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1.
Nat Genet ; 18(4): 345-9, 1998 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-9537416

RESUMO

In chordate phylogeny, changes in the nervous system, jaws, and appendages transformed meek filter feeders into fearsome predators. Gene duplication is thought to promote such innovation. Vertebrate ancestors probably had single copies of genes now found in multiple copies in vertebrates and gene maps suggest that this occurred by polyploidization. It has been suggested that one genome duplication event occurred before, and one after the divergence of ray-finned and lobe-finned fishes. Holland et al., however, have argued that because various vertebrates have several HOX clusters, two rounds of duplication occurred before the origin of jawed fishes. Such gene-number data, however, do not distinguish between tandem duplications and polyploidization events, nor whether independent duplications occurred in different lineages. To investigate these matters, we mapped 144 zebrafish genes and compared the resulting map with mammalian maps. Comparison revealed large conserved chromosome segments. Because duplicated chromosome segments in zebrafish often correspond with specific chromosome segments in mammals, it is likely that two polyploidization events occurred prior to the divergence of fish and mammal lineages. This zebrafish gene map will facilitate molecular identification of mutated zebrafish genes, which can suggest functions for human genes known only by sequence.


Assuntos
Vertebrados/genética , Vertebrados/fisiologia , Peixe-Zebra/genética , Animais , Mapeamento Cromossômico , Evolução Molecular , Genes/genética , Genoma , Família Multigênica , Poliploidia
2.
Ir Med J ; 101(10): 307-10, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-19205141

RESUMO

We reviewed the reports of 79 newly diagnosed acute myeloid leukaemia patients admitted to our department between 1996 and 2005. Patients' characteristics and outcome were analysed. The acute myeloid leukaemia rate for all patients who received intensive chemotherapy, i.e. age > or = 60 years was 52.9%; in the age group (60-69) and > or = 70 years it was 62.5% and 44.4%, respectively. The acute myeloid leukaemia rate difference between the diagnosis periods (1996-2000) and (2001-2005) are statistically significant only in the age group (60-69) years (P = 0.018). For patients who received intensive chemotherapy and treatment other than intensive chemotherapy, the median overall survival was 9.73 and 3.6 months, respectively (P < 0.0001). There was no significant difference in overall survival between the age groups for the two diagnosis periods, except in patients aged > or = 80 years 3.0 and 0.63 month, respectively (P = 0.023). This study improved knowledge of characteristics and outcome of elderly acute myeloid leukaemia patients in our department.


Assuntos
Leucemia Mieloide Aguda/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Citogenética , Feminino , Humanos , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/mortalidade , Leucemia Mieloide Aguda/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Sobrevida , Resultado do Tratamento , Adulto Jovem
3.
Mol Cell Biol ; 18(7): 3659-67, 1998 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-9632748

RESUMO

Although Cks proteins were the first identified binding partners of cyclin-dependent protein kinases (cdks), their cell cycle functions have remained unclear. To help elucidate the function of Cks proteins, we examined whether their binding to p34(cdc2) (the mitotic cdk) varies during the cell cycle in Xenopus egg extracts. We observed that binding of human CksHs2 to p34(cdc2) was stimulated by cyclin B. This stimulation was dependent on the activating phosphorylation of p34(cdc2) on Thr-161, which follows cyclin binding and is mediated by the cdk-activating kinase. Neither the inhibitory phosphorylations of p34(cdc2) nor the catalytic activity of p34(cdc2) was required for this stimulation. Stimulated binding of CksHs2 to another cdk, p33(cdk2), required both cyclin A and activating phosphorylation. Our findings support recent models that suggest that Cks proteins target active forms of p34(cdc2) to substrates.


Assuntos
Proteína Quinase CDC2/metabolismo , Quinases relacionadas a CDC2 e CDC28 , Proteínas de Transporte/metabolismo , Proteínas de Ciclo Celular , Ciclina A/metabolismo , Ciclina B/metabolismo , Quinases Ciclina-Dependentes/metabolismo , Proteínas Quinases , Proteínas Serina-Treonina Quinases/metabolismo , Animais , Proteínas de Transporte/genética , Quinase 2 Dependente de Ciclina , Ativação Enzimática , Fosforilação , Ligação Proteica , Proteínas Recombinantes de Fusão/metabolismo , Treonina/metabolismo , Xenopus , Proteínas de Xenopus , Quinase Ativadora de Quinase Dependente de Ciclina
4.
J Natl Cancer Inst ; 62(5): 1265-8, 1979 May.
Artigo em Inglês | MEDLINE | ID: mdl-155752

RESUMO

A technique was developed for continuous iv infusion chemotherapy in an inbred rat model of acute myelogenous leukemia. Polyethylene tubing was inserted surgically into the internal jugular vein of adult WF rats, burrowed sc to the base of the tail, and connected to an infusion pump. A flexible spring was sutured at the base of the tail and fastened to the cage wall; it protected the infusion catheter and allowed movement of the rat within the cage. This technique was used to compare bolus with continuous infusion therapy with adriamycin, cytosine arabinoside, and neocarzinostatin. Only small differences were noted in host toxicity and in antitumor effect against tumor grown as a subcutaneous myeloblastoma. Nearly three times more neocarzinostatin was required by continuous infusion for an effect equivalent to that of bolus injection. In contrast, continuous infusion of methotrexate with concurrent thymidine infusion prevented toxicity, enhanced the antitumor effect, and prolonged survival. This infusion system should facilitate rapid preclinical evaluation of drugs considered for constant iv infusion therapy.


Assuntos
Antineoplásicos/administração & dosagem , Leucemia Mieloide Aguda/tratamento farmacológico , Animais , Citarabina/administração & dosagem , Relação Dose-Resposta a Droga , Doxorrubicina/administração & dosagem , Esquema de Medicação , Infusões Parenterais/métodos , Injeções Intravenosas , Leucemia Experimental/tratamento farmacológico , Ratos , Ratos Endogâmicos WF , Timidina/administração & dosagem , Timidina/farmacologia , Zinostatina/administração & dosagem
5.
Cancer Res ; 42(8): 3005-9, 1982 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-6212116

RESUMO

We have demonstrated previously the presence of 5-fluorouracil (FUra) residues in L1210 DNA. These findings have been extended to the MCF-7 human breast carcinoma cell line. Cesium sulfate gradient centrifugation has been used to separate the MCF-7 RNA and DNA fractions. Alkali and RNase digests have also been used to remove any possible RNA contaminating the DNA fraction. The purified DNA has been analyzed by high-pressure liquid chromatography following digestion to nucleotides and nucleosides. The results demonstrate that FUra residues are detectable in the DNA of these human breast carcinoma cells following exposure to either FUra of 5-fluorodeoxyuridine. Further, the extend of FUra incorporation in both MCF-7 RNA and DNA is similar with either fluorinated pyrimidine. We also demonstrate that the FUra incorporation in DNA from this human cell line can be enhanced by concurrent incubation with thymidine.


Assuntos
Neoplasias da Mama/metabolismo , DNA de Neoplasias/biossíntese , Fluoruracila/metabolismo , Linhagem Celular , Replicação do DNA , Feminino , Floxuridina/metabolismo , Humanos , Cinética , Radioisótopos de Fósforo , Timidina/farmacologia , Trítio
6.
J Neurosci ; 19(10): 3665-73, 1999 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-10233998

RESUMO

Photic entrainment of insect circadian rhythms can occur through either extraretinal (brain) or retinal photoreceptors, which mediate sensitivity to blue light or longer wavelengths, respectively. Although visual transduction processes are well understood in the insect retina, almost nothing is known about the extraretinal blue light photoreceptor of insects. We now have identified and characterized a candidate blue light photoreceptor gene in Drosophila (DCry) that is homologous to the cryptochrome (Cry) genes of mammals and plants. The DCry gene is located in region 91F of the third chromosome, an interval that does not contain other genes required for circadian rhythmicity. The protein encoded by DCry is approximately 50% identical to the CRY1 and CRY2 proteins recently discovered in mammalian species. As expected for an extraretinal photoreceptor mediating circadian entrainment, DCry mRNA is expressed within the adult brain and can be detected within body tissues. Indeed, tissue in situ hybridization demonstrates prominent expression in cells of the lateral brain, which are close to or coincident with the Drosophila clock neurons. Interestingly, DCry mRNA abundance oscillates in a circadian manner in Drosophila head RNA extracts, and the temporal phasing of the rhythm is similar to that documented for the mouse Cry1 mRNA, which is expressed in clock tissues. Finally, we show that changes in DCry gene dosage are associated predictably with alterations of the blue light resetting response for the circadian rhythm of adult locomotor activity.


Assuntos
Proteínas de Drosophila , Proteínas do Olho , Flavoproteínas/química , Proteínas de Insetos/química , Células Fotorreceptoras de Invertebrados/química , Complexo de Proteínas do Centro de Reação Fotossintética/química , Sequência de Aminoácidos , Animais , Relógios Biológicos , Encéfalo/metabolismo , Mapeamento Cromossômico , Ritmo Circadiano/fisiologia , Criptocromos , Drosophila , Genes de Insetos , Humanos , Camundongos , Dados de Sequência Molecular , Oscilometria , RNA Mensageiro/biossíntese , Receptores Acoplados a Proteínas G , Homologia de Sequência de Aminoácidos
7.
J Clin Oncol ; 7(7): 890-9, 1989 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-2661735

RESUMO

The efficacy and toxicity of leucovorin 500 mg/m2 administered intravenously (IV) over 30 minutes daily for five days followed in one hour by fluorouracil (5-FU) 375 mg/m2 administered IV daily for five days, each given every 3 weeks, was assessed in 54 previously treated patients with metastatic breast cancer. An overall objective response rate of 24% was achieved (95% confidence interval, 13% to 38%), with an additional 56% of patients maintaining stable disease. Eleven of 12 patients who responded had received previous 5-FU therapy. Toxicity of this regimen included grade 3 diarrhea in 13%, grade 3 or 4 mucositis in 33%, grade 3 or 4 granulocytopenia in 65%, and grade 3 or 4 thrombocytopenia in 19%. Delay of treatment was required for hematologic toxicity in 44 patients. Thirty-eight patients required dose reductions due to toxicity. Biochemical evaluation of tumor biopsy specimens obtained from 17 patients used as their own controls with and without leucovorin was performed. These studies reveal an increased stabilization of the 5-fluorodeoxyuridylate (FdUMP)-thymidylate synthase (TS) folate ternary complex with the addition of leucovorin. There was a 71% +/- 14% occupancy or inhibition of the enzyme with the use of both 5-FU and leucovorin, v 30% +/- 13% for 5-FU alone (P2 less than .037). The percent TS bound in responding patients was substantially higher than in those patients with progressive disease. Finally, the mean total tumor TS pre-therapy in seven patients was 31 fmol/mg compared with a mean of 81 fmol/mg in these same seven patients 24 hours after therapy. This 2.6-fold increase suggests that there is an induction of the enzyme, TS, with 5-FU treatment.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias da Mama/enzimologia , Ensaios Clínicos como Assunto , Feminino , Fluoruracila/administração & dosagem , Fluoruracila/metabolismo , Humanos , Leucovorina/administração & dosagem , Leucovorina/metabolismo , Menopausa , Pessoa de Meia-Idade , Metástase Neoplásica , Timidilato Sintase/metabolismo
8.
J Clin Oncol ; 14(5): 1565-72, 1996 May.
Artigo em Inglês | MEDLINE | ID: mdl-8622073

RESUMO

PURPOSE: A dose-escalation study was conducted to determine the maximum-tolerated dose (MTD) and dose-limiting toxicities (DLTs) of cyclophosphamide (CY) in combination with granulocyte colony-stimulating factor (G-CSF0 and doxorubicin (DOX) given every 2 weeks for eight cycles as outpatient adjuvant therapy for node-positive breast cancer. A pilot study to assess quality of life (QOL) was performed. PATIENTS AND METHODS: From March 1991 to April 1993, 19 patients were entered. Patients received escalating doses of CY intravenously (i.v.) (1,000 mg/m2, 1,500 mg/m2, 2,000 mg/m2, or 2,500 mg/m2) with DOX 40 mg/m2, G-CSF 10 micrograms/kg/d on days 2 to 12, and mesna, every 2 weeks for eight cycles. QOL was measured by the Profile of Mood States (POMS), the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR), and a 27-item QOL scale. RESULTS: The CY dose of 2,500 mg/m2 every 2 weeks elicited toxicities that required dose reductions secondary to a combination of thrombocytopenia, hematuria, and anemia that required transfusion. The dose of 2,000 mg/m2 resulted in an acceptable toxicity profile. Ninety-two percent of cycles at the 2,000-mg/m2 dose were delivered on schedule and 77% without hospitalization. QOL assessments indicated high levels of distress measured by POMS in 47%, poor overall quality of life in 40%, and significant problems with physical symptoms in less than 27% of all patients for any given cycle. CONCLUSION: A dose of CY at 2,000 mg/m2 can be administered every 2 weeks with DOX and G-CSF for eight cycles in the outpatient setting with manageable toxicity. The majority of women described levels of physical symptoms and emotional distress as tolerable during treatment.


Assuntos
Antineoplásicos/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Quimioterapia Adjuvante/efeitos adversos , Ciclofosfamida/efeitos adversos , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Qualidade de Vida , Adulto , Assistência Ambulatorial , Antineoplásicos/administração & dosagem , Neoplasias da Mama/psicologia , Ciclofosfamida/administração & dosagem , Relação Dose-Resposta a Droga , Doxorrubicina/administração & dosagem , Doxorrubicina/efeitos adversos , Estudos de Viabilidade , Feminino , Humanos , Pessoa de Meia-Idade , Projetos Piloto
9.
Genetics ; 148(1): 373-80, 1998 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9475747

RESUMO

Genetic screens in zebrafish have provided mutations in hundreds of genes with essential functions in the developing embryo. To investigate the possible uses of chromosomal rearrangements in the analysis of these mutations, we genetically characterized three gamma-ray induced alleles of cyclops (cyc), a gene required for development of midline structures. We show that cyc maps near one end of Linkage Group 12 (LG 12) and that this region is involved in a reciprocal translocation with LG 2 in one gamma-ray induced mutation, cyc(b213). The translocated segments together cover approximately 5% of the genetic map, and we show that this rearrangement is useful for mapping cloned genes that reside in the affected chromosomal regions. The other two alleles, cyc(b16) and cyc(b229), have deletions in the distal region of LG 12. Interestingly, both of these mutations suppress recombination between genetic markers in LG 12, including markers at a distance from the deletion. This observation raises the possibility that these deletions affect a site required for meiotic recombination on the LG 12 chromosome. The cyc(b16) and cyc(b229) mutations may be useful for balancing other lethal mutations located in the distal region of LG 12. These results show that chromosomal rearrangements can provide useful resources for mapping and genetic analyses in zebrafish.


Assuntos
Rearranjo Gênico/genética , Translocação Genética , Peixe-Zebra/genética , Alelos , Animais , Mapeamento Cromossômico , Marcadores Genéticos/genética , Peixe-Zebra/embriologia
10.
Neuropharmacology ; 44(8): 1031-7, 2003 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12763096

RESUMO

The 5-HT(7) receptor is a recent addition to the 5-HT receptor family and to date there is no clear idea as to its potential role in the CNS. The receptor has been mapped by in situ hybridization and 5-HT(7)-like immunoreactivity and has been detected in discrete areas of the brain including the hypothalamus (Oliver et al., 1999). This suggests the receptor may be involved in temperature regulation and have shown that a selective 5-HT(7) receptor antagonist reverses the hypothermic effect of 5-CT in guinea-pigs. The current study confirmed that the 5-HT(7) receptor antagonists, SB-269970 (1-30 mg/kg, i.p.) and SB-258719 (5-20 mg/kg, i.p.), but not the 5-HT(1A) receptor antagonist, WAY 100635(0.1-1 mg/kg, s.c.), or the 5-HT(1B/D) antagonist, GR127935 (1.25-5 mg/kg, i.p.), reversed the hypothermic effect of 5-CT in mice. In addition the effect of 5-CT on body temperature was examined on 5-HT(7) receptor null mutant mice. 5-CT (0.1-1 mg/kg, i.p.) significantly reduced rectal temperature in wildtype but not 5-HT(7) receptor knockout mice. This suggests that the hypothermic effects of 5-CT are mediated through the 5-HT(7) receptor. All procedures were carried out in accordance with the UK Animals (Scientific Procedures) Act (1986).


Assuntos
Hipotermia/metabolismo , Receptores de Serotonina/efeitos dos fármacos , Agonistas do Receptor de Serotonina/farmacologia , Serotonina/análogos & derivados , Serotonina/farmacologia , Animais , Temperatura Corporal/efeitos dos fármacos , Hipotermia/induzido quimicamente , Hipotermia/fisiopatologia , Injeções Intraventriculares , Camundongos , Camundongos Knockout , Fenóis/farmacologia , Piperidinas/farmacologia , Receptores de Serotonina/genética , Antagonistas da Serotonina/farmacologia , Sulfonamidas/farmacologia
11.
Pediatrics ; 78(5): 767-74, 1986 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-3532016

RESUMO

Data from two groups of infants (24 to 28 weeks' gestational age) excluded from a controlled trial of the use of calf lung surfactant extract for the prevention of hyaline membrane disease are reported. The two groups were excluded from the trial because the mothers had received betamethasone for greater than 24 hours prior to delivery or because, on admission to the hospital, labor was too far advanced for proper informed consent to enter the trial. Attempts were made to delay delivery of threatened premature labor by the use of ritodrine in all mothers without evidence of infection, heavy vaginal bleeding, or severe preeclampsia and to induce surfactant production by maternal injection of betamethasone. A prospective scoring system and respiratory support variables were used to compare the groups. Infants born to mothers who successfully completed this regimen had a 28% incidence of hyaline membrane disease v a 68% incidence in infants in whose mothers it was unsuccessful due to inability to stop advanced labor (P = .001). Inspired oxygen, mean airway pressure, and ventilator rate were lower and the ventilator efficiency index was higher in the treated group during the first 48 hours of life. An aggressive approach to postpone premature delivery and to induce surfactant production by using tocolysis and a regimen of glucocorticoids reduces the incidence of hyaline membrane disease in very premature infants, 24 to 28 weeks' gestation.


Assuntos
Betametasona/uso terapêutico , Doença da Membrana Hialina/prevenção & controle , Trabalho de Parto Prematuro/prevenção & controle , Ritodrina/uso terapêutico , Feminino , Humanos , Doença da Membrana Hialina/fisiopatologia , Recém-Nascido , Ventilação com Pressão Positiva Intermitente , Consumo de Oxigênio , Gravidez , Síndrome do Desconforto Respiratório do Recém-Nascido/etiologia , Fatores Sexuais , Fatores de Tempo , Gêmeos
12.
Pediatrics ; 76(4): 585-92, 1985 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-3900906

RESUMO

A prospective, double-blind, controlled trial was conducted to determine whether instillation of an exogenous surfactant into the lungs before the first breath could prevent hyaline membrane disease. The surfactant is calf lung lipid extracted from saline lung lavage. Entry was limited to infants who were 24 to 28 weeks' gestation, who were born at Children's Hospital of Buffalo, and whose mothers had not received betamethasone for more than 24 hours before birth. Treated infants received 3 mL (90 mg) of calf lung surfactant extract instilled into their trachea before the first breath; control infants received 3 mL of normal saline. A prospective scoring system and respiratory support variables were used to compare the groups. At 48 hours of age, only two of 14 calf lung surfactant extract-treated infants (14%) had hyaline membrane disease compared with seven of 13 control infants (54%) (P = .033). Inspired oxygen, mean airway pressure, ventilator rate and ventilator efficiency index were also lower in the treated group during the first 48 hours of life (P less than .01 to P less than .001). Calf lung surfactant extract instillation at birth appears to be an effective material and method of preventing hyaline membrane disease in extremely premature infants.


Assuntos
Doença da Membrana Hialina/prevenção & controle , Surfactantes Pulmonares/administração & dosagem , Extratos de Tecidos/administração & dosagem , Animais , Bovinos , Ensaios Clínicos como Assunto , Método Duplo-Cego , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Estudos Prospectivos , Projetos de Pesquisa
13.
Pediatrics ; 58(2): 192-7, 1976 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-951133

RESUMO

Five cyanotic newborn infants underwent cardiac catheterization between 8 and 36 hours of age with a tentative diagnosis of cyanotic congenital heart disease. All had normal cardiovascular anatomy. Cyanosis was the result of persistence of fetal cardiopulmonary circulation with right-to-left shunting across the ductus arteriosus. In all infants, cyanosis resolved spontaneously and the infants survived without sequelae. Admission chest roentgenograms of all infants showed marked hyperinflation of the lungs. Except for severe hypoxemia, the clinical presentation, chest films, and course of illness of these infants were consistent with transient tachypnea of the newborn. It is proposed that an increase in pulmonary vascular resistance, due to hyperinflation of the lungs, was the mechanism which reopened the fetal cardiopulmonary circulatory channels and produced hypoxemia, and that these infants suffered from a rare manifestation of a usually benign newborn respiratory condition. Further, given these pathophysiologic mechanisms, the use of continuous transpulmonary pressure gradients in the management of such infants would be contraindicated.


Assuntos
Circulação Sanguínea , Permeabilidade do Canal Arterial/complicações , Doenças do Recém-Nascido , Taquicardia/etiologia , Humanos , Recém-Nascido , Resistência Vascular
14.
Pediatrics ; 59(3): 330-7, 1977 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-138840

RESUMO

Fourteen term newborn infants have been recognized as having transient tricuspid insufficiency associated with significant perinatal stress. Five of these infants underwent cardiac catheterization for presumed congenital heart disease, but had only massive tricuspid valve insufficiency. The other nine infants were diagnosed on the basis of a murmur characteristic of tricuspid valve insufficiency and on other clinical grounds. All had a history of significant perinatal stress in the form of asphyxia with or without hypoglycemia. Frequently, congestive heart failure, persistent cyanosis, and ECG evidence of myocardial ischemia were present. Twelve of the 14 survived, and in each of them all cardiac signs and symptoms, including the murmur, spontaneously resolved. The two patients who died had histopathologic evidence of necrosis in the anterior papillary muscle of the tricuspid valve. The constant features of perinatal stress, ST-T wave abnormalities on the ECG, and spontaneous resolution of the transient tricuspid insufficiency strongly suggest that this syndrome is secondary to a reversible form of myocardial dysfunction, perhaps by affecting papillary muscle specifically. We believe that hypoxia with or without hypoglycemia precipitates the events leading to this clinical syndrome which is distinguishable from other cardiac abnormalities in the newborn by the history, distinctive murmur, and the ECG abnormalities.


Assuntos
Asfixia Neonatal/complicações , Insuficiência da Valva Tricúspide/complicações , Cateterismo Cardíaco , Cardiomegalia/complicações , Eletrocardiografia , Sopros Cardíacos , Humanos , Hipoglicemia/complicações , Recém-Nascido , Remissão Espontânea , Síndrome
15.
Pediatrics ; 106(2 Pt 1): 282-8, 2000 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10920152

RESUMO

UNLABELLED: Surfactant therapy has become an effective standard therapy for infants with respiratory distress syndrome (RDS). The first dose may be given either as prophylaxis immediately after delivery, or as rescue after an infant has developed RDS. Second and subsequent doses are currently recommended by the manufacturers to be administered at minimal levels of respiratory support. PURPOSE: This study compared the relative efficacy of administering second and subsequent doses of Infasurf surfactant at a low threshold (FIO(2) >30%, still requiring endotracheal intubation) versus a high threshold (FIO(2) >40%, mean airway pressure >7 cm H(2)O) of respiratory support. METHODS: A total of 2484 neonates received a first dose of surfactant; 1267 reached conventional retreatment criteria and were randomized to be retreated according to low- or high-threshold criteria. They were then retreated at a minimum of 6-hour intervals each time they reached their assigned threshold until receiving a maximum of 4 total doses. Subjects were stratified by whether they received their first dose by prophylaxis or rescue and by whether their lung disease was considered complicated (evidence of perinatal compromise or sepsis) or uncomplicated. RESULTS: Among the patients randomized, 33% of prophylaxis and 23% of rescue subjects met criteria for the complicated stratum. Although infants allocated to the high-threshold strategy were receiving slightly more oxygen at 72 hours, there was no difference in the number receiving mechanical ventilation at 72 hours or in the secondary respiratory outcomes (requirement for supplemental oxygen or mechanical ventilation at 28 days, supplemental oxygen at 36 weeks' postconceptional age, inspired oxygen concentration >60% at any time). However, there was a significantly higher mortality for infants with complicated RDS who had received retreatment according to the high-threshold strategy. CONCLUSIONS: We conclude that equal efficacy can be realized by delaying surfactant retreatment of infants with uncomplicated RDS until they have reached a higher level of respiratory support than is the current standard. We speculate that this would result in a substantial cost-saving from less utilization of drug. Conversely, we believe that infants with complicated RDS should continue to be treated by the low-threshold retreatment strategy, which is currently recommended by the manufacturers of the commercially available surfactants.


Assuntos
Produtos Biológicos , Surfactantes Pulmonares/administração & dosagem , Síndrome do Desconforto Respiratório do Recém-Nascido/tratamento farmacológico , Terapia Combinada , Redução de Custos , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Humanos , Recém-Nascido , Terapia Intensiva Neonatal/economia , Masculino , Surfactantes Pulmonares/economia , Respiração Artificial , Síndrome do Desconforto Respiratório do Recém-Nascido/economia , Resultado do Tratamento
16.
Biochem Pharmacol ; 32(24): 3849-52, 1983 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-6661257

RESUMO

We have demonstrated previously that 9-beta-D-arabinofuranosyl adenosine (ara-A), like 1-beta-D-arabinofuranosyl cytosine (ara-C), incorporates exclusively into DNA, not RNA [Kufe et al., Cancer Res. 43, 2000 (1983)]. We have also demonstrated that (ara-C)DNA is degraded by alkali [Major et al., Biochem. Pharmac. 31, 861 (1982)], suggesting a structural instability of this abnormal nucleic acid. These findings have been extended by investigating the effects of various alkaline conditions on ara-A and (ara-A)DNA. The results indicate that the nucleoside was degraded under stringent conditions (0.4 M NaOH, 0.5 hr, 100 degrees) and that a similar effect occurred following exposure of (ara-A)DNA. The results also indicate that milder alkaline conditions (0.4 M NaOH, 6 hr, 37 degrees) resulted in strand scission of (ara-A)DNA at the 3'-carbon of the incorporated arabinosyl sugar without degradation of the ara-A moiety itself. These findings may be useful when attempting to purify (ara-A)DNA and confirm the structural instability of arabinosyl-containing DNA.


Assuntos
Álcalis , DNA de Neoplasias/isolamento & purificação , Leucemia L1210/metabolismo , Vidarabina/isolamento & purificação , Animais , Células Cultivadas , Fenômenos Químicos , Química , Cromatografia Líquida de Alta Pressão/métodos , Camundongos
17.
Biochem Pharmacol ; 31(5): 861-6, 1982 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-7200770

RESUMO

We employed both [5-3H] ara-C and ([2-14C] ara-C labeled L1210 DNA for analysis following exposure to alkali under various conditions. The results demonstrated that the tritium label on C5 of ara-C molecules incorporated in DNA was exchanged with water under alkaline conditions and, therefore, radioactivity was subsequently detectable in the acid-soluble fraction. The [14C] ara-C labeled DNA, however, was not susceptible to loss or radioactivity by this mechanism, and the appearance of this isotope in the acid-soluble fraction required degradation of the DNA strand or pyrimidine ring. Our results indicated that the [14C] labeled DNA was degraded by alkali, suggesting structural instability of this abnormal nucleic acid. These findings provide useful technical information on the purification of (ara-C) DNA labeled with different isotopes.


Assuntos
Citarabina/metabolismo , DNA de Neoplasias/metabolismo , Álcalis , Animais , Radioisótopos de Carbono , Leucemia L1210/metabolismo , Trítio
18.
Biochem Pharmacol ; 31(18): 2937-40, 1982 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-7138584

RESUMO

Recent work using isolated DNA polymerase-template complexes has shown that arabinofuranosyl derivatives con slow DNA synthesis by being incorporated into DNA. Our results suggest that these agents act by a similar mechanism in L1210 cells. The results demonstrate that inhibition of cellular DNA synthesis by cytosine arabinoside (ara-C) was significantly related to the extent of ara-C incorporation in DNA over a wide range of drug concentrations and times of exposure. Furthermore, treatment with increasing concentrations of ara-C resulted in a greater proportion of ara-C residues at the 3'-terminus of the elongating DNA chain. These observations suggest that ara-C incorporation results in poor primer termini for further chain elongation.


Assuntos
Citarabina/metabolismo , DNA/biossíntese , Animais , Células Cultivadas , Células Clonais/metabolismo , DNA de Neoplasias/biossíntese , Leucemia L1210/metabolismo , RNA Neoplásico/biossíntese
19.
Leuk Res ; 7(2): 243-9, 1983.
Artigo em Inglês | MEDLINE | ID: mdl-6855268

RESUMO

Adriamycin (doxorubicin) and cytosine arabinoside (Ara-C) induce single strand DNA breaks and DNA fragmentation. In view of the therapeutic efficacy of adriamycin in combination with Ara-C in the treatment of human acute non-lymphocytic leukemia, we have attempted to assess the accumulation of DNA strand breaks and DNA fragmentation with these agents by alkaline elution analysis. Although a less than additive enhancement was noted for the elution of pulse labelled, replicating DNA, the results demonstrate an additive effect of adriamycin and Ara-C on the elution of pre-labelled L1210 murine leukemia DNA.


Assuntos
Citarabina/farmacologia , DNA de Neoplasias/metabolismo , Doxorrubicina/farmacologia , Leucemia L1210/genética , Animais , Células Cultivadas , Relação Dose-Resposta a Droga , Camundongos
20.
J Appl Physiol (1985) ; 73(1): 213-8, 1992 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-1506372

RESUMO

During the latter third of gestation, the number of resistance vessels in the lungs of the fetal sheep increases by 10-fold even after correction for lung growth. We measured pulmonary arterial pressure and blood flow directly and calculated total pulmonary resistance (pressure divided by flow) in intrauterine fetal lambs at 93-95 days and at 136 days of gestation (term is 145-148 days). In addition, we used a hyperbaric chamber to increase oxygen tension in the fetuses and measured the effect on the pulmonary circulation. When corrected for wet weight of the lungs, pulmonary blood flow did not change with advancing gestation (139 +/- 42 to 103 +/- 45 ml.100 g-1.min-1). Pulmonary arterial pressure increased (42 +/- 5 to 49 +/- 3 mmHg); thus total pulmonary resistance increased with advancing gestation from 0.32 +/- 0.12 to 0.55 +/- 0.21 mmHg.100 g.min.ml-1. If the blood flow is corrected for dry weight of the lungs, neither pulmonary blood flow nor total pulmonary resistance changed with advancing gestation. Increasing oxygen tension increased pulmonary blood flow 10-fold in the more mature fetuses but only 0.2-fold in the less mature fetuses. At the normal low oxygen tension of the fetus, pulmonary blood flow does not increase between these two points of gestation in the fetal lamb despite the increase in vessel density in the lungs. However, during elevated oxygen tension, pulmonary blood flow does increase in proportion to the increase in vessel density.


Assuntos
Feto/fisiologia , Oxigênio/farmacologia , Circulação Pulmonar/efeitos dos fármacos , Líquido Amniótico/fisiologia , Animais , Pressão Sanguínea/efeitos dos fármacos , Feminino , Idade Gestacional , Frequência Cardíaca/efeitos dos fármacos , Concentração de Íons de Hidrogênio , Oxigenoterapia Hiperbárica , Pulmão/crescimento & desenvolvimento , Pulmão/fisiologia , Gravidez , Pressão , Ovinos , Resistência Vascular/efeitos dos fármacos
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