[Clinicopathological features of early- and late-stage primary biliary cirrhosis: a comparative study]

OBJECTIVE

To investigate the clinicopathological features of different stages of primary biliary cirrhosis (PBC), and to provide a basis of evidence-based medicine for early identification and effective treatment of this disease.

METHODS

A total of 130 patients with pathologically confirmed PBC and complete clinical data were enrolled and divided into early-stage group and late-stage group based on pathological results. A retrospective analysis was performed for patients' general information, clinical manifestations, laboratory examinations, and pathological changes.

RESULTS

The PBC patients had a mean age of 43.5±7.1 years, with middle-aged female patients accounting for 89%. The most common symptom was fatigue, followed by jaundice, pruritus, and abdominal distension in the late stage. Of all patients, 11.5% were complicated by autoimmune disease. The level of aminotransferases tended to decrease with the progression of PBC and showed no significant differences between the two groups (P > 0.05). Most patients showed an increase in serum bilirubin, mainly direct bilirubin; serum total bilirubin and direct bilirubin tended to increase with disease progression and showed significant differences between the two groups (P < 0.01). The patients showed increases in the serum levels of alkaline phosphatase (ALP) andγ-glutamyl transpeptidase (GGT), but with the disease progression, the serum level of ALP increased and that of GGT decreased; the serum levels of ALP and GGT showed no significant differences between the early- and late-stage groups (P > 0.05). The positive rate of antimitochondrial antibody was 85%. The histopathological changes of PBC included severe lesions in the portal area and surrounding areas and slight lobular lesions. In the early stage, there were injuries of the interlobar bile ducts, proliferation of small bile ducts, aggregation and invasion of mononuclear cells in surrounding tissues, and the formation of lymphoid follicle-like structure; in the late stage, there were fibrotic expansion of the portal area, formation of fibrous septa and pseudolobuli, and even liver cirrhosis.

CONCLUSION

PBC is commonly seen in middle-aged women and has an insidious onset. Early- and late-stage PBC have their own clinicopathological features. As for patients with no characteristic changes in serological test, liver biopsy should be performed to give a confirmed diagnosis and avoid missed diagnosis and misdiagnosis.

Mechanism of BMP and TG2 in mesenchymal stem cell osteogenesis

OBJECTIVE

To study the interactive effects of Type II glutamine transaminase (TG2) and bone morphogenetic protein-9 (BMP-9) in the induction of osteogenesis in mice mesenchymal stem cells (MSCs) C3H10T1/2 model.

MATERIALS AND METHODS

Batches of MSCs C3H10T1/2, divided into two groups, were treated with BMP-9 (control group) or BMP-9 and TG2 (experimental group) under oxygen deficient conditions. The secreted alkaline phosphatase (SEAP) chemiluminescence and the histochemical staining methods were used to detect the alkaline phosphatase (ALP) expression. The alizarin red S staining was used to detect the calcium salt precipitation and the caspase-3 protein expression was monitored using Western blot. Flow cytometry was employed to identify cell cycle, and trypan blue exclusion method to count the living cells and monitor cell proliferation.

RESULTS

The levels of ALP expression in the experimental group were much higher than that of the control group. The level of expression of advanced caspase-3 protein was significantly lower (p < 0.05) in the experimental group than in the control group. The highest fraction of cells in the experimental group was in the phase M while cells in the control group were in the interphase. Moreover, cell number in the experimental group was significantly increased (p < 0.05) relatively to the control group.

CONCLUSIONS

BMP-9 interacts with TG2 in osteogenesis of MSCs C3H10T1/2 cells. Further studies are needed to understand the exact mechanism of BMP9/PG2 interactions in osteogenesis.

miR-71b regulation of insulin/IGF-1 signaling during starvation in planarians

Planarians, which have a large population of stem cells called neoblasts, are molecularly tractable model systems used in the study of regeneration. However, planarians have strong resistance to hunger and have developed growth arrest strategies. For example, they can change their size and undergo growth regression during starvation periods. The results of the current study show that the microRNA, miR-71b, and the insulin/IGF-1 signaling pathway have important functions in the development of starvation-induced planarians. We demonstrate tissue-specific expression of miR-71b using in situ hybridization. By employing real-time polymerase chain reaction, we provide evidence that miR-71b is upregulated in starvation-induced planarians. Furthermore, we validate and verify the target genes of miR-71b.

P1BS, a conserved motif involved in tolerance to phosphate starvation in soybean

Available phosphate (Pi) is a major limiting factor for plant growth, development, and productivity. Phosphate starvation response 1 (PHR1) is a binding dimer that binds to an imperfect palindromic sequence. PHR1-binding sequences (GnATATnC) exist in the promoter of Pi starvation-responsive structural genes, indicating an effect occurring downstream in the Pi starvation signaling pathway. These sequences are referred to as PHR1-binding site (P1BS) structures. In this study, the sequences of GmPHR1 and GmSPX1 from Glycine max (L.) Merr. soybean were determined and analyzed. We found that GmPHR1 is an MYB-related transcription factor. In addition, GmSPX1 contained a P1BS structure, which is an important cis-regulatory motif in the phosphate signaling pathway. We found that GmPHR1 can physically interact with GmSPX1 through the cis-element, which may be a major pathway for the GmPHR1-mediated Pi starvation stress response. Thus, the P1BS structure in the Pi starvation signaling pathway is an important cis-regulatory motif that improves the tolerance to low phosphorus conditions in soybean.

Biomimetic Deposition of Hydroxyapatite by Mixed Acid Treatment of Titanium Surfaces

A simple chemical method was established for inducing bioactivity of Ti metal. In the present study, two kinds of mixed acid solutions were used to treat Ti specimens to induce Ca-P formation. Following a strong mixed acid activation process, Ca-P coatings successfully formed on the Ti surfaces in the simulated body fluid. Strong mixed acid etching was used to increase the roughness of the metal surface, because the porous and rough surfaces allow better adhesion between Ca-P coatings and substrate. Nano-scale modification of titanium surfaces can alter cellular and tissue responses, which may benefit osseointegration and dental implant therapy. Some specimens were treated with a 5 M NaOH aqueous solution, and then heat treated at 600 °C in order to form an amorphous sodium titanate layer on their surface. This treated titanium metal is believed to form a dense and uniform bone-like apatite layer on its surface in a simulated body fluid (SBF). This study proved that mixed acid treatment is not only important for surface passivation but is also another bioactive treatment for titanium surfaces, an alternative to alkali treatment. In addition, mixed acid treatment uses a lower temperature and shorter time period than alkali treatment.

[Regulatory effect of As₂O₃on imbalance between adipogenic and osteogenic differentiation of BM-MSC from patients with aplastic anemia]

This study was aimed to explore the regulation of arsenic trioxide (As₂O₃) on imbalance between adipogenic and osteogenic differentiation of BM-MSC from patients with aplastic anemia(AA). The BM-MSC from AA patients were separated and purified, placed into the adipogenic and osteogenic differentiation culture system, then added the As₂O₃, CsA, As₂O₃combined with CsA were added to corresponding differentiation culture system, the concentration of As₂O₃and CsA were set at 0.001 µmol/ml and 2.5 mmol/ml respectively, the cells were divided into As₂O₃group, the CsA group, combined group and control group (no drug). The cell morphological observation, oil red 'O' staining, Von-Kossa staining, and RT-PCR were used to detect corresponding differentiation marks. The results indicated that in respect to adipogenic differentiation, cellular morphology observing and oil red 'O' staining showed that the rate of adipocyte differentiation in As₂O₃group was (18.3 ± 1.9)%, which was lower than the (91.8 ± 2.7)% in the CsA group and (92.1 ± 1.2)% in control group (P < 0.05), there was no significant difference in comparison with (8.3 ± 1.9)% in the combined group (P > 0.05), but the rate of differentiation in CsA group was higher than that in combined group (P < 0.05), and there was no significant difference in comparison wtih control group. RT-PCR showed that the LPL-mRNA expression level in As₂O₃group were significantly lower than that in the CsA group and the control group (P < 0.05), no difference was observed while compared with the combined group (P > 0.05), but the LPL-mRNA expression level in CsA group was significantly higher than that in the combined group (P < 0.05). In terms of osteogenetic differentiation, the calcium deposition in As₂O₃group and combined group was obviously observed while rarely in the CsA group and the control group when detected by the Von-Kossa staining. OST-mRNA expression level in As₂O₃group were higher than that in CsA group and the control group (P < 0.05), while compared with the combined group, there was no significant difference (P > 0.05), but the OST-mRNA expression level in the CsA group was lower than that in the combined group (P < 0.05). It is concluded that As₂O₃can significantly enhance the ability of BM-MSC from AA patients to differentiate into osteoblast, also can inhibit the adipogenic differentiation, in contrast, the CsA can not promote the osteoblast differentiation of BM-MSC from AA patients.

Evaluation of the bonding strength of dental zirconia with veneering porcelains

The effect of thermo-cycling treatment on the bond strength and flexural strength of porcelain veneered zirconia was evaluated. After thermo-cycling treatment between 5 degrees C to 55 degrees C, porcelain-zirconia bond strength and zirconia flexural strength was not significantly affected. In the phase analyses using XRD after thermo-cycling treatment, both the experimental group and the control group showed only tetragonal phases. That is, the porcelain-zirconia bond strength and zirconia flexural strength were not affected by low temperature degradation. So low temperature aging treatment did not reduce the flexural strength and the effect of temperature applied to the aging treatment could beignorable.

Digestibility and retention of zinc, copper, manganese, iron, calcium, and phosphorus in pigs fed diets containing inorganic or organic minerals

The objective of this experiment was to measure the apparent total tract digestibility (ATTD) and the retention rate of Zn, Cu, Mn, and Fe in pigs fed either inorganic or organic sources of Zn, Cu, Mn, and Fe. The experimental design was a randomized complete block design with a 2 × 3 factorial arrangement of treatments. There were 2 types of diets (corn grits-based or corn-soybean meal [SBM]-based diets) and 3 micromineral treatments (basal micromineral premix [BMM], inorganic micromineral premix [IMM], and organic micromineral premix [OMM]). The BMM contained no added Zn, Cu, Mn, or Fe; the IMM microminerals were provided as sulfates of Zn, Cu, Mn, and Fe at 40, 50, 20, and 100 mg/kg, respectively. The OMM contained the same levels of the 4 microminerals as IMM, but Zn, Cu, Mn, and Fe in this premix were provided by Zn(2-hydroxy-4-methylthio butanoic acid [HMTBa])2, Cu(HMTBa)2, Mn(HMTBa)2, and FeGly, respectively. Forty-eight barrows (initial BW: 31.1 ± 4.2 kg) were housed individually and allowed ad libitum access to the corn grits diet with BMM for 2 wk. All pigs were then moved to metabolism cages and randomly assigned to 1 of the 6 treatment diets with 8 replicates per diet. Fecal and urine samples were collected for 5 d following a 5-d adaptation period. Compared with corn grits diets, pigs fed corn-SBM diets had greater (P < 0.05) absorption and retention of Zn, Cu, and Mn but less (P < 0.05) ATTD of Zn and Cu. Compared with BMM, supplementation of IMM or OMM increased (P < 0.05) absorption, retention, ATTD, and retention rate of Zn, Cu, Mn, and Fe. Compared with IMM, adding OMM to the corn-SBM diet improved (P < 0.05) the absorption and retention of Cu and Mn and the ATTD of Cu, but these differences were not observed in the corn grits diets (interaction, P < 0.05). In addition, adding OMM to the corn-SBM diet increased (P < 0.05) absorption and retention of Zn and Fe and ATTD of Zn, Mn, and Fe compared with adding IMM to the corn-SBM diet. Supplementation of OMM also increased (P < 0.05) the ATTD and retention rate of P in corn-SBM diets. Results indicate that Zn(HMTBa)2 has greater digestibility and Cu(HMTBa)2 and Mn(HMTBa)2 have greater digestibility and retention rates compared with their inorganic sulfates, if included in a corn-SBM diet. Supplementation of organic microminerals also improves the digestibility of P in a corn-SBM diet.

Effect of JJYMD-C, a novel synthetic derivative of gallic acid, on proliferation and phenotype maintenance in rabbit articular chondrocytes in vitro

Tissue engineering encapsulated cells such as chondrocytes in the carrier matrix have been widely used to repair cartilage defects. However, chondrocyte phenotype is easily lost when chondrocytes are expanded in vitro by a process defined as “dedifferentiation”. To ensure successful therapy, an effective pro-chondrogenic agent is necessary to overcome the obstacle of limited cell numbers in the restoration process, and dedifferentiation is a prerequisite. Gallic acid (GA) has been used in the treatment of arthritis, but its biocompatibility is inferior to that of other compounds. In this study, we modified GA by incorporating sulfamonomethoxine sodium and synthesized a sulfonamido-based gallate, JJYMD-C, and evaluated its effect on chondrocyte metabolism. Our results showed that JJYMD-C could effectively increase the levels of the collagen II, Sox9, and aggrecan genes, promote chondrocyte growth, and enhance secretion and synthesis of cartilage extracellular matrix. On the other hand, expression of the collagen I gene was effectively down-regulated, demonstrating inhibition of chondrocyte dedifferentiation by JJYMD-C. Hypertrophy, as a characteristic of chondrocyte ossification, was undetectable in the JJYMD-C groups. We used JJYMD-C at doses of 0.125, 0.25, and 0.5 µg/mL, and the strongest response was observed with 0.25 µg/mL. This study provides a basis for further studies on a novel agent in the treatment of articular cartilage defects.

Cloning and expression analysis of a stress-induced GmIMT1 gene in soybean (Glycine max)

Here, we aimed to clone and identify the GmIMT1 gene related to the salt stress response in soybean. The full-length cDNA sequence of the GmIMT1 gene was amplified in soybean using degenerate primers of Mesembrythmum crystallium. To understand the stress response, the GmIMT1 gene was cloned and sequenced. Then, the expression vectors of the gene were constructed, and introduced into the model plant Arabidopsis thaliana through Agrobacterium mediated transformation, and the salt tolerance was analyzed in the transgenic plants. In addition, the expression patterns of GmIMT1 gene in soybean were analyzed. The expression was examined in different organs (roots, leaves, flower seeds, and stem) and under different stress conditions (drought, high salt, low temperature, salicylic acid, ethane, abscisic acid, and methyl jasmonate) by real-time fluorescent quantitative polymerase chain reaction analysis. The results showed that the root, leaves, and stems exhibited high level of GmIMT1 gene expression, whereas there was no expression in the seeds. In addition, the GmIMT1 gene expression was upregulated under all stress conditions. Overall, the results clearly indicate that GmIMT1 might be involved in multiple plant response pathways to the different environmental conditions. Furthermore transgenic plants exhibited higher salt-tolerance compared to wild type plants.

[Analyse related factors of impact and prognosis of 73 cases of severe hepatitis]

OBJECTIVE

A retrospective study was conducted to investigate the clinical features and prognostic factors of 73 cases of severe hepatitis.

METHODS

To summarize clinical features of 73 cases of severe hepatitis, grouping by etiology and pathogenesis. A retrospective analysis was performed to evaluate the relationship between biochemical characteristics (liver function, renal function, electrolytes, PTA, etc) and complications (hepatic encephalopathy, upper gastrointestinal bleeding, hepatorenal syndrome, ascites, abdominal infections, etc) and prognosis.

RESULTS

(1) HBV infection alone accounted for 65.75%. Alcoholic liver disease, drug-induced liver injury, hepatitis E, autoimmune hepatitis, overlapping causes and other factors were five cases (6.85%), six cases (8.22%), two cases (2.74%), two cases (2.74%), seven cases (9.59%) and three cases (4.11%) respectively. According to the incidence rate, severity and underlying liver condition, subacute hepatitis, cases based on chronic hepatitis and on cirrhosis were 12 cases (16.43%), 11 cases (15.07%), 50 cases (68.49%) respectively. Clinical manifestations with or without hepatic encephalopathy accounted for 58.90% or 41.10%. (2) The highest mortality of severe hepatitis was alcoholic liver disease and patients on the basis of overlapping factors (66.67%), followed by autoimmune liver disease (50%). The mortality of HBV-related hepatitis was 18.75%. Overall mortality of 73 cases of severe hepatitis was 28.77%, of which cirrhosis group was higher than non-cirrhotic group (40% vs 4.3%, P = 0.002). The difference was statistically significant. Patients without hepatic encephalopathy had lower mortality than with hepatic encephalopathy (3.33% vs 46.51%). The mortality of patients with hepatic encephalopathy Stage III and IV was 72.73%. (3) Independent samples t test filtered nine factors associated with death, namely cirrhosis, upper gastrointestinal bleeding, hepatic encephalopathy, hepatorenal syndrome, serum creatinine, total bilirubin (TBIL), direct bilirubin (DBIL), albumin (ALB) and serum sodium. The results of multivariate conditional logistic regression analysis indicated that hepatic encephalopathy, serum creatinine levels were risk factors for death, whereas ALB as a protective factor.

CONCLUSION

Hepatic encephalopathy, serum creatinine levels were risk factors for severe hepatitis death, But ALB was protective factor. Nucleotide analogs using was the main reason why the mortality of hepatitis B was as low as 18.75%.

Posterior cruciate substituting versus posterior cruciate retaining total knee arthroplasty prostheses: a meta-analysis

PURPOSE

The arguments about whether posterior-substituting prostheses or cruciate-retaining prostheses are superior to the other after total knee arthroplasty never stop. This meta-analysis was conducted to evaluate the clinical effects of these two different designs.

METHODS

The study was performed according to the guidelines described in the Cochrane handbook for systematic reviews of interventions. Methodological features were collected and extracted by two reviewers independently.

RESULTS

Nine randomized controlled trials with 1261 knees were eligible for pooled analysis. The meta-analysis demonstrated there were no statistical differences in the Knee Society Score, Hospital for Special Surgery, Western Ontario and McMaster Universities index, tibial component alignment, femoral component alignment, tibial posterior slope, joint line, and incidence of complications with short-to medium-term follow-up (p>0.01). Statistically difference in postoperative range of motion (WMD: 4.34°, 95% CI: 3.18° to 5.50°) in favor of PS prostheses was found between groups (p<0.01).

CONCLUSION

The findings indicate there were no significant statistical differences in knee scores, radiological outcomes, and complications between the two types of implants. Statistically significant difference in postoperative ROM was found between the two groups, but no clinical difference.

[STR polymorphisms in five Chinese ethnic groups(2)]

Population genetic studies were performed in Chinese Han, Hui, Mongolian, Tibetan and Uygur. Allele frequency distributions were analyzed for ten loci, i.e., D3S1358, VWA, CSF1PO, FGA, THO1, TPOX, D5S818, D13S317 and D7S820 by GeneScan. The results showed that there were 60 STR alleles and 149 genotypes in Han; 63 STR alleles and 144 genotypes in Hui; 69 STR alleles and 173 genotypes in Mongolian; 77 STR alleles and 168 genotypes in Tibetan; 70 STR alleles and 148 genotypes in Uygur. Significant differences were identified among ethnic groups (African-American, US-Caucasian and Chinese-Oriental), but similarity was found among the five Chinese populations, and immunogenomics and pharmacogenomics studied in this report. These findings indicated that the nine STR loci and amelogenin locus were very useful for individual identification in forensic science.

[Determination of degraded products of penicillin by high performance liquid chromatography]

A method for the determination of main composition in degraded products of penicillin, 6-aminopenicillanic acid (6-APA), penicillin G kalium (PGK), phenylacetic acid (PAA), and the by-product benzylpenicilloic acid (BPA) by HPLC was studied. Separation conditions were as follows: Spherisorb C18 column, 250 mm x 4.6 mm i.d., 10 micrograms; mobile phase: V (methanol): V(0.004 mol/L KH2PO4 buffer, pH 4.5) = 50:50; flow rate: 1 mL/min; detector: UV 230 nm. The method is effective, quick, accurate and reproducible. The satisfactory results show that this new method has certain practical values as an approach of quality control.

Respiratory studies in SUNCT syndrome

Seven SUNCT patients (six men, one woman) took part in this study. In four patients, respiratory variables were compared during and outside attacks. In five patients, peripheral chemosensitivity was tested and compared with a control group matched with respect to age, sex, and smoking habits. The results indicate that SUNCT patients hyperventilate during attacks. Moreover, they appear to hyperventilate slightly under basal conditions. The tests for peripheral chemoreceptor activity indicated no differences between the SUNCT and the control groups except for one variable, namely the mean ventilatory response to a single breath of 13% CO2. It is possible that this indicates a blunted response of the peripheral chemoreceptors. On the other hand, it may also represent a chance finding, since none of the other results presented suggested such a conclusion, and the size of the test group was very small. The results do not indicate that a reduction in oxygen saturation can trigger SUNCT since low levels of oxygen saturation were only rarely accompanied by SUNCT, whereas many attacks were not associated with any appreciable lowering in arterial oxygen saturation.

SUNCT syndrome: VIII. Pupillary reaction and corneal sensitivity

SUNCT is a newly described headache characterized by shortlasting, unilateral attacks of a neuralgiform character, accompanied by conjunctival injection and tearing on the symptomatic side. At present, 8 patients have been observed, all males. In the present work, vertical pupillary diameters have been estimated by the binocular, Whittaker infrared pupillometer (Gulf & Western). Measurements have been carried out both during the basal state and after topical, pharmacologic stimulation (by sympathicomimetic agents, i.e. tyramine (2%), OH-amphetamine (1%) and phenylephrine (1%). In the basal state, there was no clear tendency to anisocoria. After sympathicomimetic drugs, there was a tendency to underreaction on the symptomatic side, mainly as regards the indirectly acting ones (OH-amphetamine and tyramine). These two agents should supposedly give similar results, but, nevertheless, the results partly deviated. Phenylephrine did not invariably normalize the symptomatic/non-symptomatic side ratio. Corneal sensitivity was investigated with the Cochet-Bonnet esthesiometer. Two of 6 patients studied outside attack showed moderately lowered values on the symptomatic side. During attack, there seemed to be reduced corneal sensitivity in both patients investigated, in one bilaterally, in the other, on the symptomatic side only.

SUNCT syndrome: forehead sweating pattern

The forehead sweating function has been assessed in SUNCT syndrome--a short-lasting, unilateral, neuralgiform headache syndrome with autonomic phenomena on the symptomatic side (conjunctival injection, lacrimation, etc.). In the three patients (of a total of six) who could be studied during paroxysms, increased evaporation was present on the symptomatic side of the forehead compared to the non-symptomatic side during attacks or to the symptomatic side between attacks. Basal sweating was generally within control limits, so long as the attack frequency was not so high as to influence the interictal level. During attacks precipitated by eating chocolate or sour apple (in the case of one of the patients), forehead sweating was also increased on the symptomatic side. The forehead sweating responses to heating and pilocarpine were without any notable or systematic asymmetries. The forehead sweating pattern in SUNCT syndrome may differ from the patterns in unilateral headaches like cluster headache, on the one hand (in which there is generally an asymmetry during heating and pilocarpine tests), and chronic paroxysmal hemicrania (CPH) and cervicogenic headache, on the other (where there is no systematic increase during attacks.

Corneal sensitivity during and outside attacks of cluster headache

Corneal sensitivity has been studied in cluster headache (n = 38) and controls (n = 16). The patients were studied either during remission (n = 20), interparoxysmally in a bout (n = 17), or during attacks (spontaneously occurring attacks (n = 5) and nitroglycerin-provoked attacks (n = 6). For the measurements, a Cochet-Bonnet esthesiometer was utilized. This esthesiometer has a 6 cm long, adjustable nylon monofilament, which can be reduced in length by 0.5 cm at a time, the length of the filament determining the pressure exerted onto the corneal surface. All controls sensed the pressure at 6.0 cm filament length. In 5 cluster headache patients (remission, n = 4; cluster period, n = 1) a slight reduction in corneal sensitivity was found. No statistical difference was, however, found between any of the groups tested, and there was no asymmetry as far as averages were concerned.

Cluster headache: oxygen saturation and end-tidal CO2 during and without attack

Twenty-eight cluster headache patients were examined either in remission (n = 10), in the interparoxysmal period ("cluster phase") (n = 12), or during spontaneously occurring (n = 7), or nitroglycerin provoked (n = 7) attacks. Fourteen healthy controls participated in the study. Oxygen saturation (SaO2), end-tidal CO2 (PCO2), and respiratory rate (R.R.) were recorded for the controls and the patients during the different phases of cluster headache. Both PCO2 and SaO2 tended to be lower during the interparoxysmal period of the cluster phase when compared to the control group or to the remission. During both nitroglycerin-provoked and spontaneous attacks, PCO2 and SaO2 tended to respectively decrease and increase, both when compared with the "cluster phase" and with the period immediately prior to attack ("pre-attack"). Hence the "pre-attack" state may, on an average, be characterized by a slight hypoxia and a slight hyperventilation. Marked, clinically observable hyperventilation was present only in the occasional cluster headache patient. There was no SaO2 decrease from the "cluster phase" (interparoxysmal period) to the period immediately preceding the attack ("pre-attack"), and SaO2 "dips" preceding an attack were only observed in one cluster headache patient. As demonstrated previously by our group, a considerable lowering of SaO2 (i.e. partly to less than or equal to 83%) does only exceptionally lead to attack (Zhao et al, 1990). This observation combined with the evidence presented herein may seem to indicate that the slight pre-attack oxygen desaturation probably is too small to be a symptom-producing factor in cluster headache--be it in the spontaneously occurring or in the induced attack.(ABSTRACT TRUNCATED AT 250 WORDS)

[Dynamic changes of Ito cells in experimental cirrhosis of rat]

That Ito cells in rat liver express desmin was confirmed by immunohistochemical technique. Anyhow, changes of desmin-positive cells, lysozyme-positive cells and fibronectin were further studied in experimental cirrhosis of rat. It was found that desmin-positive cells, with the transitional features between Ito cells and myofibroblasts or fibroblasts under electron microscope, increased in number and expression of desmin in the necrotic areas as well as in the cellular fibrous septa, but decreased in number in the fibrous septa except those areas close to the edges of the septa. These results suggested that Ito cells, myofibroblasts and fibroblasts may belong to the same cellular system and play an important role in the pathogenesis of cirrhosis. Meanwhile, it was also noted that changes of both fibronectin and lysozyme-positive cells were correlated with those of desmin-positive cells. These provide evidence in vivo that fibronectin and Kupffer cells may exert certain effects on the migration and proliferation of Ito cells in cases of liver cirrhosis.

The effect of hyperventilation in cluster headache patients

The effect of voluntary hyperventilation was assessed in 22 cluster headache patients (8 in a cluster period and 14 in a remission) and 19 healthy individuals. Using an ear oximeter and a capnograph with a nasal probe, the oxygen saturation (SaO2) and the end-tidal CO2 were monitored continuously. During the hyperventilation per se, cluster headache patients and controls showed absolute values of end-tidal CO2 and of SaO2 of the same order of magnitude. In the posthyperventilation phase, however, the average of the lowest SaO2 levels was lower in controls than in cluster headache patients. In the posthyperventilation phase, headache patients outside the cluster period showed a trend more similar to that of the controls with respect to SaO2 than did those inside the cluster period. The observed discrepancy might, if reproducible, be a consequence of an altered chemoreceptor sensitivity in cluster headache patients during the bout.

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection, tearing, etc. (SUNCT): III. Another Norwegian case

"SUNCT" is a recently reported head pain syndrome characterized by shortlasting, unilateral neuralgiform paroxysms with conjunctival injection and tearing, and to a lesser extent nasal secretion, and (subclinical) sweating. Another case--that of a 56 year old male--is reported herein. The attacks lasted 1/2-1 min. and occurred only infrequently, i.e. once or twice in 1-4 weeks, except for a week recently when there were up to 20 or more typical attacks per day, with the usual ipsilateral, autonomic accompaniments. Due to the benign nature and low frequency of attacks, the diagnosis would have been most difficult to establish prior to the occurrence of this shortlasting period with more marked symptoms. A variety of precipitation mechanisms were present, partly concerning the V 2-3 areas, partly concerning the neck. Precipitation mechanisms in "SUNCT" to some extent seem to differ from those in trigeminal neuralgia. It is remarkable that all four hitherto reported cases are males.

The effect of high pH upon diphtheria toxin conformation and model membrane association: role of partial unfolding

Penetration of membranes by diphtheria toxin in vivo is at least partially triggered by a low pH-induced conformational change occurring within the lumen of an acidic organelle. In order to gain insight into the nature of this change the behavior of the toxin at high pH was characterized and compared to that previously determined at low pH. We find that near pH 10.5 a major conformational change occurs. This change is accompanied by a marked decrease in fluorescence intensity, a red shift in fluorescence emission maximum, and increased susceptibility of protein fluorescence to acrylamide quenching. Differential scanning calorimetry shows that the high pH conformational change involves a cooperative endothermic unfolding transition. These changes at high pH are very similar to those induced by low pH, supporting the conclusion that the changes at low pH also involve a denaturation-like process. In addition, at high pH the toxin gains the ability to bind to model membranes, again similar to its behavior at low pH. On the basis of these studies we conclude that exposure of hydrophobic sequences due to partial unfolding is one dominating component in inducing hydrophobic behavior at both high and low pH, but that at low pH Asp/Glu protonation also contributes to hydrophobicity.