Fatigue in children and adolescents with cancer.

Fatigue is a common symptom found in the adult oncology literature. However, little is known about its occurrence, causes, conceptual and operational definitions, and effective interventions in children and adolescents with cancer. The purpose of this study was to define and describe fatigue experienced by children and adolescents receiving treatment for cancer. A focus group approach was used to reveal the contextual understanding of fatigue through discussions. Eleven focus groups were convened during a 2-month period at two major children's cancer centers. Twenty-nine children participated in the focus groups: 14 were 7 to 12 years of age and 15 were 13 to 16 years of age. Focus groups were held separately for each age group, lasted from 30 to 45 minutes, and were audiotaped. The audiotapes were transcribed verbatim, and Ethnograph software was used to number the data to sort and code the information. Researchers at both study sites coded the data independently within the context of the unit of analyses, which, in this study, were the study questions. Codes and descriptions were developed for the definitions of fatigue, causes of fatigue, and what helps. Eight codes emerged from the children groups and 12 from the adolescent groups to define fatigue. Six codes were developed from the children groups and 12 from the adolescent groups to describe causes of fatigue. Three codes from the children groups and eight from the adolescent groups described what helps. This study is the first to evaluate fatigue as a symptom in children and adolescents with cancer. Findings from this study will provide the foundation for developing a conceptual model for cancer-related fatigue in children and adolescents.

Isolation and identification of a peptide from rat brain which inhibits [3H]TCP binding.

1. A stereospecific radioreceptor binding assay for the phencyclidine analogue [3H]TCP was utilized to screen for inhibitors of binding in extracts of rat brain. 2. Extracts were prepared from rat cortex and hippocampus by methods employing aqueous acid or acidified methanol. Samples were fractionated by reversed phase-HPLC (RP-HPLC) and tested for activity in the radioreceptor assay. Three zones of activity were detected. The most active fraction was further purified by high performance-size exclusion chromatography. 3. Size exclusion chromatography revealed two zones of activity, corresponding to mol. wts of 4000-8000 Da and 1000-2000 Da. Final purification of the lower molecular weight material was achieved by RP-HPLC. 4. Two well-separated peaks were shown to be homogeneous. Their amino acid sequences were determined by automated Edman degradation and data base searching identified these two peaks as the undecapeptide Substance P and its oxidized counterpart (Substance P sulfoxide). 5. Comparative HPLC of synthetic Substance P, or its sulfoxide, as well as spectral analysis confirmed the identity of the isolated peptides. 6. Synthetic Substance P inhibits specific [3H]TCP binding in the radioreceptor assay.

Identification of a domain in cytochrome C that displaces [3H]TCP binding from rat brain membrane receptors: synthesis of beta-neuroprotectin.

1. A stereospecific radioreceptor binding assay for the phencyclidine analogue, [3H]TCP, was utilized to screen for inhibition of binding in extracts of rat brain. 2. Extracts were prepared from rat cerebral cortex and hippocampus by methods employing aqueous acid. The extracts were fractionated by reversed phase-HPLC (RP-HPLC) and tested for activity in the radioreceptor assay. Three zones of activity were detected. The middle zone was further purified by high performance-size exclusion chromatography (HP-SEC). 3. Size exclusion chromatography revealed a single zone of activity corresponding to mol. wts of ca 12,000-31,000 daltons. A fraction from this zone was digested with trypsin, and the resulting enzyme fragments, isolated by a combination of HP-SEC and RR-HPLC, were identified as fragments of rat cytochrome C. 4. Horse cytochrome C was digested with trypsin and the fragments were similarly purified on the basis of the [3H]TCP binding displacement assay. The fragments were sequenced and found to be trypsin cleavage products of a single largely invariant domain of the cytochrome C molecule: Lys-Lys-Lys-Asp-Glu-Arg-Ala-Asp-Leu-Ile-Ala-Tyr-Leu-Lys-Lys. 5. beta-neuroprotectin (D)-Ala-Asp-Leu-Ile-Ala-Tyr-Leu-NH2, inhibits [3H]TCP binding and provides protection against NMDA mediated neuronal cell death at low concentrations.

Distribution and possible metabolic role of class III alcohol dehydrogenase in the human brain.

In human brain, the sole alcohol dehydrogenase (ADH) present in significant quantity has been shown to be Class III (chi) ADH and this ADH is ineffective in generating potentially toxic and reactive acetaldehyde from ethanol at concentrations attainable in living brain tissue. We have extended this finding to show that Class I ADH potentially present is undetectable even when concentrated several hundred-fold. Purified Class III ADH from human brain is identical in its pattern of tryptic peptides and in other properties to Class III ADH from human liver. Immunohistochemical staining and western immunoblots using polyclonal antibodies reveal that Class III ADH is widely distributed in brian and most concentrated in the subependymal layer and perivascular areas. Class III ADH closely resembles omega-hydroxyfatty acid dehydrogenase and a possible role for the brain enzyme is in the oxidation of long chain fatty alcohols and omega-hydroxyfatty acids.

The opiate receptor: a single 110 kDa recognition molecule appears to be conserved in Tetrahymena, leech, and rat.

We compared the molecular nature of the rat brain opiate receptor with that of the invertebrate leech, Haemopis marmorata, and the protozoan, Tetrahymena, in order to examine the issue of apparent receptor heterogeneity with respect to biochemical structure. A binding study with rat brain membrane verified that [125I]beta-endorphin [( 125I]beta E), a broad specificity ligand, is displaced by the antagonist (-)-naloxone, but not the inactive stereoisomer (+)-naloxone; agonists considered prototypes for mu, delta, and kappa opiate receptors all displayed stereospecific binding displacement. For SDS-PAGE analysis of the opiate receptor [125I]beta-endorphin was covalently affixed to its recognition molecule with the cross-linking reagent DSS. Primary reaction products occur at 110, 58/55, and 29 kDa. Cross-linking products of all 3 molecular weights are effectively reversed by opiate ligands, regardless of their mu, delta, or kappa specificities. Peptide mapping studies in SDS gels, using limited proteolysis, showed that the 110 kDa band can be digested into 58 and 29 kDa fragments and the 58 kDa band into a 29 kDa fragment. Additional smaller molecular weight fragments were generated from the 110, 58/55, and 29 kDa bands which shared their molecular weights. Two possible explanations for the extensive sequence homology between the three major cross-linking products are: (1) the 110 kDa species is the opiate receptor, and the 58 and 29 kDa species are proteolytic fragments; and (2) one of the lower molecular weight species is the opiate receptor, and adjacent receptors are aggregated into the 110 kDa complex through cross-linking.(ABSTRACT TRUNCATED AT 250 WORDS)

Identification and characterization of the opiate receptor in the ciliated protozoan, Tetrahymena.

Tetrahymena, a ciliated protozoan, is a highly specialized, differentiated eukaryotic organism. It is known to possess many informational substances, including beta-endorphin (beta E). We wished to investigate the possibility that this organism possesses a functional opiate receptor which might be similar to the well-characterized opiate receptor in the rat brain. Binding assays using both living cells and membrane preparations, verified stereospecific, saturable, reversible 125I-beta E binding. This binding was displaceable by various opiates chosen to represent each of the putative opiate subtypes. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of a disuccinimidyl suberate cross-linked 125I-beta E-receptor complex revealed a pattern of bands which consistently included bands at 110, 58-55, and 29 kDa. These bands, which were all displaceable by the classical antagonist, naloxone, as well as by other opiates, are thought to be prototypic for various opiate receptor subtypes. Limited proteolysis in SDS-PAGE showed that the 110 kDa band could be fragmented into 58-55 and 29 kDa bands and that the 58 kDa band could generate a 29 kDa fragment. The limited digest fragments of the 110, 58-55 doublet and 29 kDa bands were remarkably similar to those generated from the rat brain receptor. Analytical isoelectric focusing of digitonin solubilized 125I-beta E-receptor complexes showed the isoelectric points (pI) from both the rat and Tetrahymena were identical (pI 4.6). Chemotactic experiments with the intact Tetrahymena, demonstrated that these unicellular animals migrated toward a 10(-9) M beta E gradient. Chemotaxis was blocked by (-)-naloxone but not (+)-naloxone, suggesting a stereospecific opiate receptor-mediated response. We conclude that Tetrahymena possesses a functional opiate receptor (recognition molecule) very similar to the opiate receptor of the rat brain.

Gradients of protein kinase C substrate phosphorylation in primate visual system peak in visual memory storage areas.

Two protein kinase C (PKC) substrates of 50 and 81 kDa display topographical gradients in 32P-incorporation along the occipitotemporal visual processing pathway in rhesus monkey cerebral cortex. The 50 kDa protein appears to be homologous to protein F1 from rat (47 kDa) on the basis of isoelectric point, two-dimensional phosphopeptide maps, and kinase specificity, while the 81 kDa protein is probably the same as a previously described PKC substrate. The phosphorylation of protein F1 and 81 kDa was significantly higher in temporal regions of the occipitotemporal pathway, which have been implicated in the storage of visual representations, than in occipital regions, which appear to be less important for visual memory functions. These results suggest that the PKC phosphorylation system, which has been related previously to changes in neural plasticity, plays a progressively greater role in later stages of visual processing, and that this role may involve the storage of visual information in inferotemporal cortical areas.

Cortical connections of the somatosensory fields of the lateral sulcus of macaques: evidence for a corticolimbic pathway for touch.

The ipsilateral corticocortical connections of the somatosensory fields of the lateral sulcus of macaques were examined with both anterograde and retrograde axonal transport methods. In most cases, the field of interest was identified prior to the injection of the tracer substance by recording neuronal responses to somatic stimulation. The results show that the second somatosensory area (S2) is reciprocally connected with the retroinsular area (Ri), area 7b, and the granular (Ig) and dysgranular (Id) insular fields. Ri is also reciprocally connected with Ig. Previously reported connections were confirmed between S2 and areas 3a, 3b, 1, and 2 and between area 5 and both area 7 and Ri. Moreover, the portions of Ig and Id that receive somatic inputs were shown to project to the amygdaloid complex. Id projects, in addition, to the perirhinal cortex, which supplies input to the hippocampal formation. The corticocortical projections were found to have two distinct laminar patterns of termination. One is characterized by heavy terminations in layers IV and IIIb and the other by heavy terminations in layer I, but no terminations in layers IV and IIIb. These two patterns were typically found to be reciprocally related. The results suggest that somatosensory information is processed by a series of cortical fields, including areas 3a, 3b, 1, 2, 5, 7b, S2, Ig, and Id. These fields have access to the amygdaloid complex and the hippocampal formation. Thus, a ventrally directed tactile processing pathway can be followed from S1 to the temporal lobe limbic structures via relays in S2 and the insula; this corticolimbic pathway may subserve tactile learning and memory.

Regional distribution of [3H]naloxone binding in the brain of a newborn rhesus monkey.

The distribution of opiate receptors in the brain of a newborn monkey (Macaca mulatta) was mapped by in vitro autoradiographic localization of [3H]naloxone binding to tissue sections. The autoradiographs of the newborn brain were compared to those from two adult brains. The distribution of opiate receptors appeared to be adult-like in subcortical structures (both limbic and nonlimbic) and allocortical areas. By contrast, all neocortical areas, except the primary visual cortex, lacked at birth the laminar specific patterns that characterize the adult. The results therefore suggest that, like many other aspects of neocortical maturation, such as dendritic growth, synaptogenesis, myelination and neurotransmitter concentrations, the distribution of opiate receptors continues to develop postnatally.