Chronic suppurative parotitis: a proposed classification

OBJECTIVE

To propose a practical and reasonable classification of chronic suppurative parotitis (CSP) on the basis of the various entities.

MATERIAL AND METHODS

Clinical, laboratory, sialographic, scintigraphic, histopathologic (including ultrastructural) study of recurrent parotid swellings (RPS) was performed in 291 patients over a 10-year period.

RESULTS

It is suggested that CSP should be classified into recurrent parotitis in childhood (RPC), recurrent parotitis in adults (RPA), chronic obstructive parotitis (COP) and should be differentiated from other subdivisions including subclinical Sjögren's syndrome (SCSS), chronic parotid swelling of Sjögren's syndrome and sialadenosis with retrograde infection. RPA is a continuation of recurrent parotid swelling from childhood (RPC) to adulthood. Remission can take place spontaneously in RPC and RPA so that self-conservative therapy is mainly used for reducing the parotid swellings. COP is recurrent parotid swellings and/or purulent discharge resulting from various obstructive factors. Mild COP can recover completely with the use of conservative methods, severe COP is often resistant to conservative treatment and should be treated with surgical modality or injection of methyl violet into the diseased gland. Treatment with methyl violet is considered as a convenient and practical method with a definite effect. SCSS is an autoimmune disease and should be treated as systemic disease.

CONCLUSIONS

Because there exists confusion in the nomenclature of RPS this revised classification is based on the various entities and can be used as a guide in the diagnosis and treatment of RPS.

[The sialographic characteristics of Warthin tumor in the parotid gland]

The sialograms of 80 cases with Warthin tumor in parotid gland were analysed. The sialographic characteristics were found as follows: irregular arrangement, dilation and narrow of branch ducts which surrounded the tumor, sausagelike change of main ducts just like that seen in obstructive parotitis, and spot-like dilation of the terminal ducts. The comparative study on roentgen-pathology showed that the spot-like dilation of the terminal ducts was related to the dilation of interlobular duct of the gland surrounding the tumor. The roentgen differential diagnosis of Warthin tumor from the aggressive benign tumor and Sjögren syndrome is discussed.

Overexpression of the insulin-like growth factor-1 receptor and autocrine stimulation in human cervical cancer cells

We characterized mechanisms of growth control involving insulin-like growth factor-1 (IGF-1), IGF-2, and IGF-1 receptor (IGF-1R) by investigating their expression in human cervical cancer cell lines, primary cervical tumor cell cultures, and normal ectocervical epithelial cells maintained in short-term culture. By reverse transcription followed by PCR, IGF-1 mRNA was not detected in any of the cell lines, whereas IGF-2 mRNA transcripts were detected in all of them. Using the RNase protection assay, low levels of IGF-2 mRNA were also detected in all of the cervical cancer cell lines, primary cervical tumor cell cultures, and normal ectocervical cultures tested, but no IGF-1 transcripts were detected. Scatchard analysis revealed 3- and 5-fold increases in IGF-1R expression by the primary cervical cancer cell cultures and cervical cancer cell lines, respectively, compared with the normal ectocervical cells. In proliferation assays, epidermal growth factor (EGF) consistently enhanced cervical cancer cell growth, but an antisense oligonucleotide to IGF-2 uniformly inhibited the EGF-induced mitogenic effect. These studies suggest that autocrine production of IGF-2 and overexpression of the IGF-1R are important components controlling the proliferation of cervical carcinoma cells, and that autocrine IGF-2 production in cervical cancer cells may participate in the mitogenic signaling of EGF.

A catalogue of genes in mouse embryonal carcinoma F9 cells identified with expressed sequence tags

We used expressed sequence tags (ESTs) to identify genes expressed in mouse embryonal carcinoma F9 cells and prepared 2132 ESTs from undifferentiated F9 cDNA libraries: 1026 were prepared after randomly selecting clones from one of the libraries and the remaining 1106 ESTs were prepared after classifying 2896 clones of the libraries into four classes, according to the levels and patterns of expression. Among the former 1026 ESTs, 797 (78%) matched known genes, 61 (6%) matched database sequences of uncharacterized cDNAs, and 168 (16%) represented novel genes. The ESTs matching known genes were catalogued according to putative structural and cellular functions. As many as 53% were related to transcription and translation, and 19% were related to energy metabolism, including transcripts of mitochondrial DNA. These percentages were significantly higher in F9 cells than in the human heart and brain, and a human liver cell line, HepG2. We found that approximately 7% of the ESTs corresponding to low-abundance mRNAs are either related to retinoic acid-regulated genes or mammalian development- and/or differentiation-related genes. Cataloguing of the genes expressed in the F9 cells paves the way for isolating genes involved in early mammalian development.

[Sialographic follow-up study of patients with Sjögren's syndrome]

Sialographic follow-up studies of 36 cases of Sjögren's syndrome (SS) were performed with the duration of 5-72 months (mean 25 months). Three groups were divided according to the intenational criteria: secondary group, 14 cases (xerophthalmia, or/and xerostomia, and connective tissue diseases), primary group, 14 cases (xerostomia and xerophthalmia), and possible group, 8 cases (xerophthalmia or xerostomia only). Sialographic findings at follow-up examination included (1) delayed evacuation, which may occur as early as 5 months later; (2) increased punctate sialectasis; (3) decreased punctate sialectasis with globular increase; (4) Punctate, globular, and cavity sialectasis with radiolucent sialolith; and (5) centripetal atrophy. The cases with secondary and possible SS without xerostomia demonstrated little involvement of the parotid gland, without sialectasis. But sialodochitis was shown when radiolucent sialolith formed. The stimulated whole salivary flow rate (SWSFR) was closely related to sialographic appearance, i.e., the cases with lower value of SWSFR showed more sialectasis sialographically, but with higher SWSFR value, and less sialectasis.

Isolation and characterization of retinoic acid-inducible cDNA clones in F9 cells: a novel cDNA family encodes cell surface proteins sharing partial homology with MHC class I molecules

Rae-1 cDNA is one of the retinoic acid (RA) inducible cDNA clones in mouse embryonal carcinoma F9 cells. Rae-1 mRNAs were detected in mouse early embryos, but not in various tissues of adult mice. RAE-1 protein apparently consists of 253 amino acids and is likely to be a glycoprotein consisting of a leader sequence, an extracellular domain, a serine, threonine, proline-rich domain, and a transmembrane domain. Interestingly, it has a weak, but significant homology with major histocompatibility complex (MHC) class I molecules and was immunocytochemically identified as a cell surface protein. By determining partial nucleotide sequences of 17 Rae-1 cDNAs isolated from the RA-induced F9 cells, at least three different kinds of Rae-1 cDNAs were identified and were named Rae-1 alpha, Rae-1 beta, and Rae-1 gamma cDNAs, respectively. As the overall nucleotide sequence homology among these three cDNAs was about 98%, they constitute a novel gene family which is likely to be involved in early mammalian embryogenesis.

[Clinical and radiographic study of Sjögren syndrome in children]

Eight cases of Sjögren syndrome in children were presented. Recurrent swelling of salivary glands was shown to be predominant findings in children with Sjögren syndrome. It was first reported that "lace-like" appearance of main duct was of great value in sialographic diagnosis of Sjögren syndrome in children. The differentiation between Sjögren syndrome and recurrent parotitis in children was discussed.

Insulin-like growth factor II mediates epidermal growth factor-induced mitogenesis in cervical cancer cells

There is increasing evidence that activation of the insulin-like growth factor I (IGF-I) receptor plays a major role in the control of cellular proliferation of many cell types. We studied the mitogenic effects of IGF-I, IGF-II, and epidermal growth factor (EGF) on growth-arrested HT-3 cells, a human cervical cancer cell line. All three growth factors promoted dose-dependent increases in cell proliferation. In untransformed cells, EGF usually requires stimulation by a "progression" factor such as IGF-I, IGF-II, or insulin (in supraphysiologic concentrations) in order to exert a mitogenic effect. Accordingly, we investigated whether an autocrine pathway involving IGF-I or IGF-II participated in the EGF-induced mitogenesis of HT-3 cells. With the RNase protection assay, IGF-I mRNA was not detected. However, IGF-II mRNA increased in a time-dependent manner following EGF stimulation. The EGF-induced mitogenesis was abrogated in a dose-dependent manner by IGF-binding protein 5 (IGFBP-5), which binds to IGF-II and neutralizes it. An antisense oligonucleotide to IGF-II also inhibited the proliferative response to EGF. In addition, prolonged, but not short-term, stimulation with EGF resulted in autophosphorylation of the IGF-I receptor, and coincubations with both EGF and IGFBP-5 attenuated this effect. These data demonstrate that autocrine secretion of IGF-II in HT-3 cervical cancer cells can participate in EGF-induced mitogenesis and suggest that autocrine signals involving the IGF-I receptor occur "downstream" of competence growth factor receptors such as the EGF receptor.

[Evaluation of the condylar position in the diagnosis of temporomandibular joint dysfunction syndrome]

26 cases with Temporomandibular Joint Dysfunction Syndrome (TMJDS) were included in the present study. Fully corrected lateral tomogrames of TMJ in the intercuspid position were taken for all the cases; and fully corrected lateral arthrotomogrames were taken for 19 cases (21 joints) of them. The area and linear measurements of the joint space were made with the aid of computer. The results showed that the position of the condyle in the patients with TMJDS was located in the posterior position of the fossa. Statistics results showed that there was significant difference between the patient group and control group. Although the posterior displacement of the condyle was often associated with the anterior displacement of the disc, it was not always agreement with the anterior disc displacement. So, the exact diagnosis of disc displacement should be still on the basis of arthrography or other examinations, such as CT or MRI.

Sialographic follow-up study of patients with Sjogren's syndrome

Sialographic follow-up studies of 36 cases of Sjogren's syndrome (SS) were performed with the duration of 5-72 months (mean 25 months). Three groups were divided according to the international criteria: secondary group, 14 cases (xerophthalmia, or/and xerostomia, and connective tissue diseases), primary group, 14 cases (xerostomia and xerophthalmia), and possible group, 8 cases (xerophthalmia or xerosptomia only). Sialographic findings at follow-up examination included (1) delayed evacuation, which may occur as early as 5 months later; (2) increased punctate sialectasis; (3) decreased punctate sialectasis with globular increase; (4) punctate, globular, and cavity sialectasis with radiolucent sialolith; and (5) centripetal atrophy. The cases with secondary and possible SS without xerostomia demonstrated little involvement of the parotid gland, without sialectasis. But sialodochitis was shown when radiolucent sialolith formed. The stimulated whole salivary flow rate (SWSFR) was closely related to sialographic appearance, i.e., the cases with lower value of SWSFR showed more siatectasis sialographically, but with higher SWSFR value, and less sialectasis. The relationship between the SS and pyogenic or candidal infection was discussed.

Differential expression of elafin in human normal mammary epithelial cells and carcinomas is regulated at the transcriptional level

Elafin is an elastase inhibitor with a unique structure, not related to the serpin family, which includes the neutrophil elastase inhibitor. The gene was identified in this laboratory by subtractive hybridization between RNAs from human mammary tumor-derived cells and cDNAs from normal human mammary epithelial cells. Elafin is consistently expressed in normal mammary epithelial cells, but is down-regulated in most breast tumor cell lines. Restriction fragment analysis detected no gross deletions or rearrangement of the gene in any of the tumor cell lines examined. The elafin gene was cloned, and both the cDNA and the promoter region were sequenced. A major positive upstream promoter element was identified by chloramphenicol acetyltransferase assay and deletion analysis, active in normal cell extracts but not in extracts of tumor cells. These results demonstrate that differential expression of elafin in normal mammary epithelial cells and breast tumor cells is regulated at the transcriptional level. Cell synchronization experiments demonstrated that elafin mRNA is down-regulated in S phase in normal cells. These results suggest that elafin may act as an inhibitor of cell cycle progression.

[Monitoring of lead content in foodstuff in China]

Lead contents in six kinds of foodstuff in China were monitored in 1992. Six hundred and three specimens of food were collected from the markets in Beijing, Shanghai, Jiangsu, Sichuan and Guangdong. Results showed that 96.2% of cereals, 84.4% vegetables, 97.6% dairy products, 96.0% eggs and, 100% meat and fish met the national food hygienic standards for lead allowable content. Daily dietary intake of lead of residents in six areas of China was lower than the provisional standard for Daily Allowable Intake of lead set by World Health Organization.

[Evaluation of radiographic diagnosis on osteoarthrosis of the temporomandibular joint]

84 cadavers' temporomandibular joints were used to compare the results shown in standard lateral tomographs and Schuller's position films with gross views on the bone and cartilage changes. The results and conclusions were as follows: (1) The positive rates of the radiographic evidences were associated with the degrees of the macroscopic lesions. The more severe the macroscopic lesion, the higher the positive rate of radiographic evidence. (2) The sensitivity of radiographic examination was positively correlated with the extent of the macroscopic lesion. So, the negative predictive value was. However, the specificity and the positive predictive value of the radiographic examination were negatively correlated with macroscopic change index. It has been found that the more the extent of osteoarthrosis changes, the higher the sensitivity of radiographic examination; the higher the negative predictive values, the higher the positive rate of radiographic evidence, and the lower the underdiagnosis rate was. Meanwhile, the more the extent of bone pathological changes in the joint, the lower specificity of the radiographic examination, and the lower the positive predictive values and the misdiagnosis is increased. (3) The radiographic diagnostic value based on the standard latreal tomographs of TMJ, Schuller's position films or based on the both methods was not satisfied. Its underdiagnosis rate was higher. Therefore, we suggest that multiple-layers lateral tomography should be widely used in clinical practice.

[Synthesis of new fluorescent reagent and its application in solution fluorescence analysis]

In our laboratory we have designed and synthesized a new fluorescent CGE(N), which has a fluo-rigen and can react with active hydrogen in chemical compounds. We have studied its application in solution fluorescence, thin-layer fluorescence and solid fluorescence analysis. The results have indicated that CGE (N) is a good reagent in analysis. And the example of its application in solution fluorescence analysis is given in this paper.

A survey of genes expressed in undifferentiated mouse embryonal carcinoma F9 cells: characterization of low-abundance mRNAs

As a first step to catalogue mRNAs present in mouse embryonal carcinoma F9 cells, 879 clones corresponding to low-abundance mRNAs were selected from among 2,896 randomly picked up clones of undifferentiated F9 cDNA libraries, using DNA probes complementary to poly(A)+RNAs prepared from undifferentiated F9 cells and to ones prepared from mouse fibroblast L cells. Five-hundred and eighty-two of the 879 clones were partially sequenced, and the subsequent homology search revealed that 201 corresponded to 180 known genes or known DNA sequences, which include not only housekeeping genes but also various tissue-specific genes. Interestingly, at least 24 of the 180 genes are development-related genes in mammals. Among these 24, those for midkine (growth and/or differentiation factor) and interferon-beta are reportedly up-regulated, and those for ECA39 (target for c-Myc regulation), REX-1 (zinc finger protein), and OCT-3 (POU-domain transcription factor) are down-regulated during the development of mouse embryonal carcinoma cells. Thirty-seven of the 582 clones matched the 36 previously reported unidentified ESTs (expressed sequence tags) and the remaining 344 corresponded to 329 novel ESTs. Therefore, partial sequencing of F9 cDNA clones corresponding to low-abundance mRNAs in F9 cells not only provides valuable information concerning development-related genes in mammals, but also many novel ESTs useful for studying mammalian genomes.

Angiotensin II receptor antagonist TCV-116 induces regression of hypertensive left ventricular hypertrophy in vivo and inhibits the intracellular signaling pathway of stretch-mediated cardiomyocyte hypertrophy in vitro

BACKGROUND

Previous studies have demonstrated that angiotensin II (Ang II) acts as a growth-promoting factor directly on cardiac myocytes and that angiotensin-converting enzyme inhibitor induces regression of hypertrophied hearts both in experimental animals and in humans. These results suggest that the renin-angiotensin system (RAS) is involved in the formation of left ventricular hypertrophy (LVH). To elucidate the role of RAS in the progression of cardiac hypertrophy, we evaluated the effect of an Ang II receptor antagonist on LVH in spontaneously hypertensive rats (SHRs) and investigated the molecular mechanisms by which antagonizing Ang II receptors reduces cell hypertrophy of myocytes using the in vitro model of mechanical stretch.

METHODS AND RESULTS

In the in vivo study, we treated SHRs with the nonpeptide Ang II receptor antagonist TCV-116 (0.1, 1, or 10 mg/kg per day) or hydralazine (10 mg/kg per day). Blood pressure was measured by the tail-cuff method, and wall thickness of left ventricle was serially monitored using M-mode echocardiography. Rats were killed at the age of 13, 17, 21, or 25 weeks, and left ventricular (LV) weight, transverse diameter of cardiomyocytes, relative amount of V3 myosin heavy chain (MHC), and degree of interstitial collagen accumulation were examined. Untreated SHRs progressively developed severe hypertension, but treatment with TCV-116 or hydralazine inhibited the increase in blood pressure. Treatment with TCV-116 reduced LV weight, LV wall thickness, transverse diameter of myocytes, relative amount of V3 MHC, and interstitial fibrosis, whereas treatment with hydralazine slightly prevented an increase in LV wall thickness but did not exert significant reduction in other parameters. In the in vitro study, neonatal rat cardiomyocytes were cultured on deformable silicone dishes and mechanically stretched with or without pretreatment of CV-11974 (an active metabolite of TCV-116), and [3H]phenylalanine incorporation, activity of mitogen-activated protein (MAP) kinase, and c-fos mRNA expression were analyzed. Pretreatment of cultured cardiomyocytes with 10(-7) mol/L CV-11974 inhibited an increase in [3H]phenylalanine incorporation, MAP kinase activity, and c-fos gene expression induced by stretch of cardiomyocytes.

CONCLUSIONS

The Ang II receptor antagonist TCV-116 induced regression of cardiac hypertrophy and had cardioprotective effects on hypertrophied myocardium in vivo, and antagonizing Ang II receptors inhibited intracellular signaling of stretch-mediated cardiomyocyte hypertrophy in vitro. These results suggest a crucial role of the cardiac RAS in the development of LVH produced by pressure overload.

Maspin, a serpin with tumor-suppressing activity in human mammary epithelial cells

A gene encoding a protein related to the serpin family of protease inhibitors was identified as a candidate tumor suppressor gene that may play a role in human breast cancer. The gene product, called maspin, is expressed in normal mammary epithelial cells but not in most mammary carcinoma cell lines. Transfection of MDA-MB-435 mammary carcinoma cells with the maspin gene did not alter the cells' growth properties in vitro, but reduced the cells' ability to induce tumors and metastasize in nude mice and to invade through a basement membrane matrix in vitro. Analysis of human breast cancer specimens revealed that loss of maspin expression occurred most frequently in advanced cancers. These results support the hypothesis that maspin functions as a tumor suppressor.

[The applicability of a new stable fluorescence reagent CGE (N) for TLC measurements and spectrofluorimetry]

A new stable fluorescent reagent, CGE (N), was designed and synthesized in our laboratory. This paper presents the results of using it to detect a compound having aminogroup. Glycine as an example was derived by using CGE (N), the best condition of derivatisation reaction was pH8, T 50 +/- 1 degree C, and time 3-5 h. Spread agent was CHCl3: CH3OH:CH3COOC2H5: iceHAc (1:3:5:1). Rf of glycine-CGE (N) was 0.45, of which fluorescent spectrum Em was 356nm (at Ex = 277nm). The correlation coefficient between the fluorescent scanning area and quantity was over 0.99, the linear relation retained for 24 h, the detection limit 0.24 microgram, and the linear range 0.24-19.2 micrograms. The data revealed that stability, sensitivity and reproducibility were good. These indicate that CGE(N) is a fine fluorescent reagent for compounds having primary amino-group and this method is reliable.

Sequential quantitative scintigraphy of parotid glands with chronic inflammatory diseases

A practical, time-saving procedure for sequential quantitative scintigraphy is introduced and 4 parameters chosen from 12 parameters by discriminant analysis are used to evaluate the function of the parotid gland. The examination was performed in 120 cases, including 16 cases with recurrent parotitis in childhood, 33 with chronic obstructive parotitis (COP), 37 with Sjögren's syndrome (SS), 4 with sialadenosis, and 30 normal controls. The scintigraphic findings were analyzed and compared with the histologic findings. The diagnostic value of this method was investigated and scaling for differential diagnosis of COP and SS was established. Scintigraphy is considered to be a useful method for evaluation of parotid function and as a diagnostic aid for SS and COP, especially in patients in whom sialography cannot be performed.

[The qualitative and quantitative analyses of protein with a novel fluorescence agent (EPQS) by fluorescent scanning on solid substrate]

We synthesized a new fluorescence agent, EPQS, which could be soluble in water and was stable in the analytical process. It was characteristic of good fluorescence parameters. Human serum albumin (HSA) was marked with EPQS and purified by the paper electrophoresis dialysis. We determined the fluorescent spectra and excitation spectra of the marked HSA, or EPQS on the cellulose acetate paper by RF-510 fluorescence spectrophotometer-thin-layer chromatoscanner. The former lambda ex = 370nm lambda em = 470nm; the latter lambda ex = 382nm lambda em = 476 nm. Then we touched different quantity of EPQS-HSA upon the cellulose acetate. The fluorescent scanning on the paper disclosed that the relationship between the quantity adopted and the fluorescence intensity is linear. These showed that the protein could be quickly determined qualitatively and quantitatively by this simple method, and EPQS was useful.

[Clinical study and long-term follow-up observations on the effect of PCV and SV+A in the treatment of duodenal ulcer]

From Aug. 1977 to June 1988, vagotomy had been performed in 238 patients with duodenal ulcer (DU). According to the clinical signs and the result of gastric acid secretion test, (GAST) parietal cell vagotomy (PCV) and selective vagotomy plus antrectomy (SV+A) were performed in 100 and 138 cases respectively. The patients were followed up for 1 to 10 years. 96% and 97% of them belonged to Visick grade I and II respectively. The recurrence rate was 1.96% in PCV group, while no ulcer recurrence was seen in SV+A group, long-term side effect was rare and the nutritional status was quite good. The follow-up data showed that recurrence rate could be greatly reduced if the mode of vagotomy was selected according to results of GAST.

[States of dentine surface and interface between dentine and coupling agent]

In order to research the states of dentine surface and dentine surface primed with coupling agent, we used microscope, transmission electron microscope (TEM) and solid fluorescence method. Observed under microscope, patterning of dentinal tubules and their poles was very explicit; through the view of interface between coupling agent adsorbed and human dentine powder by TEM, it was revealed that the coupling agent was adsorbed onto the dentine surface as if it "grew out" of the dentine surface; through examination of interface between the coupling agent adsorbed and dentine surface by fluorescence spectrum, which differed from that of the coupling agent or dentine surface, i.e., this fluorescence spectrum of interface changed obviously (red shift). This phenomenon indicated that there was a chemical reaction occurring between tooth surface and adsorbed coupling agent. Therefore we can conclude that the three examinations are necessary to provide the argument for establishment of chemical bonding mechanism between dentine and coupling agent.