Enhanced activity of demineralised bone matrix augmented with xenogeneic bone morphogenetic protein complex in rats.

INTRODUCTION: Demineralised bone matrix (DBM) is an allograft material widely used as a bone filler and bone graft substitute. DBM contains bone morphogenetic proteins (BMPs), which induce and regulate bone formation during embryogenesis and in postnatal life. AIMS AND OBJECTIVES: To investigate the osteoinductivity of DBM augmented with xenogeneic BMP-complex at different doses. MATERIALS AND METHODS: Rat DBM was augmented with BMP-complex purified from porcine diaphyseal bone. RESULTS: Dorsal subcutaneous implantation of 25 mg rat allogeneic DBM augmented with 0, 3, 6 and 12 mg BMP-complex per gram of DBM resulted in dose dependant up-regulation of bone formation on day 21, as scored histologically and biochemically. CONCLUSIONS: Allogeneic DBM can be augmented with xenogeneically sourced BMP-complex to improve DBM performance in vivo. This work demonstrates the potential of BMP-complex augmented DBM to induce new bone formation with improved parameters of bone formation.

High-resolution computed tomography of the chest in children with cystic fibrosis: support for use as an outcome surrogate.

BACKGROUND: Outcome surrogates are indicators that reflect, rather than directly measure, patient benefit. In order to provide useful results, however, outcome surrogates must be carefully chosen and must meet specific criteria. OBJECTIVE: To support development of high-resolution computed tomography (HRCT) as an outcome surrogate in cystic fibrosis (CF) by demonstrating the ability of HRCT to show short-term improvement in the appearance of the lungs in children with CF. MATERIALS AND METHODS: HRCT was performed at admission and after discharge on 8 children during 15 admissions for acute pulmonary exacerbation of CF. Three radiologists scored each study separately, then compared admission and discharge pairs. RESULTS: HRCT scores improved in 13/15 admissions. Mean score decreased from 25 to 22. The decrease was significant (P = 0.014). Comparison of admission and discharge scans showed improvement in peribronchial thickening (P = 0.007), mucous plugging (P = 0.002), and overall appearance (P = 0.025). CONCLUSION: HRCT has the potential to be a useful outcome surrogate in CF. A necessary attribute of an outcome surrogate is that it improves rapidly with effective therapy. Despite widespread belief among radiologists and pulmonologists that HRCT meets this criterion, no previous report has demonstrated this ability in children. These findings support further development of HRCT as an outcome surrogate in children with CF.

Ideology and technology: the social context of procreative technology.

Biomedical practices and research in procreation are shaped by three ideologies deeply rooted in American society: patriarchy with its control of women's bodies in the interest of men's procreative concerns and with its focus on 'seeds' and therefore genetics; technology as an ideology of efficiency, productivity, rationality, and control; and capitalism both as an ideology and as a practice, a mechanism that markets technologies of procreation.

Detection of primary breast cancer in women with known adenocarcinoma metastatic to the axilla: use of MRI after negative clinical and mammographic examination.

The purpose of this study was to evaluate the ability of MRI to identify a primary site of malignancy in the breast of patients who present clinically with ipsilateral lymph nodes containing metastatic carcinoma but whose physical and mammographic examination are negative. MRI of the breast was performed on four patients using a variety of imaging parameters, all with and without gadolinium contrast. All patients had biopsy-proven adenocarcinoma of the ipsilateral axilla, with negative physical and mammographic examinations. Foci of enhancement assessed visually on precontrast and postcontrast scans (n = 1) and on subtraction studies (n = 3) were considered suspicious under the clinical circumstances defined for this study. Lesions identified on MRI were re-identified on ultrasound examination and either preoperative localization for excisional biopsy or tissue sampling was performed. Surgery was performed and histopathologic correlation was obtained in all cases. Primary sites of breast carcinoma were identified in all four patients, with multiple sites of malignancy identified in three of four patients. Breast conservation therapy was made possible for three of four patients based on the results of the MRI study showing sites of malignancy and no features of cancer elsewhere in the breast. Follow-up data of 1, 2, and 5 years of these patients show no evidence of recurrent disease. MRI of the breast is a useful technique for identifying primary sites of malignancy in patients presenting with ipsilateral lymph nodes positive for metastatic adenocarcinoma when the physical and mammographic examinations are negative.

The effect of in vitro modeling conditions on the surface reactions of bioactive glass.

Using one parametric variation in solution composition, this paper documents that the surface reactions on bioactive glass (BG) 45S5 are exquisitely dependent upon the modeling conditions. The solutions used were 0.05 M tris hydroxymethyl aminomethane/HCl (tris buffer), tris buffer complemented with plasma electrolyte and/or serum, and serum. The reacted surfaces were analyzed using Fourier transform infrared (FTIR), scanning electron microscopy (SEM) with energy dispersive X-ray analysis (EDXA), and Rutherford backscattering spectroscopy (RBS). Post-immersion solutions were analyzed for changes in Ca and PO4 concentrations. After a short immersion (3 h), a crystalline, carbonated hydroxyapatite (c-HA) layer formed only in tris. Reaction surfaces of different structure, morphology, and composition were observed after various short and longer term immersions in all other solutions. They comprised two layers with the layer in contact with the bulk consisting mainly of Si; the outer layer, composed of Si, Ca, and P, was amorphous, and had a Ca/P ratio of about 1. Serum proteins adsorbed on the BG surfaces at the early stages of the solution-mediated BG reactions. Formation of a crystalline c-HA layer was delayed up to three or more days in solution with plasma ions. In the presence of serum, only amorphous surfaces composed of Si, Ca, and P were observed for any time up to seven days of immersion. The present data suggest that serum proteins adsorb in tandem with the occurrence of solution-mediated reactions leading to formation of a silica-gel. Amorphous Ca-P phases accumulate in the Si-rich matrix. Furthermore, the present data, in conjunction with the data published before, suggest that physicochemical and cell-mediated reactions occur in parallel to form the glass-tissue interfacial layer.

A multicenter clinical trial of Gadolite Oral Suspension as a contrast agent for MRI.

The purpose of this study was to assess the effectiveness and safety of Gadolite Oral Suspension as a gastrointestinal (GI) contrast agent for MRI in a phase II and two phase III multicenter clinical trials. Gadolite was administered to 306 patients with known or suspected abdominal and/or pelvic disease. MRI with T1- and T2-weighted sequences was performed before and after ingestion. Efficacy was evaluated by having two masked readers rate the certainty of their MR diagnosis (0 = uncertain, 1 = probable, 2 = definite) on randomly presented pre- and post-Gadolite Oral Suspension enhanced images. Principal investigators also evaluated the images and established the final diagnosis. Vital signs, clinical chemistries, and adverse events were documented. Blood and urine samples were analyzed for gadolinium content to determine whether Gadolite Oral Suspension was absorbed systemically. Certainty in MR diagnosis increased significantly (P < .001) for both blinded readers between pre- and post-Gadolite images (.49-1.18 for reader 1: .46-1.53 for reader 2). Sensitivity, specificity, and accuracy also increased for both masked readers. No gadolinium was detected in blood or urine samples. There were no serious adverse events and no apparent drug-related trends in mean vital signs or laboratory values. Gadolite is a highly effective, safe, and well tolerated contrast agent for clinical use with MRI.

Women, providers, and control.

Childbirth in America is dominated by a management perspective that emphasizes the efficient removal of a fetus from a woman's body. This article discusses the obvious and not so obvious ways that routine American management of childbirth systematically strips women of power and control. It is argued that, although providers may be well-meaning and nurturing in their care of childbearing women, their approach is most often nurturing to weakness, rather than strength.

Technical note: magnetic resonance imaging-guided pre-operative breast localization using "freehand technique".

A 1.5 cm focus in the breast with intense gadolinium uptake was incidentally detected during magnetic resonance (MR) imaging evaluation of a cluster of microcalcifications. Because the apparent mass was both mammographically and sonographically occult, MR imaging was used to guide a needle by "freehand technique" to the lesion, permitting successful pre-operative localization and subsequent surgical excision of the area.

Ex vivo evaluation of ferromagnetism, heating, and artifacts of breast tissue expanders exposed to a 1.5-T MR system.

Three breast tissue expanders were evaluated for compatibility with MR imaging (1.5 Tesla). The metallic components of the breast tissue expanders were shown to be nonferromagnetic, heating < or = .2 degrees C and the artifacts varied. These results indicate that MR procedures may be performed safely in patients with these implants; however, artifacts may obscure implant leaks or breast lesions if located near and metal portion of the breast tissue expanders.

Silica induced suppression of the production of third and fifth components of the complement system by human lung cells in vitro.

Although investigations to date have demonstrated the ability of the monocyte/macrophage to synthesize complement components, only a limited number of studies on complement synthesis by nonhepatic tissue cells have been reported. To begin to fill this gap in our knowledge we have recently evaluated the ability of lung tissue cells to synthesize and secrete various complement components in vitro. Using 35S-methionine incorporation and immunoprecipitation techniques we have previously demonstrated the ability human lung type II pneumocytes (A549) and human lung fibroblasts (WI-38), to synthesize and secrete a variety of both early and terminal complement components, as well as several regulatory proteins including Clr, Cls, C4, C3, C5, C6, C7, C8, C9, Factor B, Factor H, Factor I and Cls inactivator. Our present studies demonstrate the capability of silica to regulate complement component production by A549 cells, but not complement component production by WI-38 cells. Specifically, using sensitive ELISAs we demonstrated that a non-toxic dose of silica had the capability to suppress the production of both C3 and C5 by A549 pneumocytes by 40-50 percent, but had no effect on C3 or C5 synthesis by WI-38 fibroblasts. Additionally, using 35S-methionine incorporation and TCA precipitation techniques, we demonstrated that suppression of C3 and C5 production by silica treated A549 pneumocytes was not a result of suppression of total protein synthesis. These studies demonstrate that silica, which has been implicated in pulmonary diseases, has the capability to regulate local complement production by lung tissue cells in vitro. In vivo, this suppression of complement production by the type II pneumocytes could alter the local tissue reservoir of complement components during infection and pulmonary injury, thus resulting in depressed pulmonary host defense.

Neuropeptide degradation produces functional inactivation in the crustacean nervous system.

The pentapeptide proctolin (Proct.; Arg-Tyr-Leu-Pro-Thr) is a modulatory transmitter found throughout the crustacean nervous system. No information is available in this system, however, as to how the actions of this peptide are terminated. To study this issue in the crab Cancer borealis, we incubated exogenous proctolin (10(-5) M) with either the thoracic ganglion (TG) or with conditioned saline (CS) that had been preincubated with the TG. We removed aliquots at standard time points for analysis by reverse-phase high-performance liquid chromatography (HPLC). We found that over time the proctolin peak became progressively smaller, while three novel peaks appeared and increased in size. Comigration experiments using HPLC indicated that the major novel peak was Proct. (Tyr-Leu-Pro-Thr), while one of the two minor peaks was Proct. (Leu-Pro-Thr). The other minor peak appeared to be Proct. (Arg-Tyr), based on similar HPLC retention time to synthetic Proct. The reduction in the proctolin peak and the increase in the Proct. peak was prevented by co-incubation of proctolin with any one of several aminopeptidase inhibitors (10(-4) M). Proct. and Proct. appeared to result from a diaminopeptidase-mediated cleavage of proctolin. We tested whether N-terminal cleavage functionally inactivated proctolin by coapplying proctolin (10(-8) M) and individual aminopeptidase inhibitors (10(-5) M) to the isolated stomatogastric ganglion (STG). We found that these inhibitors significantly enhanced the proctolin excitation of the pyloric rhythm. Furthermore, application of synthetic Proct. to the STG had no effect unless high concentrations (> 10(-6) M) were used, and neither Proct. nor Proct. (10(-4) M) influenced the pyloric rhythm. Our results indicate that proctolin is enzymatically degraded and thereby biologically inactivated in the crab nervous system, primarily by extracellularly located aminopeptidase activity.

Elevation of intracellular cAMP in human T lymphocytes by an anti-CD44 mAb.

Regulation of lymphocyte responses to activation of the CD3/TCR complex by other cell surface proteins expressed on lymphocytes is a well established phenomenon. CD44 is an example of such a cell surface protein. Anti-CD44 mAb have been identified which either stimulate or inhibit lymphocyte function. Certain anti-CD44 mAb augment proliferation and IL-2 production by T cells stimulated through the CD2 or CD3/TCR pathways. An anti-CD44 mAb with opposing properties has also been identified. This mAb inhibits activation of human T cells by preventing the rise in [Ca2+]i stimulated by OKT3. The purpose of experiments reported here was to further characterize this phenomenon. The results show that the anti-CD44 mAb, 212.3, does not inhibit inositol phosphate turnover stimulated by OKT3 but does inhibit elevation of intracellular [Ca2+]i in these same cells. Addition of 212.3 to purified human T cells results in a rapid increase in intracellular levels of cAMP. Elevation of cAMP by 212.3 is time- and concentration-dependent. Activation of adenylate cyclase by forskolin also results in elevation of intracellular cAMP and inhibition of the increase in [Ca2+]i stimulated by OKT3. Taken together, these data suggest that CD44 may be positively coupled to adenylate cyclase and that activation of adenylate cyclase by the anti-CD44 mAb, 212.3, may mediate the inhibition of the OKT3-stimulated elevation of [Ca2+]i.

Aplysia peptide neurotransmitters beta-bag cell peptide, Phe-Met-Arg-Phe-amide, and small cardioexcitatory peptide B are rapidly degraded by a leucine aminopeptidase-like activity in hemolymph.

We have been investigating the role of proteolytic enzymes in the inactivation of peptide neurotransmitters in the marine snail Aplysia. Previous studies (Squire, C. R., Talebian, M., Menon, J. G., Dekruyff, S. D., Lee, T. D., Shively, J. E., and Rothman, B. S. (1991) J. Biol. Chem. 266, 22355-22363) showed that neuroactive fragments of the neurotransmitter alpha-bag cell peptide (alpha-BCP) were rapidly degraded (t1/2 = 0.5-2.7 min) in plasma, hemolymph that had been cleared by centrifugation. Degradation was caused by one or more enzymes resembling mammalian leucine amino-peptidase (LAP, EC 3.4.11.1). In this report we show that three other Aplysia peptide neurotransmitters, beta-BCP(1-5) (Arg-Leu-Arg-Phe-His), FMRFa (Phe-Met-Arg-Phe-amide), and SCPB(1-9) (Met-Asn-Tyr-Leu-Ala-Phe-Pro-Arg-Met-amide) are rapidly degraded (t1/2 = 0.3-2.4 min) in plasma by apparently the same LAP-like enzyme(s). Our findings strongly suggest that the LAP-like enzyme(s), by means of its broad substrate specificity and access to the extracellular spaces of the nervous system in vivo, plays a significant role in the inactivation of many Aplysia peptide neurotransmitters, and they raise the possibility that proteolytic enzymes in the extracellular fluid contribute significantly to the inactivation of peptide neurotransmitters in other animal species.

Mechanism of peripheral T cell activation by coengagement of CD44 and CD2.

A number of CD44 antibodies are known to augment peripheral T cell proliferation stimulated with suboptimal concentrations of activating pairs of CD2 mAb. These findings have implicated the CD44 adhesion receptor in the activation of peripheral T cells via CD2. We have investigated early events after CD44 and CD2 coengagement on peripheral T cells. CD44 and CD2 coengagement resulted in enhanced [Ca2+]i mobilization. However, the increase in [Ca2+]i mobilization did not occur until at least 3 min after CD2 and CD44 coengagement, suggesting that other events precede the elevation in [Ca2+]i. Using a T cell/fibroblast adhesion assay, we could demonstrate a dramatic increase in T cell adhesiveness after about 1 min after CD44 and CD2 coengagement. The increase in T cell adhesiveness was comparable to that induced by PMA. In the absence of antibodies or treatment with mAb directed to other T cell surface Ag, there was little if any adhesion between unstimulated peripheral T cells and fibroblasts. Enhancement of T cell adhesiveness through CD44 engagement was not mediated by a direct effect on lymphocyte-function associated Ag-3, the known ligand of CD2. However, cross-linking of CD44 resulted in epitopic modulation of CD2 as demonstrated by the increased expression of the T11(3) activation epitope. Furthermore, anti-CD44 could substitute for anti-T11(2) in the activation of peripheral T cells via CD2. These results suggest that CD44 ligation has profound effects on CD2-mediated events by inducing epitopic modulation of CD2.

Structure-activity relationship of the neurotransmitter alpha-bag cell peptide on Aplysia LUQ neurons: implications regarding its inactivation in the extracellular space.

Alpha-bag cell peptide [alpha-BCP (Ala-Pro-Arg-Leu-Arg-Phe-Tyr-Ser-Leu)] is a neurotransmitter that mediates bag cell-induced inhibition of left-upper-quadrant (LUQ) neurons L2, L3, L4, and L6 in the abdominal ganglion of Aplysia. Our recent biochemical studies have shown that alpha-BCP[1-9] is cleaved into alpha-BCP[1-2], [3-9], [1-5], [6-9], and [7-9] by a combination of three distinct peptidase activities located within the extracellular spaces of the CNS: A diaminopeptidase-IV (DAP-IV)-like enzyme cleaves alpha-BCP[1-9] at the 2-3 peptide bond; a neutral metalloendopeptidase (NEP)-like enzyme cleaves either alpha-BCP[1-9] or alpha-BCP[3-9] at the 5-6 bond; an aminopeptidase M-II (APM-II)-like enzyme cleaves alpha-BCP[6-9] at the 6-7 bond, but cleaves neither alpha-BCP[1-9], nor the other ganglionic peptidase products. To further understand the manner in which alpha-BCP is inactivated after release, that is loses its electrophysiological activity, we studied its structure-activity relationship by recording intracellularly from LUQ neurons in isolated abdominal ganglia that were arterially perfused with peptides dissolved in artificial sea water. The effects of alpha-BCP[1-9] and 15 of its fragments ([1-8], [1-7], [1-6], [1-5], [2-9], [3-9], [3-8], [6-9], [7-9], [8-9], [6-7], [6-8], [1-2], Phe, Tyr) indicated that the sequence Phe6-Tyr7 was both necessary and sufficient to produce LUQ inhibitory activity.(ABSTRACT TRUNCATED AT 250 WORDS)