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To compare prescribing patterns between the elderly and nonelderly in 1994, to disclose prescribing trends in the elderly-between 1992 and 1994, to explore whether drug utilization is in agreement with disease prevalence, and to identify suboptimal prescribing by drug category for ambulatory elderly patients.Cross-sectional survey at two separate time intervals.All public group practice centers (GPCs) in Taiwan.Ambulatory adults who visited GPCs during 1 random week. Those 65 years or over were classified as the elderly group, and those 20-64 years were the nonelderly group.Mean diagnosis, drug use, and expenditure; frequency of diagnosis; and prescribing by therapeutic category.Data on 30777 elderly and 38184 nonelderly patients were collected in 1994. There was widespread use of antacids. Compared with nonelderly adults, the elderly were diagnosed with more diseases (1.3 vs. 1.2, respectively; p0.01), received more medications (4.7 vs. 4.1, respectively; p0.01), and had higher drug expenditures (5.4 vs. 4.6, respectively; p0.01). Chronic illness was more prevalent in the elderly, which accounted for the extensive use of cardiovascular drugs (32.1%), nonsteroidal antiinflammatory drugs (25.9%), and anxiolytics (15.9%). The upward trend in the elderly from 1992 to 1994 with hypertension (18.6% vs. 20.0%) or diabetes (9.2% vs. 10.9%) did not result in more cases of cerebrovascular disease (7.1% vs. 4.9%). There was a substantial increase in use of antispasmodic and gastroprokinetic agents (4.5% to 10.7%); the use of antacids decreased (73.6% to 63.4%) in the elderly.Compared with the prevalence of disease, there was extensive nonspecific use of anxiolytics and antacids. However, lessened use of antidepressants and postmenopausal hormone replacement may have an impact on morbidity and mortality and deserves particular attention.

We determined that the larval nervous system of Ilyanassa obsoleta contains paired cerebral, pleural, pedal, buccal and intestinal ganglia and unpaired apical, osphradial, and visceral ganglia. We used a modified form of NADPH diaphorase histochemistry to compare the neuroanatomy of precompetent (including specimens 6, 8, and 12 days after hatching), competent, and metamorphosing larvae with postmetamorphic juveniles. This method highlighted ganglionic neuropils and allowed us to identify individual ganglia at various stages of development, thereby laying a foundation for concurrent histochemical studies. The first ganglia to form were the unpaired apical and osphradial ganglia and the paired cerebral and pedal ganglia. In larvae 6 days after hatching, the neuropil had already appeared in the apical and osphradial ganglia. Neuropil began to be apparent in the cerebral and pedal ganglia 2 days later. At that time, the pleural and buccal ganglia were identifiable and adjacent to the posterior edge of the cerebral ganglia. The ganglia of the visceral loop were concurrently recognizable, although the supraintestinal ganglion developed slightly earlier than the subintestinal and visceral ganglia. By 12 days after hatching all of the major adult ganglia were discernible. The apical ganglion was retained by newly metamorphosed juveniles, but not by juveniles 2 days later. After metamorphosis was complete, the central nervous system (CNS) was consolidated into its juvenile form with ipsilateral cerebral and pleural ganglia being partially fused. The metamorphic translocation of ganglia, which included a caudal relocation of the cerebrals and the migration of the buccals from above the esophagus to a position below it, correlated with the movement of the proboscis to the dorsal part of the head.

Gaseous nitric oxide (NO) is produced through the action of the enzyme nitric oxide synthase (NOS) and acts as a neurotransmitter (Jacklet and Gruhn, 1994b. Elphick et al., 1995a; Jacklet, 1995) in the nervous systems of adult gastropod molluses. By comparison, little or no information appears to exist about the ontogeny of molluscan NOS-containing neurons. NADPH-diaphorase (NADPHd) has been determined biochemically and histochemically to colocalize with NOS immunoreactivity in neurons; NOS is an isoform of NADPHd (Dawson et al., 1991; Hope et al., 1991). We used NADPHd histochemistry to map the distribution of NOS activity in the nervous systems of larvae, including metamorphosing individuals, and juveniles of the marine snail Ilyanassa absoieta. Several ganglionic neuropils displayed reaction product throughout development. The most intense NADPHd staining occurred in the neuropil of the apical ganglion, a specialized larval structure. Intermediate staining levels occurred in neuropils of the cerebral, pedal, and pleural ganglia. Larval buccal and intestinal ganglia showed little reaction product, with slight increases arising in metamorphically competent larvae. NADPHd activity conspicuously decreased in the central nervous systems of metamorphosing larvae. The osphradial ganglion, which was present in young larvae, showed only weak NADPHd activity. Our results provide evidence for the existence of a nitrergic signalling system in molluscan larvae and juveniles.

An intravaginal foreign body of long duration can pose a diagnostic dilemma, since a number of diagnostic modalities may fail to detect its existence. We present the case of an 8-year-old girl who suffered from a bloody, malodorous vaginal discharge for over 4 years, during which time she had been evaluated by several gynecologists. A vaginal examination performed under analgesia revealed a pinpoint-sized opening 2 cm above the hymen. We inserted a cannula and injected radio-opaque contrast medium. An intravaginal filling defect was visible, which strongly suggested the presence of a foreign body. An incision through this scarred area was performed and two foreign bodies, one shaped like a plastic tube and the other a cap, were removed. We conclude that vaginography may provide an alternative diagnostic tool for this condition.

Human prostatic acid phosphatase (PAcP) is a prostate epithelium-specific differentiation antigen and its expression has been proposed to be regulated by androgens. Since cellular PAcP may function as a protein tyrosine phosphatase, we investigated the regulatory mechanism of its expression at different growth stages in LNCaP cells, the only cultured human prostate carcinoma cells that express an endogenous PAcP. Cells were plated at different densities to represent different stages of cellular growth for quantitating the expression of PAcP. In 4-d subconfluent cells, the cellular PAcP activity and protein level increased following the seeded cell density, consistent with mRNA levels. By day 7, all cultures had an approximately equal amount of total cellular proteins, indicating that cell growth approached to confluence, except the one that was plated at the lowest density. The cellular PAcP activity per cell was increased and corresponded to its protein level as observed in 4-d cultures. However, in 7-d cultured cells, although the PAcP protein level increased, its mRNA level declined. This increased PAcP protein level despite the decreased message was in part due to a prolonged half-life of the protein. Further, androgen effect on the PAcP mRNA level was also shown to be a cell density-dependent phenomenon. In low-density cultured cells, the PAcP mRNA level was elevated approximately 100% by 5 alpha-dihydrotestosterone (DHT) stimulation. However, in high-density confluent cells the mRNA level was slightly decreased by DHT treatment. Further, treatments with various growth stimulators resulted in various degrees of inhibition on PAcP mRNA levels. In conclusion, the data indicate that the cellular level of PAcP activity is associated with the cell density/confluence of LNCaP cells. Further, cell density could modulate androgen effect on PAcP expression at the mRNA level.

Human prostatic acid phosphatase (PAcP) is a tissue-specific differentiation antigen and is the major phosphotyrosyl (p-tyr) protein phosphatase in normal differentiated prostate epithelial cells. In prostate carcinomas, cellular PAcP has a low expression. We examined the expression of cellular PAcP activity and its correlation with cell growth that may lead us to understand the role of tyrosine phosphorylation in human prostate cells. LNCaP cells, which expressed the highest cellular PAcP activity, had the slowest growth rate and the lowest p-tyr level among three human prostate carcinoma cell lines: LNCaP, DU145, and PC-3. This inverse correlation was further examined in LNCaP cells, since these cells remain hormone-sensitive. Androgen, a classical stimulator of prostate cells, stimulated the growth of LNCaP cells while cellular PAcP activity decreased and p-tyr levels increased. This phenomenon was also observed when cells were treated with epidermal growth factor and fetal bovine serum. Both epidermal growth factor and fetal bovine serum stimulated the growth of LNCaP cells whereas cellular PAcP activity decreased. Furthermore, when cell growth was arrested at low temperatures (23 degrees C), cellular PAcP activity was elevated. To establish the relationship of cellular PAcP activity with cell growth rate, we transfected a complementary DNA encoding the full length PAcP protein into another human prostate carcinoma line, PC-3, that lacks endogenous PAcP. Two stable transfectants, designated PC-18 and PC-416 cells, were obtained and shown to express PAcP mRNA transcribed from the transfected complementary DNA. The expression of PAcP activity in PC-416 cells, but not PC-18 cells, was associated with a lower p-tyr level and a slower growth rate than control cells transfected with the expression vector alone. In conclusion, in LNCaP cells, the stimulated cell growth is associated with an increased p-tyr level and a decreased cellular PAcP activity. In PAcP complementary DNA-transfected PC-416 cells, the low level of p-tyr corresponds to a slow growth rate.

23 cases of T-lineage acute lymphoblastic leukemia (TALL) were identified by multiple monoclonal antibodies. TALL was characterized by a younger age of the patients (average age 28 years), strong male preponderance (M:F, 4.8: 1), mediastinal mass (19%), higher leucocyte count (71.4%), hepatomegaly (76.2%) and splenomegaly (90.5%). Of 19 cases of TALL who were subclassified according to the criteria for subclassification of TALL proposed by Reinherz, 10 cases expressed a surface antigen pattern consistent with the early thymocyte stage of TALL development, 8 cases were of common thymocyte stage and 1 case was of mature thymocyte stage. The phenotypes of TALL cells appear to be considerably heterogeneous. 12 of 18 patients who received chemotherapy had achieved complete remission (67%).

Prostatic acid phosphatase (PAP) was purified from human malignant prostate tissue by means of ammonium sulfate fractionation followed by sequential chromatographies of ion exchange, affinity column, and gel filtration. PAP has a molecular weight of 100,000 and consists of two subunits of 50,000. Owing, in part, to sialic acid contents in the molecule, PAP has multiple isoelectric points (pIs) at 4.2-5.5. In 0.2 M citrate, PAP has the highest affinity (Km 9.2 x 10(-5) M) in hydrolyzing alpha-naphthyl phosphate among the phosphomonoesters. Tartrate and heat at 37 degrees C for 2 hours almost completely inhibit PAP enzymic activity. By immunoprecipitate technique, anti-PAP heteroantiserum exhibited a distinct immunologic characteristics. Further, PAP possessed different antibody-binding site from enzyme hydrolytic site.

A glycoprotein (GP) which is immunochemically and biologically related to human prostatic acid phosphatase (PAP) has been isolated from human seminal plasma by ammonium sulfate precipitation followed by sequential concanavalin A:Sepharose 4B column, anion-exchange chromatography and gel filtration. The purified GP was shown to be homogeneous by disc- and sodium dodecyl sulfate: polyacrylamide gel electrophoresis. The apparent molecular weight of purified GP was estimated to be 50,000 by gel filtration and 45,000 by sodium dodecyl sulfate: gel electrophoresis. In gel diffusion against antiserum to purified PAP, a partial immunological identity was shown between GP and PAP. This was further confirmed by an inhibition reaction between GP and antiserum to purified GP by PAP. Significantly, 30% of PAP enzyme activity was inhibited by anti-GP antiserum, while only 5% was inhibited by anti-PAP antiserum. Purified GP was shown to exhibit a weak, but significant, acid phosphatase activity by hydrolyzing alpha-naphthyl phosphate at pH 5.6. The Km and Vmax for GP are 1.6 X 10(-4) M and 0.056 mumol/min/microgram protein, respectively, using alpha-naphthyl phosphate as the substrate. In the presence of anti-PAP antibody, the enzyme activity of GP was enhanced severalfold. Furthermore, the acid phosphatase activity of GP also was inhibited by tartrate, which is the most commonly used inhibitor for PAP. GP and PAP were found to have different carbohydrate content, amino acid composition, amino-terminal sequence, and peptide map. Thus, GP represents a newly identified protein. The significance of these results at molecular and clinical levels is discussed.

Tyrosyl kinase activity was detected in 1.0 microliter or less of human serum with the substrates angiotensin II, polyamino acid polymer Glu-Tyr (4:1), anti-pp60src IgG, and endogenous serum proteins. Most (about 84%) of the tyrosyl kinase activity was in the 100,000 X g soluble fraction from serum and a similar level of activity was found in the soluble fraction from plasma. Expression of tyrosyl kinase activity in individual serum samples differed more than 15-fold. The different levels of tyrosyl kinase activity were not likely due to phosphatases, proteases, ATPases, or kinase inhibitors and activators in serum. The normal serum and plasma tyrosyl kinase activities were not stimulated by epidermal growth factor, platelet-derived growth factor, insulin, or growth factors from fetal calf serum. Investigations of samples from patients with malignant disorders indicated that those with malignant melanoma contained the highest levels of serum tyrosyl kinase activity.

Serum prostate-specific antigen and prostatic acid phosphatase were simultaneously evaluated in 22 healthy males, 29 patients with benign prostatic hypertrophy, and 192 patients with prostate cancers at various stages as well as in 30 patients with cancers other than prostate cancer. Both markers were quantitated by specific sandwich-type, enzyme-linked, immunosorbent assays with the use of specific antiserum reagents. Serum assays revealed a discordance between these two markers; thus expressions of these two biochemically and immunologically distinct prostate-specific proteins may reflect different aspects in the biology of prostate cancer. A combination test with the use of 7.5 ng of prostate antigen and 15.5 ng of prostatic acid phosphatase/ml of serum, respectively, as cutoff values resulted in a positive detection rate of 58% for prostate cancers of stages A (7/12) and B (21/36) each, 68% for prostate cancer of stage C (19/28), 92% for prostate cancer of stage D (106/116), and only 10% for benign prostatic hypertrophy (3/29). None of 52 other cancers or healthy controls was registered as positive. This study demonstrates that a multiple marker test of tissue-specific antigens can be of an additive value in the immunodiagnosis of cancer and may be a logical and effective approach at this time, in light of the unavailability of human tumor-specific markers.

We report optical pump-soft X-ray scattering probe studies of YBCO single crystals. The experiments reveal a picosecond relaxation dynamics of charge density waves, which is in turn strongly modified by the onset of superconductivity.