Effect of exercise testing protocol on parameters of aerobic function

Four different patterns of increasing work rate (ramp and 1-min, 2-min, and 3-min steps) to maximum tolerance were studied in eight normal male subjects during cycle ergometer exercise testing to determine the effect of the work rate protocol on the parameters of aerobic function. The overall rate of work rate increase was kept constant. Measurements included VO2max, anaerobic threshold (AT), and the O2 uptake increase with respect to work rate increase (delta VO2/delta WR). VO2, VCO2, VE, respiratory exchange ratio (R), PETCO2, and PETO2 were calculated breath-by-breath. No significant difference was found in VO2max, AT, AT/VO2max, and delta VO2/delta WR among the four work rate protocols. Other measurements such as total work, maximal work rate, VCO2, VE, R, HR, O2 pulse, and the VO2 at which VE increases disproportionately to VCO2 (ventilatory compensation point) were also similar among the four protocols. Both the ramp and 1-min step work rate tests had no step pattern in either VO2 or VCO2, and the step pattern for the 2-min and 3-min step tests was attenuated or disappeared at work rates above AT. We conclude that the parameters of aerobic function, and other physiological responses at maximum work rate, were independent of the pattern of work rate increase, provided that the overall rate of work rate increase was the same.

Comparison of pre-S1 and pre-S2 proteins in hepatocytes with replication by in situ hybridization assay

To compare the relationship of pre-S1 and pre-S2 proteins in hepatocytes with HBV replication, HBVDNA in situ hybridization was performed for a group of patients with chronic hepatitis by bio-probe, in conjunction with detection of intrahepatic HBsAg, HBcAg, pre-S1 and-S2 antigens. It was found that the expression of intrahepatic pre-s1 and pre-S2 proteins was visualized as cytoplasmic homogeneous and inclusion types, on some occasions as membranous localization. However, the positive rate for pre-S1 protein was up to 75% (15/20), being significantly higher than that of pre-S2 protein (35%; 7/20) in the same group (P less than 0.05). What in more important, the pre-S1 expression, rather than pre-s2, was in parallel with the presence of intrahepatic HBVDNA and HbcAg. All these findings suggest that the pre-S1 protein might be mainly expressed at the HBV replication phase, thus, to some extent, the detection of pre-S1 protein might complement HBe system and HBVDNA clinical routine.

The cytoplasmic HBVDNA implication: HBV replication or non-replicative status

Intrahepatocellular HBVDNA was investigated in patients with chronic hepatitis B by in situ hybridization assay, employing biotin-labelled HBVDNA as the specific probe. It was found that HBVDNA was predominantly present in the cytoplasm of hepatocytes. In general the cases with cytoplasmic HBVDNA could be grouped as follows: 1) cytoplasmic HBVDNA coinciding with intrahepatic envelope protein and nucleocapsid component expression, this pattern of the cytoplasmic HBVDNA would be replicative; 2) cytoplasmic HBVDNA accompanied by intrahepatic single HBsAg expression, common to HBVDNA integrated into host genome with only HBsAg being found frequently in liver; 3) with only cytoplasmic HBVDNA, with neither HBsAg nor HBcAg expression, representative for non-replicative status. It is speculated that the reason for the occurrence of the cytoplasmic hybridization signal in cases with non-replicative HBVDNA may be due to DNA-RNA transcript hybrid. The prudent way to evaluate the implication of the cytoplasmic HBVDNA is to consider the combination of HBVDNA location, intrahepatic gene product expression, and HBV markers in the serum.

A study on hepatitis D virus infection in liver tissues of patients with hepatitis B in China

2346 liver samples from 17 areas in China were investigated for intrahepatic hepatitis D antigen (HDAg) by direct enzyme-labelled technique. HDAg was detected in 167 out of 1764 samples of HBsAg positive individuals with the detection rate of 9.47%. Hepatitis D virus (HDV) infection existed in all the examined areas without any significant difference regarding HDAg detection rate. A relationship of intrahepatic HDAg to the pathologic type of the liver disease was observed. The HDAg detection rate in chronic liver diseases and severe hepatitis was higher than in other liver diseases. It suggested that HDV infection was associated with the progression and chronicity of the liver disease. Studies on the relationship between HDV infection and HBV replication showed that HBV replication might be suppressed by HDV infection. Both HDV and HBV, however, could replicate in the same hepatocyte simultaneously.

Etiology of acute exacerbation in patients with severe chronic active hepatitis by in situ HBVDNA hybridization technique

To explore etiology of acute exacerbation in severe chronic active hepatitis, in situ HBVDNA hybridization was carried out combined with detection of HBV markers in the serum and the liver as well as intrahepatic HDAg in 15 cases. Four subgroups were identified based on the etiological evidence: 1) 9 cases were still undergoing HBV active replication or reactivation with cytoplasmic and membraneous HBcAg expression, often associated with the hepatic necrosis foci; 2) 3 cases showed HBsAg or/and HBVDNA positivity despite absence of HBcAg expression, the membranous and homogeneous HBsAg expression being closely related with hepatic necrosis; 3) 2 cases were HDAg positive; 4) the remaining case exhibited no HBV infection evidence. All findings suggested that HBV active replication or reactivation was the major cause of the exacerbation in severe chronic active hepatitis. In addition, HBV superinfection accounted for over 10% of cases with acute exacerbation. Hepatitis A or C may contribute to some episodes of exacerbation.

Intrahepatic HBVDNA replication and gene products expression correlated with foci of hepatic necrosis

Intrahepatic HBVDNA of patients with chronic hepatitis B was detected by in situ cytohybridization assay in combination with demonstration of HBsAg and HBcAg expression, and correlated with the foci of hepatic necrosis. It was found that HBsAg and HBcAg expressing sites appeared in the same areas where HBVDNA replicated; when HBsAg and HBcAg simultaneously expressed in the liver, one antigen usually dominated, the other declined. This unbalanced expression may be caused by the gene or transcripts variance which encodes the surface or core antigen, or by the activity of each replication. The other observation is that HBVDNA-positive hepatocytes outnumbered liver cells containing HBsAg and HBcAg in a few cases. It is supposed that a part of cytoplasmic HBVDNA was on replicative phase with gene production expression, on the contrary, another part of cytoplasmic HBVDNA may be out of replication with no gene product expression during chronic hepatitis B. Finally HBsAg and HBcAg expressing sites corresponding to HBVDNA-positive hepatocytes were closely attached to the foci of hepatic necrosis. There was no significant difference in the frequency of HBsAg and HBcAg expression correlating to hepatic necrosis.

Investigation of HBV infection status in anti-HBe Chinese patients with chronic hepatitis by in situ hybridization assay

To investigate HBV infection in anti-HBe positive Chinese patients with chronic hepatitis, demonstration of intrahepatocellular HBV-DNA was performed by in situ hybridization technique, coupled with detection of intrahepatic HBcAg and HBsAg. Based on the presence or absence of HBV-DNA, HBcAg and HBsAg of 15 cases, three subgroups were identified: 1) 4 cases with HBV active replication characterized by intrahepatic HBV-DNA, HBcAg and HBsAg copositive; 2) 8 cases with HBV incomplete replication or antigen expression defined as positivity of both intrahepatic HBV-DNA and HBsAg; 3) 3 cases with HBV inactive replication described as absence of intrahepatic HBV-DNA, HBcAg and HBsAg. All findings strongly suggest that different HBV infection status could be distinguished among Chinese patients with seroconversion from HBeAg to anti-HBe positivity: a small number of cases had stopped replication; but part of the cases was still undergoing HBV active replication; on the other hand, HBV infection status in half of the remaining cases seemed to stay in an intermediate phase from active virus replication to inactive replication.

Reconstitution of translocation-competent membrane vesicles from detergent-solubilized dog pancreas rough microsomes

Dog pancreas rough microsomes were solubilized in 1% octyl beta-glucoside, and membrane vesicles were reconstituted by slow 30-fold dilution with a buffer of low ionic strength. Asymmetric assembly of the membranes occurred during reconstitution since the vesicles formed contained ribosomes bound only to the vesicular outer surfaces. The reconstituted vesicles were similar in protein composition to native rough microsomes, although these vesicles were largely devoid of luminal-content proteins. These reconstituted vesicles could translocate and process nascent secretory (human placental lactogen) and membrane proteins (influenza hemagglutinin and rat liver ribophorin I) synthesized in cell-free translation systems programmed with the corresponding mRNAs. Signal cleavage and N-glycosylation only occurred when the reconstituted membranes were present during translation, providing evidence that the translocation apparatus was asymmetrically assembled into the reconstituted membranes. When a supernatant lacking ribosomes and particles greater than 50S from centrifuging the detergent-solubilized microsomes at high speed was used for reconstitution, smooth-surfaced membrane vesicles were obtained that, except for the absence of ribosomal proteins, were similar in protein composition to that of the reconstituted vesicles from total solubilized rough microsomes. The reconstituted smooth-surfaced vesicles, however, were totally inactive in cotranslational processing and translocation of nascent polypeptides. These findings suggest that ribosomes and/or large macromolecular complexes, not dissociated under our solubilization conditions, are essential for in vitro assembly of a functional translocation apparatus.

Intrahepatic expression of pre-S proteins of hepatitis B virus and its possible relation to liver cell necrosis

To assess the significance of intrahepatic expression of pre-S1 and S2 proteins of hepatitis B virus (HBV) in patients with HBV infection, an indirect immunoperoxidase technique employed monoclonal antibodies to pre-S proteins was used to detect pre-S1 and -S2 proteins in 80 liver specimens. The frequency of pre-S1 and -S2 proteins was 61.3% and 51.3%, respectively, and the co-expression of pre-S and HBsAg occurred in most specimens. The preferential expression of pre-S1 and -S2 in HBcAg-positive specimens suggests that pre-S proteins are associated with HBV replication. Membranous expression of both pre-S1 and -S2 is associated with inflammatory activity and liver cell necrosis. Furthermore, our results show that T cells, not NK or B cells, were the predominantly infiltrating cells in necrotic foci with pre-S expression. Almost all of these T cells may express HLA-DR antigen simultaneously; therefore, they are activated. In conjunction with these data, we conclude that, as the essential components of HBV envelope proteins, pre-S proteins may play an important role in resulting in liver cell necrosis.

Morphology, distribution and its significance of intrahepatic HBV DNA in liver disease: a study by in situ hybridization

A biotin-labeled DNA probe specific for hepatitis B virus (HBV) nucleotide sequences was hybridized in situ to liver tissue of 129 cases with liver disease. It was found that HBV DNA was predominantly visualized in cytoplasm of hepatocytes in three patterns: cytoplasmic compact, discrete and inclusion pattern. Its distribution in parenchyma in the sections of specimens may be defined as lobular, focal and spotty. The detection of intrahepatic HBV DNA depended on two factors, at least in the present study: 1) liver disease activity; chronic active hepatitis (CAH) group had a significant higher prevalence (81%) as compared to cirrhosis, chronic lobular hepatitis (CLH), acute hepatitis and hepatocellular carcinoma (HCC) groups; 2) HBV infection state: HBV DNA was more easily detected in HBeAg positive or intrahepatic HBcAg positive patients than in single HBsAg positive or anti-HBc cases. The findings that hepatocytes expressing HBV DNA, particularly in focal distribution, were closely related to hepatic necrosis sites suggested that HBV replication might occur in conjunction with hepatic necrosis.

Hepatocyte necrosis associated with HBV marker expression and T cytotoxic cells in situ in chronic hepatitis B

To explore the role of HBV antigen expression and monocyte infiltrate in situ in chronic hepatitis, HBV markers and compositions and number of monocytes in the liver of chronic hepatitis B were immunohistochemically located and identified, and correlated with hepatocyte necrosis. It was found that hepatic necrosis frequently took place in the centre or boundary of membranous HBsAg and/or HBcAg expression and the majority of monocytes accumulated in the necrotic areas showed CD8+ cell token in HBeAg-positive stage of chronic active hepatitis. On the other hand, with HBeAg positivity converted into HBeAg-negativity or anti-HBe-positivity, HBV antigen expression significantly declined, CD4+ cells remarkably increased as compared to HBeAg-positive status. These findings suggest that there may be distinct pathogenesis of hepatic necrosis in different stages of chronic HBV infection.

[The penetration of cephalosporins across the blood-brain barrier and its clinical significance]

The penetration of Cefuroxime (CXM), Ceftazidime (CTZ), Cefotaxime (CTX), Ceftizoxime (CZX), and Ceftriaxone (CTRX) across the blood-brain barrier was studied in 119 patients with or without meningitis after an intravenous injection of 2 grams. Cephalosporins were undetectable or their concentrations very low in the cerebrospinal fluid (CSF), when there was no inflammation in the meninges. On the contrary, the mean CSF concentrations of cephalosporins were 2.21-5.36 micrograms/ml and the CSF/serum ratios 3.73-31.80% in acute stage of purulent meningitis. The CSF levels of all the five cephalosporins were much higher than the mean MICs of the common pathogens of bacterial meningitis as well as that of Enterobacteriaceae. It is thus shown that these five new cephalosporins are useful for treatment of meningitis including those caused by gram-negative bacilli.

A preliminary study on expression and significance of pre-S1 protein in liver tissue of patients with HBV infection

Rabbit antiserum to Pre-S1 protein was used to establish peroxidase-antiperoxidase (PAP) and avidin-biotin-peroxidase complex (ABC) immunohistochemical techniques for detection of Pre-S1 protein in paraffin-embedded liver tissue. Pre-S1 protein could be expressed in hepatocyte cytoplasm and on membrane in some cases with chronic viral hepatitis, cirrhosis and hepatocellular carcinoma (HCC), and its expression was intimately associated with HBsAg, HBcAg in liver and HBV DNA in serum, indicating that pre-S1 protein may represent the essential component of hepatitis B virus (HBV) and also serve as one of the markers of HBV infection. The incidence of Pre-S1 protein was slightly lower in nontumorous liver of HCC than in other cases and Pre-S1 protein could not be detected in tumorous tissue of HCC suggesting that expression of pre-S1 protein may be suppressed in HCC cases.

Immunohistochemical research on HDV infection in Chinese patients with chronic liver disease

The prevalence of HDAg in the liver of Chinese patients with chronic hepatitis and hepatocellular carcinoma was determined by using direct immunofluorescence and immunoperoxidase. Six patients (6.3%) out of 95 HBsAg carriers with inflammatory liver disease and neoplasia were found to be HDAg positive. HDAg was shown in the liver of 6 patients (7.6%) among 79 patients with chronic hepatitis. The relative frequency of HDAg in cirrhosis-B, chronic active hepatitis B and chronic persistent hepatitis B was 14.3%, 7.1% and 5.9% respectively. These results suggest that a sizeable number of HBsAg carriers are superinfected with HDV. In view of the large amount of HBV carriers in China, the relative minor but distinct presence of HDV poses an important community health problem.

Double-blind crossover controlled study on antiepilepsirine

Antiepilepsirine (AES) is one of the derivatives of a Chinese folk prescription. It is a new antiepileptic drug (AED) synthesized in cooperation by Chinese medical and pharmaceutical workers. Pharmacological experiments on animal models prove that its antiepileptic action is marked, but there has been little evaluation of its clinical effects. We used the double-blind placebo-controlled crossover study which is generally acceptable as a proper method for new drug study. This study covered 58 epileptic children treated with classical AEDs and observed 6.5 months. Every patient took AES and placebo for 3 months each by random crossover on the basis of add-on therapy. The blood levels of AES and other antiepileptic drugs were determined regularly. The results show that there are no significant differences in clinical effects between AES and placebo in pediatric epilepsies as a whole, but AES is effective in tonic-clonic seizures (P less than 0.05), the most common type of seizure in the series. There are no significant differences in AED blood levels between the AES effective and ineffective groups. AES has no effect on the blood levels of other AEDs. AES is very safe, children given large doses (10 mg/kg/day) demonstrate no serious side-effects. It is suggested that there is potential improvement in patient psychological and cognitive status. This article also discusses the evaluation of new drugs for clinical effects, subject sampling, the criteria for efficacy evaluation and relationship between animal information and human outcome. The AES chemical structure is different from other well-known AEDs, this is a unique advantage.(ABSTRACT TRUNCATED AT 250 WORDS)

Purification and characterization of a lysophospholipase from a macrophage-like cell line P388D1

Two lysophospholipase activities (designated I and II) were identified in the macrophage-like cell line P388D1. Lysophospholipase I was purified (8,500-fold) to homogeneity by DEAE-Sephacel, Sephadex G-75, Blue-Sepharose, and chromatofocusing chromatography. Lysophospholipase II was separated from the lysophospholipase I in the Blue-Sepharose step. The apparent molecular mass of lysophospholipase I and II are 27,000 and 28,000 daltons, respectively, determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Their pI values were 4.4 and 6.1 respectively, as determined by isoelectric focusing. Lysophospholipase I exhibited a broad pH optimum between 7.5-9.0. The double-reciprocal plot of the substrate dependence curve of the purified lysophospholipase I showed a break around the critical micelle concentration of the substrate (1-palmitoyl-sn-glycerol-3-phosphorylcholine). The apparent Km, determined from substrate concentrations above 10 microM was 22 microM, and the apparent Vmax was 1.3 mumol min-1mg-1. The purified enzyme did not have phospholipase A1, phospholipase A2, acyltransferase, or lysophospholipase-transacylase activity. No activity was detected toward triacylglycerol, diacylglycerol, p-nitrophenol acetate, p-nitrophenol palmitate, or cholesterol ester. The enzyme did, however, hydrolyze monoacylglycerol although at a rate 20-fold less than lysophospholipid, 0.06 mumol min-1mg-1. The lysophospholipase I was inhibited by fatty acids but not by glycerol-3-phosphorylcholine, glycerol-3-phosphorylethanolamine, or glyc-fjerol-3-phosphorylserine. A synthetic manoalide analogue 3(cis,cis,-7,10)hexadecadienyl-4-hydroxy-2-butenolide inhibited the enzyme with half-inhibition (IC50) at about 160 microM. Triton X-100 decreased the enzymatic activity, although this apparent inhibition can be explained by a "surface dilution" effect. The pure lysophospholipase I was stable for at least 5 months at -20 degrees C in the presence of glycerol and beta-mercaptoethanol. Lysophospholipid also demonstrated a protective effect during the later stage of purification.

Analysis of conjugated bile acids in human serum by high-performance liquid chromatography using post-column enzyme reaction and off-line fluorimetric determination

An assay for glycine and taurine conjugates of cholic (GC, TC), chenodeoxycholic (GCDC, TCDC), deoxycholic (GDC, TDC) and ursodeoxycholic (GUDC, TUDC) acids in human serum by high-performance liquid chromatography using an immobilized 3-alpha-hydroxysteroid dehydrogenase post-column reaction and an off-line spectrofluorimetric detection is described. The detection limit is 0.2 microM. Recoveries of extraction and chromatographic analysis range from 89.50 to 91.68% and from 96.75 to 98.83%, respectively. The analysis in serum reveals a coefficient of variation for reproducibility between 16.2% for GC and 4.7% for TDC; inter-assay variability ranges between 4.06% for TCDC and 8.24% for TUDC.

Acetabuloplasty for congenital dislocation of the hip in children

A modified acetabuloplasty, which has been employed at our hospital since 1977, is described for the treatment of congenital dislocation of the hip in children. The procedure has been performed on a total of 74 hips in 61 children (average age 6.7 years), with satisfactory results obtained in 87.8% of hips. The technique, its indications, and pre- and postoperative management are detailed. The procedure possesses the advantages of both the shelf and Pemberton procedures and has proved to be an effective operation for older children with poor acetabular development. Our results show that, when performed correctly, this procedure is simple, safe, and effective.

Determination of metoprolol and two major metabolites in plasma and urine by column liquid chromatography and fluorometric detection

Metoprolol and its alpha-hydroxy metabolite were determined in plasma down to 2 nmol/l (S.D. 10-15%) after solvent extraction and bonded-phase liquid chromatography with fluorometric detection. The major metabolite with a carboxylic function was also measured in plasma when liquid-solid extraction on a column activated with dodecyl sulphate was applied. In urine the three components were assayed by direct injection of a diluted sample.