[Innominate osteotomy in the treatment of subluxation of hip in adult]

The symptomatic subluxation of hip is not uncommon in adults, and several kinds of surgical options are available. Twenty-six patients (26 hips) suffering from residual symptomatic subluxation of the hip were treated with innominate osteotomy during 1985 to 1991. The patients were followed-up for 4 to 9 years. The ages of the patients ranged from 22 to 38 years with an average of 26 years and 6 months. The duration of symptoms ranged from 3 to 6 years with an average of 3 years and 5 months. The pertinent prior diseases were the congenital dislocation of hip in 12 cases, Perthes disease in 10 cases, and in the remaining 4 cases, the causes were not identified. The indications for operative intervention were that presence of a reasonable articular cartilaginous space, a reasonable range of motion preserved and particularly a reasnable joint congruity must exist. A new method of re-alignment of the acetabulum was used to placing the ipsilateral foot on the contralateral thigh. The result was evaluated by the symptoms, the function of the hip and the radiographic findings. According to these criteria, the excellent results were obtained in 11 cases and the good result in 15 cases. It was suggested that the innominate osteotomy were also suitable for the treatment of residual symptomatic subluxation of hip in carefully selected adults and the new method of re-alignment of acetabulum was simple and effective.

[Synthesis and anti-influenza virus activities of heteropoly compounds containing rare earth elements]

Tungstoborate and tungstogermanate heteropoly compounds containing rare earth elements with the general formula K15[Ln(BW11O39)2].nH2O and K13[Ln(GeW11O39)2].nH2O, where Ln = La, Ce, Pr, Nd, Sm, have been synthesized and characterized by elemental analysis, IR, 183W NMR spectra. The results of experiments on cytotoxicity and anti-influenza virus activities using cell-cultivation method showed that four compounds among them exhibited good inhibitory effect on influenza virus.

The multi-channel VEP topographies in patients with late-stage glaucoma

PURPOSE

To study the clinical application of multi-channel VEP topographies in patients with late-stage glaucoma.

METHODS

The multi-channel checkerboard reversal VEP waves of 25 normal persons and 15 patients with late-stage glaucoma were recorded and analyzed, All patients were examined using Humphrey Field Analyzer. The VEP topographies of multi-channel VEP waves were shown by computer processing system.

RESULTS

In normal subjects, the topographies showed symmetric distribution to full-field pattern stimulation. In all patients with late-stage glaucoma, even whose visual field was severely damaged, multi-channel VEP could be recorded, All channels showed simple 'NPN' wave form, N1, N2 waves were not conspicuous, even both were lost, all channels showed the reduced amplitudes of P1 waves, and longer latency. The multi-channel VEP topographies showed irregular distribution, Some showed amplitude asymmetry, other limited or widespread, lateralized.

CONCLUSIONS

Despite the severely damaged visual field, the patients with late-stage glaucoma showed special multi-channel VEPs topographies, Multi-channel VEP topographies should be useful in following up patients suffering from late-stage glaucoma and studying visual processing in human brain.

[Human tongue carcinoma model established in nude mice by orthotopic transplantation and studies on its major biological properties]

OBJECTIVE

To establish clinically relevant animal model of human tongue carcinoma.

METHODS

Cell suspensions of human tongue squamous cell carcinoma cell line (Tca8113) were inoculated orthotopically into nude mice and the growing tumors were serially passaged by orthotopic transplantation. The oral cavity, mandible and neck of the nude mice were sectioned and examined histologically. The ultrastructure and chromosome of the tumors were also investigated.

RESULTS

1. The success rate of transplant was 90%. 2. The mouse-growing tumors exhibited the same identical properties as the donor tumor. 3. Human tongue cancer cells could grow in the homologous oral cavity site of nude mice, extended and metastasized to adjacent tissues and lymph node of the neck.

CONCLUSION

The model can be useful for evaluating biological behavior and new therapeutics for tongue cancer.

What controls tissue-specific expression of the IL-4 gene?

Interleukin-4 (IL-4) plays a central role in the pathogenesis of allergic inflammation by inducing Ig class switch to IgE. IL-4 is also the most potent factor that drives naive T helper (Th) cells to differentiate to the Th2 phenotype. Recently, efforts have been made to explore the molecular basis of the Th2-specific IL-4 expression in CD4 T cells. Transcription factors, such as GATA-3, NF-IL6 and c-Maf, were found to be preferentially expressed in Th2 cells and to play an important role in regulation of the IL-4 promoter activity. Yet, other transcription factors may be indirectly involved in Th2-specific expression of IL-4 even though they are present in both Th1 and Th2 cells. In conclusion, Th2-specific expression of the IL-4 gene appears to be controlled by a multi-factor-system.

[Identification of a pure culture of nodular endophyte from Coriaria nepalensis]

A Frankia-like strain, Cs146, was isolated from nodules of Coriaria nepalensis in southwest China. The isolate is an actinomycete with vesicles and sporangia borne on the hyphae, and shown to have an ability to nodulate the host plant. No aerial hyphae is formed, but the substrate hyphae are usually orange and produce soluble yellow pigment. Cs146 could grow quite slow at 28-30 degrees C on both liquid and solid media. However, the isolate is greatly different from other frankiae in physiology (intermediate physiologocal group between A and B trains), cell wall composition of characteristical amino acids (meso-DAP plus glycine) and whole cell sugar patterns (xylose plus little amount of galactose and arabinose). Cs146 thus appears to be a member of a distinct Frankia lineage.

In vitro effects of IL-12 and IL-2 on NK cells, cytokine release and clonogenic activity in myelodysplastic syndromes (MDS)

We evaluated the in vitro effects of IL-12, alone and in association with IL-2 on MDS bone marrow and peripheral blood cells. Thirty-six patients and 14 healthy subjects were studied. Natural killer-activity (NK-a) levels and lymphocyte immunophenotypes were determined in fresh bone marrow (BMMNC) and peripheral blood mononuclear cells (PBMNC), which then were resuspended in medium containing IL-2, IL-12 or IL-2 + IL-12 for 7 days. Re-evaluation of NK-a levels, lymphocyte immunophenotypes, clonogenic activity and cytokine release showed that, unlike IL-2, IL-12 did not significantly increase NK-a or CD3-/56+ cell levels in either bone marrow or peripheral blood; IL-2 + 12 led to a significant increase that fell between the values reached by each cytokine alone. IL-2 + 12 and, although to a lesser extent, also IL-12 alone induced the release of large amounts of gamma-IFN and alpha-TNF. In addition, the number of clusters particularly decreased in the samples treated with IL-2 + 12 and IL-12 alone. Clonogenic activity was not modified after stimulation with any of the treatment. These data suggest that IL-12 induces the release of inhibitory cytokines in normal as well as MDS cells and that it could be used in patients with elevated bone marrow blastosis.

In situ measurements of Raman scattering in clear ocean water

We have further developed and improved the prototype oceanic Fraunhofer line discriminator by using a well-protected fiber-optic-wire cable and in-water electronic housing. We conducted a series of in situ measurements in clear ocean water in the Florida Straits. By comparing the reduced data with the Monte Carlo simulation results, we verify the Raman scattering coefficient B(r) with an excitation wavelength at 488 nm to be 2.6 x 10(-4) m(-1) [Appl. Opt. 29, 71-84 (1990)], as opposed to 14.4 x 10(-4) m(-1) [Appl. Opt.14, 2116-2120 (1975)]. The wavelength dependence of the Raman scattering coefficient is found to have an insignificant effect on the in-water light field. We also discuss factors that lead to errors. This study can be used as a basis for inelastic light scattering in the radiative transfer theory and will allow other inelastic light, e.g., fluorescence, to be detected with in situ measurements.

[B-ultrasonographic diagnosis of emergency complications in lung cancer patients]

OBJECTIVES

To assess the value of B-ultrasonography in the diagnosis and treatment of emergency complications in lung cancer patients.

METHODS

Thirty-five patients with lung cancer who suffered from emergency conditions were examined with B-ultrasonography. Of the 35 cases, 5 had superior vena caval syndrome due to compression by a centrally located tumor mass in the right upper lobe; 10 had moderate to large accumulation of fluid in the pericardium with cardiac tamponade; 2 had metastasis to the myocardium and pericardium with acute hemorrhagic pericardial effusion; 20 had massive pleural effusion. The ultrasonographic features of these complications were described. Patients with pericardial or pleural effusion received intervention treatment with Elemen emulsion under B-ultrasound guidance.

RESULTS

Combined with systemic chemotherapy, in 4-week period, complications were temporarily ameliorated in 82.8% and became clinically stable in 8.5% of the cases. Treatment was of no effect in 8.5%.

CONCLUSION

B-ultrasonography is of value in the diagnosis of emergency complications of lung cancer and is of help to guide intervention treatment.

[An analysis of causes of death in 329 emergency cancer patients]

OBJECTIVE

To analyze the causes of death in cancer patients.

METHODS

In collection of 2,167 cancer cases coming to the emergency clinic, the causes of death were analyzed in 329 cases.

RESULTS

Of the 329 cases, 25.8% (85/329) was due to the cancer growth itself while 59.9% (197/329) was resulted from complications. Thirty-seven cases (11.2%) died within 12 h in the emergency clinic. Most of the deaths were seen in patients with cancer of the lung, stomach and liver. Infection, respiratory failure, shock, hemorrhage and cardiac attack were the causes of death. The first two causes accounted for 36.2% and 32.5% of the total deaths in this series, respectively.

CONCLUSION

Complications are the major causees of death. The importance of their proper prevention needs to be emphysized.

The strategy of prevention of blindness

OBJECT

To reduce the prevalence of blindness at 0.30% by 2,000 in our country.

METHODS

To realize the about goal effectively, the 4 aspects should be included. 1. Epidemiological survey of ocular diseases. 2. Measures of prevention and treatment of blindness. 3. Establishment of a primary network for the prevention and treatment of ocular diseases. 4. Strengthening the organizations for prevention of ocular diseases.

CONCLUSION

Restoration of eye sight can elevate people's health level, relieve the blind from sufferings and restore their work capacity. Launching a mass movement to prevent and treat blindness has significance in promoting both material and spiritual civilizations in our country.

[Treatment of liver or renal cyst by percutaneous injection of TH glue into the cyst cavities]

From April 1995 to May 1996, 32 cases of liver or renal cyts were detected by B ultra sound. Among them, TH glue was injected into the cyst to make it coagulated and occluded in 4 cases of liver cyst and 8 cases of renal cyst after intracapsular fluid was abstracted. The curative effect was good. The curative rate of single injection was 83.3%. The period of treatment and the curative rate were obviously different from the past methods. The present method is easy, quick, small wounded, few complicated and no toxic and side effects.

Hinge total knee replacement revisited

OBJECTIVE

To determine if aseptic loosening is a major problem in hinge total knee replacement.

DESIGN

A cohort study.

SETTING

A university-affiliated institute, specializing in elective orthopedic surgery.

PATIENTS

Fifty-eight patients, mainly those requiring revision, in whom the conditions were such that it was felt only a totally constrained implant was appropriate. In 7 patients the implant was press-fitted; in the remainder it was cemented. Five patients required fusion or revision, and 8 died less than 2 years after implantation, leaving 45 for review. Follow-up was 2 to 13 years.

INTERVENTION

Total knee replacement with a Guepar II prosthesis.

MAIN OUTCOME MEASURES

Radiolucency determined by the Cameron system and clinical scoring using the Hospital for Special Surgery system.

RESULTS

Of the cemented components, 91% of femoral stems were type IA (no lucency), 9% were type IB (partial lucency), with no type II or III lucency. Tibial lucency was 87% type IA and 13% type IB, with no type II or III lucency. Of the noncemented components, 58% of femoral components were type IA and 42% type IB. Tibial lucency was 71% type IA and 29% type IB. Lucency was mainly present in zones 1 and 2 adjacent to the knee. Clinical rating was 18% excellent, 20% good, 20% fair and 42% poor. Postoperative complications included infection (13%), aseptic loosening (7%), quadriceps lag (16%) and extensor mechanism problems (16%).

CONCLUSIONS

Aseptic loosening is an uncommon problem in hinge total knee replacement. The complication rate in cases of sufficient severity as to require a hinge replacement remains high. Current indications for a hinge prosthesis are anteroposterior instability with a very large flexion gap, complete absence of the collateral ligaments and complete absence of a functioning extensor mechanism.

p16 overexpression: a potential early indicator of transformation in ovarian carcinoma

OBJECTIVE

The recently cloned gene p16 (MST1) has been identified as a putative tumor suppressor gene that binds to CDK4 and CDK6 (cyclin-dependent kinases), preventing their interaction with cyclin D1 and thereby preventing cell cycle progression at the G1 stage. In addition, the p16 gene has been shown to have a high frequency of mutation in some tumor cell lines; however, it has also been shown that a much lower frequency of mutation occurs in primary tumors. This study investigated the mRNA expression level and mutation status of the p16 gene in ovarian tumors.

METHODS

We performed quantitative polymerase chain reaction and direct cDNA sequencing analysis. To confirm the p16 protein level in ovarian tumors, Western blotting and immunohistochemical staining were performed. Expression levels of mRNA for the p16 gene relative to the beta-tubulin gene were examined in 32 ovarian tumors (24 carcinomas, six low malignant potential tumors, and two benign tumors) and six normal ovaries.

RESULTS

The mRNA expression level of p16 was significantly elevated in 28 ovarian tumors (22 carcinomas, five low malignant potential tumors, and one benign tumor) compared with that of normal ovaries. Western blotting analysis and immunohistochemical staining confirmed elevated p16 protein levels in ovarian tumor samples. Among 32 ovarian tumors, cDNA sequencing of the p16 gene showed no p16 mutation resulting in a coding error, although one silent mutation and three polymorphisms were found.

CONCLUSIONS

Although p16 is seldom mutated in ovarian tumors, the overexpression of p16 in most ovarian tumor cases indicates a dysfunction in the regulatory complex for G1 arrest. Therefore, overexpression of p16 may be an important early event in the neoplastic transformation of the ovarian epithelium.

Differential ability of T cell subsets to undergo activation-induced cell death

Human T cell clones were analyzed for their susceptibility to activation-induced cell death (AICD) in response to CD3/T cell receptor ligation. AICD was observed only in Th1 clones and was Fas-mediated, whereas Th2 clones resisted AICD. Analysis of a panel of Th0 clones, characterized by their ability to secrete both Th1 and Th2 cytokines, revealed that this subset included both AICD-sensitive (type A) and -resistant (type B) clones. Resistance to AICD by Th2 and Th0-type B clones was not due to lack of expression of either Fas receptor or its ligand. Paradoxically, the AICD-resistant clones were susceptible to apoptosis when Fas receptor was directly ligated by anti-Fas antibodies. However, prior activation of the resistant clones by monoclonal antibodies to CD3/TCR complex induced resistance against Fas-mediated apoptosis. Thus, the Fas-FasL pathway is critical for the induction of AICD in T cells, and moreover this pathway can be negatively regulated in the AICD-resistant clones by signals that are generated from ligation of the CD3/TCR complex.

Characterization of constitutive and inducible transcription factors binding to the P2 NF-AT site in the human interleukin-4 promoter

Interleukin-4 (IL-4) is a pleiotropic immunomodulatory cytokine secreted by T helper 2 cells. The IL-4 promoter contains multiple sites with DNA sequences homologous to the IL-2 NF-AT binding site. One of these sites--the P2 site--located between -173 and -150 was previously found to be flanked by two octamer-like motifs. NF-ATp/c and octamer proteins were suggested to bind to this region and to cooperatively activate the promoter activity (Chuvpilo et al., 1993). To precisely analyze the P2-binding factors we used antibodies against NF-ATp, NF-ATc, Fos, Jun, Oct-1 and Oct-2 in EMSA. We show here that nuclear extracts from T-cells form two P2-binding complexes--a PMA/ionomycin-inducible and a constitutive one. The PMA/ionomycin-inducible complex contains NF-ATp/c, Fos and Jun. No octamer binding factors could be detected in either of the two complexes. Analysis of the precise DNA contact points of the two complexes showed that both complexes are formed in the center of the NF-AT consensus site. No DNA contact points could be detected in the octamer-like motif site. Furthermore, purified recombinant POU domains of Oct-1 and Oct-2 failed to bind to the P2 site, suggesting that this site is not an independent octamer-binding site. Therefore, the DNA sequence at -173 to -150 of the IL-4 promoter is a binding site for NF-ATp/c and AP-1. Octamer proteins are unlikely to cooperate with NF-ATp/c at this site.

Clinical significance of the immunohistochemical detection of p53 protein in endoscopic biopsy specimens

OBJECTIVE

To evaluate the utility of immunohistochemical staining of p53 expression in endoscopic biopsy specimens in clinical practice.

METHODS

Using a streptavidin-peroxidase (S-P) conjugate method with monoclonal p53 antibody Do-7, the expression of p53 was investigated immunohistochemically in 150 endoscopic biopsies and paired brushings from patients with benign and malignant gastric diseases. Among them, 22 cases with gastric carcinoma underwent the gastrectomy and the immunohistochemistry was repeated in the resected cancerous tissues of the same patient.

RESULTS

p53 expression in endoscopic specimens was detectable in 35.7% cases of gastric carcinoma (n = 70), 5.9% of gastric polyps (n = 17), 16.7% of gastric mucosal dysplasia (n = 18) and 4.0% of chronic atrophic gastritis (n = 25), but no protein expression was observed in cases of chronic active gastritis (n = 20). In 22 patients with tumor resection, 8 (36.4%) were identified with p53 expression in endoscopic specimens before surgery, while 10 (45.5%) were identified with the same expression in surgical specimens, the real positive rate was 80.0%, no false positives were observed in endoscopic specimens. Furthermore, p53 expression in gastric carcinoma was closely correlated with clinical stage and lymph nodes involvement, but did not correlate with histologic type.

CONCLUSIONS

Assay of p53 by immunohistochemistry in endoscopic biopsy specimens and brushings is an easy and reliable technique to assess p53 status in gastric carcinoma, and thus could serve as a marker to foresee the prognosis in these patients and assist in the diagnosis of malignancy before surgery. It may also be a valuable marker in screening patients with high risk of gastric carcinoma.

Differential interaction of nuclear factors with the PRE-I enhancer element of the human IL-4 promoter in different T cell subsets

The immunomodulatory cytokine IL-4 affects cells of most hemopoietic lineages. IL-4 is secreted by activated Th2 but not Th1 cells and plays a major role in the immune response by modulating the differentiation of naive Th cells toward the Th2 phenotype. We have previously identified an enhancer element, PRE-I, that is essential for the function of the human IL-4 promoter. To investigate the mechanisms responsible for tissue-specific expression of the IL-4 gene, we analyzed nuclear factors binding to the PRE-I site and compared the binding activities of these factors to the IL-4 promoter of Th1 and Th2 cells. We show that PRE-I interacts with PMA- and PMA/ionomycin-inducible, cyclosporin A-sensitive nuclear factors. Using anti-C/EBPbeta (NF-IL6), anti-C/EBPdelta (NF-IL6beta), anti-NF-ATc, anti-NF-ATp, anti-Fos, and anti-Jun Abs we demonstrate that the previously identified PRE-I binding factor POS-1 is composed of different transcription factors in different Th cell subsets. In the IL-4-producing Th0-like human Jurkat and mouse EL-4 cells, POS-1 (designated POS-1a) contains NF-IL6beta and Jun. In the mouse Th2 D10 cells and in the human Th2 clones, POS-1 (designated POS-1b) contains NF-IL6beta, Jun, and NF-ATc/p. In contrast, POS-1 was not found in nuclear extracts of human Th1 clones. These findings suggest that PRE-I may play a role in the differential regulation of IL-4 gene expression levels.

Differential interaction of nuclear factors with the PRE-I enhancer element of the human IL-4 promoter in different T cell subsets

The immunomodulatory cytokine IL-4 affects cells of most hemopoietic lineages. IL-4 is secreted by activated Th2 but not Th1 cells and plays a major role in the immune response by modulating the differentiation of naive Th cells toward the Th2 phenotype. We have previously identified an enhancer element, PRE-I, that is essential for the function of the human IL-4 promoter. To investigate the mechanisms responsible for tissue-specific expression of the IL-4 gene, we analyzed nuclear factors binding to the PRE-I site and compared the binding activities of these factors to the IL-4 promoter of Th1 and Th2 cells. We show that PRE-I interacts with PMA- and PMA/ionomycin-inducible, cyclosporin A-sensitive nuclear factors. Using anti-C/EBPbeta (NF-IL6), anti-C/EBPdelta (NF-IL6beta), anti-NF-ATc, anti-NF-ATp, anti-Fos, and anti-Jun Abs we demonstrate that the previously identified PRE-I binding factor POS-1 is composed of different transcription factors in different Th cell subsets. In the IL-4-producing Th0-like human Jurkat and mouse EL-4 cells, POS-1 (designated POS-1a) contains NF-IL6beta and Jun. In the mouse Th2 D10 cells and in the human Th2 clones, POS-1 (designated POS-1b) contains NF-IL6beta, Jun, and NF-ATc/p. In contrast, POS-1 was not found in nuclear extracts of human Th1 clones. These findings suggest that PRE-I may play a role in the differential regulation of IL-4 gene expression levels.

Superior dislocation of mandibular condyle into the middle cranial fossa. A case report

A case of superior dislocation of the mandibular condyle into the middle cranial fossa is presented. A modified method of reducing the mandibular condyle was used, and restitution of the perforated glenoid fossa was achieved by a combination of titanium plate and repair of the articular disk.