[A pathological study on pulmonary fibrosis caused by chronic obstructive pulmonary disease]

OBJECTIVE

To estimate the morphologic characteristics of chronic obstructive pulmonary disease (COPD) induced pulmonary fibrosis.

METHODS

41 autopsy cases of COPD were chosen as the study group and other 10 autopsy cases died from non-respiratory diseases as control group. Histochemical stain and image quantitative analysis were used to identify the type of collagen.

RESULTS

In 36 cases (88%) of study group, fibrosis proliferation could be seen in peri-bronchial area, especially in the bronchi under grade VI. Respiratory bronchiole and alveoli were also involved in 11 cases. The main component of collagen in fibrosis area was identified as type III collagen by sirius red stain, reticular fiber could also be seen by Gomori stain. The type III collagen in alveoli distributed interruptedly. Image quantitative analysis showed: the integral optical density (A) of type III collagen was much higher than that of type I collagen in peri-bronchial area (P < 0.01); Both A of type III and type I collagen in peri-bronchial area were higher than that in alveolar area (P < 0.01). Mucous purulent plugs, interrupted elastic fibers in bronchial wall and chronic inflammation accompanied with lymphocytes infiltration in fibrosis area could also be seen.

CONCLUSIONS

COPD induced pulmonary fibrosis distributed mainly in peri-bronchial area, especially in the bronchi under grade VI. The main component of proliferative collagen was type III collagen. The genesis of pulmonary fibrosis might be associated with chronic inflammation accompanied with lymphocytes. Peri-bronchial fibrosis, interrupt of elastic fibers in bronchial wall caused the bronchial lumen narrowed or collapsed making both airway obstruction and ventilation insufficiency deteriorated.

Expression, characterization, and detection of human uridine phosphorylase and identification of variant uridine phosphorolytic activity in selected human tumors

Uridine phosphorylase (UPase) catalyzes the reversible phosphorolysis of uridine to uracil. We purified the enzyme from the murine colon 26 tumor using a two-step procedure through 5-amino-benzylacyclouridine affinity chromatography. Antibodies raised in rabbits against the purified protein revealed single bands in Western blots of normal human tissue and tumor extracts. The polyclonal antibody used to screen a human liver expression library allowed the isolation of a 1.2-kb clone that contained the entire open reading frame of the human UPase. The UPase cDNA has been expressed as a fusion protein in Escherichia coli using the pMal-C2 vector. The kinetic analysis demonstrated that the recombinant UPase preferentially uses uridine, 5-fluorouracil, and uracil as substrates, although lower levels of activity were observed with 2-deoxyuridine and thymidine. Clinical samples of human tumors and adjacent normal tissues were assayed for phosphorolytic activity and sensitivity to 5-benzylacyclouridine (BAU), a potent inhibitor of the enzyme presently in Phase I-II clinical trial. Activity in normal tissues appeared to be low but very sensitive to BAU (approximately 90% inhibition at 10 microM). Tumors had generally 2-3-fold greater activity compared with adjacent normal tissues. In breast cancer specimens and head-neck squamous carcinomas, however, uridine cleavage was only partially inhibited (40-60%) by 10 or 100 microM BAU. The BAU-insensitive activity requires phosphate and pH conditions similar to the normal enzyme, and the new phosphorolytic activity was independent from thymidine phosphorylase. The BAU-insensitive phosphorolytic activity in selected tumors, coupled with the potent inhibitory activity of BAU against the "classical" uridine phosphorylase in normal human tissues, provides the rationale for combining BAU with 5-fluorouracil in the treatment of breast and head-neck tumors.

Notch spatial filtering with an acousto-optic modulator

The role of acousto-optic (AO) modulators in programmable real-time image processing has recently been demonstrated. For fully investigating the image-processing capabilities of the AO modulator, general techniques to derive spatial transfer functions are needed for a variety of physical situations. We develop a technique to determine the spatial transfer functions numerically for various cases of beam incidence on an AO modulator. Normal incidence and incidence at twice the Bragg angle are investigated as examples for which double-sided and single-sided notch spatial filtering, respectively, are achieved. The observed spatial-filtering characteristics are reconciled with simple intuitive physical arguments.

Multiple heparan sulfate chains are required for optimal syndecan-1 function

Syndecans have three highly conserved sites available for heparan sulfate attachment. To determine if all three sites are required for normal function, a series of mutated syndecans having two, one, or no heparan sulfate chains were expressed in ARH-77 cells. Previously, we demonstrated that expression of wild-type syndecan-1 on these myeloma cells mediates cell-matrix and cell-cell adhesion and inhibits cell invasion into collagen gels. Here we show that to optimally mediate each of these activities, all three sites of heparan sulfate attachment are required. Generally, an increasing loss of syndecan-1 function occurs as the number of heparan sulfate attachment sites decreases. This loss of function is not the result of a decrease in either the total amount of cell surface heparan sulfate or syndecan-1 core protein. In regard to cell invasion, cells expressing syndecan-1 bearing a single heparan sulfate attachment site exhibit a hierarchy of function based upon the position of the site within the core protein; the presence of an available attachment site at serine 47 confers the greatest level of activity, while serine 37 contributes little to syndecan-1 function. However, when all three heparan sulfate chains are present, significantly greater biological activity is observed than is predicted by the sum of the activities occurring when the chains act individually. This synergy provides a functional basis for the evolutionary conservation of the three heparan sulfate attachment sites on syndecans and supports the idea that molecular heterogeneity, which is characteristic of proteoglycans, contributes to their functional diversity.

A pathological study of in situ thrombosis of small pulmonary arteries and arterioles in autopsy cases of chronic cor pulmonale

OBJECTIVE

To investigate the incidence of in situ thrombosis of small pulmonary arteries and arterioles during the exacerbation stage of chronic cor pulmonale.

METHODS

49 autopsy cases died from the exacerbation of chronic cor pulmonale were chosen as the study group, while 103 other autopsy cases without chronic cor pulmonale and disseminated intravascular coagulation (DIC) as control group. Morphologic and morphometric studies were taken on lung tissues and other organs with focus on the thrombi in small pulmonary arteries and arterioles.

RESULTS

44 cases of the study group had multiple thrombi in small pulmonary arteries and arterioles, the incidence is 89.8%, and in 9 of them, thrombi in proximal pulmonary arteries co-existed, the incidence is 18.4%. 80% of the thrombi existed in pulmonary arterioles. In the control group, only 3 cases had thrombi in small pulmonary arteries and arterioles, the incidence is 2.9%. All thrombi adhered to endangium, implying that they were in situ thrombi. No intravascular thrombosis was found in other organs. chi 2 test showed that the incidence of thrombosis and the number of thrombi in small pulmonary arteries and arterioles in cases with chronic cor pulmonale were significantly higher than those of the control group (P < 0.01).

CONCLUSIONS

Multiple in situ thrombosis in small pulmonary arteries and arterioles is a prominent and common pathological change during the exacerbation stage of chronic cor pulmonale. The study suggests a new diagnostic and therapeutic concept and gives a morphological and theoretical basis for the clinical application of anticoagulants or even the thrombolytic agents for the cases of chronic cor pulmonale in the exacerbation stage.

Image edge enhancement with two cascaded acousto-optic cells with contrapropagating sound

Basic real-time programmable image-processing operations are accomplished by use of acousto-optic (AO) cells. Instead of frequency-plane filters, the AO cells are placed directly behind the object. The one-dimensional edge-enhancement results with one AO cell can be improved by use of two AO cells that are placed in tandem with contrapropagating sound. The dominant second-derivative operation obtained from the transfer function of the undiffracted order works like a one-dimensional Laplacian operator that enables improved edge enhancement.

Identification and characterization of a novel human aldose reductase-like gene

We have identified a novel human protein that is highly homologous to aldose reductase (AR). This protein, which we called ARL-1, consists of 316 amino acids, the same size as AR, and its amino acid sequence is 71% identical to that of AR. It is more closely related to the AR-like proteins such as mouse vas deferens protein, fibroblast growth factor-regulated protein, and Chinese hamster ovary reductase, with 81, 82, and 83%, respectively, of its amino acid sequence identical to the amino acid sequence of these proteins. The cDNA of ARL-1 was expressed in Escherichia coli to obtain recombinant protein for characterization of its enzymatic activities. For comparison, the cDNA of human AR was also expressed in E. coli and analyzed in parallel. These two enzymes differ in their pH optima and salt requirement, but they act on a similar spectrum of substrates. Similar to AR, ARL-1 can efficiently reduce aliphatic and aromatic aldehydes, and it is less active on hexoses. While AR mRNA is found in most tissues studied, ARL-1 is primarily expressed in the small intestines and in the colon, with a low level of its mRNA in the liver. The ability of ARL-1 to reduce various aldehydes and the locations of expression of this gene suggest that it may be responsible for detoxification of reactive aldehydes in the digested food before the nutrients are passed on to other organs. Interestingly, ARL-1 and AR are overexpressed in some liver cancers, but it is not clear if they contribute to the pathogenesis of this disease.

Basic image-processing operations by use of acousto-optics

We describe some basic optical image-processing operations with acousto-optic (AO) Bragg diffraction. Instead of using frequency-plane filters, we place an AO cell behind the object. We then realize experimentally one-dimensional edge enhancement, which utilizes a high-pass filtering effect in the undiffracted order from the AO cell. A numerical simulation compares well with the experimental results. With two AO cells oriented orthogonally to each other, a second-order mixed derivative operation, evident from the four-corner enhancement of a square, is also demonstrated.

Mechanisms for the coordination of intercellular calcium signaling in insulin-secreting cells

Insulin-mediated increases in cytosolic calcium are synchronized among the cells in a pancreatic islet, and result in pulsatile secretion of insulin. Pancreatic beta cells express the gap junction protein connexin43 and are functionally coupled, making gap junctional communication a likely mechanism for the synchronization of calcium transients among islet cells. To define the mechanism by which pancreatic islet cells coordinate calcium responses, we studied mechanically-induced intercellular calcium waves in the communication-deficient rat insulinoma cell line RINm5f, and in RINm5f cells transfected with the gap junction protein connexin43. Both RINm5f and RINm5f cells transfected with connexin43 propagated calcium waves that required release of calcium from intracellular stores, did not involve gap junctional communication, and appeared to be mediated by autocrine activity of secreted ATP acting on P2U purinergic receptors. Connexin43 transfectants also propagated calcium waves that required gap junctional communication and influx of extracellular calcium through voltage-gated calcium channels. Gap junction-dependent intercellular calcium waves were inhibited by preventing plasma membrane depolarization. These studies demonstrate two distinct pathways by which insulin-secreting cells can coordinate cytosolic calcium rises, and show that it is by ionic traffic that gap junctions synchronize calcium-dependent events in these cells.

[A pathological study of in situ thrombosis of small pulmonary arteries and arterioles in autopsy cases of chronic cor pulmonale]

OBJECTIVE

To study the incidence of thrombosis of small pulmonary arteries and arterioles during the exacerbation stage of chronic cor pulmonale.

METHODS

49 autopsy cases died from the exacerbation of chronic cor pulmonale were chosen as the study group, while other 103 autopsy cases without chronic cor pulmonale and disseminated intravascular coagulation (DIC) as control group. Morphologic and morphometric studies were taken on lung tissues and other organs with focus on the thrombi in small pulmonary arteries and arterioles.

RESULTS

44 cases of the study group had multiple thrombi in small pulmonary arteries and arterioles, the incidence is 89.8%, and in 9 of them, thrombi in proximal pulmonary arteries co-existed, the incidence is 18.4%, 80% of the thrombi existed in pulmonary arteriole. In control group, only 3 cases had thrombi in small pulmonary arteries and arteriole, the incidence is 2.9%. All thrombi adhered to endangium, implying that they were in situ thrombi. No intravascular thrombosis were found in other organs. chi(2) test showed that the incidence of thrombosis and the number of thrombi in small pulmonary arteries and arteriole in cases with chronic cor pulmonale were significantly higher than that of the control group (P < 0.01).

CONCLUSIONS

Multiple in situ thrombosis in small pulmonary arteries and arterioles is a prominent and common pathological change during the exacerbation stage of chronic cor pulmonale. The study suggests a new diagnostic and therapeutic concept and provides a morphological and theoretical basis for the clinical application of anticoagulants or even the thrombolytic agents for the cases of chronic cor pulmonale in the exacerbation stage.

Tissue-specific expression of two aldose reductase-like genes in mice: abundant expression of mouse vas deferens protein and fibroblast growth factor-regulated protein in the adrenal gland

Aldose reductase (AR), the first enzyme in the polyol pathway, has been implicated in the pathogenesis of diabetic complications, although its physiological role is unclear. In mice, besides AR, two AR-like proteins, mouse vas deferens protein (MVDP) and fibroblast growth factor-regulated protein (FR-1), have been reported recently. Tissue-specific expression of these two genes was examined using the RNase protection assay method. Contrary to previous reports, MVDP was detected in a variety of tissues besides the vas deferens. High levels of MVDP mRNA were found in the adrenal glands, and low levels of expression were detected in eye, intestine, seminal vesicle, kidney, liver, testis and lung. The major gene expression pattern for FR-1 was slightly different from that of MVDP, with the highest levels of mRNA detected in testis, heart, adrenal gland, and ovary; less was found in the lung and it was barely detectable in eye, intestine, liver and seminal vesicle tissue. Mouse embryos, as early as 10.5 days post coitum, expressed both genes, although the levels of expression were different. Human AR mRNA was found in human vas deferens, although not at the high level found in mice. The localization of both MVDP and FR-1 transcripts in the adrenal cortex by in situ hybridization led to the speculation that these two AR-like proteins could be related to hormone production.

[Study of toxicity of iodophor,glutaradehyde and chlorhexidine to L929 Cells.]

We comparatively studied the toxicity of iodophor,glutaradehyde and chlorhexidine in different concentration and time.The result shows that the toxicity of iodophor to L929 cells is the lowest in all kinds of drug concentration and action time is much lower than that of glutaradehyde and chlorhexidine(P<0.05) with prolonging time.It indicates that iodophor can be used to oral diseases therapy with lower concentration.

[A clinicopathological study of cor pulmonale with coronary heart disease]

The necropsy findings of 18 patients with cor pulmonale and coronary heart disease (CHD) were compared with those of a control group of 30 patients with cor pulmonale alone. The results showed that there was no significant statistical difference between the two groups on average heart weight and average left and right ventricular thickness (P > 0.05). The results suggest that at the end stage of cor pulmonale left ventricule may be involved whether there are complicating left ventricular disease or not. In this study, cor pulmonale and CHD were both accurately diagnosed in 33.3%, CHD failed to be diagnosed in 38.9% and cor pulmonale failed to be diagnosed in 27.8% of the patients. Single diagnostic factor analysis for cor pulmonale with CHD indicated that age, history of hypertension, history of angina pectoris, history of MI, accentuation A2, presence of bundle branch block, abnormal Q wave and left axis or normal deviation, Cheng Xiansheng diagostic criteria and Selvester MI screening criteria are of significance (P < 0.05). Multiple factor logistic regression analysis indicated that independent prognostic factors including history of angina pectoris, Selvester MI screening criteria and Cheng Xiansheng diagnostic criteria are of help for diagnosis (P < 0.03-0.000). The above-mentioned diagnostic methods are, however, not so specific. At present the best method for diagnosis of CHD is coronary arteriography.

Human urokinase-type plasminogen activator primes neutrophils for superoxide anion release. Possible roles of complement receptor type 3 and calcium

Urokinase-type plasminogen activator (uPA), which binds to cells via a specific receptor (uPAR), participates in pericellular proteolysis during leukocyte migration. Previous studies have indicated that uPAR is physically associated with CR3 (CD11b/CD18). To test the functional interactions of CR3 and uPAR, we have examined the ability of uPA to elicit changes in cytosolic calcium levels of normal neutrophils, neutrophils from a leukocyte adhesion deficiency (LAD) patient, and 3T3 transfectants expressing CR3, uPAR, or both. We found that calcium levels of neutrophils increased from 106 +/- 6 nM in untreated cells to 199 +/- 25 nM in the presence of uPA. In contrast, no significant change in calcium was observed when neutrophils from an leukocyte adhesion deficiency patient were examined. The uPA-dependent calcium rise was inhibited by mAb directed against either CR3 or uPAR and required intact uPA. To substantiate further these findings, we prepared transfectants expressing genes encoding uPAR, CR3, and both receptors; only cells expressing both receptors experienced a rise in intracellular calcium. Although uPA's calcium signal is insufficient to trigger superoxide production, FMLP dose-dependent superoxide production was greatly enhanced by incubating neutrophils with intact, but not fragmented, uPA. Flow cytometry experiments utilizing an FMLP analogue exclude the possibilities that urokinase binds to the FMLP receptor or up-regulates its expression. We suggest that calcium is a second messenger of uPA, that this message is mediated in a CR3-dependent fashion, and that this signal primes neutrophils for superoxide production.

Human urokinase-type plasminogen activator primes neutrophils for superoxide anion release. Possible roles of complement receptor type 3 and calcium

Urokinase-type plasminogen activator (uPA), which binds to cells via a specific receptor (uPAR), participates in pericellular proteolysis during leukocyte migration. Previous studies have indicated that uPAR is physically associated with CR3 (CD11b/CD18). To test the functional interactions of CR3 and uPAR, we have examined the ability of uPA to elicit changes in cytosolic calcium levels of normal neutrophils, neutrophils from a leukocyte adhesion deficiency (LAD) patient, and 3T3 transfectants expressing CR3, uPAR, or both. We found that calcium levels of neutrophils increased from 106 +/- 6 nM in untreated cells to 199 +/- 25 nM in the presence of uPA. In contrast, no significant change in calcium was observed when neutrophils from an leukocyte adhesion deficiency patient were examined. The uPA-dependent calcium rise was inhibited by mAb directed against either CR3 or uPAR and required intact uPA. To substantiate further these findings, we prepared transfectants expressing genes encoding uPAR, CR3, and both receptors; only cells expressing both receptors experienced a rise in intracellular calcium. Although uPA's calcium signal is insufficient to trigger superoxide production, FMLP dose-dependent superoxide production was greatly enhanced by incubating neutrophils with intact, but not fragmented, uPA. Flow cytometry experiments utilizing an FMLP analogue exclude the possibilities that urokinase binds to the FMLP receptor or up-regulates its expression. We suggest that calcium is a second messenger of uPA, that this message is mediated in a CR3-dependent fashion, and that this signal primes neutrophils for superoxide production.

[Application of T-subgroup cells assay in the immunology of oral-maxillofacial cancer]

We report on T-subgroup cells in 70 cases of oral-maxillofacial cancer determined by T-monoclone antibody-OKT system. The results are as follows: CD3, CD4/CD8 value of cancer patients was decreased significantly, compared with that of health or oral benign tumor patients. CD8 was significantly increased (P < 0.001); however, CD8 was decreased and CD4/CD8 ratio was increased after operation. 20 cases underwent the dynamic testing, determined in 1 week, 1 and 3 month. The results are as follows: CD3, CD4, CD4/CD8 values were increased gradually and CD8 was decreased gradually in 17 cases of curative patients, but CD4, CD4/CD8, values were decreased and CD8 was increased significantly in 3 cases of metastased patients. Our conclusion is that determination of T-subgroup cells is of reference value for monitoring and treating cancer patients.

Retentive characteristics of dental cementation materials

Glass ionomer, polycarboxylate, zinc phosphate, and two resin cements were tested in vitro to cement base and noble metal crowns to prepared extracted teeth. The cements had different retentive characteristics. Among cements, statistically significant tensile resistance to dislodgment in order of decreasing strength was: (1) C & B Metabond (resin); (2) Panavia (resin); (3) Fuji I (glass ionomer); (4) Durelon (polycarboxylate); and (5) Fleck's (zinc phosphate). Tensile resistance to dislodgment did not differ statistically among base and noble metal crowns cemented with glass ionomer, polycarboxylate, or zinc phosphate cements. Tensile resistance to dislodgment differed statistically among base and noble crowns cemented with the resin cements (C & B Metabond and Panavia); the base metal crowns had the highest rate of retention.

Deposition of reactive oxygen metabolites onto and within living tumor cells during neutrophil-mediated antibody-dependent cellular cytotoxicity

In this study we test the hypothesis that reactive oxygen metabolites are delivered from neutrophils to simultaneously both the cell surface and cytosol of opsonized YAC erythroleukemic target cells. Using 5' (or 6') carboxyl-2',7'-dichlorodihydrofluorescein (H2-CDCF) diacetate as starting material, we synthesized its succinimidyl ester derivative. H2-CDCF-conjugated IgG prepared from the succinimidyl ester derivative was used to opsonize targets. In vitro studies have shown that H2-CDCF becomes fluorescent upon exposure to reactive oxygen metabolites, including hydrogen peroxide. Using video intensified epifluorescence microscopy, we observed that reactive oxygen metabolites are deposited on tumor cell membranes during neutrophil-mediated antibody-dependent cellular cytotoxicity (ADCC). This deposition process is catalase sensitive. The role of reactive oxygen metabolites produced by neutrophils in triggering the oxidation of H2-CDCF is further supported by the observation that neutrophils from chronic granulomatous disease (CGD) patients did not affect target fluorescence. YAC tumor cells were also labeled with dihydrorhodamine 123 or dihydrotetramethylrosamine. The oxidized forms of these reagents were found within the cytoplasm of YAC cells. During ADCC normal neutrophils, but not neutrophils obtained from CGD patients, triggered the oxidation of dihydrorhodamine 123 and dihydrotetramethylrosamine within tumor cells. Using two-color automated epifluorescence microscopy, we could not detect temporal intermediates with fluorescence in only one compartment, i.e., either solely on the plasma membrane or in the cytoplasm. These observations suggest that reactive oxygen metabolites cross target membranes (< 12 sec. These studies show that reactive oxygen metabolites are deposited both onto and into tumor cells during ADCC, wherein both compartments could become vulnerable to oxidant-mediated damage.

Simultaneous calcium-dependent delivery of neutrophil lactoferrin and reactive oxygen metabolites to erythrocyte targets: evidence supporting granule-dependent triggering of superoxide deposition

Optical microscopic techniques have been utilized to study the deposition of lactoferrin, a specific granule marker, and superoxide anions into target erythrocytes during antibody-dependent phagocytosis. Previous studies from this laboratory have shown that the entry of superoxide anions into erythrocytes can be sensitively monitored with Soret band transmitted light microscopy. When neutrophils were incubated with BAPTA/AM, an intracellular Ca2+ chelator, they phagocytosed IgG-opsonized sheep red blood cells (SRBC) but did not affect the microscopically detected absorption of their Soret band. When these same erythrocytes were observed after the infusion of 20 microM ionomycin, a Ca2+ ionophore, 58% of the cell-bound SRBC targets were destroyed immediately. However, neutrophils from chronic granulomatous disease (CGD) patients were unable to affect the Soret absorption of erythrocyte targets under any conditions. These results suggest that a Ca2+ signal can participate in triggering superoxide deposition in targets. Since Ca2+ signals are known to participate in the exocytic release of granules, we tested the hypothesis that specific lactoferrin-bearing granules are delivered to targets in parallel with superoxide anions. Lactoferrin delivery to phagosomes was monitored using resonance energy transfer (r.e.t.) microscopy. SRBCs were opsonized with both unconjugated and rhodamine B isothiocyanate (RBITC)-conjugated rabbit anti-SRBC IgG. After incubation with adherent neutrophils, the samples were washed, fixed with 3.7% paraformaldehyde, then labeled with fluorescein isothiocyanate (FITC)-conjugated antilactoferrin IgG. Energy transfer between FITC and RBITC was imaged microscopically and quantitated by photon counting. Significant levels of r.e.t. between antilactoferrin and anti-SRBC labels were observed after phagocytosis, but not in the absence of acceptor fluorochromes. To control for r.e.t. specificity, neutrophil membranes were labeled with FITC-conjugated, anti-HLA IgG after internalization of rhodamine B-tagged SRBCs (RSRBCs). Although r.e.t. between lactoferrin and RSRBCs labels was observed, no r.e.t. between HLA and RSRBC labels could be found. Further studies showed that treatment of neutrophils with BAPTA inhibited r.e.t. between anti-lactoferrin and RSRBCs. However, addition of ionomycin relieved this inhibition of energy transfer. These experiments show that both lactoferrin and superoxide delivery to targets are regulated in parallel by a Ca(2+)-dependent pathway. Furthermore, by combining Soret microscopy with r.e.t. microscopy, we have shown that superoxide anions and lactoferrin are delivered to the same phagosomes. We speculate that the NADPH oxidase, which produces superoxide anions, is assembled on specific granule membranes, thus accounting for their parallel Ca(2+)-dependence, activation, and delivery.

[Immune status of oral lichen planus and squamous cell cancer patients-T subgroup cells evaluation in PBL]

The levels of T-subgroup cells for 30 oral lichen planus(LP) and 25 cancers are reported.15 health are constracted.The results are as follows:Health OKT value T(3) 62.8+/-1.81,T(4) 44.4+/-7.34,T(8) 25.5+/-0.71,T(4)/T(8) 1.79+/-0.13;OLP OKT value:T(3) 53.2+/-1.92,T(4) 40.2+/-1.9, T(8)38.61+/-2.2, T(4)/T(8) 1.10+/-0.07,Cancer value 52.9+/-1.9,40.2+/-2.3,36.4+/-2.05,1.17+/-0.09. Both group of patients were compared with health.The level of OKT(3) OKT(4)/OKT(8) was decreased significantly(0.001),but OKT(8) qA increased significantly(0.001).This shows that T cell immune function is decreased in the oral LP and cancer patients.

Influence of associated valvular lesions on long-term prognosis of mitral stenosis. A 20-year follow-up of 202 patients

Other valvular lesions associated with pure MS were studied in 202 consecutive patients whose mean age was 43.4 +/- 12.7 years; 76.7% were females. MS was isolated in 63.4%, associated with aortic regurgitation (AR) in 27.7%, aortic stenosis in 1.0%, tricuspid stenosis (+aortic valve lesion) in 1.0%. In isolated MS, 42.4% were NYHA class III or IV, compared with 49.0% in MS + aortic valve lesion. One hundred and sixty-nine (85.4%) patients were operated on; 23.1% had mitral valve replacement, 76.9% had closed (31.4%) or open (45.6%) mitral commissurotomy; 7.1% had associated aortic valve replacement. There were perioperative complications in 20.4%, and the perioperative death rate was 4.1%. Two patients were reoperated in the postoperative course, and 28 patients after this period. The follow-up was 13.3 +/- 4.5 years. The survival rate was 77.7 +/- 4.6% (SE) for isolated MS, and 71.1 +/- 6.3% for MS associated with an aortic valve lesion (NS). The prognosis of MS is very good: the survival rate at 20 years follow-up is 75%. The association of aortic stenosis or tricuspid stenosis does not appear to alter this survival, but numbers are small. Important aortic regurgitation is a significant predictor of higher mortality in patients with MS.