[Influence of radiotherapy on reconstruction flaps in oral and maxillofacial regions]

OBJECTIVE

To evaluate the influence of radiotherapy on reconstruction flaps in oral and maxillofacial regions and the radiation tolerance of flaps, and therefore provide clinical information for perioperative radiotherapy.

METHODS

Sixty-six free flaps and 22 pedicled flaps were used in the reconstruction of oral and maxillofacial tumor defects. The success and healing of the total 88 reconstruction flaps(14 flaps in preoperative radiation group and 74 flaps in postoperative radiation group) were observed. The acute and late side effects of radiotherapy in the flaps of the postoperative group were studied as well.

RESULTS

Of the preoperative 14 flaps, 12 were successful (85.7%), one partially successful and one failed. Of the postoperative 74 flaps, however, 73 were successful (98.6%) and only one partially successful. No total loss of the flap was noted in the postoperative group. The success and healing rates in the preoperative group were lower than those in the postoperative group significantly (P < 0.01-0.05). The rate of acute radiation response of flaps in the postoperative group was significantly lower than that in the surrounding normal tissues(35.1% versus 83.8%, P < 0.01). The late side effects of radiotherapy were rare. The radiation tolerance in different kinds of flaps was similar.

CONCLUSION

Reconstruction flaps in oral and maxillofacial regions have a good radiation tolerance and routine postoperative radiation doses can be safely delivered.

Monoclonal antibodies that inhibit the transport function of the 190-kDa multidrug resistance protein, MRP. Localization of their epitopes to the nucleotide-binding domains of the protein

Multidrug resistance in tumor cells is often accompanied by overexpression of multidrug resistance protein (MRP), a 190-kDa transmembrane protein that belongs to the ATP-binding cassette superfamily of transport proteins. MRP mediates ATP-dependent transport of a variety of conjugated organic anions and can also transport several unmodified xenobiotics in a glutathione-dependent manner. To facilitate structure-function studies of MRP, we have generated a panel of MRP-specific monoclonal antibodies (mAbs). Four of these mAbs, QCRL-2, -3, -4, and -6, bind intracellular conformation-dependent epitopes, and we have shown that they can inhibit the transport of several MRP substrates. Binding competition and immunoprecipitation assays indicated that mAbs QCRL-4 and -6 probably recognize the same detergent-sensitive epitope in MRP, whereas mAbs QCRL-2, -3, and -4 each bind distinct, non-overlapping epitopes. Fab fragments inhibit transport as effectively as the intact mAbs, suggesting that inhibition results from direct interactions of the mAbs with MRP. Immunodot blot and immunoprecipitation analyses revealed that the minimal regions of MRP sufficient for full reactivity of mAbs QCRL-2 and -3 are amino acids 617-858 and 617-932, respectively, which encompass the NH2-proximal nucleotide-binding domain (NBD). In contrast, the epitope bound by mAb QCRL-4 localized to amino acids 1294-1531, a region that contains the COOH-proximal NBD. However, none of the mAbs inhibited photolabeling of intact MRP with 8-azido-[alpha-32P]ATP. This suggests that rather than preventing nucleotide binding, the mAbs inhibit transport by interfering with substrate binding or by trapping MRP in a conformation that does not allow transport to occur. Our results also demonstrate for the first time that the NBDs of MRP can be expressed as soluble polypeptides that retain a native conformation.

[Craniofacial resection for advanced malignant tumors in oral and maxillofacial region]

OBJECTIVE

To investigate the clinical significance of craniofacial resection for advanced malignant tumors of OMS region.

METHODS

Forty-six patients underwent craniofacial resection for malignancies involving the anterior and middle cranial fossa over a 20-year period between June 1978 and December 1997 in our department were evaluated. The extents of cranial resections were anterior cranial fossa in 20 cases, middle crania fossa in 16 cases and anterior and middle skull base in 10 cases. There were 18 patients undergoing orbital exenteration simultaneously. 14 cases had limitted dura resected because of dural involvement.

RESULTS

The survival rate at 3 and 5 years was 48.8% (20/41) and 35.1% (13/37), respectively. The survival rate at 10 years was 20.0% (4/20).

CONCLUSION

Our results revealed a considerably fine prospect of craniofacial resection for patients with advanced malignancies in oral and maxillofacial region.

Two non-reactive ternary complexes of estrogenic 17beta-hydroxysteroid dehydrogenase: crystallization and preliminary structural analysis

Human estrogenic 17beta-hydroxysteroid dehydrogenase (17beta-HSD1, EC1.1.1.62) is an important enzyme that catalyses the last step of active estrogen formation. 17Beta-HSD1 plays a key role in the proliferation of breast cancer cells. The three-dimensional structures of this enzyme and of the enzyme-estradiol complex have been solved (Zhu et al., 1993, J. Mol. Biol. 234:242; Ghosh et al., 1995, Structure 3:503; Azzi et al., 1996, Nature Struct. Biol. 3:665). The determination of the non-reactive ternary complex structure, which could mimic the transition state, constitutes a further critical step toward the rational design of inhibitors for this enzyme (Ghosh et al. 1995, Structure 3:503; Penning, 1996, Endocrine-Related Cancer, 3:41). To further study the transition state, two non-reactive ternary complexes, 17beta-HSD1-EM519-NADP+ and 17beta-HSD1-EM553-NADP+ were crystallized using combined methods of soaking and co-crystallization. Although they belong to the same C2 space group, they have different unit cells, with a = 155.59 A, b = 42.82 A, c = 121.15 A, beta = 128.5 degrees for 17beta-HSD1-EM519-NADP+, and a = 124.01 A, b = 45.16 A, c = 61.40 A, beta = 99.2 degrees for 17beta-HSD1-EM553-NADP+, respectively. Our preliminary results revealed that the inhibitors interact differently with the enzyme than do the natural substrates.

Selection of quantitative criteria for evaluating metastases of a highly metastatic salivary adenoid cystic carcinoma cell line to the lungs of nude mice

OBJECTIVE

To select reliable quantitative criteria for evaluating metastases of a highly metastatic salivary adenoid cystic carcinoma cell line (ACC-M) cell to the lungs of nude mice.

MATERIALS AND METHODS

The within-group coefficients of correlation of 5 parameters were measured from lung slides using a video image digital analysis system (VIDAS), and the intergroup coefficients of correlation of 6 sets of parameters from all the lungs, which were taken from ACC-M lung metastases models, were calculated and statistically analyzed.

RESULTS

The within-group coefficients of correlation of 5 parameters are as follows: ratio of area of metastases, t = 0.9 (P < 0.001); area of metastases, t = 0.7 (P < 0.05), size of lung section, numbers of metastases, and size of the largest metastatic focus all t < 0.4 (P > 0.05). The intergroup coefficients of correlation of the parameters are as follows: ratio of area of metastases was assigned 1, weight of the lung was 0.9755, and area of metastases was 0.8628.

CONCLUSION

For evaluating lung metastases of ACC-M, the ratio of area of metastases and weight of the lung are precise; the area of metastases is also significant within the 6 quantitative parameters.

[Long-term effectiveness of arthroscopic subsynovial sclerotherapy and suturing on recurrent dislocation of the temporomandibular joint]

OBJECTIVE

To evaluate long-term effect of arthroscopic surgery on recurrent mandibular dislocation.

METHODS

30 patients with 34 involved temporomandibular joints (TMJs) (26 unilateral, 4 bilateral) were treated by arthroscopic subsynovial sclerotherapy with or without a discal traction suture. Of them, four patients with 4 TMJs were undergone repeat arthroscopic operations. In total, 38 operations were performed in 34 TMJs. After arthroscopic lysis, lavage, and manipulation, the subsynovial sclerotherapy was performed with 5% sodium morrhuate and was located at retrodiscal lamina. Suturings were taken simultaneously in 19 cases, others (n = 19) were not sutured. The total amount of 5% sodium morrhuate was from 0.4 to 1.2 ml, and the numbers of injection points were from 2 to 5, and the subsynovial depth of injection was not more than 5 mm. The follow-up was from 1 mon to 8 years.

RESULTS

The total success rate was 97% (33/34). There were 21 patients with 22 involved TMJs whose follow-ups were more than 2 years. The mean follow-up was 4 years (2-8 years). The long-term success rate was 95% (21/22). There were no serious complications.

CONCLUSION

The long-term effectiveness of arthroscopic sclerotherapy and suturing on recurrent mandibular dislocation is stable.

[Experimental study on the osteoradionerosis of jaw model of dogs with vascular corrosion casting]

OBJECTIVE

To study pathologic alterations of mandibular microvascular system in osteoradionecrosis of jaws (ORNJ) in order to disclose its pathologic mechanism.

METHODS

The right maxillofacial regions of 10 dogs were exposed to cobalt-60 radiation with a total dose of 60-80 Gy and dental extraction were performed at 3, 6 months after radiation. The ORNJ was diagnosed by gross observation, X-ray film and histopathologic examination. Then, the vascular corrosion castings of jaws were implemented and investigated.

RESULTS

At 12 months after radiation, 7 cases of ORNJ occured. It was discovered on the casting specimen that the continuity of inferior alveolar arteries remained intact except one case where the artery was obliterated due to lesion involvement. There were defects of vascular networks in the necrotic area with irregular capillaries proliferating in the periphery of lesions and around the inferior alveolar arteries, where x-ray examination showed new bone formation.

CONCLUSION

Based on the experimental evidences, a new concept of pathogenesis of ORNJ is put forward: following the formation of "3-hypo" structures, local trauma-repairing process might induce capillary proliferation which bring about a large amount of mitotic death of endotheliocytes, the microcirculation failure takes place leading to ORNJ eventually.

Genetic diversity of ospC in a local population of Borrelia burgdorferi sensu stricto

The outer surface protein, OspC, is highly variable in Borrelia burgdorferi sensu stricto, the agent of Lyme disease. We have shown that even within a single population OspC is highly variable. The variation of ospA and ospC in the 40 infected deer ticks collected from a single site on Shelter Island, New York, was determined using PCR-SSCP. There is very strong apparent linkage disequilibrium between ospA and ospC alleles, even though they are located on separate plasmids. Thirteen discernible SSCP mobility classes for ospC were identified and the DNA sequence for each was determined. These sequences, combined with 40 GenBank sequences, allow us to define 19 major ospC groups. Sequences within a major ospC group are, on average, <1% different from each other, while sequences between major ospC groups are, on average, approximately 20% different. The tick sample contains 11 major ospC groups, GenBank contains 16 groups, with 8 groups found in both samples. Thus, the ospC variation within a local population is almost as great as the variation of a similar-sized sample of the entire species. The Ewens-Watterson-Slatkin test of allele frequency showed significant deviation from the neutral expectation, indicating balancing selection for these major ospC groups. The variation represented by major ospC groups needs to be considered if the OspC protein is to be used as a serodiagnostic antigen or a vaccine.

[Arthroscopic sclerotherapy and suturing for disc displacement of the TMJ]

OBJECTIVE

The generation of the scar using TMJ arthroscopic sclerotheray in retrodiscal tissue needs some weeks. As the sclerotherapy can't fix disc reposited at once, we designed some new methods of discal traction suture with posterior sclerotherapy and anterior release.

METHODS

30 cases with 15 joints of disc displacement with reduction and 16 joints of disc displacement without reduction were treated with the above-mentioned techniques.

RESULTS

The mean follow-up period was 27 mon (range 6-39). According to the rang of interincisal distances during maximum active opening and painful level using a standard 100 mm visual analog scale, and, analyzing an eight-item jaw pain questionnaire and jaw function using 5 item jaw function questionnaire, the total success rate was 74.2% (23/31), the success rate of disc displacement with reduction was 93.3% (14/15), and the success rate of disc displacement without reduction was 56.4% (9/16).

CONCLUSION

TMJ arthroscopic disc traction suture with posterior sclerotherapy and anterior release is effective on disc displacement. Diagnosis, treatment and post-operative evaluation can be performed in the same arthroscopic procedure.

Evoked potential estimation using modified time-sequenced adaptive filter

A method called modified time-sequenced adaptive filtering (MTSAF) is applied to estimate evoked potential (EP) signals and track the temporal variations of EPs. The MTSAF consists of a set of adaptive filters (AFs), with each processing a time segment of EP data. After convergence, each AF reaches the best estimation of EP signals over its own time segment in terms of minimum mean squared error (MMSE). Numerical results of simulated and human EP data show that the MTSAF reaches better estimation of EPs than a conventional adaptive signal enhancer (ASE). With the MTSAF, the temporal variations of EPS across trials can be estimated to reveal more subtle variations of EPs, which may be of clinical value.

[Low frequency of precore stop mutation in patients with dual infection of hepatitis B and C viruses]

In order to study the mutation of hepatitis B virus(HBV) precore gene in patients with dual infections of HBV and HCV and its possible clinical significance, the precore stop codon mutation (stop 28) was analysed by polymerase chain reaction (PCR) and restriction fragment length polymorphism(RFLP) in patients with chronic liver disease, which were 25 cases with HBV DNA and HCV RNA positive(group A) and 31 cases with HBsAg and HBV DNA positive but anti-HCV and HCV RNA negative (group B). The results showed that the serum HBV DNA positive rate by 1st PCR in patients with dual infections(group A, 16%) was significantly lower than that in patients with HBV infection alone (group B, 65%), the stop 28 positive rate was also significantly lower (28%, versus 68%). The results suggest that the low frequency of precore stop codon mutant in patients with HBV and HCV dual infections was possibly due to low replication of HBV.

Inhibition of p130cas tyrosine phosphorylation by calyculin A

P130cas is a dominant tyrosine phosphorylated protein in v-src-and v-crk-transformed cells. Tyrosine phosphorylation also occurs in response to integrin-mediated cell adhesion. P130cas has a unique structure with multiple SH2 and SH3 binding sites, which makes it a candidate docking protein that might be involved in several signal transduction pathways. Little is known about how p130cas itself is regulated. In this report we present evidence that tyrosine phosphorylated p130cas was rapidly dephosphorylated in several lymphatic cell lines after treatment with calyculin A, a serine/threonine phosphatase inhibitor. A similar result was obtained with okadaic acid, but higher concentrations and longer incubation times were required. Constitutive phosphorylation as well as receptor-cross linking-induced p130cas phosphorylation was inhibited. Furthermore, the p130cas-Crk association was disrupted by treatment of cells with calyculin A. However, the p130cas-Lyn association was not affected. These results suggest that calyculin A specifically affects SH2 domain-mediated protein-protein interactions and that Lyn does not bind to a susceptible SH2 domain. Furthermore, the data presented is consistent with the existence of a calyculin A-sensitive phosphatase or tyrosine kinase that may be a critical regulator of p130cas tyrosine phosphorylation.

[Phacoemulsification and foldable intraocular lens implantation through a clear corneal incision]

OBJECTIVE

To evaluate the therapeutic effects of phacoemulsification with foldable intraocular lens implantation through a clear corneal incision.

METHODS

The surgery was performed through a 3.2 mm clear corneal incision on 100 eyes of 90 patients with senile, complicated, congenital and traumatic cataracts.

RESULTS

Postoperatively, the visual acuities with spherical correction or without correction were 0.5 or better in 93.0% of eyes at one day, and 1.0 or better in 56.0%, 65.1% and 67.5% at one week, one month and three months respectively. The mean postoperative astigmatism was 0.93 +/- 0.58 D at one week and 0.20 D more than the mean preoperative one (P < 0.001). There was no statistical difference between the mean preoperative astigmatism and postoperative astigmatism at one and three months which were respectively 0.78 +/- 0.60 D and 0.73 +/- 0.59 D.

CONCLUSION

The phacoemulsification with foldable intraocular lens implantation through a clear corneal incision can reduce early postoperative astigmatism, shorten the period of visual rehabilitation and simplify operative procedures.

[Experimental study of radiation effects on the mandibular microvasculature of the guinea-pigs]

In the experiment, both 180 kV X-ray and cobalt-60 radiation were delivered to right mandibles of 128 guinea-pigs with different dose (1000 cGy x 4, 800 cGy x 4, 600 cGy x 4, 400 cGy x 4 within 1 week). Dental extractions were conducted 1, 3, 5 months after radiation and the irradiated animals were examined by using microvascular corrosion castings of mandibles. It was found that the number of capillaries reduced and microvascular networks broke off after radiation with small veins shrinking subsequently while the alterations of arteries were slight. This result indicated that capillary was the most vulnerable part to the damage of radiation in the vascular system. In addition the defects of vascular networks around the non-healing tooth extraction sites were also discovered with irregularly capillary proliferation in the periphery of the lesion. The phenomena suggested that microcirculation failure induced by trauma-repairing process lead to occurRence of osteoradionecrosis of jaws.

[B-ultrasonographic diagnosis of emergency complications in lung cancer patients]

OBJECTIVES

To assess the value of B-ultrasonography in the diagnosis and treatment of emergency complications in lung cancer patients.

METHODS

Thirty-five patients with lung cancer who suffered from emergency conditions were examined with B-ultrasonography. Of the 35 cases, 5 had superior vena caval syndrome due to compression by a centrally located tumor mass in the right upper lobe; 10 had moderate to large accumulation of fluid in the pericardium with cardiac tamponade; 2 had metastasis to the myocardium and pericardium with acute hemorrhagic pericardial effusion; 20 had massive pleural effusion. The ultrasonographic features of these complications were described. Patients with pericardial or pleural effusion received intervention treatment with Elemen emulsion under B-ultrasound guidance.

RESULTS

Combined with systemic chemotherapy, in 4-week period, complications were temporarily ameliorated in 82.8% and became clinically stable in 8.5% of the cases. Treatment was of no effect in 8.5%.

CONCLUSION

B-ultrasonography is of value in the diagnosis of emergency complications of lung cancer and is of help to guide intervention treatment.

[Experimental study on antitumor effect in vitro of modified DNL of oral squamous cell carcinoma with TNF-alpha gene]

The gene coding for TNF-alpha was introduced into DNL of human oral squamous carcinoma by retroviral-mediated gene transduction, and experiments proved that the gene had been introduced into the DNL and the DNL could secrete TNF-alpha of high activity with PCR analysis, bioactivity analysis of TNF-alpha, selection test in G418. Cytotoxicity of gene-transduced and nontransduced DNL to Tca8113 cell was compared with MTT method. The result showed that cytotoxicity of the former was higher than that of the latter.

[The different influences of splenectomy plus ligation of pericardial vein and shunt on portal hypertensive gastropathy]

A prospective and controlled study has been made to probe into the different influences of splenectomy plus ligation of pericardial vein (SPLPY) and shunt on portal hypertensive gastropathy (PHG). 26 patients with cirrhosis of liver and portal hypertension admitted from January 1994 to April 1996 were randomized into two groups. One group was treated with SPLPV (15 cases), and the other shunt (11 cases). Gastroscopy was made in all patients pre- and postoperatively to observe the changes of gastric mucosa. It has been shown that SPLPV exacerbate PHG (P < 0.05) and the shunt has an opposite effect (P < 0.05). We consider that it is necessary to modify SPLPV and reevaluate the clinical effects of the both.

[Transposition of the fibular skin flap of the great toe to repair the fore plantar defect]

The sole, as the body weight-bearing region, is characterized with the skin of thick stratum corneum. Wound in the region is difficult to cure. Based on the blood supply of the foot, a fibular skin flap of the great toe was designed and used to treat the defect of the planta pedis. Clinical applications in 6 cases were successful. The operation results were satisfactory.

[The primarily study on the correlation between the cephalometric characteristics and the results of ploysomnography]

A study on correlation between temporomandibular joint ankylosis and Obstructive Sleep Apnea Syndrome (OSAS) was conducted. The statistic results demonstrate that there is significant correlation between (TA + SPA)/OPA and AI, and there is negative correlation between PAS and AI, (TA + SPA)/OPA and SaO2min by correlation and step regression between the cephalometric analysis and polysomnogram of fourteen cases of OSAS patients.

Cloning and widespread distribution of the rat rod-type cyclic nucleotide-gated cation channel

We used Northern blot analysis, ribonuclease protection assay (RPA), reverse transcriptase-polymerase chain reaction, and in situ hybridization to investigate the hypothesis that the CNG1 isoform of the cyclic nucleotide-gated nonselective cation channel may be widely distributed in tissues of the rat. A cDNA encoding the CNG1 isoform was isolated from rat eye and human retina, and partial sequences were isolated from rat pineal gland and human kidney. Northern blot analysis revealed a 3.1-kilobase (kb) CNG1 transcript in rat eye, pineal gland, pituitary, adrenal gland, and spleen, and a larger transcript of 3.5 kb was found in testis. RPA confirmed the identity of CNG1 mRNA in rat eye, lung, spleen, and brain. Polymerase chain reaction-based detection of the mRNA for CNG1 indicates that the channel is expressed in lower abundance in many other tissues, including thymus, skeletal muscle, heart, and parathyroid gland. The cellular distribution of CNG1 was further studied by in situ hybridization, which demonstrated expression of mRNA in lung, thymus, pineal gland, hippocampus, cerebellum, and cerebral cortex but not in heart or kidney.

cGMP stimulates sodium and chloride currents in rat tracheal airway epithelia

To test the hypothesis that guanosine 3',5'-cyclic monophosphate (cGMP) regulates ion transport in airway epithelial cells, we measured short-circuit current (I(sc)) and (22)Na+ fluxes in primary cultured rat tracheal epithelial cells. In Cl- -containing Ringer solution, I(sc) was increased by approximately 17 microA/cm2 after application of 1 mM 8-bromoguanosine 3',5'-cyclic monophosphate (8-BrcGMP), whereas, in Cl- -free solutions, the Na+ -mediated component was approximately 5 microA/cm2, suggesting a cGMP stimulation of Cl-secretory current and a smaller Na+ absorptive current. Inward and net mucosal-to-serosal (22)Na+ flux was doubled in the presence of 2 mM 8-BrcGMP. To determine whether nucleotide-gated channels play a role in this transepithelial Na+ absorption, blockers of nucleotide-gated cation channels were used to inhibit I(sc). The cGMP-stimulated Na+-mediated I(sc) was blocked by as little as 500 nM dichlorobenzamil or 50 microM L-cis-diltiazem, which are known blockers for cyclic nucleotide-gated cation channels. These agents also blocked the basal (non-cGMP-stimulated) current when measured in the presence of 10 microM amiloride, which blocks current through 5-pS amiloride-sensitive Na+ channels. To document whether the distribution of nucleotide-gated nonselective cation channels was consistent with a role in airway epithelial transport, in situ hybridization was performed. In situ hybridization of mRNA encoding for nucleotide-gated cation channels was found in epithelial cell layers of rat trachea, bronchi, bronchioles, and alveolar cells but not in smooth muscle layers or tracheal cartilage. Reverse transcriptase-polymerase chain reaction, restriction enzyme analysis, and sequencing of the cDNA transcribed from mRNA of whole lung and tracheal epithelial cells indicate that a channel highly homologous to the retinal nucleotide-gated nonselective cation channel (CNG1) is present. Thus these data, along with evidence supporting the existence of signal transduction pathways elevating intracellular levels of cGMP, indicate that cGMP regulates transepithelial ion transport in lung epithelial tissues.

[nm23 expression and its correlation with lung metastasis in human salivary adenoid cystic carcinoma]

The nm23 gene products, nucleoside diphosphate kinase (NDPK), expression in salivary adenoid cystic carcinoma (ACC) was evaluted by using LSAB immunohistochemical method. Of 25 cases tested, 16 (64.0%) showed positive staining, in which, higher incidence of positive staining was found in ACC without lung metastasis (88.2%, 15/17) than in that with lung metastasis (12.5%, 1/8; P < 0.01). Expression of NDPK/nm23 was correlated with the P-TNM pattern (P < 0.05), otherwise it was not correlated with pathologic types (P > 0.05). The result suggest that the nm23/NDPK may play a role in suppressing the metastatic potential in ACC.

Factors related to the donor organ are major determinants of renal allograft function and survival

In this study, we analyzed the relative impact of donor and recipient variables on cadaveric renal allograft function and survival. The unique feature of the study population is that each pair of recipients received their allografts from a single donor. The study includes 378 adult patients. In 129 pairs both recipients were Caucasian, and in 60 pairs one recipient was Caucasian and the other was African-American. All transplants were done in one center, thus minimizing differences in preservation time and providing uniform posttransplant management. The initial analysis showed a relationship between the function of the allograft 6 months after transplantation (serum creatinine [SCr]6 mo) and donor variables (P = 0.0004, analysis of variance). Furthermore, it was calculated that 64% of the variability in the SCr 6mo among patients was due to donor factors and 36% was due to recipient factors. An elevated SCr 6 mo was significantly associated with older donors, male recipients, and patients with acute rejection episodes. Furthermore, other unidentified donor factors may have an impact on allograft function. Reflecting the importance of donor factors, there was a significant relationship between SCr 6mo in paired recipients (P < 0.0008 by Spearman). Analysis of racially dissimilar pairs showed that the SCr 6mo and graft survival 6 months after transplantation were not significantly different between Caucasians and African-Americans. However, beyond 6 months, graft survival was worse in African-Americans (P < 0.0001 by Cox). Compared with Caucasians, graft survival was significantly worse in African-Americans with poorly controlled blood pressure (mean arterial pressure > 105 mmHg) (P = 0.002, Cox), but not in those patients with mean arterial pressure < 105 mmHg. In conclusion, donor factors are major determinants of renal allograft function. However, those factors may not be easily identifiable or quantifiable. Donor factors do not contribute to racial differences in allograft survival. However, poorly controlled hypertension correlates with poor renal graft survival in African-Americans.

[The MRI of cervical lymph node metastasis with malignant tumor of the head and neck]

A prospective diagnostic study on cervical lymph node metastasis from malignant tumor of the head and neck using MRI was performed for 62 cases in order to assess the potential or limitation of MRI for demontrating the pathological cervical lymph node. The double blind method was used in the study. The result reveals MRI has obvious higher sensitivity (85.7%), higher specificity (94.8%) and higher accuracy (89.6%) than palpation. Besides changes in size and shape of the lymph nodes, the intensity of MRI inside lymph nodes was altered showing, mixed hypo-iso-intensity in T1WI and hyper intensity in T2WI. Thus, MRI will probably play an important role as a staging modality in the detection of malignant lymph nodes metastasis.

Studies of Choristoneura fumiferana nuclear polyhedrosis virus gene expression in insect cells

To investigate the mechanisms regulating baculovirus virulence and host range we have begun to study Choristoneura fumiferana nuclear polyhedrosis virus (CfMNPV) and its gene expression in permissive and nonpermissive cells. We have identified and mapped three genes on the CfMNPV genome. The polyhedrin gene is located from 0.0 to 2.0 m.u. and two other genes, dnapol and p143, both of which are essential for baculovirus DNA replication, are located from 35.3 to 40.9 m.u. and 55.5 to 63.4 m.u., respectively. To gain insight into the expression of CfMNPV genes in permissive C. fumiferana and nonpermissive Spodoptera frugiperda cells, we constructed three expression plasmids in which the promoter region of the dnapol, the p143, and polyhedrin genes were placed in front of a chloramphenicol acetyltransferase reporter gene. All three CfMNPV promoters were active in nonpermissive cells in the presence of Autographa californica nuclear polyhedrosis virus (AcMNPV) DNA, but no activity was detected in permissive cells either in the presence of CfMNPV DNA or AcMNPV DNA. This lack of promoter activity was not due to failure of viral or plasmid DNA to enter the cell nucleus. It was possible that the reporter plasmids were inefficient templates for transcriptional transactivation so we developed a CfMNPV transfer vector and generated a recombinant virus in which the polyhedrin promoter driving CAT gene cassette was integrated into the CfMNPV genome. In this case, the CfMNPV polyhedrin promoter was highly active in the permissive cells.

[The selection of highly lung metastatic salivary adenoid cystic carcinoma clone]

After 5 times repeated selection in vivo, combined with cloning technique in vitro and analysing of platelet aggregation activity, we had selected a highly lung metastatic salivary adenoid cystic carcinoma clone M-5clone24 (Acc-M). Compared with Acc-2, its metastatic rate was 96% vs. 18%; the weight of metastatic lung was 0.88 g vs. 0.31 g. The metastatic rate and the weight of metastatic lung positively correlated with platelet aggregation activity. The aggregation activity might be used as a useful parameter to assess Acc metastasis potential.

Impact of serum lipids on long-term graft and patient survival after renal transplantation

The results after primary cadaveric renal transplantation in 665 consecutive patients were reviewed with respect to posttransplant serum lipids. Data were available for 182 of 665 patients on serum total cholesterol and triglycerides at 1 year posttransplant. Hypercholesterolemia (cholesterol > 200 mg/dl) developed in 141 of 182 patients (77%) and hypertriglyceridemia developed in 73 of 166 patients (44%). At 1 year posttransplant, hypercholesterolemia and hypertriglyceridemia both correlated with age at transplant (P = 0.0001, P = 0.01). Hypercholesterolemia and hypertriglyceridemia were also correlated with obesity as determined by body mass index (kg/m2) (P = 0.006, P = 0.01). Hypertriglyceridemia at 1 year posttransplant correlated with pretransplant triglyceride level (P = 0.006), but hypercholesterolemia did not correlate with pretransplant cholesterol level (P = 0.53). Hyperlipidemia was not correlated with cyclosporine (CsA) or prednisone dose (mg/kg), CsA trough levels, number of rejection episodes, or serum creatinine at 1 year. Despite significant differences in serum cholesterol and triglycerides, actuarial graft and patient survival were similar between the normolipidemic and hyperlipidemic groups.

Obesity as a risk factor after combined pancreas/kidney transplantation

The impact of pretransplant overweight/obesity was analyzed in a group of 268 consecutive primary pancreas renal transplant recipients. Obesity was defined as body mass index (BMI) greater than 27 kg/m2. BMI was available for 240 of the 268 patients. A total of 88% (212/240) of the patients had a BMI < or = 27 and 28/240 (12%) had BMI > 27. There were no significant differences in age, sex, or race between obese and nonobese patients. The incidence and degree of posttransplant hypertension, weight gain, increase in BMI, and hyperlipidemia did not differ on the basis of pretransplant BMI. Serum creatinine at one year posttransplant was slightly increased in obese patients, but the increase was not statistically significant. Cumulative prednisone dose (mg/kg) as well as cyclosporine (CsA) dose (mg/kg) at one year was not significantly different between obese and nonobese patients. However, there was a marginally significant negative correlation between BMI and one-year cumulative (mg/kg) prednisone dose (P = .06). Types and frequency of posttransplant complications were similar between obese and nonobese patients, although there was a slightly higher incidence of wound related complications in obese patients (11% vs. 6.8%) (P = NS). There was no difference in the frequency of acute rejection episodes in obese and nonobese patients. Actuarial patient survival was comparable between patients with BMI < or = 27 versus those with BMI > 27 (P = .10). However, actuarial graft survival, both pancreas and renal, were significantly decreased in patients with BMI > 27 (P = .029). The decrease in pancreas and kidney graft survival in obese patients could not be attributed to decreased "early" patient survival, increased incidence of perioperative or postoperative complications, differences in hypertension, acute rejection episodes, serum lipids, or immunosuppression dosage. The most common causes of graft loss were rejection and patient death in both obese and nonobese patients. After three years posttransplant, the decreased pancreas and renal graft survival in obese patients corresponded to decreased patient survival. The most common cause of patient death was cardiovascular complications in both obese and nonobese PKT recipients.

[A preliminary study on the mechanism of against human tongue cancer cell line]

Inverted phase contrast microscope and transmission electron microscope examination reveals that, tumor-draining lymphnode lymphocytes (DNL) conjugated with tumor cells very tightly at 12 hours co-culture. The DNL cell nucleus was seen positioned away from the target cells, whereas the cell mitochondria granules were oriented toward the point of contact with the target cells. The injured target cell had a highly condensed cytoplasm and chromatin and formation of cytoplasmic blebs, which were consistent with an apoptotic cell death rather than with a lytic or necrotic cell death. The mechanism was exocytosis of granules containing a pore-forming protein. Holes formed in the target cell's membrane may allow a lethal substance to enter and to induce its death via an apoptotic mechanism.

[Urinary calcium excretion in patients with pregnant hypertension syndrome]

We observed the urinary calcium in 103 patients in the third trimester of pregnancy and the relation between the 24 hour calcium excretion and the calcium/creatinine ratio of a single void urine sample. The study population included 75 normal pregnant women and 28 pregnant woman with pregnant hypertension syndrome. The 24 hour urinary calcium excretion in the patients with pregnant hypertension syndrome was significantly lower (0.70 +/- 0.36 mmol/L) than that in normal pregnant women (4.00 +/- 1.90 mml/L) P < 0.0005. The 24 hour calcium excretion correlated well with the calcium to creatinine ratio of a single void morning urine sample in the two groups. We conclude that the urinary calcium excretion can be used as an indicator for pregnant hypertension syndrome. The 24 hour urinary calcium excretion can be estimated from a single void urine sample. Pregnant hypertension syndrome is associated with hypocalciuria, probably due to increased tubular reabsorption of calcium.

Detection of brainstem auditory evoked potential by adaptive filtering

A method of detecting brainstem auditory evoked potential (BAEP) using adaptive signal enhancement (ASE) is proposed and tested in humans and cats. The ASE in this system estimates the signal component of the primary input, which is correlated with the reference input to the adaptive filter. The reference input is carefully designed to make an optimal and rapid estimation of the signal corrupted with noise, such as ongoing EEG. With a good choice of reference input, it is possible to track the variability of BAEP efficiently and rapidly. Moreover, the number of repetitions required could be markedly reduced and the result of the system is superior to that of ensemble averaging (EA). To detect BAEP in cats, only 30 ensemble averages are needed to obtain a reasonable reference input to the adaptive filter, and, for humans, 350-750 ensemble averages are sufficient for a satisfactory result. Using the LMS adaptive algorithm, individual BAEP can be obtained in real-time.

[Etiology of blindness in remote area: a clinic report]

This paper analyzes the cause for blindness in 408 patients of Xinfeng People's Hospital from 1977 to 1991. The results show that cataract is the major cause for blindness (32.84%). The others are eye injury in patients below age 46, cataract and glaucoma in patients above age 46. It is suggested that the stress of prevention and treatment for blindness should be put on the prevention of eye injury in juveniles and middle aged people, and the treatment for senile cataract in remote mountain areas.

An enhanced approach to adaptive processing of the brain stem auditory evoked potential

The present paper describes an adaptive signal enhancer (ASE) method for improving signal-to-noise ratio (SNR) and also for tracking the variation of brain-stem auditory evoked potential (BAEP). The enhancer has two inputs: a primary input which is the original data to be processed, consisting of signal badly corrupted by noise, and a reference input. A method called dynamic averaging (DA) is introduced to obtain the reference input. The improved reference signal allows closer tracking of evoked potential in each subsequent trial. For BAEP measurement in human, the SNR is typically very low. It requires about 200 ensembles to generate the reference input acceptable for ASE, and tracking of the variation of BAEP can be obtained satisfactorily. Our results show that while ensemble averaging is still needed, the total number of ensembles is greatly reduced. The adaptive method thus reduces the time of measurement for BAEP compared with the conventional method of ensemble averaging.

[Immunological diagnosis of light chain disease--analysis of 11 cases found in Fujian Province]

This paper reports 11 cases of light chain disease (LCD) sequentially found in several coastal cities of Fujian Province. Immunological classification of this group of LCD was as follows: 6 belonged to lambda type, 4 were kappa type, and 1 was double LCD. We found that LCD was common in Fujian next only to MM of IgG class and accounted for 20% of the total 55 MM cases found in recent years. Several important points should be stressed when making immunological diagnosis of LCD. 1) It is well known that in most patients with LCD, M protein or Bence Jones proteinemia (BJPemia) is not detectable by conventional electrophoresis. Our studies show that running serum protein along with urinary BJP on the same one gel plate can allow for the recognition of small and faint band (s) of free light chain in serum, and also provides a rapid and sensitive method (immunofixation) to directly detect urinary light chains. 2) The concurrent presence of albumin with BJP in urine may interfere with the routine BJP test and lead to misdiagnosis. 3) As a result of the molecular seiving effect, the presence of light chain polymers in high BJP urine may lead to the presence of several parallel bands on the BJP gel electrophoretic spectrum, 4) Determination of light chain in urine is essential for final immunological diagnosis of LCD, but care should be taken, since many patients with other immunological types of MM may have a positive BJP test.