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High expression of a new marker PCA-1 in human prostate carcinoma.

PURPOSE: Identifying the genetic factors involved in prostate carcinogenesis is critical. Novel cancer-specific markers aid in early detection, in differentiating between cancer and nonmalignant disorders, and in monitoring clinical of prostate disease. We therefore examined differential gene displays in an attempt to identify genes that may be involved in prostate carcinogenesis. EXPERIMENTAL DESIGN: Applying fluorescent differential display analysis to human prostate carcinomas, we have identified and cloned several cDNA transcripts. Antisera were raised against synthetic peptides and used in Western blot and immunohistochemical analyses. The mRNAs were also analyzed by real-time reverse transcription-PCR. For functional analysis, we assessed methylmethane sulfonate (MMS)-induced toxicity in COS-7 cells after cDNA transfection. RESULTS: We identified a gene, designated prostate cancer antigen-1 (pca-1), which shows high mRNA expression in prostate carcinoma. Database analysis of the deduced amino acid sequence of PCA-1 indicated high similarity to Escherichia coli AlkB, a DNA alkylation damage repair enzyme. By immunohistochemical analysis, PCA-1 was expressed in a high number of both prostate carcinoma samples and in the atypical cells within high-grade prostatic intraepithelial neoplasias but not in benign prostatic hyperplasia or normal adjacent tissues. PCA-1-transfected COS-7 cells further showed resistance against MMS-induced cell death. CONCLUSIONS: These findings suggest that PCA-1 could be a useful diagnostic marker. Furthermore, because this human counterpart of AlkB exhibits a protective function against alkylation damage in mammalian cells, PCA-1 may also serve as a therapeutic target molecule for prostate cancer.

Amino Acid Sequence↗

Studies on vascular permeability increasing factors involved in 48-hour homologous PCA in the mouse ear.

Several attempts were made to elucidate the possible role of histamine, serotonin, leukotrienes C4 (LTC4) and D4 (LTD4), and prostaglandin E1 (PGE1) as vascular permeability increasing factors involved in 48-hour homologous passive cutaneous anaphylaxis (PCA) in the mouse ear. Increased vascular permeability in the mouse ear caused by the mediator injection or PCA was assessed quantitatively by measuring the amount of extravasated dye. In skin reactions, all of the mediators used in the present study significantly increased vascular permeability. The most potent mediator was serotonin, which increased the vascular permeability from a concentration of 10(-8) g/ml, and the activity was about 100 times higher than that of histamine on a weight basis. Vascular permeability increasing activity of LTC4 was about 10 times higher than that of histamine, and LTD4 and PGE1 were also more potent than histamine. Increases of vascular permeability caused by histamine, serotonin, LTC4 and LTD4 were significantly potentiated by injecting 10(-6) g/ml of PGE1 simultaneously. Histamine-, serotonin- and LTC4-induced skin reactions in the mouse ear were suppressed significantly by the administrations of chlorpheniramine, methysergide and FPL 55712, respectively. In contrast, though chlorpheniramine and methysergide suppressed also mouse ear PCA (about 50 and 40%, respectively), neither FPL 55712, indomethacin nor BW 755C suppressed it. These results strongly suggest that the most important mediator involved in mouse ear PCA is histamine and that serotonin also plays an important role in the increase of vascular permeability caused by PCA. Despite their potent vascular permeability increasing activity LTC4, LTD4 and PGE1 do not seem to play an important role in mouse ear PCA.

4,5-Dihydro-1-(3-(trifluoromethyl)phenyl)-1H-pyraz↗

[Effects of MY-5116 on PCA reaction and on the histamine release from peritoneal cells induced by antigen antibody reactions].

Influences of the new compound MY-5116: isoamyl 5,6-dihydro-7,8-dimethyl-4,5-dioxo-4H-pyrano (3,2-C) quinoline-2-carboxylate and its metabolites were investigated on 48-hr rat homologous PCA (PCA) and the release of histamine from rat peritoneal mast cells induced by antigen antibody reaction (histamine release). MY-5116 (30 mg/kg) inhibited PCA significantly from 10 min to 2 hr after oral administration, and its ID50 (30 min) was 19.1 mg/kg. The inhibitory effect of its main metabolite, MY-1250, was the most potent among all the metabolites, 7HPQ, 8HPQ, 7CPQ and 8CPQ on the PCA (i.v.). Effect of MY-5116 suspended in 1% CMC on the PCA increased gradually after intravenous administration, but MY-1250 suppressed PCA immediately after intravenous injection. MY-5116 dissolved in DMSO in the concentration of 10(-7)-10(-6) g/ml didn't inhibit the histamine release, but the metabolite MY-1250 inhibited the histamine release. On the other experiment, MY-1250 inhibited the histamine release (IC50: 1.4 X 10(-7) g/ml), and MY-1250 was 17 times more potent than DSCG (2.4 X 10(-6) g/ml). From these results, it is suggested that MY-1250 is the main active metabolite of MY-5116.

Administration, Oral↗

Poor outcome of the PCA and Harris-Galante hip prostheses. Randomized study of 171 arthroplasties with 9-year follow-up.

155 patients (171 hips) with a mean age of 50 years (24-64) were randomized to uncemented PCA (84 hips) or Harris-Galante type I (87 hips) total hip arthroplasty. Clinical and radiographic evaluations were done regularly. The improvements in the Harris hip and pain scores did not differ. Osteolysis developed in 5 PCA and 17 Harris-Galante hips. 13 hips in the PCA and 16 in the Harris-Galante (HG) group were revised because of mechanical failures and 1 hip (HG) because of infection after a mean follow-up of 9 years. Decreased 10-year survival rate, based on revision as end-point, was noted for the PCA (85%), compared with the Harris-Galante cup (99%). The corresponding survival rate of the PCA stem (96%) was higher than that observed for the Harris-Galante design (86%). When radiographic failures were included, the survival rates of the 4 different components dropped to between 73% and 94%. These findings indicate that further revisions will be necessary and continuous radiographic follow-up is indicated to enable revision before severe bone destruction has occurred. Although the PCA and the Harris-Galante designs differed as regards the survival of the individual components, the overall clinical and radiographic survival rates of these cementless total hip arthroplasties were poor.

Adult↗

New Purkinje cell antibody (PCA-2): marker of lung cancer-related neurological autoimmunity.

Neuron-restricted autoantibodies are important markers of neurological autoimmunity related to cancer. We identified a new paraneoplastic IgG, PCA-2 (Purkinje cell cytoplasmic antibody type 2), in 10 patients. Nine had mixed subacute neurological presentations (5 brainstem or limbic encephalitis, 3 cerebellar ataxia, 2 Lambert-Eaton myasthenic syndrome, 1 autonomic neuropathy, and 1 motor neuropathy). All 9 were smokers, and 8 had definite or probable lung cancer (7 with biopsy-confirmed small cell lung carcinoma [SCLC]; 1 imaged only). One patient had no follow-up information. A 10th patient was among 58 with uncomplicated SCLC. PCA-2 binds to a cytoplasmic antigen in neurons and SCLC cells. Its immunostaining pattern in mouse tissues is distinct from that of the paraneoplastic autoantibodies PCA-1 (anti-Yo, marker of immune response initiated by ovarian or breast carcinoma) and PCA-Tr (anti-Tr, immune response marker of Hodgkin's lymphoma). PCA-2 binds to cerebellar Purkinje somata and dendrites, neurons in internal granular layer and dentate nucleus, and neuronal elements in gut and kidney. Western blots of reduced/denatured cerebellar and SCLC proteins reveal a common antigenic band, of approximately 280 kd. PCA-2 is the seventh IgG neuronal autoantibody marker of paraneoplastic autoimmunity identifiable unambiguously by standardized immunofluorescence criteria.

Adult↗

PCA after subarachnoid block for cesarean section.

We studied the pain control, narcotic side effects, and PCA utilization with intravenous PCA morphine during 24 hours post cesarean section period. Fifty-two consecutive women were included in the study. Each received subarachnoid block with hyperbaric bupivacain with addition of fentanyl. After surgery, the patient received diclofenac suppository and IV-PCA commenced in the recovery room. Severity of pain and sedation was assessed hourly, and maximum pain and sedation scores for each 6-hour period were recorded. Two-third of the patients felt mild to moderate pain during transition from spinal analgesia to IV-PCA. Pain severity steadily improved during four 6-hour periods (p-value <0.001). Highest mean sedation score was noticed during the third six-hour postoperative period. Mean morphine consumption was 50 mg. The ratio between number of time PCA activated and dose received and pain score helped in managing the postoperative pain. Morphine IV-PCA, adequately replaces post cesarean section spinal (bupivacain-fentanyl) analgesia with fewer side effects.

Adult↗

[Pharmacological studies on rat passive cutaneous anaphylaxis (PCA) (author's transl)].

A study was made of the PCA reaction in rat hind paw for analysis of the mechanisms of the of the anaphylactic release of mediators in vivo. Also studied was the function of cyclic AMP in the anaphylactic release of histamine during PCA induced in rats with homologous and heterologous antibody. A close correlation was seen among edema formation, histamine release and decrease of cyclic AMP during homologous and heterologous PCA. Theophylline, epinephrine and isoproterenol increased the cyclic AMP level and strongly inhibited edema formation and histamine release, in all animals. Aminopyrine and trasylol also increased the cyclic AMP level but aminopyrine did not inhibit either edema formation or histamine release in case of heat labile homocytotropic antibody induced PCA in rats and trasylol did not inhibit histamine release in any animal. Methysergide and mepyramine strongly inhibited histamine release but did not alter cyclic AMP levels. Thus, the increase of the cyclic AMP level did not always inhibit the histamine release during PCA in rats. It has also been demonstrated that the PCA reaction in rat hind paw is a suitable model for studying the mechanisms of the anaphylactic release of mediators in vivo.

Aminopyridines↗

Intravenous tenoxicam reduces dose and side effects of PCA morphine in patients after thoracic endoscopic sympathectomy.

BACKGROUND: Among surgical modalities for treatment of palmar hyperhidrosis, endoscopic sympathectomy is the most popular choice in recent years. After surgery, the major complaint was anterior chest pain. This study was conducted to evaluate the analgesic efficacy and side effects of tenoxicam (a thienothiazine derivative) in combination with patient-controlled analgesia (PCA) using morphine in patients who received thoracic endoscopic sympathectomy. METHODS: Forty-one ASA class I patients who underwent endoscopic sympathectomy (T2 and T3 ganglia) were randomly divided into two groups. Operation was conducted under general anesthesia with single lumen endotracheal intubation. No narcotic was given during the operation except for fentanyl (3 micrograms/kg) during induction. After surgery, patients in group I received PCA morphine only and patients in group II received PCA morphine plus tenoxicam (20 mg, i.v.) immediately for pain relief. In addition, rescue analgesia with intramuscular meperidine (1 mg/kg) was available to each patient every 4 h prn. The intensity of pain was assessed with VAS pain score every 4 h for 24 h. The frequency of demand and doses of delivered PCA morphine were recorded. RESULTS: Results showed no statistically significant difference between groups in respect of age, body height, body weight and pain scores. However, based upon similar qualitative pain relief, patients in group II revealed less demand for analgesic, less doses of morphine requirement and less side effects. CONCLUSIONS: Tenoxicam may be an effective adjuvant to PCA morphine for postoperative pain control. This combination reduces the total consumption of PCA morphine with less side effects.

Adult↗

[Pain therapy after thoracotomies--systemic patient-controlled analgesia (PCA) with opioid versus intercostal block and interpleural analgesia].

Both regional analgesia and systemic opioid therapy (e.g. PCA) are commonly used for pain relief following thoracic surgery. Many anaesthesiologists are reluctant to use thoracic epidural analgesia on general surgical wards. Therefore, we investigated in a prospective randomised study the efficacy of intercostal blocks (ICB) or interpleural analgesia (IPA) compared to PCA with systemic opioids (PCA). Following ethics committee approval and informed consent, 45 thoracotomy patients were randomised for postoperative pain management: group 1: intravenous PCA with piritramide (PCA-control), group 2: intercostal blocks of the segments concerned with 5 ml bupivacaine 0.5% at the end of surgery and 6 hours thereafter (ICB), group 3: interpleural analgesia with 20 ml bupivacaine 0.25% applied every 4 hours using a catheter placed during surgery near the apex of the pleural space (IPA). Patients in the ICB and IPA groups were able to obtain additional pain relief by PCA with piritramide. Alternative medication for all groups in case of insufficient analgesia was metamizol. Both regional analgesia groups used significantly less piritramide up to the 3rd (IPA) or 7th (ICB) postoperative day than the control group (p < 0.05). The consumption of metamizol was lower as well (n. s.). No significant differences between the study groups were observed with regard to pain scores (visual analogue scale VAS) at rest, during deep inspiration, coughing or mobilisation. Respiratory parameters as forced vital capacity, forced expiratory volume (1 sec) and peak flow (FVC; FEV1; PF) were reduced significantly following thoracotomy and showed a slow restitution in all three study groups without major inter-group differences. Intercostal blocks and interpleural analgesia significantly reduce opioid demand following thoracotomy and are effective means of postoperative pain management. Nevertheless, in contrast to epidural analgesia, both methods have to be supplemented by, or combined with, systemic analgesics in most patients. On the other hand, compared to epidural analgesia, ICB and IPA are less invasive and easier to manage on general surgical wards.

Adult↗

Comparison of PCA nalbuphine and morphine in Chinese gynecologic patients.

BACKGROUND: The aim of this study was to evaluate the efficacy and side effects of PCA nalbuphine (intravenous) versus morphine on postoperative pain in Chinese gynecologic patients. METHODS: Sixty women undergoing abdominal hysterectomy or myomectomy under spinal anesthesia were enrolled into the investigation. Patients were randomly divided into 2 groups (n = 30 each). Group 1 received intravenous nalbuphine using PCA device for the management of postoperative pain, whereas group 2 received PCA morphine for the same purpose. During the first 48 hours postoperatively, we collected the following data: analgesic doses, pain scores, vital signs, nausea, vomiting, pruritus and dizziness. RESULTS: The results showed that despite different treatments, pain scores on day 1 and day 2 postoperatively were low and were not significantly different between groups. Meanwhile, the cumulative consumption of PCA nalbuphine (32 +/- 10 mg) and PCA morphine (30 +/- 9 mg) was similar. Both treatments showed only minor side effects and the incidence of each side effect was not significant between groups. CONCLUSIONS: Both PCA nalbuphine and morphine are effective in the treatment of postoperative pain in Chinese gynecologic patients undergoing hysterectomy or myomectomy after spinal anesthesia and the potency of nalbuphine is similar to that of morphine.

Analgesia, Patient-Controlled↗

Treatment of resistant A/J mice with methylprednisolone (MP) results in loss of resistance to murine hepatitis strain 3 (MHV-3) and induction of macrophage procoagulant activity (PCA).

BALB/cJ mice die of fulminant hepatitis within 7 days of exposure to murine hepatitis virus strain 3 (MHV-3) whereas A/J mice are fully resistant to the lethal effects of MHV-3 infection. Previous studies have implicated macrophage activation with production of a unique macrophage prothrombinase (PCA) and lymphocyte cytokine secretion in the pathogenesis of MHV-3 susceptibility and have demonstrated that immunosuppression induces susceptibility in resistant mice. This study was undertaken to determine whether macrophages, derived from resistant A/J mice and treated in vitro with methylprednisolone sodium succinate (MP), elaborated PCA following MHV-3 exposure and whether therapy with MP altered resistance of A/J mice to MHV-3 infection in vivo. Macrophages, incubated with MP in vitro, expressed dose dependent increases in PCA following infection with MHV-3. No induction of PCA occurred in macrophages treated with MHV-3 or MP alone. Analysis of mRNA transcripts for mouse fibrinogen like protein (musfiblp), the MHV-3 specific prothrombinase, in macrophages which were incubated with MP prior to exposure to MHV-3 demonstrated significantly increased mRNA levels as compared to macrophages not incubated with MP prior to MHV-3 exposure. In vivo, A/J mice treated for 3 days with 500 mg/kg/day of MP prior to infection with MHV-3 demonstrated extensive hepatocyte necrosis and fibrin deposition in hepatic sinusoids on histological examination of liver tissue, elevated serum transaminases and 100% mortality within 10 days of infection. These results therefore provide further support for the role of increased PCA in the pathogenesis of MHV-3 related liver necrosis.

Animals↗

Hydromorphone patient-controlled analgesia (PCA) after coronary artery bypass surgery.

We conducted a study to compare the effectiveness of patient-controlled analgesia (PCA) technique to conventional analgesic therapy (CAT) after coronary artery bypass graft (CABG). The PCA group received hydromorphone 0.1 mg.hr-1 basal infusion and bolus doses of 0.2 mg Q 5 min (maximum 1.2 mg.hr-1) while the CAT group received morphine 2.5 mg iv Q 30 min prn until extubation followed by prn meperidine 1 mg.kg-1 im Q 4 hr or acetaminophen 325 mg with codeine 30 mg po (1 or 2 tablets) when oral intake was possible. The degree of pain was assessed using a Visual Analogue Scale (VAS) starting after extubation and every 6-8 hr for the next 60 hr. Holter monitoring was initiated one hour after patient arrival in the Intensive Care Unit (ICU) and continued for 72 hr. Other measured variables were pulmonary function, sedation, side effects and total opioid requirements. Results show that the day-to-day VAS pain score decreased in the PCA group (P < 0.001) while it remained unchanged in CAT patients. The PCA patients had lower VAS pain scores at extubation (P < 0.05). During the third postoperative day, the PCA group had a lower VAS pain score, a lower incidence of severe pain defined as a score > 5 on the VAS scale, and a reduced incidence of myocardial ischaemia (P < 0.01). However, there was no difference in the duration, severity, area under the curve (AUC), or heart rate during ischaemic events. Postoperative pulmonary function was abnormal in both groups (NS) with minimal recovery by the fourth day.(ABSTRACT TRUNCATED AT 250 WORDS)

Analgesia↗

Comparison of tramadol and morphine via subcutaneous PCA following major orthopaedic surgery.

PURPOSE: To compare subcutaneous PCA tramadol with subcutaneous PCA morphine for postoperative pain relief after major orthopaedic surgery and for the incidence of side-effects. METHODS: In a double-blind randomised controlled study 40 patients (20 in each group) self-administered either tramadol or morphine for 72 hr after surgery via s.c. PCA. The following variables were recorded at various time intervals: (i) pain score by means of a visual analogue scale, (ii) drug consumption and total PCA demands, (iii) vital signs (blood pressure and heart rate), (iv) oxygen saturation and respiratory rate, and (v) side-effects (sedation, nausea/vomiting, pruritus, urinary retention and constipation). RESULTS: Both drugs provided effective analgesia. The mean consumption in the first 24 hr was 792 +/- 90 mg tramadol and 42 +/- 4 mg morphine. Thereafter, consumption of both drugs declined markedly. Moderate haemodynamic changes were observed in both the tramadol and morphine groups (with a maximum 20% decrease in mean blood pressure and a maximum 17% increase in heart rate) during the 72 hr period. Both tramadol and morphine were associated with a clinically and statistically significant (P < 0.001) decrease in oxygen saturation, but without changes in respiratory rates. Desaturation was less marked with tramadol. Tramadol appeared to cause more nausea and vomiting than morphine. Sedation was mild and only seen during the first few hours after surgery in both groups. CONCLUSION: Tramadol is an effective analgesic agent for the relief of acute postoperative pain when administered by PCA via the subcutaneous route. Under these conditions tramadol behaves much like morphine with a similar side-effect profile.

Adult↗

Behavioral evidence for the rapid release of CNS serotonin by PCA and fenfluramine.

Administration of p-chloroamphetamine (PCA) (2.5-10.0 mg/kg) or fenfluramine (FF) (5.0-15.0 mg/kg) to rats induces a behavioral syndrome--consisting of tremor, rigidity, Straub tail, hindlimb abduction, lateral head weaving and reciprocal forepaw treading--which is a reflection of the activity of central serotonin-mediated synapses. The syndrome appears within 3-5 min following i.p. administration of PCA or FF, and the syndrome-inducing effects of PCA and FF are blocked by prior depletion of serotonin with p-chlorophenylalanine. By contrast, the syndrome-inducing effect of 5-methoxy-N,N-dimethyltryptamine (5-M-DMT), which directly stimulates postsynaptic serotonin receptors, is not changed by prior serotonin depletion. Catecholamine depletion with alpha-methyl-p-tyrosine produces essentially no change in the syndrome-inducing effects of PCA, FF or 5-M-DMT. These data indicate that the initial effect of PCA or FF administration is the rapid functional release of stored serotonin.

Amphetamines↗

Compound PCA-4248 interferes with bronchopulmonary anaphylaxis and with in vitro hyperresponsiveness to platelet-activating factor.

The intravenous (i.v.) or oral administration of the platelet-activating factor (PAF) antagonist, PCA-4248, to guinea-pigs blocked selectively the bronchoconstriction induced by PAF, as well as the accompanying thrombocytopenia and leucopenia. In addition, PCA-4248 i.v. or intratracheal (i.t.) administration blocked the bronchoconstriction caused by the i.t. instillation of PAF. As in the case of other PAF antagonists, bronchoconstriction caused by the i.t. instillation of antigen was only inhibited by PCA-4248 in guinea-pigs that did not receive a booster injection of antigen during sensitization whereas the booster injection of antigen made anaphylactic bronchoconstriction resistant to the compound. In vitro, when lungs from non-sensitized guinea-pigs were perfused with Krebs-bovine serum albumin (BSA) solution supplemented with PCA-4248, bronchoconstriction and the formation of thromboxane A2 by PAF were blocked. In this in vitro model of perfused lungs, active sensitization with a booster injection of antigen leads to bronchopulmonary hyperresponsiveness to PAF and failure of other PAF antagonists to inhibit the effects of PAF itself. Surprisingly, in lungs isolated from actively sensitized and boosted guinea-pigs, PCA-4248 blocked the effects of PAF, indicating that this compound possesses additional original properties in this model.

Anaphylaxis↗

Depletion of serotonin using p-chlorophenylalanine (PCPA) and reserpine protects against the neurotoxic effects of p-chloroamphetamine (PCA) in the brain.

The present study attempts to determine whether the neurotoxicity of p-chloroamphetamine (PCA) is dependent on a releasable pool of serotonin (5-HT). Rats treated with PCA alone or with reserpine and PCA exhibit a profound loss of 5-HT innervation in cerebral cortex after a 2-week survival period. However, depletion of 5-HT by combined treatment with p-chlorophenylalanine (PCPA) and reserpine provides substantial protection against the neurotoxic effects of PCA. These results indicate that release of 5-HT is a necessary step in the neurotoxicity of PCA and that a peripheral source of 5-HT is involved. We suggest that 5-HT release from platelets into the peripheral circulation may result in the formation of a neurotoxic 5-HT metabolite.

Amphetamines↗

Procoagulant cellular activity (PCA) in the classification of acute leukemia.

The procoagulant cellular activity (PCA) of leukemic cells was evaluated, before and after endotoxin stimulation, in 38 patients with acute leukemia at presentation subdivided according to the FAB classification. In the M4 and M5 subgroups the stimulated leukemic cells showed a significant increase in the production of PCA compared with freshly isolated cells. No evident PCA was documented in M1 and M2 AML as well as in the majority of acute lymphoid leukemias tested, both before and after endotoxin stimulation. The myeloid and lymphoid leukemic cells appear to behave similarly to normal leucocytes, within which only monocyte/macrophages are capable of producing PCA following endotoxin stimulation. These findings suggest that in human leukemic cells the endotoxin-induced production of PCA may be considered a indicator of monocyte/macrophage differentiation and thus represent a valuable diagnostic tool in the classification of acute leukemias.

Acute Disease↗

PCA: effects on ejaculation, thermoregulation, salivation, and irritability in rats.

The short term monoamine releaser p-chloroamphetamine (PCA) was injected intraperitoneally in male rats housed at 20 degrees C. Within 2 hr of PCA injections (2.5, 5.0, 8.0 or 10.0 mg/kg), rats showed ejaculation, decreased colonic temperature, increased salivation, and increased irritability. Ejaculation and salivation scores were considerably lower in the 2.5 mg/kg than in the higher dose groups, but otherwise were not dose dependent at the doses used. Hypothermia was of similar magnitude in all groups, but lasted longer in the higher dose groups. Irritability increased with dose size. In order to study the role of ambient temperature in PCA-induced behavioral changes, observations were made on an additional group or rats housed at the higher ambient temperature of 25 degrees C. In these rats an increase, rather than a decrease, in mean colonic temperature was observed following PCA injection (5 mg/kg). Ejaculation and irritability scores were similar to those observed at the lower ambient temperature, but salivation was enhanced. It is suggested that PCA induces ejaculation, salivation, irritability and, depending on the ambient temperature, either hypothermia or hyperthermia.

Aggression↗