course of disease in chronic hepatitis B patients.

Metabolic characteristics and enflurane defluorination of cytochrome P450-dependent monooxygenases in human hepatocellular carcinoma

BACKGROUND

Xenobiotic metabolism and defluorination capacity of microsomal monooxygenases were investigated in vitro through the surgical specimens of liver resected from patients with hepatocellular carcinoma and patients of extrahepatic pathology as control.

METHODS

In microsomes of hepatocellular carcinoma tissues, the activities of cytochrome P450-dependent monooxygenase isoenzymes 1A1, 2B1, and 2E1 were evaluated in vitro by reacting with the specific marker substrates benzo(a)pyrene, benzphetamine and aniline, respectively, in the generating incubation system. The distant normal liver tissues and tissues from control patients with extrahepatic lesion were also investigated for comparison. The ability of enflurane defluorination was assessed by Orion combined for detection of free fluoride ion production.

RESULTS

Concentrations of P450 total content, cytochrome b5, and NADPH-cytochrome c reductase showed parallel and marked reduction in tumor tissues when compared with its distant normal regions or normal livers. The monooxygenase functions displayed significant decreases within the tumor tissues as benzo(a)pyrene hydroxylation > or = benzphetamine demethylation > aniline hydroxylation in magnitude. Defluorination of enflurane also markedly decreased in tumor tissues comparing with normal livers.

CONCLUSIONS

These marked reductions in the compositions and in vitro metabolic activities, including defluorination of anesthetics, in the cytochrome P450-dependent monooxygenases within the tumor tissues characterize the unique pattern of xenobiotic metabolism in patients with hepatocellular carcinoma.

[Midazolam and Meperidine for colonoscopy]

We studied the sedative, analgesic and amnesic effects of intravenous midazolam and meperidine for colonoscopy, and also compared patient's satisfaction, changes of vital signs, safety and complications with intramuscular meperidine during the colonoscopy. Two hundred and ninety-nine patients undergoing physical check-up were randomized to receive intramuscular meperidine 50 mg and Hyoscine-N-Butylbromide (buscopan) 20 mg (Group IM-MB, n = 57) or intravenous midazolam 0.05 mg/kg, meperidine 1 mg/kg and buscopan 20 mg (Group IV-MMB, n = 242) before colonoscopy. All patients were closely observed and arterial oxygen saturations (SaO2) were monitored with pulse oximeter in Group IV-MMB. The demographic data of both groups were similar. There were significantly more severe pain responses (grimacing, moaning, shouting for pain, abdominal rigidity and body moving during colonoscopy) in Group IM-MB (51%) than in Group IV-MMB (13%) (p < 0.01). In immediate procedure recall after recovery from medications, 39% of Group IM-MB remembered severe pain during colonoscopy and only 3% of Group IV-MMB did (p < 0.01). 92% of Group IV-MMB who felt satisfactory with the medications were significantly higher than 21% in Group IM-MB (p < 0.01). Both groups significantly increased in heart rate after the injection of medications (p < 0.01). Group IM-MB increased 15 +/- 18% and Group IV-MMB 61 +/- 28% with significant difference between groups (p < 0.01). This might be caused by meperidine, buscopan, and relative hypovolemia of patients. There were significant decreases in SaO2 in Group IV-MMB, mean 4.5 +/- 1.7% (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

[Patient-controlled intravenous versus epidural analgesia after major joint replacement]

The analgesic efficacy, side effects, and satisfaction of patient-controlled analgesia (PCA) with intravenous and epidural morphine for postoperative pain were evaluated in this study. Twenty patients undergoing major joint replacement surgery were randomly allocated to intravenous PCA (IPCA) group or epidural PCA (EPCA) group. All patients had a standardized balanced anesthesia, and an epidural catheter was introduced after the operation in EPCA group. Postoperative pain relief was evaluated with verbal pain scale. The result showed that pain intensity and pain relief were similar in either group without significant difference (p greater than 0.05). Morphine consumption in IPCA group was 1.72 +/- 0.30 mg/h in the postoperative 0 - 12 h and 1.14 +/- 0.44 mg/h in 12 - 24 h. In EPCA group, relatively low doses of morphine were used, i.e., 0.20 +/- 0.07 mg/h in the postoperative 0 - 12 h and 0.17 +/- 0.07 mg/h in 12 - 24 h. Both groups showed an "incomplete" but satisfactory analgesia with relatively low doses of morphine. The "equianalgesic dose ratio" of IPCA to EPCA with morphine was approximately 8.5:1. Sedation was minimal in both groups. No respiratory depression developed in all patients. Nausea and vomiting were the most prominent side effects which might limit the usefulness of PCA. The incidence was 5 out of 10 patients in IPCA group and 4 out of 10 patients in EPCA group, despite under the treatment of droperidol (15 micrograms/kg, iv, prn) for most of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Can cancer pain attenuate the physical dependence on chronic long-term morphine treatment?

This prospective and comparative study was designed to determine the role of cancer pain and attitudes towards morphine in attenuating the intensity and duration of physical dependence following chronic morphine treatment. Morphine was administered via a stepwise ladder approach in order of oral, spinal and intravenous routes depending on the adequacy of analgesia. On-demand titration of a dose, either upward or downward, was liberal and unlimited. Withdrawal strategy was evaluated and initiated either by patients (PI group) or their families (FI group). The manifestation of physical dependence on morphine was compared between patients who successfully withdrew (total withdrawal), and patients who failed to withdraw (episodic withdrawal), from morphine for a period of more than two weeks. Eighty-eight out of 627 patients (14.1%) were excluded from our protocol; 75% of these exclusions were due to objections toward morphine as the major form of analgesic. Drop-out due to poorly tolerated side effects was relatively rare (18.2%). Fifty-four (10.0%) achieved total withdrawal and 212 (39.3%) experienced episodic withdrawal. Non-pain-related abstinence symptoms were highly prevalent but were tolerable for both groups. Pain-related symptoms were more exaggerated during episodic withdrawal. Intolerable pain, rather than physical dependence, contributed to the failure to withdraw from morphine. Among a total of 539, addiction was found in only one patient (0.18%) who began drug use long before entering our protocol. Attitudes towards morphine affect the acceptance of treatment and hasten the withdrawal strategy. Families were more anxious about morphine than the patients themselves which led to more aggressive, but less tolerable, withdrawal.(ABSTRACT TRUNCATED AT 250 WORDS)

Hyperamylasemia following cardiopulmonary bypass

In order to study the occurrence of postbypass hyperamylasemia, 75 patients undergoing cardiopulmonary bypass (CPB) were studied from March 1989 to January 1990. There were 49 males and 26 females. Among them, 27 had congenital heart disease, 30 had valvular disease, and 18 had coronary artery disease. There were 27 patients with at least one elevated serum amylase sample after operation. Thus, the overall incidence of hyperamylasemia was 36%. As compared with the preoperative data (1.3%), there was a statistically significant difference in the occurrence of hyperamylasemia (p less than 0.05). Three patients had overt clinical pancreatitis postoperatively. There was no positive correlation between the serum amylase level and the occurrence of pancreatitis (p greater than 0.05). Forty-two cases had a significant elevation of the amylase creatinine clearance ratio (ACCR) after CPB. However, there was no significant difference between the groups with pulsatile and nonpulsatile CPB (p greater than 0.05). Three patients (4%) died in our series. The causes of death were heart failure in two and fulminant pancreatitis associated with low cardiac output in one. Although our experience in dealing with pancreatitis improved survival, mortality was still high (33.3%) in our series. Nevertheless, there was no apparent correlation between mortality and postbypass hyperamylasemia (p greater than 0.05). Logistic regression analysis was used to analyze the risk factors of the occurrence of hyperamylasemia, and the analysis revealed that patients with coronary artery disease were susceptible to postbypass hyperamylasemia. Our studies indicate that the use of total serum amylase or ACCR to monitor for the occurrence of pancreatitis in postbypass patients is inadequate.(ABSTRACT TRUNCATED AT 250 WORDS)

T lymphocyte changes in open heart surgery

To investigate the effect of open heart surgery on T lymphocytes and their subpopulations, 20 patients, who had undergone moderate- to high-dose fentanyl anesthesia and a cardiopulmonary bypass (CPB), were studied using flow cytometry techniques and monoclonal antibodies during and after surgery. The ages of these patients ranged from four to 61 years with eight being male and 12 being female. The disease entity consisted of four with coronary, six with congenital and 10 with valvular heart disease. No cyanotic patients were included in this study. Peripheral blood samples were collected before anesthesia, immediately before the surgical incision, on the first postoperative day (POD1) and on the second postoperative day (POD2), respectively. We found no significant changes in the percentage of total T cells (T3), or helper (T4) and suppressor (T8) T cells during anesthesia before the surgical incision. On POD1, all T lymphocyte subset percentages decreased significantly when compared to pre-operative values (total T cells: 58.4 +/- 12.6 vs 24.4 +/- 8.4, helper T cells: 33.3 +/- 10.1 vs 15.4 +/- 6.3, suppressor T cells: 23.0 +/- 6.4 vs 10.0 +/- 4, all p less than 0.001) but returned to preoperative levels on POD2. Throughout the study period, there were no significant changes in the T helper cell to T suppressor cell ratio. In spite of the transient decrease in T lymphocytes and their subpopulations, no clinical evidence of infection was noted in any patient.(ABSTRACT TRUNCATED AT 250 WORDS)