[Clinical xenotransplantation: current progress, problems and solutions]

Xenotansplantation has become a global focus because it may solve the formidable problems in allotransplantation, that is, the donor source. Hitherto clinical xenotransplantion has been in the stage of research with limited cases and unsatisfactory results. The difficulties which hinder the progress of xenotransplantation include: the ideal animal donor has not been found, it is rather difficult to control the rejections (hyperacute rejection, acute vascular rejection, perhaps acute cellular rejection and chronic rejection) after xenotransplantation compared with those after allotransplantation, some animal diseases might be transmitted to and do harm to human recipients, even the community. It is still unknown whether the functions of animal organs can substitute those of human organs permanently. Transgenic pigs on research and various measurements to suppress humoral and cellular immunity may be helpful in overcoming the problems of xenogeneic rejections. Animal diseases should be prevented, screened and treated, and animal models should be established to study the possibility of satisfactory working of animal organs in human body before clinical xenotransplantation is widely practised.

[National epidemiological study on obesity of children aged 0-7 years in China 1996]

OBJECTIVE

To study on obesity of children aged 0-7 years in 11 cities in 1996.

METHODS

The sampling size was 208, 513. The children were divided into 9 groups: birth-, 1 mo-, 6 mo-, 1 yr, 2 yr-, 3 yr, 4 yr-, 5 yr-, 6-7 yr.

RESULTS

The prevalence of overweight was 4.2% (M4.2%, F4.2%); and of obesity, 2.0%(M2.2% F1.9%). The obesity to overweight ratio (ORR) was 2.1%(M1.9%, F2.2%). The adiposity rebound age (ARA) was 5 years. The adiposity rebound ratio (ARR) was 3.2 for ARR1 (M2.9%, F.5%) and 2.0 for ARR2 (M1.7%, F2.4%) in obese children and 3.5 for ARR1 (M 3.5, F3.5) and 2.5 for ARR2 (M2.8, F2.8) in overweight children respectively. The secular trend of prevalence of childhood obesity during 1986-1996 showed that the prevalence of obesity increased annually at 9.1% (M10%, F8.7%).

CONCLUSION

The obesity has already been a severe health and social problem of preschool children in China. The increment of prevalence of obesity during 1986-1996 has been out of control. The earlier of ARA and the larger of OOR is an important risk factor of increasing of obesity. 1 year and 5 years after birth, predicted by ARR, are two critical periods of obesity control in preschool children in China.

Risk factors for nuclear opalescence in a longitudinal study. LSC Group. Longitudinal Study of Cataract

This study evaluated risk factors for increases in nuclear opacification of the lens in the Longitudinal Study of Cataract (1989-1993; Boston, Massachusetts), which included 764 participants. Baseline data on demographic, medical, and other risk factors were available from an earlier case-control study; follow-up visits were completed yearly over a 4-year period. The lens photographs taken at baseline and at each follow-up visit were graded using the Lens Opacities Classification System III protocol. Analyses evaluated which risk factors collected at baseline were related to increased nuclear opacification at follow-up. The MULCOX2 method, an extension of Cox regression for nested event-time data, was used to estimate the effects of the risk factors. This method accounted for the correlation between fellow eyes. Results showed that the risk of nuclear opacification increased with each year of age (relative risk (RR) = 1.07), white race (RR = 2.94), lower education (RR = 1.50), use of gout medications (RR = 2.32), current smoking (RR = 1.58), family history of cataract (RR = 1.39), and preexisting posterior subcapsular opacities (RR = 6.67). An association with early use of eyeglasses was also suggested (RR = 1.37). In conclusion, nuclear opacification was related to demographic and other variables, including potentially modifiable factors such as current smoking and use of gout medications. Most risk factors identified by this longitudinal study confirm those found by the original case-control study. The increased risk of nuclear opacities in whites appears to be a new finding.

[One-stage vagina reconstruction using the pudendal-thigh skin flap]

OBJECTIVE

This is to introduce a method for vagina reconstruction using the pudendal-thigh skin flap.

METHODS

The pudendal-thigh skin flap has been used for vagina reconstruction in 70 cases since 1989.

RESULTS

All the operations were successful and the method has become a mature technique.

CONCLUSION

The advantages of the method are 1. the reconstructed vagina has good sensation and stable in maintaining its dimensions; 2. the linear scars of the donor site are hidden and inconspicuous; 3. the appearance of the perineum looks well; 4. the procedure is simple and favors its application.

Incidence and progression of cortical and posterior subcapsular opacities: the Longitudinal Study of Cataract. The LSC Group

OBJECTIVE

The purpose of the study is to estimate incidence and progression rates of cortical and posterior subcapsular (PSC) opacities in the Longitudinal Study of Cataract (LSC).

DESIGN

An epidemiologic study of the natural history of lens opacities in a clinic-based population.

PARTICIPANTS

The LSC was based on 764 participants in an earlier case-control study of lens opacities.

MAIN OUTCOME MEASURES

Baseline data, collected until 1988, included color slit and retroillumination photographs. The same data were collected at follow-up visits from 1989 to 1993. The Lens Opacities Classification System III (LOCS III) was used to assess lens changes between baseline and follow-up photographs. The product-limit method was used to estimate the incidence and progression rates.

RESULTS

After 5 years of follow-up, the incidence rates for developing cortical and PSC opacities were 7.7% and 4.3%, respectively. The progression rate of pre-existing cortical opacities was 16.2% after 5 years, and was twice as high as the incidence rate. The progression of pre-existing PSC opacities was much higher, and reached 55.1% after 5 years of follow-up. The incidence of newly developed cortical or PSC opacities increased with age. The incidence of PSC opacities also increased when coexisting opacities were present at baseline.

CONCLUSIONS

After 5 years, 1 in every 13 patients developed new cortical opacities, and 1 in 24 developed new PSC opacities. The 5-year progression rates for cortical and PSC opacities were much higher than the incidence rates. These results can be used to estimate the rate of cortical and PSC changes in similar populations.

Photothermal lensing detection: theory and experiment

Photothermal lensing signal shapes are experimentally investigated and compared with those predicted theoretically in our earlier paper. The investigation included flowing and stationary media and pulsed and cw excitations. Good qualitative agreement between theory and experiment is found. Since the lensing signal is almost always accompanied by a deflection signal, the influence of the deflection signal on the detection of lensing signal is investigated. For a perfectly aligned detection geometry the influence of the deflection signal on the lensing signal is negligible, but in the presence of misalignments a significant amount of deflection signal could be superimposed on the lensing signal. The effect of lensing on the deflection signal is also been considered. The effect of the finite size of the probe beam on the lensing signals is also investigated.

[R wave relative oscillometric blood pressure measurement]

To improve the accuracy of oscillometric blood pressure measurement, an artifact rejection method for oscillations detection called R wave-relative method was developed. It was mainly based on the correlation between ECG R wave and oscillation. Combining with identification of oscillation characteristics this method can distinguish valid signals from interference. This algorithm has been implemented in 8098 microcontroller. Its program flowchart has also been presented in this paper.

Safety and efficacy of angiography-guided stent placement in small native coronary arteries of < 3.0 mm in diameter

BACKGROUND AND HYPOTHESIS

Increased operator experience, greater insight in stent deployment techniques, and improved poststent medication regimen have significantly reduced the risk of thrombotic stent closure following stent placement in large coronary arteries (> or = 3.0 mm in diameter). Whether equally favorable results are afforded by stent placement in small vessels (< 3.0 mm), however, remains unclear. Accordingly, the aim of this study was the specific examination of the risk of stent placement in small native coronary vessels, using stent deployment technique consisting of supplementary dilatations with larger balloons or high-pressure inflations, and aggressive aspirin-ticlopidine and short-term oral anticoagulation poststent therapy.

METHODS

Forty-seven balloon-expandable stents (20 Gianturco-Roubin, 21 NIR, 6 Palmaz-Schatz) were successfully implanted without intravascular guidance in 45 native coronary arteries (mean reference diameter of 2.5 mm) in 44 consecutive patients (31 men, 13 men), the majority of whom (87%) were stented for the treatment of failed or suboptimal balloon angioplasty outcome.

RESULTS

Successful stent placement reduced the lesion diameter stenosis from 91 +/- 9% to 3 +/- 7% (p = 0.0001). There were no early stent thrombosis or major cardiovascular events prior to hospital discharge. During a 12-month follow-up period, most patients remained symptomatically improved and no myocardial infarction, stroke, or death was observed. Five-month angiographic reassessment revealed an in-stent restenosis rate of 41%, which was higher in vessels < or = 2.5 mm in size (47 vs. 33% for vessels > 2.5 mm, p = 0.2747).

CONCLUSIONS

In selected patients with small native coronary vessels < 3.0 mm in diameter, angiography-guided optimal stent placement is associated with a low risk of stent thrombosis and bleeding complications. However, the in-stent restenosis rate is high with the stents used in this study.

Modulation of actin filament behavior by GAP-43 (neuromodulin) is dependent on the phosphorylation status of serine 41, the protein kinase C site

Synthesis of GAP-43 (also known as neuromodulin) in neurons is induced during axon growth, and high concentrations (estimated between 50 and 100 microM) accumulate in the growth cone. GAP-43 is tightly associated with the growth cone membrane skeleton, the structure that transduces extracellular guidance cues into alterations in morphology by spatially regulating polymerization of actin filaments, thereby causing directional changes in axon growth. GAP-43 cosediments with actin filaments, and its phosphorylation on serine 41 by PKC, too, is spatially regulated so that phosphorylated GAP-43 is found in areas where growth cones make productive, stable contacts with other cells. In contrast, unphosphorylated GAP-43, which binds calmodulin, is always found in parts of the growth cone that are retracting. Here we have used a cell-free assay to investigate how the phosphorylation status of GAP-43 affects its interactions with actin and show that both phosphorylated and unphosphorylated GAP-43 have different, independent effects on actin filament structure. Phosphorylated GAP-43 stabilizes long actin filaments (Kd = 161 nM), and antibodies to phosphorylated GAP-43 inhibit binding of actin to phalloidin, implying a lateral interaction with filaments. In contrast, unphosphorylated GAP-43 reduces filament length distribution (Kd = 1.2 microM) and increases the critical concentration for polymerization. Prebinding calmodulin potentiates this effect. The results show that spatially regulated post-translational modifications of GAP-43 within the growth cone, which can be regulated in response to extracellular signals, have the ability to directly influence the structure of the actin cytoskeleton.

[Ocular socket plasty with orbital implant of hydroxyapatite]

OBJECTIVE

To evaluate the clinical effect of a new surgical procedure to reconstruct socket with sclera-encapsulated hydroxyapatite after enucleation and evisceration.

METHODS

Hydroxyapatite spheres were implanted primarily into auto-sclera capsule in 41 cases. Secondary implantation was performed with heterosclera-encapsulated ones in 9 cases.

RESULTS

No inflammation, implant extrusion and implant dislocation occurred in 7-23 months (mean = 15.6 months) of follow-up.

CONCLUSION

Satisfactory prothetic motility was obtained in all cases.

Effects of the cholecystokinin agonist pentagastrin in patients with generalized anxiety disorder

OBJECTIVE

The anxiogenic and panicogenic effects of peripheral administration of the cholecystokinin-B receptor agonist pentagastrin and placebo were evaluated in patients with generalized anxiety disorder and normal comparison subjects.

METHODS

Seven patients with generalized anxiety disorder and seven age- and sex-matched normal subjects received an intravenous bolus of placebo and pentagastrin.

RESULTS

Panic attacks occurred in five patients with generalized anxiety disorder (71%) and in one normal subject (14%). Patients with generalized anxiety disorder were more likely to report more nonpanic anxiety than were normal subjects.

CONCLUSIONS

Patients with generalized anxiety disorder appear to exhibit greater subjective sensitivity to pentagastrin than do normal subjects.

[The expression of MLC2-chymase fusion gene in cultured neonatal myocardial cells]

A series of MLC2-chymase fusion genes consisting of nested 5' deletion of the chymase promoter region were constructed and transfected into primary cultured neonatal Wistar rat myocardial cells according to the modified calcium phosphate precipitation method. Total RNA Dot-blot hybridization and analysis of densitometric scanning demonstrated that MLC2 promoter is enough to direct human heart chymase gene transcription in cultured neonatal rat myocardial cells. The highest level of expression was found with the MLC2-chymase construct containing 6 bp of the chymase promoter region. More sequence of the chymase promoter region between MLC2 promoter and the ATG of chymase gene resulted in a subsequent decrease in the expression of human heart chymase gene.

Theory of photothermal spectroscopy in an optically dense fluid

The theory of photothermal spectroscopy in an optically dense fluid is presented. The general case is considered in which the fluid may be flowing or stationary, and the excitation could be cw (modulated or unmodulated) or pulsed (arbitrary pulse length). All three detection schemes, deflection, phase shift, and lensing, are considered. This is the most complete theory of photothermal spectroscopy in fluids to date.

[The development of a fluid percussion device for brain injury of animals]

This paper discusses a fluid percussion device for brain injury. The injury is produced by striking the cork with a pendulum dropped from a known fall height to produce transient high pressure through a fluid transfer system. Experimental results show the device has the advantages of making a controllable, repeatable, and precise injury, and it can produce different levels of injury on different animals.

Epidemiology and prevention of pertussis

Pertussis continues to be a common cause of morbidity and mortality in unimmunized young children. In immunized populations, the disease remains endemic and epidemic. Reports of pertussis infection in older children and adults are increasing, and the data indicate that lifelong immunity from either pertussis immunization or childhood pertussis does not exist, which stresses the importance of continued booster immunization in this population. The less reactogenic acellular pertussis vaccines, which may provide protection equal to or even better than that provided by currently used whole-cell vaccines, seem to be suitable not only for primary immunization but also for boostering in all age groups. This review focuses on some recent developments in the epidemiology and prevention of pertussis infection.

Delivery of liposome-sequestered hydrophobic proteins to lysosomes of normal and Batten disease cells

We have developed a method to deliver hydrophobic proteins such as ATP synthase subunit c and ubiquitin to lysosomes of PMN (polymorphonucleocytes) and fibroblasts. ATP synthase subunit c is stored in the lysosomes of various tissues in late infantile and juvenile forms of neuronal ceriod lipofuscinosis, also called Batten disease (BD). Whether this protein storage is due to an abbreviation in protein or in the lysosomal hydrolases of BD is still not clear. We have sequestered this protein and ubiquitin in the lipid membrane of liposomes. The liposomes coated with autologous heat-aggregated IgG or apolipoprotein E when presented to the PMN and fibroblasts, respectively, accumulated in the lysosomes. Both normal and BD PMN degraded 125I-ubiquitin; the rate of degradation was, however, slower by Batten PMN. These studies indicate that a hydrophobic molecule such as subunit c can be delivered to PMN and fibroblasts, and the sequestered proteins are accessible to lysosomal hydrolases. Therefore, this technique can be used to study the metabolism of highly hydrophobic proteins by lysosomes, especially the biochemical mechanism(s) of subunit c storage in BD.

[Experimental and clinical study on the blood supply of the subdermal vascular network island flap]

A comparison study on the blood supply of the buttock subdermal vascular network island skin flap and the conventional buttock island flap was undertaken in pigs. The former was created by thinning the distal half of the conventional buttock island flap, preserving the subdermal vascular network. Evaluation was made by measurement of skin temperature, laser Doppler, fluorescence stain, ink perfusion, microangiography and transparent specimen technique. It was found that the blood supply of the subdermal vascular network island skin flap was much lower than that of the conventional island flap. The reason was thought to be the change in the blood supply after the conventional island flap was thinned. The subdermal vascular network island skin flap was composed of the axial pattern and the random pattern. Fifteen subdermal vascular network island skin flaps have been successfully transferred with vessel anastomosis in 15 patients. The average area of the thinned distal part was 49% of the flap, with the maximum of 60%.

Kinetics of G1/S and G2/M transition in X-irradiated ataxia-telangiectasia cells

Cell cycle transition defects of homozygous ataxia-telangiectasia (A-T) cells were studied by using a cell cycle flow calculation method, which evaluates the dynamics of cell cycle traverse. We compared five human lymphoblastoid cell lines (LCLs) from A-T homozygotes belonging to complementation group A (ARO, BRO, RJO) and group C (CSA, BMA) with three cell lines from healthy volunteers (KK-B2, MTB, HGL). The A-T cell lines ARO and BRO were derived from the same family. Cell growth and cell cycle traverse were followed for 72 h after X-irradiation with 1-6 Gy. LCLs from healthy volunteers immediately arrested in G1 in a dose-dependent pattern, while the A-T cells did not arrest in G1 until after 12 to 24 h. The time for the appearance of the G1 arrest of these cells was independent of complementation group. The delayed G1 arrest seen in the A-T cells paralleled a lack of induction of p53, as described by others. In respect to G2 arrest, A-T cells from complementation group C (CSA, BMA) arrested to the same extent as cells from healthy volunteers. On the other hand, the other LCLs from complementation group A arrested normally, while cells from ARO and BRO did not arrest in G2. The lack of G2 arrest in BRO cells was accompanied by unchanged cdc2p34 activity. In summary, a defective radiation-induced G1 arrest seems to be present in both complementation groups of A-T homozygotes, whereas a defective G2 arrest in not always observed. The defective G1 arrest seen in A-T cells may play an important role in tumor cell survival after exposure to therapeutic irradiation.

Impact of polymerase chain reaction on clinical pertussis research: Finnish and Swiss experiences

Since April 1993 in Finland and March 1994 in Switzerland, polymerase chain reaction (PCR) has been used routinely nationwide for the diagnosis of pertussis. Nasopharyngeal specimens from 3794 patients suspected of having pertussis and 1125 controls were tested. Finnish and Swiss assays found 23% and 36% of clinical specimens positive, respectively. PCR showed a higher incidence of pertussis infection among 1- to 6-year-old children in Switzerland than in Finland (P < .001). This difference may be due to the booster dose of vaccine given at 2 years of age in Finland but not in Switzerland. In Finland, PCR-confirmed asymptomatic cases were more common among children <7 years old than in older children (P < .001), whereas older children tended to have symptomatic infection. The use of PCR markedly improves the diagnosis of pertussis and opens new perspectives for epidemiologic and vaccine efficacy studies.

Analyses of reported family history of glaucoma: a preliminary investigation. The Barbados Eye Study Group

This study investigated the self-reported family history of open-angle glaucoma (OAG) among 4,314 black participants in the Barbados Eye Study (BES), which was based on a random sample of Barbados-born citizens between 40 and 84 years of age. Data collection included Humphrey perimetry, fundus photography, various ophthalmic and other measurements and a comprehensive interview, including family history. Results showed that participants with OAG and previous OAG treatment reported more family history; maternal history was reported twice as often as paternal history. In persons without previous OAG treatment, those with newly diagnosed OAG reported more sibling history (Odds Ratio = 4.5). The Statistical Analysis for Genetic Epidemiology (S.A.G.E.) system was used to test the transmission models for OAG in a subset of 1,048 families (5,806 individuals) with the most complete self-reported family information. The S.A.G.E. results are consistent with the existence of a major dominant allele for OAG. These results should be viewed as promising, but preliminary, since they are based on self-reported data. More definitive information is currently being collected by the Barbados Family Study of Open-angle Glaucoma.