[Prognosis of laryngeal carcinoma in youth]

The prognosis of 55 cases of laryngeal carcinoma in young people had been studied. The major factors mainly related to prognosis were smoking and misdiagnosis, while the tumour differentiation might be not so important. There was a high recurrence rate of 25.5% in the young patients and low 3- and 5-year survival rates of 47.4% and 34.5% respectively. The mortality of 1-year after surgery was 21.8%. The 3-and 5-year survival rates between total and partial laryngectomy made no difference. The survival rate of patients with positive node was lower. Early diagnosis is most important for young patients. Partial laryngectomy and neck dissection must be performed as far as possible.

An aspartic proteinase expressed in the equine placenta

This manuscript describes the cloning of a novel aspartic proteinase expressed in the placenta of the horse (order Perrisodactyla). Evidence for similar genes in the cat (Carnivora) and ruminants (Artiodactyla), indicates that these molecules have been conserved within widely divergent species with distinct types of placentation. Since ePAG is produced by the outer cell layer (trophoblast) of the placenta, it can tentatively be grouped with the pregnancy-associated glycoproteins (PAG) of cattle, sheep, and pig. The high sequence identity that ePAG shares with pepsinogens as well as the PAG, indicates that ePAG may be the evolutionary bridge that links these two groups of aspartic proteinases.

Anti-Sa antibody in Chinese rheumatoid arthritis

OBJECTIVE

To test anti-Sa antibody in different autoimmune connective tissue diseases and analyze the relationship between Sa antibody and clinical manifestations and laboratory tests in rheumatoid arthritis.

METHOD

Sa antigen was extracted from human placenta. Anti-Sa antibody was tested in 40 normal people and 478 connective tissue disease (CTD) patients using Western Blotting (WB).

RESULTS

Sa antigen was a protein with molecular weights of 50 kD and 55 kD. Anti-Sa antibody was positive in 31.9% (61/191) rheumatoid arthritis (RA), 3.0% (2/67) Sjögren's syndrome (SS), 4.3% (2/46) systemic lupus erythmatosus (SLE) and 0% (0/66) Behcet's disease, 0% (0/60) polymyositis/dermatomyositis (PM/DM), 0% (0/66) other CTD and 0% (0/40) normal controls. Anti-Sa antibody was different from other auto-antibodies in RA. In rheumatoid arthritis its sensitivity, specificity, positive prediction rate, negative prediction rate were 31.9%, 98.6%, 93.8% and 68.5% respectively. Anti-Sa antibody positive patients were significantly different from anti-Sa antibody negative patients in moming stiffness, ESR, ANA and X-ray grade.

CONCLUSION

Anti-Sa antibody was a new auto-antibody for the diagnosis of RA. Anti-Sa antibody positive patients seem to have more serious inflammation and more advanced disease process.

[The expression of P16, Rb and cyclin D1 and biological behavior of laryngeal cancer]

To determine the effect of gene of carcinorma on the proliferation and regulation in primary laryngeal cancer, P16, Rb, Cyclin D1 were examined with immunohistochemical SABC method in 36 cases of primary laryngeal cancer. The results showed: P16 was positive in 11 of 36 in carcinoma specimens (30.6%), 22 of 36 in the specimens surrounding the carcinoma (61.1%) were positive. The difference was significant (P < 0.05). The positive rates of Rb and Cyclin D1 were 61.1% and 47.2% respectively. Comparing the positive rate of P16 to Rb was more significantly (P < 0.05). In most circumstances, when Rb was positive, P16 was negative and vice versa. The positive rate of Rb correlated with the one of Cyclin D1 positively by rank correlation. The expression of P16 and Rb was significantly different between well and poor tissues differenciation. The expression had no significant difference in the same antibody in various clinical stage and position or in the same stage and position but different antibody. The results suggest that the feedback regulation chain consisted of P16 plays an important role in the proliferation and regulation.

[Clinical features and treatment of congenital inferior oblique paresis]

OBJECTIVE

To discuss the diagnosis and differential diagnosis of isolated congenital inferior oblique paresis.

METHODS

13 patients with isolated congenital inferior oblique paresis examined and operated between 1984 and 1994 in our hospital were retrospectively reviewed.

RESULTS

After a follow-up of 6-75 months, six patients had excellent surgical results, and the rest had improvement.

CONCLUSIONS

Isolated congenital inferior oblique paresis occurs infrequently. Its diagnosis is based on the following: (1) presence of vertical deviation in primary position, (2) the results of duction and version examination, (3) negative forced duction test that is different from the test in Brown's syndrome. Surgery is usually indicated in most patients. It consists of weakening superior oblique muscle and recession of inferior rectus muscle in the homolateral eye and recession of superior rectus in the contralateral eye.

TNF-alpha opens a paracellular route for HIV-1 invasion across the blood-brain barrier

BACKGROUND

HIV-1 invades the central nervous system early after infection when macrophage infiltration of the brain is low but myelin pallor is suggestive of blood-brain-barrier damage. High-level plasma viremia is a likely source of brain infection. To understand the invasion route, we investigated virus penetration across in vitro models with contrasting paracellular permeability subjected to TNF-alpha.

MATERIALS AND METHODS

Blood-brain-barrier models constructed with human brain microvascular endothelial cells, fetal astrocytes, and collagen I or fibronectin matrix responded in a dose-related fashion to cytokines and ligands modulating paracellular permeability and cell migration. Virus penetration was measured by infectious and quantitative HIV-1 RNA assays. Barrier permeability was determined using inulin or dextran.

RESULTS

Cell-free HIV-1 was retained by the blood-brain barrier with close to 100% efficiency. TNF-alpha increased virus penetration by a paracellular route in a dose-dependent manner proportionately to basal permeability. Brain endothelial cells were the main barrier to HIV-1. HIV-1 with monocytes attracted monocyte migration into the brain chamber.

CONCLUSIONS

Early after the infection, the blood-brain barrier protects the brain from HIV-1. Immune mediators, such as TNF-alpha, open a paracellular route for the virus into the brain. The virus and viral proteins stimulate brain microglia and macrophages to attract monocytes into the brain. Infiltrating macrophages cause progression of HIV-1 encephalitis.

Cystine deprivation induces oligodendroglial death: rescue by free radical scavengers and by a diffusible glial factor

In this study we examined the effect on oligodendroglial survival of exogenous cystine deprivation. Oligodendroglia isolated from mixed glial primary cultures derived from brains of 1-day-old rats, and then grown for 3 days, were markedly dependent on extracellular cystine for survival. The EC50 values for cystine for a 24-h exposure ranged from 2 to 65 microM. After 6 h of cystine deprivation, the cellular glutathione level decreased to 21 +/- 13% of the control. Free radical scavengers (alpha-tocopherol, ascorbate, idebenone, and N-tert-butyl-alpha-phenylnitrone) were protective against cystine deprivation but had no effect on the glutathione level. An iron chelator, desferrioxamine mesylate, also was protective. These findings suggest that intracellular hydroxyl radicals are important for this toxicity. In contrast to the observations in 3-day-old cultures, the dependence on exogenous cystine for cell viability was not observed consistently in oligodendroglia cultured for 6 days before the onset of cystine deprivation. Several observations suggested that this loss of cystine dependence was due to a diffusible factor. Sensitivity to the toxicity of cystine deprivation in day 6 cultures increased as the volume of medium was increased from 0.3 to 2 ml. Furthermore, preincubation of cystine-depleted medium with astrocyte cultures eliminated the toxicity of the cystine deprivation. HPLC assay of the conditioned cystine-depleted medium showed no significant change in cystine or cysteine concentration. We conclude that oligodendroglia are highly susceptible to cystine deprivation in day 3 cultures and that this susceptibility is due to the accumulation of intracellular free radicals in the setting of glutathione depletion. The resistance of day 6 oligodendroglial cultures is caused at least in part by a diffusible factor.

[Proliferation of PBMC in patients with Sjögren's syndrome via CD2 pathway]

Primary Sjögren's syndrome is an autoimmune disease whose etiology is unknown. Recent studies show that there is T cell abnormalities in addition to B cell hyperreactivity. In order to better understand the immunoregulatory abnormalities of primary Sjögren's syndrome, cellular immunology has become the main focus of recent studies. As such, the function of CD2 and CD3 pathways constitutes an integral part of these studies. The proliferation of PBMC, non-adhesive cells (mainly T cells) and adhesive cells (mainly B cells) has been investigated in patients with primary Sjögren's syndrome and normal controls; the results show that the proliferation of PMBC and non-adhesive cells in patients is much lower than that in normal controls (P < 0.05), whereas there is no difference in that of adhesive cells between these two groups (P > 0.05). It is also found that the non-adhesive cells' abnormality can not be adjusted by adding adhesive cells of normal controls. In addition, it seems that there is a relationship between the proliferation of PBMC via CD2 pathway in patients and the positivity of anti-SSA and anti-SSB antibodies. However, the underlying mechanism behind the pathogenesis of primary Sjögren's syndrome has yet to be fully understood. This study warrants further research into gaining a better concept of the CD2 pathway at molecular levels.

Quantitative study of AgNOR in differential diagnosis between non-Hodgkin's lymphoma and reactive hyperplasia

The argyrophilic staining technique was used in differential diagnosis between non-Hodgkin's lymphoma (NHL) and reactive hyperplasia (RH) of lymphatic tissues in 30 cases of RH and 71 cases of NHL which were classified as low (11 cases), moderate (49 cases) and high malignant (11 cases) groups. The number and the area of Ag nucleolar organizer region (AgNORs) in 100 cells of each case were examined by both IBAS-200 cytoimage analyser and microscope. The results showed that there was significant difference in the number, but not in area, of AgNOR granules between RH and low malignant group of NHL (P < 0.001). In NHL, the significant differences in the number and area of AgNORs were found between each groups (P < 0.05 or P < 0.001). It was also observed that in NHL, the number of AgNOR was negatively correlated with the area of the granules, and the shapes and distribution patterns of AgNOR were significantly different between each groups. Our results suggest that the quantitative study of AgNOR combining with the histological characteristics is very helpful in the differential diagnosis of RH and NHL and in the classification of NHL.

[The diagnosis and treatment of congenital bilateral superior oblique palsy]

13 patients with surgically treated congenital superior oblique palsy are presented. Follow-up ranged at least three months after surgery. Most patients received one operation, three cases required the secondary operation. Clinical symptom, Asymmetrical palsies: anomalous head posturing; hypertropia in primary position. Symmetrical palsies; a right hypertropia in left gaze and left hypertropia in right gaze; a positive Bielschowsky test on tiltion the head toward either shoulder, many cases have "V" pattern. The patients who need operation should usually undergo bilateral surgery. The most patients obtained satisfactory results after surgery.