Erdheim-Chester disease in a child

Erdheim-Chester disease (ECD) is a rare systemic non-Langerhans histiocytosis that affects multiple organ systems. It occurs more often in adults, and paediatric ECD is extremely rare. The diagnosis of ECD can be established based on clinical presentations and imaging but the final diagnosis should be based on biopsy. Treatment of ECD has involved the use of corticosteroids, radiotherapy, chemotherapy, surgery and haematopoietic stem cell transplantation, yet the efficacy of these treatments is difficult to determine. At present, it is thought that the treatment of interferon-alpha (IFN-alpha) is safe and effective for ECD. Herein, we report on an 11-year old girl who was admitted to hospital because of systemic bone pain and limping, and the final diagnosis of ECD was based on evidence provided by her clinical presentation, imaging and biopsy of a lesion of the right ilium. The patient was treated with subcutaneous IFN-alpha at a dosage of 3 x 10(6) units three times weekly for 19 months. We thought that the treatment of IFN-alpha was safe and effective for the girl's clinical manifestations, and IFN-alpha might be a valuable first-line therapy for paediatric ECD.

Global IRS-1 phosphorylation analysis in insulin resistance

AIMS/HYPOTHESIS

IRS-1 serine phosphorylation is often elevated in insulin resistance models, but confirmation in vivo in humans is lacking. We therefore analysed IRS-1 phosphorylation in human muscle in vivo.

METHODS

We used HPLC-electrospray ionisation (ESI)-MS/MS to quantify IRS-1 phosphorylation basally and after insulin infusion in vastus lateralis muscle from lean healthy, obese non-diabetic and type 2 diabetic volunteers.

RESULTS

Basal Ser323 phosphorylation was increased in type 2 diabetic patients (2.1 ± 0.43, p ≤ 0.05, fold change vs lean controls). Thr495 phosphorylation was decreased in type 2 diabetic patients (p ≤ 0.05). Insulin increased IRS-1 phosphorylation at Ser527 (1.4 ± 0.17, p ≤ 0.01, fold change, 60 min after insulin infusion vs basal) and Ser531 (1.3 ± 0.16, p ≤ 0.01, fold change, 60 min after insulin infusion vs basal) in the lean controls and suppressed phosphorylation at Ser348 (0.56 ± 0.11, p ≤ 0.01, fold change, 240 min after insulin infusion vs basal), Thr446 (0.64 ± 0.16, p ≤ 0.05, fold change, 60 min after insulin infusion vs basal), Ser1100 (0.77 ± 0.22, p ≤ 0.05, fold change, 240 min after insulin infusion vs basal) and Ser1142 (1.3 ± 0.2, p ≤ 0.05, fold change, 60 min after insulin infusion vs basal).

CONCLUSIONS/INTERPRETATION

We conclude that, unlike some aspects of insulin signalling, the ability of insulin to increase or suppress certain IRS-1 phosphorylation sites is intact in insulin resistance. However, some IRS-1 phosphorylation sites do not respond to insulin, whereas other Ser/Thr phosphorylation sites are either increased or decreased in insulin resistance.

Increased abundance of the adaptor protein containing pleckstrin homology domain, phosphotyrosine binding domain and leucine zipper motif (APPL1) in patients with obesity and type 2 diabetes: evidence for altered adiponectin signalling

AIMS/HYPOTHESIS

The adiponectin signalling pathway is largely unknown, but recently the adaptor protein containing pleckstrin homology domain, phosphotyrosine binding domain and leucine zipper motif (APPL1), has been shown to interact directly with adiponectin receptor (ADIPOR)1. APPL1 is present in C2C12 myoblasts and mouse skeletal muscle, but its presence in human skeletal muscle has not been investigated.

METHODS

Samples from type 2 diabetic, and lean and non-diabetic obese participants were analysed by: immunoprecipitation and western blot; HPLC-electrospray ionisation (ESI)-mass spectrometry (MS) analysis; peak area analysis by MS; HPLC-ESI-MS/MS/MS analysis; and RT-PCR analysis of APPL1 mRNA.

RESULTS

Immunoprecipitation and western blot indicated a band specific to APPL1. Tryptic digestion and HPLC-ESI-MS analysis of whole-muscle homogenate APPL1 unambiguously identified APPL1 with 56% sequence coverage. Peak area analysis by MS validated western blot results, showing APPL1 levels to be significantly increased in type 2 diabetic and obese as compared with lean participants. Targeted phosphopeptide analysis by HPLC-ESI-MS/MS/MS showed that APPL1 was phosphorylated specifically on Ser(401). APPL1 mRNA expression was significantly increased in obese and type 2 diabetic participants as compared with lean participants. After bariatric surgery in morbidly obese participants with subsequent weight loss, skeletal muscle APPL1 abundance was significantly reduced (p < 0.05) in association with an increase in plasma adiponectin (p < 0.01), increased levels of ADIPOR1 (p < 0.05) and increased muscle AMP-activated protein kinase (AMPK) phosphorylation (p < 0.05).

CONCLUSIONS/INTERPRETATION

APPL1 abundance is significantly higher in type 2 diabetic muscle; APPL1 is phosphorylated in vivo on Ser(401). Improvements in hyperglycaemia and hypoadiponectinaemia following weight loss are associated with reduced skeletal muscle APPL1, and increased plasma adiponectin levels and muscle AMPK phosphorylation.

RKTG inhibits angiogenesis by suppressing MAPK-mediated autocrine VEGF signaling and is downregulated in clear-cell renal cell carcinoma

Vascular endothelial growth factors (VEGFs) are crucial regulators of angiogenesis and vasculogenesis. The autocrine VEGF signaling is required for maintaining the homeostasis of vasculature. Dysregulation of angiogenesis is implicated in the development of many human cancers, especially in clear-cell renal cell carcinoma (ccRCC), a highly vascularized tumor. Meanwhile, antiangiogenesis has become a mainstay in the treatment of human cancers. In this study, we analyzed the functional roles of RKTG (Raf Kinase Trapping to Golgi), a negative regulator of mitogen-activated protein kinase (Raf/MEK/ERK) signaling, by sequestration of Raf kinase to the Golgi apparatus, in angiogenesis and ccRCC. Through a series of in vitro and in vivo experiments, we found that RKTG has a negative effect on cell proliferation, migration, sprouting and angiogenesis of endothelial cells. RKTG, by suppressing mitogen-activated protein kinase signaling, negatively regulates the transactivation activity of hypoxia-inducible factor 1α (HIF-1α) by inhibiting formation of HIF-1α/p300 complex and suppressing VEGF transcription, thereby reducing hypoxia-induced VEGF production. The expression level of RKTG is significantly downregulated in clinical ccRCC tumor samples, with an inverse correlation with VEGF expression level. These results highlight the functional roles of RKTG and its regulated Raf/ERK/MEK signaling cascade in angiogenesis and autocrine VEGF signaling. In addition, this study indicates that RKTG is likely implicated in the development of ccRCC through its regulation on angiogenesis.

Human ATP synthase beta is phosphorylated at multiple sites and shows abnormal phosphorylation at specific sites in insulin-resistant muscle

AIMS/HYPOTHESIS

Insulin resistance in skeletal muscle is linked to mitochondrial dysfunction in obesity and type 2 diabetes. Emerging evidence indicates that reversible phosphorylation regulates oxidative phosphorylation (OxPhos) proteins. The aim of this study was to identify and quantify site-specific phosphorylation of the catalytic beta subunit of ATP synthase (ATPsyn-beta) and determine protein abundance of ATPsyn-beta and other OxPhos components in skeletal muscle from healthy and insulin-resistant individuals.

METHODS

Skeletal muscle biopsies were obtained from lean, healthy, obese, non-diabetic and type 2 diabetic volunteers (each group n = 10) for immunoblotting of proteins, and hypothesis-driven identification and quantification of phosphorylation sites on ATPsyn-beta using targeted nanospray tandem mass spectrometry. Volunteers were metabolically characterised by euglycaemic-hyperinsulinaemic clamps.

RESULTS

Seven phosphorylation sites were identified on ATPsyn-beta purified from human skeletal muscle. Obese individuals with and without type 2 diabetes were characterised by impaired insulin-stimulated glucose disposal rates, and showed a approximately 30% higher phosphorylation of ATPsyn-beta at Tyr361 and Thr213 (within the nucleotide-binding region of ATP synthase) as well as a coordinated downregulation of ATPsyn-beta protein and other OxPhos components. Insulin increased Tyr361 phosphorylation of ATPsyn-beta by approximately 50% in lean and healthy, but not insulin-resistant, individuals.

CONCLUSIONS/INTERPRETATION

These data demonstrate that ATPsyn-beta is phosphorylated at multiple sites in human skeletal muscle, and suggest that abnormal site-specific phosphorylation of ATPsyn-beta together with reduced content of OxPhos proteins contributes to mitochondrial dysfunction in insulin resistance. Further characterisation of phosphorylation of ATPsyn-beta may offer novel targets of treatment in human diseases with mitochondrial dysfunction, such as diabetes.

Organization of NMDA receptors at extrasynaptic locations

NMDA receptors are found in neurons both at synapses and in extrasynaptic locations. Extrasynaptic locations are poorly characterized. Here we used preembedding immunoperoxidase and postembedding immunogold electron microscopy and fluorescence light microscopy to characterize extrasynaptic NMDA receptor locations in dissociated hippocampal neurons in vitro and in the adult and postnatal hippocampus in vivo. We found that extrasynaptic NMDA receptors on neurons in vivo and in vitro were usually concentrated at points of contact with adjacent processes, which were mainly axons, axon terminals, or glia. Many of these contacts were shown to contain adhesion factors such as cadherin and catenin. We also found associations of extrasynaptic NMDA receptors with the membrane associated guanylate kinase (MAGUKs), postsynaptic density (PSD)-95 and SAP102. Developmental differences were also observed. At postnatal day 2 in vivo, extrasynaptic NMDA receptors could often be found at sites with distinct densities whereas dense material was seen only rarely at sites of extrasynaptic NMDA receptors in the adult hippocampus in vivo. This difference probably indicates that many sites of extrasynaptic NMDA receptors in early postnatal ages represent synapse formation or possibly sites for synapse elimination. At all ages, as suggested in both in vivo and in vitro studies, extrasynaptic NMDA receptors on dendrites or the sides of spines may form complexes with other proteins, in many cases, at stable associations with adjacent cell processes. These associations may facilitate unique functions for extrasynaptic NMDA receptors.

GLS/IL-12-modified Mycobacterium smegmatis as a novel anti-tuberculosis immunotherapeutic vaccine

OBJECTIVE

To study the effects and mechanisms of recombinant Mycobacterium smegmatis (rMS) carrying pZM03 (a co-expression plasmid encoding human granulysin [GLS] and murine interleukin 12 [IL-12]) on murine M. tuberculosis infection.

DESIGN

BALB/c mice infected with M. tuberculosis were treated with normal saline, M. smegmatis, pZM03 or rMS. The number of viable bacteria in the lungs and spleens were counted to observe the therapeutic effects. The levels of IL-12 and interferon-gamma (IFN-gamma) in serum, and IFN-gamma and tumour necrosis factor-alpha (TNF-alpha) released from spleen lymphocytes were detected to observe the T-helper 1 (Th1) response. Secretory IgA (SIgA) in bronchoalveolar lavage fluid was measured to observe the mucosal immunity. The lungs and spleens were prepared for pathological analysis.

RESULTS

The rMS group showed a significantly reduced number of colony-forming units compared to the other groups. The expression of GLS in the tissue, and increased levels of IL-12, IFN-gamma, TNF-alpha and SIgA, were found in the rMS group. The pathological changes in the lungs of the rMS group were localised, while those in the control group were extensive.

CONCLUSION

rMS had immunotherapeutic effects associated with a switch to the Th1 response and the antibacterial activity of GLS.

Association Study between Ntrk2 Gene Polymorphisms and Schizophrenia in Chinese Han People

Objective:

To explore the relationships between Neurotrophic Tyrosine Kinase Receptor Type 2 (NTRK2) gene polymorphisms and schizophrenia in Chinese Han population.

Methods:

The NTRK2SNPs rs1187272 were genotyped by applying polymerase chain reaction-restriction fragment length polymorphism (PCR-RLFP) technique in 100 patients with schizophrenia and 119 unrelated healthy controls, then the comparison of the alleles and genotypes frequencies of the NTRK2 gene between two groups was performed.

Results:

There were no significant difference in alleles（χ2=1.78, df=1, P>0.05）and genotypes（χ2=1.01, df=2, P>0.05） distribution of NTRK2 gene between patients and controls. There were also no significant difference in alleles（χ2=2.70, df=3, P>0.05）and genotypes（χ2=4.72, df=6, P>0.05） distribution among male and female patients and controls. There were significant difference in alleles（χ2=5.53, df=1, P=0.02）distribution between different first-onset age patients groups, There were also significant difference in alleles（χ2=4.38, df=1, P=0.04）distribution between schizophrenia with earlier first-onset age (≤25 years old) and control subjects.

Conclusion:

The NTRK2 gene was associated with schizophrenia with earlier first-onset age, and it may be one of common susceptible genes for schizophrenia in Chinese Han population.

Adsorption and surface rheology of n-dodecanol at the water/air interface

Adsorption layers of n-dodecanol at the water/air interface show phase transitions at low temperatures [Vollhardt, Fainerman, Emrich, J. Phys. Chem. B 104 (2000) 8536]. Using a drop shape technique it is shown that the dilational elasticity disappears in the coexistence region of the adsorption layer. The relaxation time between the condensed and liquid-like surface states is in the sub-second time range.

Prospects of vaccination as a means of preventing mother-to-child transmission of HIV-I

Although short-course antiretroviral therapy is efficient in reducing mother-to-child transmission (MTCT) of HIV-1, it does not prevent transmission during the breastfeeding period. There is therefore an urgent need to test various approaches, including HIV-1 vaccination, to try to prevent postnatal transmission of HIV-1 in breastfeeding populations in developing countries.

Trend of change in various kinds of nuclear families in China since the 1980s

"By using the latest data of 1% sampled data made in the Fourth Population Survey in 1990 and 1 [per 1,000], sampled data made in the Third Population Survey in 1982, we have attempted an analysis...of the trend of change of proportion among nuclear parents-families, separated-parents, single-parent and interval-generation families, as well as two-, three- and four-generation lineal and joint families in China during the 1980s, both as a nation and in all provinces, municipalities directly under the central government and autonomous regions."

[Preventive efficiency of IVIgG on nosocomial infection in the children with nephrotic syndrome]

In order to study the preventive efficiency of IVIgG on nosocomial infection(NI), 54 cases of the children with nephrotic syndrome(NS) were randomly divided into 2 groups, test group(n = 22) and control group(n = 32). Routine treatment was adopted to all cases. Besides the routine treatment, the test group was injected with IVIgG(100-300 mg.kg-1.d-1) for 2-3 days. The results showed that the NI rate of test group (13.6%) was significantly lower than that of the control(46.88%) (P < 0.05), and the hospital days of the test group(27.33 +/- 15.51) d was significantly shorter than that of the control(64.50 +/- 18.52) d (P < 0.05). These suggest that IVIgG, as one of the ways to prevent NI, can improve the immune state and effectively prevent the NI in the children with NS.

[Inhibitory effect of antisense c-myb cDNA on the growth of asynchronous glioma cells in vivo]

OBJECTIVE

To examine the therapeutic effect of oncogene c-myb antisense oligodeoxynucleotide (AON) on rat C6 glioma in vivo.

METHODS

C6 glioma cells were implanted into the subcutis of nude mice, the animals were randomly divided into three groups (12 mice respectively) when the tumor grew about 10 mm in size, and the mice with subcutaneous tumor foci were treated with sense oligodeoxynucleotide (SON), AON and normal saline. Three animals of each group were killed after treatment at 4, 8, 12 and 16 days respectively. The dynamic growth manifestations, features, histopathological changes and apoptosis of the glioma in each group were observed.

RESULTS

AON suppressed the growth of C6 glioma cells, the suppression rates being 66.7%, 71.4%, 72% and 73% at 4, 8, 12, 16 days respectively (P < 0.05). The changes in weight were concurrent with the variations of tumor volume, the tumor weight of AON groups was significantly decreased (P < 0.05). The immunohistochemical assay showed the expression of c-myb proto-oncogenes was significantly decreased in AON groups (P < 0.05). The flow cytometry analysis found the apoptosis cell percentage of AON groups to be 13.4%, 27.1%, 46.1% and 48.4% at 4, 8, 12 and 16 days respectively, and this percentage of AON groups was about 3.5 times the apoptosis cell percentage of SON and control groups at the corresponding time. In addition, noticeable inflammatory infiltration and calcification were observed after the treatment with AON.

CONCLUSION

The above findings indicate that c-myb gene might be associated with the suppression of carcinogenesis in brain glioma, and oncogene c-myb might be chosen as a target for antisense gene therapy of gliomas.

Effects of growth factors on insulin-like growth factor binding protein (IGFBP) secretion by primary porcine satellite cell cultures

Insulin-like growth factor-binding proteins (IGFBP) regulate the biological functions of insulin-like growth factors (IGF) and may affect cell growth through IGF-independent actions. Growth factors and hormones have been shown to alter IGFBP production by target cells suggesting that the effects of these factors may be partially mediated by the local production of IGFBP. Growth factors, including IGF-I, transforming growth factor-beta1 (TGF-beta1), and basic fibroblast growth factor (bFGF) have potent effects on satellite cell proliferation and differentiation, and some of these factors have been shown to alter IGFBP production in various cell types. Consequently, some of their actions on muscle satellite cells may be mediated by the local production of IGFBP. In this study, we measured the effects of IGF-I, bFGF, and TGF-beta1 on IGFBP production by primary porcine satellite cell (PSC) cultures after first determining physiologically active concentrations of these growth factors to use according to [3H]thymidine incorporation dose responses. There is little information on the effects of these growth factors on IGFBP production in primary porcine myogenic cells due to the confounding affects of contaminating nonmuscle fibroblasts. Comparative studies show that primary porcine satellite cells produce IGFBP-3 and -5 whereas porcine muscle-derived nonfusing cells (FIB) produce IGFBP-2 and -4 but not IGFBP-3 or -5. Because of this, our investigations have focused on growth factor-induced production of IGFBP-3 and -5 in primary porcine satellite cells cultures. Both IGF-I and bFGF exhibited dose-dependent increases in [3H]thymidine incorporation with increasing concentration from 1 to 50 ng/mL (P < 0.05), whereas TGF-beta1 caused a dose-dependent decrease from 0.01 to 0.5 ng/mL (P < 0.05). When 20 ng/ mL of IGF-I was added to the media, IGFBP-3 was increased approximately 65% (P < 0.05) and IGFBP-5 was increased approximately twofold (P < 0.05). The addition of 0.5 ng/mL TGF-beta1 caused more than a two-fold increase in IGFBP-3 (P < 0.05) and approximately an 80% increase in IGFBP-5 (P < 0.05), whereas 50 ng/ mL of bFGF caused approximately 40% (P < 0.05) and 70% (P < 0.05) increases in IGFBP-3 and -5, respectively. Neither IGFBP-3 nor -5 was detectable in the conditioned media from fibroblasts whether or not IGF-I, TGF- beta1 or bFGF were present. These data suggest that the effects of IGF-I, TGF- beta1 and bFGF on porcine satellite cells may in part be through the autocrine/ paracrine production of IGFBP-3 and -5 by porcine satellite cells.

[Herpesviridae and laryngeal neoplasia]

OBJECTIVE

To investigate the relationship between herpesviridae and malignant or benign laryngeal diseases.

METHOD

128 paraffin-embedded laryngeal squamous cell carcinoma and laryngeal epithelium hyperplastic lesions were detected by polymerase chain reaction (PCR) and PCR-ISH for herpesviridae.

RESULT

HSV-1 was detected in 10 cases by PCR, among them 3 were laryngeal squamous cell carcinoma (LSCC), 1 was carcinoma in situ(CIS), 4 were laryngeal polyps and 2 were laryngeal keratosis. Except 1 LSCC and 1 CIS 8 of 10 cases were positive while detected by PCR-ISH. In benign diseases, signals were shown from basal layer to superficial cell; in malignant lesions, the signals were scattered in the diseases.

CONCLUSION

Most of laryngeal diseases were not related to herpesviridae, but HSV-1 may acts as initiator in the development of a few cases.

[Human papilloma virus infection and expression of p16 protein in laryngeal papilloma and laryngeal carcinoma]

OBJECTIVE

To evaluate the role of human papilloma virus (HPV) infection and inactivation of p16 gene in laryngeal papilloma (LP) and laryngeal squamous cell carcinoma (LC).

METHODS

HPV consensus primers direct in situ polymerase chain reaction (ISPCR) and immunohistochemical method were applied to detect the presence of HPV genomes (1, 6, 8, 11, 13, 16, 18, 30, 31, 32, 33, 45, 51) and the expression of p16 protein respectively in 93 cases of formalin-fixed, paraffin-imbedded specimens, which contained 46 cases of LPs [adult-onset laryngeal papilloma (ALP) 21, juvenile-onset laryngeal papilloma (JLP)25], 26 cases of LCs, 6 cases of normal tissues adjacent to carcinoma, and 15 cases of vocal noduli.

RESULTS

(1) The difference of positive rates of HPV-DNA in JLP group (84%, 21/25) and other groups were statistically significant (chi 2 test, P < 0.05). The difference of positive rates of HPV-DNA in ALPs(38.1%, 8/21), in LCs(19.2%, 5/26), in vocal noduli(0%, 0/15), and in normal tissues adjacent to carcinoma(0%, 0/6) were not significant statistically (chi 2 test or Fisher's exact probability test, P > 0.05). (2) The positive rates of expression of p16 protein in ALP group(57.1%, 12/21) and LC group(38.5%, 10/26) were significantly lower than that in vocal nodule group(93.3%, 14/15), in JLP group(88%, 22/25), and in normal tissues adjacent to carcinoma group (100%, 6/6) (chi 2 test or Fisher's exact probability test, P > 0.05). There were no significant differences of positive rates of expression of p16 protein between ALP group and LC group, and between JLP group and vocal nodule group (chi 2 test, P > 0.05). (3) In LPs, the difference of positive rates of p16 protein expression between HPV positive cases and HPV negative cases was significant statistically (chi 2 test, P < 0.05). In LCs, there was no difference in p16 protein expression rate between the two teams(Fisher exact probability test, P > 0.05).

CONCLUSION

The pathogenesis of JLP is closely associated with HPV infection and not associated with the inactivation of p16 gene. Conversely, the pathogenesis of ALP and LC is associated with the inactivation of p16 gene and not associated with the HPV infection.

A sensitivity analysis of the Bongaarts-Feeney method for adjusting bias in observed period total fertility rates

Our sensitivity analysis shows that the adjusted TFR'(t) using the formula of Bongaarts and Feeney (1998), which assumes an invariant shape for the fertility schedule, usually does not differ significantly from an adjusted TFR"(t) that allows the shape of the fertility schedule to change at a constant annual rate. Because annual changes in the shape of the fertility schedules often are approximately constant except in abnormal conditions, the Bongaarts-Feeney (B-F) method is generally robust for producing reasonable estimates of the adjusted TFR'(t). The adjusted TFR'(t) neither represents any real cohort experiences from the past nor forecasts any future trend. It merely provides an improved reading of the period fertility measure, which reduces the tempo distortion.

Oncomelania hupensis (Gastropoda: rissooidea) in eastern China: molecular phylogeny, population structure, and ecology

The rissooidean snail genus Oncomelania is of medical interest as various taxa are hosts for the human blood fluke Schistosoma and the lung fluke Paragonimus; because of close co-evolved host-parasite-relationships, snail diversity may reflect parasite diversity. There is a considerable amount of confusion regarding the identity of smooth- and ribbed-shelled populations of Oncomelania hupensis in eastern China. We therefore studied the genetic variation, population structure, phylogenetic relationships and ecology of five smooth- and five ribbed-shelled populations in Hubei, Hunan, Anhui, Zhejiang, and Jiangsu provinces. Based on sequencing data of a fragment of the mitochondrial gene for cytochrome oxidase I from 80 individuals, we found little genetic variability within the ingroup-individuals studied here (average pi=0.01922). Moreover, within the ingroup, smooth-shelled individuals cluster together with ribbed-shelled individuals. We therefore consider all smooth- and ribbed-shelled populations of Oncomelania throughout the lower Yangtze River basin to belong to the subspecies O. hupensis hupensis. Our data indicate that ribbing in O. h. hupensis is associated with the annual floods of the Yangtze River. The greatest haplotype (d(H)) and nucleotide diversities (pi) are found in aggregates of ribbed-shelled snails along areas of the Yangtze River drainage subject to flooding. In areas not affected by flooding, the shells are smooth and genetic diversity decreases significantly.

The nature of juvenile nasopharyngeal angiofibroma

OBJECTIVE

The goal of this study was to investigate the nature of juvenile nasopharyngeal angiofibroma.

STUDY DESIGN

Twenty-five excised tumors were studied morphologically to confirm the histopathologic features of the tumor.

METHODS

Paraffin sections of all tumor specimens were stained with hematoxylin-eosin for elastic fiber, polyclonal antibody to factor VIII-related antigen and monoclonal antibodies to smooth muscle actin, estrogen receptor, and progesterone receptor. A quantitative assessment of the vascular component changes was also performed in 14 cases. Ultrathin sections of 5 tumors were studied electromicroscopically. Particular attention was paid to the progressive changes of both vascular and fibrous components as well as their mutual relationship.

RESULTS

(1) Beneath the endothelium of the vascular component, there was a thin layer of spindle cells; these cells had a positive reaction for smooth muscle actin, thus proving to be pericytes. (2) The actively proliferating site of the tumor was usually at the peripheral portion, with abundant vascular element lined by plump endothelial cells. (3) At the central and base locations, the growth of tumor tissue usually appeared to be in a relatively resting state. The vascular component decreased in amount as the extracellular collagenous fibers increased.

CONCLUSIONS

Because of the bicellular mixed composition of the vascular component and the tendency of synchronous maturation of both vascular and fibrous elements, it is suggested that juvenile nasopharyngeal angiofibroma is similar to most hemangiomas by nature and is likely a vascular hamartoma or a pathologic and reactive proliferation of vessels.

[Prenatal diagnosis of fetal congestive heart failure by color flow imaging and pulse Doppler ultrasound]

OBJECTIVE

To investigate prenatal diagnosis of fetal congestive heart failure (CHF) by Color Doppler Flow Imaging (CDFI) and pulse Doppler Ultrasound (PU).

METHODS

3,841 pregnant women were detected by ultrasound. Maternal-placental-fetal circulation surveillance by high resolution Doppler ultrasound was performed in 302 high-risk pregnancies. The diagnosis of CHF is dependent upon (1) The cardiac area/chest area ratio > 0.33; (2) An abnormal umbilical vein pulsation; and (3) Tricuspid regurgitation.

RESULTS

There were six deaths that all had abnormal umbilical vein pulsation and five cases who had C/T area ratio > 0.33. CHF accounted 0.17% in all the pregnancies and 2% in high-risk pregnancies.

CONCLUSIONS

The results suggest that blood velocity recording abnormal pulsed sign in the umbilical veins and C/T area ratio of the fetus can give valuable clinical information with regard to the presence of fetal CHF. Fetus with CHF almost always had poor outcome. CDFI and PU may have implications for fetal diagnostic work-up and prognosis.

[Otogenic hypertrophic cranial pachymeningitis associated with edema of the temporal lobe and organic mental disorder-case report]

OBJECTIVE

Hypertrophic cranial pachymeningitis(HCP) is a rare disease which might be misdiagnosed. One typical case of otogenic hypertrophic cranial pachymeningitis (HCP) associated with edema of the temporal lobe and organic mental disorder was reported. Literatures associated with HCP were reviewed for reference.

METHODS

In July, 1997, a 26-year-old man was admitted for right-sided severe headache, dizziness, nausea, vomiting, facial and abducens nerve palsy. MRI and CT revealed inflammation in the temporal bone and locally thickened dura mater with obvious enhancement as a band in the petrous apex and nearby tentorium cerebellum. The patient then underwent operation including decompression of the facial nerve, labyrinthectomy, and eradication of the inflammatory cells in the mastoid and petrous portion. Postoperatively, the clinical signs disappeared except hearing loss. Seven months later, the patient suffered from mental disorder with interrupted excitement to hit and abuse the family members. He was then treated in a psychosis hospital but no improvement could be seen. On May 13, 1998, MRI and the enhanced MRI demonstrated diffuse thickened tentorium cerebellum and dura mater in the middle cranial fossa. The inferior portion of the temporal lobe was obvious edema. The internal carotid artery was partially occluded due to the thickened wall of cavernous sinus.

RESULTS

Hence, the diagnosis of HCP associated with edema of temporal lobe and organic mental disorder was established. The patient was cured by high dosage of penicillin.

CONCLUSION

MRI is an essential method for diagnosis of HCP. Antibiotic was an effective treatment.

[The hereditary liability of otosclerosis and the strategies for treatment and prevention]

OBJECTIVE

Otosclerosis is a disease of hereditary liability. It might be related to an autosomal dominant inheritance. The genetic penetrance is determined by multifactorial influences. This paper was designed to study the reasonable strategies for prevention and treatment of this disease.

METHODS

A retrospective review derived from data of the management and follow-up of 14 cases in 6 families. According to the special pathological features of active phase of the otospongiosis, the suitable strategies for prevention and treatment of this disease were suggested.

RESULTS

Diagnosis of 14 cases were confirmed by audiological, operative and/or pathological examinations. Eleven of fourteen cases underwent stapedectomy, in which 10 cases had the surgery on the ear with severer hearing loss, and one case on both sides. In all of the surgical cases, hearing levels improved significantly. Three cases have not yet received the stapedectomy, in which two cases scheduled for the surgery are currently treated by chondroitin sulfate and one case refused the surgical treatment due to financial shortage.

CONCLUSION

Examination of the ear function at regular intervals (6-12 months) is recommended for the adults among the family members with high-incidence of otosclerosis. Audiological and radiological examination play an important role in early diagnosis and treatment. Attention should be paid to the medicine for management and prevention of this disease. Stapedectomy is an optimal choice for clinical otosclerosis not only due to its capacity to improve the hearing level but also to prevent the advance of hearing loss. Hearing aid is the suitable choice if stapedectomy is contraindicated.

[Relationship between clinical manifestation and pathology in pediatric renal diseases]

To elevate the clinical diagnosis and pathological compatibility of pediatric kidney diseases. Pathological changes from 101 cases of pediatric renal diseases were studied, covering 13 diseases entities, including glomerulo-nephritis, simple nephrotic syndrome, nephritic nephrotic syndrome etc. The technique of tru-cut biopsy under the guidance of B ultrasonogram was used in renal biopsy. The renal puncture biopsy was 100% satisfactory. Pathological changes involved 12 pathological types. MsPGN were the most commonly seen (39.6%), followed by MPGN and ICPGN (12.87% and 10.89%) respectively. It was found that children with similar clinical manifestation may possess different pathological changes, while the same pathological entity may present multiple clinical manifestation. The results suggest that renal biopsy pathological diagnosis is important in the diagnosis, treatment and prediction of prognosis in pediatric renal disease.

[The biological behavior of jugular glomus tumor and the perioperative management]

OBJECTIVE

Based on our experiences, the biological behavior and perioperative management of the jugular glomus tumor are introduced and discussed in order to prevent the possible mortality and morbidity.

METHODS

Five cases of jugular glomus tumor treated in our institute were reviewed. Laboratory examination, modern imaging techniques such as CT, MRI, 131I-MIBG, DSA, as well as embolization of the blood vessels and/or antihypertensive drugs were selectively used in the preoperative period.

RESULTS

Surgical removal of the tumors was successful in this group.

CONCLUSION

Perioperative management plays an important role in the prevention of surgical complications.

Reconstruction plates to bridge mandibular defects: a clinical and experimental investigation in biomechanical aspects

A retrospective study of 68 patients was carried out to assess the complications arising from the use of reconstruction plates in the maintainance of space and contour following mandibular segmental resection. Skin or mucosal perforation, plate fracture and loss of screw retention were the main complications. The most susceptible sites to screw loosening in the plates were situated nearest to and farthest from the resection margin on the proximal residual segments. Some of the possible causative biomechanical mechanisms of plate failure were studied using photoelastic models simulating the types of mandibular defect and plate fixation. Isochromatic fringe analysis was used to analyse stress lines in the bone surrounding screws. It was found that, during functional loading, moment and shear forces produced high concentrations of squeeze and press stress in this bone, causing bone resorption with consequent loss of screw retention.

Blood-compatibility of polyurethane/liquid crystal composite membranes

Polyurethane/liquid crystal composite membranes were first suggested to be used as biomaterials. In our work, three series of polyurethane/liquid crystal composite membranes based on three different kinds of liquid crystal compounds [N-(-4-methyoxybenzylidene)-4'-heptylaniline, 4-pentyl-4'-nitrile-biphenyl and cholesteryl oleyl carbonate] were prepared by casting on glass plates from a tetrahydrofuran (THF) solution of polymer and liquid crystal at room temperature. In our opinion, the formation of liquid crystal phase on the composite membrane surface is the basic requirement for getting better biomaterial. The result of this work is in accordance with our opinion. The effect of liquid crystal content on the formation of liquid crystal phase was identified by the observation of optical polarization microscopy (OPM). The results showed that the content of liquid crystal in composite membrane must be more than 30% (wt) in order to form liquid crystal phase on the composite membrane surface. The blood-compatibility of the composite membranes was assessed from SEM observation of the platelet's adhesion to membrane's surface, blood clotting time and haemolysis ratio. The observation of platelet's adhesion showed that the platelets gathered together on the pure polyurethane films, but the amount of platelets which were adherent on the surface covered by the liquid crystal phase was fewer than that of pure polyurethane film when platelet-rich plasma was allowed to be in contact with the membranes for 1 h at room temperature. The determination of blood clotting time and haemolysis ratio showed that these polyurethane/liquid crystal composite membranes, in which the content of liquid crystal was more than 30% (wt), appear to be beneficial in improving the blood compatibility and reducing the thrombogenicity.

[The diagnosis and treatment of bilateral congenital absence of stapes and oval window in two members of a family]

OBJECTIVE

To date, bilateral congenital absence of stapes and oval window in two members (elder brother and younger sister) of a family has not been reported previously in the literature to our knowledge. The etiology, diagnosis and management are hereby introduced and discussed.

METHODS

The diagnosis was based on history, audiological examinations, high resolution CT scanning and/or the operation. The modified Lempert's fenestration operation of the horizontal semicircular canal was performed on one ear each of the elder brother and the younger sister.

RESULTS

Postoperative hearing threshold was 25 dB for speech frequencies with a gain of 47dB for the elder brother, and hearing threshold of 28 dB with a gain of 52 dB for the younger sister. Following up one to eight years individually showed that their hearing gains were steady.

CONCLUSION

Patients' parents are relatives of first cousin and have two sons and one daughter. However, there are two family members suffered from bilateral congenital absence of stapes and oval window, and these malformations might be related to inheritance. Good bone conduction and Carhart's notches revealed bilaterally in the patients' audiograms. These are the important indications for diagnosis of this disease. The modified Lempert's fenestration operation of the horizontal semicircular canal is a safe and good choice for treatment.

Active participation of CCR5(+)CD8(+) T lymphocytes in the pathogenesis of liver injury in graft-versus-host disease

We examined the molecular pathogenesis of graft-versus-host disease-associated (GVHD-associated) liver injury in mice, focusing on the role of chemokines. At the second week after cell transfer in the parent-into-F1 model of GVHD, CD8(+) T cells -- especially donor-derived CD8(+) T cells -- infiltrated the liver, causing both portal hepatitis and nonsuppurative destructive cholangitis (NSDC). These migrating cells expressed CCR5. Moreover, macrophage inflammatory protein-1alpha (MIP-1alpha), one of the ligands for CCR5, was selectively expressed on intralobular bile duct epithelial cells, endothelial cells, and infiltrating macrophages and lymphocytes. Administration of anti-CCR5 antibody dramatically reduced the infiltration of CCR5(+)CD8(+) T lymphocytes into the liver, and consequently protected against liver damage in GVHD. The levels of Fas ligand (FasL) mRNA expression in the liver were also decreased by anti-CCR5 antibody treatment. Anti-MIP-1alpha antibody treatment also reduced liver injury. These results suggest that MIP-1alpha-induced migration of CCR5-expressing CD8(+) T cells into the portal areas of the liver plays a significant role in causing liver injury in GVHD; thus, CCR5 and its ligand may be the novel target molecules of therapeutic intervention of hepatic GVHD.

[Treatment of complex crainocervical junction malformation by transoccipito-cervical posterolateral approach]

OBJECTIVE

To report the treatment of six patients suffering from complex craniocervical junction (CCJ) malformation by transoccipitocervical posterolateral approach which is a new surgical method.

METHODS

Transoccipitocervical posterolateral approach was confirmed feasible by anatomy of the body. Diagnosis was made sure CT-three dimensional image and MRI for every patient. All cases reaived odontoidectomy and suboccipital decompression and/or bone graft.

RESULTS

All patients showed favorable outcome without deterioration or recurrence. Six patients were followed up for 15 - 10 months. All patients showed marked progressive improvement of neurological disturbances and three of them resumed work half a year after operation.

CONCLUSION

Transoccipitocervical posterolateral approach is a new surgical procedure by which anterior and posterior decompression of foramen magnun aria and bone graft (posterior craniocervical stabilization) could be fulfilled during one operation.

[Analysis of HPLC of isomers of nitrotoluene and nitrobenzoic acid]

Nitrotoluene and nitrobenzoic acid isomers were separated completely in less than 10 minutes by Kromasil C18 (200 mm x 4.6 mm i.d.), when V(CH3OH):V(H2O):V(THF) = 55:44:1 with beta-CD of 0.02 mol/L at flow rate of 2.0 mL/min (former 4 min) and 2.6 mL/min (later 6 min). Detector of UV-254 at 0.04 AUFS was used.

Genetic analysis of obese diabetes in the TSOD mouse

The molecular pathogenesis of diabetes remains poorly understood because of the genetic complexity of the disease. One possibly effective approach to elucidate the pathogenesis is to study an animal model with a similar phenotype. The TSOD (Tsumura, Suzuki, Obese Diabetes) mouse, a newly developed animal model, exhibits both diabetes and obesity with marked hyperinsulinemia and hypertrophy of the pancreatic islets and might represent a common form of obese type 2 diabetes in humans. Phenotypic characterization revealed that the TSOD mouse had both insulin resistance and impaired glucose-stimulated insulin secretion. A comprehensive genetic dissection of diabetes and obesity has been performed using F1 and F2 progeny between the TSOD and control BALB/cA strains. A genome-wide screen for loci linked to glucose homeostasis and body weight allowed us to map three quantitative trait loci (QTLs) involved in this disorder. The major genetic determinant of blood glucose levels was identified on chromosome 11. Furthermore, two independent QTLs involved in controlling body weight were found on chromosomes 1 and 2. The QTL on chromosome 2 also affected insulin levels significantly. Each QTL has distinct effects on different traits and a different mode of inheritance. Our study indicates that hyperglycemia and obesity are clearly controlled by distinct combinations of genetic loci in this mouse model and provides insights into the genetic basis of common forms of human type 2 diabetes with obesity.

[Changes and evaluation of indexes on treating ganyanghuafengzheng with cerebral infarction by tianlongxifeng granulae]

We used TIANLONGXIFENG granulae to treat the patients with GANYANGHUAFENGZHENG of cerebral infarction, and mobilely observed the contents of plasma norepinephrine, epinephrine, cortisol, thromboxane B2 and serum triiodothyroidoglobulin. The results showed that with the improvement of curative effect and the decrease of symptom scores, the contents of parameters mentioned above changed accordingly. It is suggested that these parameters may have value for diagnosis.

[Efficacy of tianlong xifeng granule (TXG) in the treatment of acute cerebral infarction of ganyanghuafengzheng]

In this article 412 patients with acute cerebral infarction of ganyanghuafengzheng are analyzed in order to compare the efficacy between TXG and xixian tongshuan pill(XTP). The patients were randomly divided into two groups: 305 patients in Group I were treated with TXG, and 107 patients in Group II treated with XTP. The results showed that the curative rate in Group I was 69.84%, while in Group II 46.73%. It is indicated that the efficacy of TXG is superior to that of XTP. No toxicity and side effect were found in the above two groups.

[Intraventricular central neurocytoma and literature review]

OBJECTIVE

To understand the characteristics of central neurocytoma.

METHODS

Two cases were confimmed operatively and pathologyically.

RESULTS

142 cases showed that the tumor is common in young people. It occurrs in the septum pellucidumor, the wall of third or lateral ventricle. Clinical symptom is intracranial hypertension. The diagnosis must depend on electromicroscope examination.

CONCLUSION

The tumor must be removed totally by microsurgery.

[Altered cytokeratin expression of the epidermoid formation in the tympanic cavity of human fetuses]

The epidermoid formation (EF) in the developing human fetal middle ear is believed to have relationship with congenital cholesteatoma. Sixteen EFs were included in this study, of which 15 were simple EFs and one was hyperplastic EF. Four cytokeratin antibodies PK, CK13, CK18, and CK19 were used in an ABC immunohistochemical technique to compare the expression of the cytokeratin in the EFs, middle ear mucosa and external acoustic meatus skin. The results showed that the simple EFs had the same staining pattern of middle ear mucosa for all four antibodies and were different from external acoustic meatus skin. It was suggested that the simple EFs do not have the properties of an epidermis. The hyperplastic EF had an altered cytokeratin expression comparing to that of the middle ear mucosa. The expression of CK19 disappeared in the structure while the normal middle ear mucosa nearby had a positive staining for this antibody. PK staining pattern, characterized by the more intensive in the surface layer of the EF, was similar to that of external acoustic meatus skin. It is suggested that hyperplastic EF may acquire certain properties of epidermis, and may develop into congenital cholesteatoma.