[Clinical analysis of ovarian and cervical malignant lymphoma]

From Oct. 1980 to Oct. 1990, 456 cases with ovarian malignant tumor and 1,281 cases with cervical malignant tumor were admitted in our hospital. Among them, 7 were ovarian lymphoma and 3 were cervical lymphoma, accounting for 1.5% and 0.23% of ovarian and cervical malignant tumors respectively. According to the standard set up by Foxs, 5 were primary and 5 were metastatic in 10 lymphoma cases. Ovarian and cervical lymphoma were few, the primary cases were fewer. But its prognosis was better than the metastatic cases. The prognosis varied with the stages, the more advanced clinical stage, the high worse prognosis. The following condition indicates poor prognosis: rapid onset of abdominal symptoms; the presence of systemic symptoms; bone marrow infiltration; bilateral ovarian tumors; noncleaved cell pattern and cleaved-noncleaved cell mixture pattern; only treated with chemotherapy. Surgery was the first choice in the treatment of lymphoma. The typical operation on ovarian lymphoma was total hysterectomy, bilateral adnexectomy and omentectomy. The cytoreductive surgery which was used to advanced ovarian cancer was also proper for lymphoma, leaving the remained tumor 2cm in diameter, followed by introperitoneal and intravenous chemotherapy. The chemotherapy method was COP or COHP regimen. The treatment of primary cervical lymphoma was radical hysterectomy and pelvic paraaorta abdominal lymphodenectomy or radiotherapy. It seems that lymphoma was highly sensitive to radiotherapy. But radiotherapy was not proper for the metastatic cases because the affected areas were large. SLDH elevated in 5 cases of the 6 cases. It suggested that SLDH can serve as relative indicator for the diagnosis and prognosis of lymphoma.

Hemodynamic and nonhemodynamic mechanisms of experimental pulmonary edema in rats and the effects of anisodamine and tetramethylpyrazine--estimation of blood gas analysis, RBC superoxide dismutase and prostaglandin E2 in plasma and bronchoalveolar lavage (Part 3)

Anisodamine (ADM, 654-2, 30 mg/kg) and tetramethylpyrazine (TMP, 120 mg/kg) have shown an apparent preventive effect on pulmonary edema (PE). In this study, the nonhemodynamic mechanism was studied: The dynamic changes of PaO2, O2Sat, PaCO2, and blood pH were measured, and RBC superoxide dismutase (SOD) and plasma and bronchoalveolar lavage (BAL) PGE2 levels were estimated. It was concluded that ADM and TMP exerted inhibitory effects on the hypoxic state. The ability of ADM and TMP to adjust RBC SOD and PGE2 levels may be one of the preventive mechanisms of the drugs.

Postoperative astigmatism following phacoemulsification with sutured vs. unsutured wounds

A total of 293 cases of phacoemulsification cataract surgery with a 5.0- or 6.0-mm frown incision were analysed retrospectively to compare postoperative astigmatism between cases with sutured wounds and those with unsutured wounds. Astigmatic analysis was done with a simplified method (keratometric readings with steep meridians between 46 degrees and 134 degrees were considered "with-the-rule" [WTR], and those with steep meridians less than 46 degrees and greater than 134 degrees, "against-the-rule" [ATR]). Among patients with WTR astigmatism preoperatively, the mean keratometric cylinder in the sutureless group (n = 53) was significantly lower at 1 day and at 4 to 6 months postoperatively than before surgery (p < or = 0.001); in the suture group (n = 120) the mean cylinder was significantly higher at 1 day and significantly lower at 4 to 6 months than before surgery (p < 0.05). Among patients with ATR astigmatism preoperatively, the mean keratometric cylinder in the sutureless group (n = 22) was significantly higher at 1 day than before surgery (p < 0.01); in the suture group (n = 98) the mean cylinder was significantly lower at 1 day than before surgery (p < 0.001), and the difference at 4 to 6 months almost reached statistical significance (p = 0.052). Vector analysis showed that surgically induced cylinders in the suture and sutureless groups were similar. Our findings suggest that in the short term patients with preoperative WTR astigmatism may benefit from unsutured wounds, and those with preoperative ATR astigmatism may benefit from sutured wounds if the incision is placed in the vertical meridian.

Effect of contact lens wear on photorefractive keratectomy

This study compares refractive effect and epithelial healing after photorefractive keratectomy among patients who wore contact lenses before surgery versus those who wore glasses before surgery. Data were reviewed on 130 photorefractive keratectomy cases at the 1-week, 2-week, and 4- to 6-month postoperative visits. The patients were divided into three groups based on whether or not they wore contact lenses before surgery: 1) rigid gas permeable lens wearers; 2) soft lens wearers; 3) no contact lens wear. There were no significant differences in epithelial healing among the groups. Some regression of refractive effect was observed both in mean spherical equivalent and in mean keratometry in all the groups from 2 weeks to 6 months postoperatively. There was no significant difference in the regression of each group. In addition, the changes of spherical equivalent and keratometry before surgery and 4 to 6 months after surgery were compared among the groups with no significant differences. Based upon these results, we conclude that contact lens wearing does not seem to influence epithelial healing after photorefractive keratectomy surgery and also does not affect the refractive effect in the early postoperative period.

[Interleukin-6 gene expression of human fetal islets and its relation to insulin secretion]

The islet from human fetal pancreas was separated by collagenase type V (0.5 mg/ml) and cultured to observe spontaneous secretion of interleukin-6 (IL-6), its relationship to insulin secretion, regulatory effect of IL-6 on insulin secretion of islets and IL-6 gene expression of human fetal islets. IL-6 was secreted by cultured human fetal islets in vitro and paralleled to their insulin secretion. The MH60.BSF2 cell proliferated by 50 folds when cultured to the supernatant of human fetal islets. RNA dot hybridization with bioting-labelled IL-6 cDNA showed that IL-6 gene expressed on human fetal islets. IL-6 promoted the insulin secretion of islets dose-dependently. The results suggested that IL-6 may be one of the promoting or regulating factors in the insulin secretion of islets.

Hemodynamic and nonhemodynamic mechanism of experimental pulmonary edema in rats and the effect of anisodamine and tetramethylpyrazine--electron microscopic observation and measurement of pulmonary arterial, pulmonary arterial wedge and systemic arterial pressure (Part 2)

The pulmonary edema (PE) induced by adrenaline (AD) administration is similar to neurogenic PE. Anisodamine (ADM, 654-2, 30 mg/kg) and tetramethylpyrazine (TMP, 120 mg/kg) have shown significant preventive effects. Electron microscopic observation was carried out to study the changes of microvascular permeability, and the dynamic change of mean pulmonary arterial pressure (PAP, 40 rats), mean pulmonary arterial wedge pressure (PAWP, 20 rats) and mean carotid arterial pressure (CAP) were also measured. The results suggested that both ADM and TMP have significant inhibitory effects on PAWP and CAP increase, as well as on the damage responsible for the increase of microvascular and alveolar permeability.

Hemodynamic and nonhemodynamic mechanisms of experimental pulmonary edema in rats and the effect of anisodamine and tetramethylpyrazine. Part 1: Survival rate, pulmonary index, pathological change and pulmonary vascular permeability

Pulmonary edema (PE) which is similar to the neurogenic type was induced by adrenaline (AD) administration (0.1 mg/kg) in rats. Acute progressive respiratory distress, cyanosis and dyspnea occurred. All the experimental animals in the PE group died within 20 min after AD injection, with a pulmonary index (PI) of 1.70 +/- 0.47 (mean +/- S) which was much higher than that in the normal group. The mortality rate was 100%. It was found that in rats with PE, a protein-rich fluid filled the alveolar and interstitial spaces, and ecchymosis occurred. The capillary permeability as estimated by Evans blue injection showed that Evans blue from extraction fluid and bronchoalveolar lavage (BAL) in the PE rats was at a much higher level than that in the normal control (NC) rats. In anisodamine (ADM, 654-2) and tetramethylpyrazine (TMP) treated rats, almost all the damage was diminished or absent, and the mortality rates were decreased from 100% to 4.4% and 20%, respectively. 654-2 and TMP could significantly inhibit the increase of pulmonary permeability.

The role of activated neutrophils and free radical in the pathogenesis of pulmonary hypertension

In in situ perfused rat lungs, it was demonstrated that the perfusing pressure and permeability of pulmonary capillaries were obviously increased after activated neutrophils (PMNs) were added to the perfusate. The effect of free radicals generated by the xanthine-xanthine oxidase system on isolated rabbit pulmonary arterial ring tension was also observed, and the contractile response was found to be dose dependent: The smaller the vessel diameter, the higher the contractile response. Superoxide dismutase and catalase were able to obviously attenuate the contractile response. The response was endothelium independent, and was influenced neither by indomethacin (cyclooxygenase inhibitor) nor by nordihydroguaiaretic acid (lipoxygenase inhibitor), while removal of Ca from the bath solution or addition of the protein kinase C (PKC) inhibitor "H7" or an antiinflammatory drug (764-3, the effective component of Radix Salvia miltiorrhizae) could significantly inhibit the contractile response. The results suggest that activated PMNs may play an important role in the pathogenesis of pulmonary hypertension.

Visual, refractive, and patient satisfaction results following bilateral photorefractive keratectomy for myopia

Reports of the visual, refractive, and patient satisfaction results after photorefractive keratectomy (PRK) are now becoming available. The visual, refractive, and patient satisfaction results of 52 patients after bilateral excimer laser photorefractive keratectomy for myopia were studied. Patient satisfaction was measured using a five-part questionnaire. Initial patients obtained an overcorrection which necessitated adjusting the programmed correction to 75% of targeted correction.

Mapping the orientation of an antigenic peptide bound in the antigen binding groove of H-2Kb using a monoclonal antibody

The major histocompatibility complex class I molecules are receptors for intracellular peptides, both of self and non-self origin. When non-self peptides (eg., pathogen derived) are bound to the class I molecules, they form ligands for T cell receptors resulting in antigen specific lysis of the infected cells by cytotoxic T lymphocytes. Therefore, an understanding of the process of antigen recognition requires the precise definition of the structural features of the bimolecular complex formed by a single well defined antigenic peptide bound to the class I molecule. A strategy using antibodies was developed to probe the structural features of the H-2Kb containing a defined peptide in the antigen cleft. We report that the binding surface area of a Kb specific monoclonal antibody (28-13-3s) includes residues in the alpha 1 (Gly56 and Glu58) and alpha 2 (Trp167) helices of Kb thus, binding across the antigen binding groove. When cells treated with the antigenic peptide of vesicular stomatitis virus, N52-59, and its alanine substituted analogs were tested for 28-13-3s binding, it was found that position 1 of the peptide also forms a part of the antibody binding site. This finding strongly supports the positioning of the N-terminus of N52-59 proximal to pocket A, thus, assuming an orientation parallel to the alpha 1 helix.

Selective reactivity of CD8-independent T lymphocytes to a cytotoxic T lymphocyte-selected H-2Kb mutant altered at position 222 in the alpha 3 domain

To study the structural basis for specificity and affinity of cytotoxic T lymphocytes for major histocompatibility complex/peptide complexes, we have employed a cytotoxic T lymphocyte (CTL)-mediated immunoselection approach to obtain H-2Kb structural mutants which are resistant to lysis by a Kb-specific alloreactive CTL clone. In this study we describe the Kb structural mutant, designated R8.60.14, recovered following immunoselection using the CD8-dependent CTL clone 60 as a selective agent. Although serologically unaltered with respect to Kb expression, R8.60.14 is not recognized by CD8-dependent, Kb-specific CTL. DNA sequence analysis revealed a single Glu----Lys amino acid substitution at position 222 in the Kb alpha 3-domain of this variant. To determine if a direct correlation exists between CD8 dependence of a Kb specific CTL and its failure to respond to R8.60.14, we examined the lytic response against R8.60.14 by CD8-independent, Kb-specific CTL obtained from long-term culture in the presence of anti-CD8 monoclonal antibody, 3.155. CD8-independent CTL exhibit no difference in their response against the R8 parent and R8.60.14 variant. This study demonstrates unequivocally that Kb-specific recognition of R8.60.14 by CD8-independent CTL is unaltered, while the response by CD8-dependent CTL is completely abrogated. Thus, the sole basis for emergence of this variant in the CTL-mediated immunoselection approach used in this study resides in the alteration of a single CD8-binding site residue at position 222 in the Kb alpha 3 domain. The functional importance of this Glu222 residue for the interaction between the CD8 molecule on CD8-dependent CTL and the Kb alpha 3 domain is further reinforced by virtue of the recovery of the R8.60.14 variant on the basis of its resistance to lysis by a CD8-dependent CTL clone in this CTL-mediated immunoselection approach.

[A clinical analysis of atrial-ventricular sequential pacing]

Forty one patients were implanted DDD pacemakers (3 cases DDDR) from August, 1983 to July, 1990. 32 males and 9 females. The mean age was 62.3 years (range 32 to 91). 19 patients had coronary artery disease. The indication for pacing was II degrees-III degrees AV block in 16 patients and sick sinus syndrome in 25 patients. During follow-up period there were 2 patients had displacement, 4 patients had undersensing, 3 patients had pacemaker-mediated tachycardia and 3 patients had crosstalk. That was corrected through external programmer. The experience of this operation was discussed.

Viral proteins associated with the Epstein-Barr virus transactivator, ZEBRA

The BamHI Z Epstein-Barr replication activator (ZEBRA) mediates disruption of latency and induction of Epstein-Barr virus (EBV) early gene expression in latently infected lymphocytes. Polyclonal rabbit sera raised against ZEBRA were used to immunoprecipitate ZEBRA-associated proteins (ZAPs). ZAPs of 19, 21, 23, and 42 kDa were coimmunoprecipitated with ZEBRA from extracts of EBV-producing lymphoid cell lines. ZAPs were not recognized directly by the rabbit sera, but they were antigenic for EBV+ human sera. Immunoprecipitation of ZAPs by ZEBRA-specific antisera required the presence of ZEBRA. ZAPs were not coprecipitated with ZEBRA from mouse cells expressing only ZEBRA, from Raji (a cell line in which EBV is unable to complete lytic replication), or from cells treated with inhibitors of viral DNA synthesis. Thus, ZAPs are late EBV-encoded proteins. ZEBRA and ZAPs colocalized to a salt-insoluble nuclear fraction, and both were found extracellularly in crude preparations of virions. ZAPs might function to affect the cellular localization of ZEBRA, to alter its capacity to transactivate, or to influence its target gene specificity.

Topical fibronectin and aprotinin for keratectomy wound healing in rabbits

We evaluated the effect of fibronectin (an adhesive protein) and aprotinin (a protease inhibitor) as single or combined topical therapies for primary healing and prevention of recurrent corneal epithelial defects in the rabbit keratectomy wound model. The biological activity of the prepared solutions of rabbit plasma fibronectin (0.6 g/L) was suggested by in vitro assays of rabbit corneal epithelial cell adhesion and gelatin-binding affinity. In the first experiment, we compared fibronectin, albumin (a control nonadhesive protein), and saline. In the second and third experiments, fibronectin supplemented with aprotinin, aprotinin alone, and saline were compared; aprotinin was used at concentrations of 40 and 1000 kallikrein inactivating units (KIU) per mililiter. Our results suggest that topical fibronectin, 0.6 g/L, as well as aprotinin at 40- and 1000-KIU/mL concentrations, given alone or in combination, neither promote corneal epithelial wound healing nor prevent recurrent corneal epithelial defects in rabbit keratectomy wounds.

[Comparative study on the inhibitory elastase capacity of fructus Forsythiae, radix Salviae Miltiorrhizae, radix Angelicae Sinensis and Ligustrazini]

In this paper elastase capacity was measured with agar radial diffusion using elastin-agar plate. There was a linear correlation between elatase capacity and diameter of agar radial diffusion. Significant inhibitory effects of Fructus Forsythiae, Radix Salviae Miltiorrhizae, Radix Angelicae Sinensis and Ligustrazini Hydrochloridum on elastase were observed and Fructus Forsythiae proved the most effective.

Optical performance of multifocal intraocular lenses

The optical performance of one monofocal and five multifocal lenses was evaluated in the laboratory and photographically. The laboratory testing included determination of the modulation transfer function (MTF), through focus response (TFR), resolution efficiency, and Strehl ratio of each lens. The photographic testing included photographs of the Regan high contrast acuity chart at ten feet with clearest focus and 18 additional photographs in which the image was defocused using minus trial lenses in 0.25 diopter increments. A color photograph of the Kodak color chart was also taken using each lens. All testing was conducted using a 3 mm artificial pupil under ideal implant conditions with no decentration or tilt. The laboratory and photographic results demonstrate that all the multifocal lenses had a two- to three-fold increase in the depth of field with at least a 50% lower contrast in the retinal image. The photographic testing revealed a one to two line better resolution limit with the monofocal lens, which corresponded to the 12% to 41% better MTF cut-off value with the monofocal lens by laboratory testing. The measured resolution efficiencies of all six lenses were comparable. The color photographs revealed color mixing of adjacent colors with the multifocal lenses, whereas the colors appeared unchanged from the original with the monofocal lens.

Evaluation of a latex particle agglutination assay for the detection of cytomegalovirus antibody in patient serum

The Virogen CMV Antibody Test is a simple and rapid latex agglutination assay for the detection of cytomegalovirus antibody in human serum and plasma. Evaluation of this assay with respect to enzyme immunoassay yielded a sensitivity of 98% with a specificity of 100%. In comparison to CMVScan, the Virogen CMV Antibody Test had a sensitivity of 98.4% and a specificity of 100%.

Intraventricular administration of isoproterenol inhibits both heat production and heat loss mechanisms in rats

At an ambient temperature (Ta) of 8 degrees C, intraventricular administration of isoproterenol inhibited metabolic heat production and led to hypothermia in rats. In contrast, at a Ta of 22 degrees C and of 30 degrees C, isoproterenol decreased cutaneous circulation and led to hyperthermia. The data indicate that isoproterenol inhibits both heat production and heat loss mechanisms in rats.

The catecholamine mechanisms of prostaglandin E1-induced hypothermia in rats

Intraperitoneal administration of prostaglandin E1 (PGE1) produced a hypothermia in rats at room temperatue (22 degrees C). The hypothermia in response to PGE1 was due to cutaneous vasodilatation and decreased metabolic heat production. Depletion of brain 5-hydroxytryptamine (with 5,6-dihydroxytryptamine and p-chlorophenylalanine) did not alter the PGE1-induced hypothermia. However, depletion of bran catecholamines (with 6-hydroxydopamine) and blockade of central catecholaminergic receptors (with phentolamine and propranolol) both greatly reduced the PGE1-induced hypothermia. The data indicate that PGE1 lowers body temperature in rats by acting on the central catecholaminergic systems.