[Analysis of traditional Chinese medicine syndrome, traditional Chinese medicine and western medicine in 84 697 patients with coronary heart disease based on big data]

In order to understand the clinical characteristics of patients with coronary heart disease (CHD) in real world and provide reference for clinical prevention and treatment, this study analyzed informations of patient with CHD in hospital information system. Data from 17 national hospitals were collected. Select patients with coronaryheart disease in diagnosis of the first place in 17 hospitals, general informations and traditional Chinese medicine (TCM) syndrome, complications, medicine were analyzed using frequency method and association rules. This study included 84 697 patients with CHD, the majority of men and in the elderly. The average age of patients was 71 years. The proportion of men to women was about 1. 45: 1. Hospital stay time ranged from 8 to 14 d. The most common total hospitalization cost distribution was 5 000-20 000 RMB. Young patients have a rising trend year by year. The death of patients increased with increasing age. Common complications were hypertension, diabetes, cerebral infarction and hyperlipidemia, 57.24 percent of the CHD patient complicated with hypertension, 21.94 percent patients complicated with diabetes. Among TCM syndrome types, Qi-Yin deficiency and qi deficiency blood stasis were the most common syndromes. Blood stasis was the highest syndrome elements, accounted for 79.97%, followed by Qi deficiency, phlegm, Yin deficiency, and so on. The most common western medicine was aspirin, followed with isosorbide dinitrate, clopidogrel. The most common used traditional Chinese medicine was danhong injection, followed by shuxuetong injection. Combined with removing blood stasis drugs has been more common at present clinical treatment, there were 43.46 percent of patients combined with anti-platelet western drug and injection of removing blood stasis.

[Analysis of real-world use different treatment shuxuetong injection effects on liver and kidney function]

OBJECTIVE

To understand the real world, the use of ultra- treatment Shuxuetong injection on liver and kidney functions are affected.

METHOD

The 18 hospitals of the country's HIS data sources from which to choose to use Shuxuetong injection, between the ages of 18 to 80 years, using Shuxuetong and the first seven days after discontinuation of at least 7 days has once aspartate aminotransferase or alanine aminotransferase, or creatinine or blood urea nitrogen were measured value as a research object, the number of days of medication is based on more than 14 days, divided into treatment group and the normal course of super-group to reach the normal range of physical and chemical indicators 200% of the upper limit is defined as abnormal. Using the propensity score method, balance the known confounding factors, differences in the occurrence of abnormal renal function and compared between the two groups.

RESULT

The treatment group and the normal course of super-group, resulting in alanine aminotransferase, aspartate aminotransferase, creatinine, urea nitrogen equally likely targets abnormal changes, no statistically significant difference.

CONCLUSION

Based on the available data did not find "super treatment using Shuxuetong damage the liver and kidney function" the situation, but the clinical disease lasts insist on the principle can not be arbitrarily extended treatment to prevent long-term medication.

Development and validation of a sensitive liquid chromatography-tandem mass spectrometry method for the determination of naringin and its metabolite, naringenin, in human plasma

A sensitive and specific method was developed for the simultaneous determination of naringin and its metabolite, naringenin, in human plasma by liquid chromatography-tandem mass spectrometry. Hesperidin was used as the internal standard, plasma samples were extracted with ethyl acetate and the analytes were chromatographically separated by using acetonitrile-0.1% formic acid (gradient elution) as the mobile phase. Detection was performed by electrospray ionization mass spectrometry in negative ion mode with multiple reaction monitoring. The lower limit of quantification was 0.5 ng/mL for naringin and naringenin and the linear calibration curves ranged from 0.5 to 200 ng/mL. The intra-run and inter-run precision values were within 8.6 and 7.7% for naringin and between 13.1 and 10.3% for naringenin. The accuracy ranged from 91.3 to 98.2% for naringin and from 90.2 to 97.6 % for naringenin. The validated method was successfully applied to determine concentrations of naringin and naringenin in clinical patients.

First Report of Colletotrichum fructicola Causing Bitter Rot of Pear (Pyrus bretschneideri) in China

Pyrus bretschneideri cv. Dangshansuli is the most important commercial Asiatic pear cultivar worldwide. In recent years, a fruit rot disease of unknown etiology have caused considerable fresh market losses in the 'Dangshansuli' production operations in Dangshan county, Anhui Province, China. Fresh market losses typically range from 60 to 90% and in 2008 were estimated at US$150 million. Symptomatic mature 'Dangshansuli' pears were collected from an orchard in Dangshan County in February 2008. A thin section (about 1 mm³) of symptomatic tissue was sterilized in a bleach and placed on potato dextrose agar (PDA) medium for isolation. From all fruit, a single fungus was recovered displaying gray-white dense aerial mycelium. Identical fungi were isolated from six additional symptomatic 'Dangshansuli' pears collected from other orchards in the county. Pathogenicity tests using one isolate (DS-0) were conducted in triplicate by placing 4 mm diameter discs from 7-day-old PDA plates onto the mature 'Dangshansuli' pear fruit that were incubated in an incubator at 25°C with a 12-h photoperiod for 30 days. An equal number of noncolonized PDA inoculations were included as a control. Isolate DS-0 caused symptoms similar to those in the field within 7 days and complete collapse of cortical tissues within 30 days. No symptoms were observed on control fruit. Round brownish lesions with a diameter of about 3 cm on inoculated fruit was populated by sunken, rotiform acervuli on which numerous, colorless, oblong single cell shape conidia with width/length of 6 × 20 μm were produced. A comparison of morphology and sequence analysis of the ribosomal internal transcribed spacer (ITS) regions in pre- and post-inoculation cultures from inoculated fruit confirmed the presence DS-0. To further characterize DS-0, aliquots of extracted genomic DNA from the fungus were subjected to PCR amplification and sequencing of seven gene regions from the ITS, actin (ACT), β-tubulin 2 (TUB2), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), manganese-superoxide dismutase (SOD2), chitin synthase (CHS-1), and calmodulin (CAL), using the primers listed by Weir et al (4), except for the primer pair of ITS1 (5'-TCCGTAGGTGAACCTGCGG-3') and ITS4 (5'-TCCTCCGCTTATTGATATGC-3') for ITS amplification, and SODglo2-R (5'-TAGTACGCGTGCTCGGACAT-3') and SODglo2-R (5'-TAGTACGCGTGCTCGGACAT-3') for TBU2 amplification. Two or three clones of PCR products of each gene were sequenced and compared (GenBank Accession Nos. KC410780 to KC410786) to published data at http://www.cbs.knaw.nl/colletotrichum . The result indicated that DS-0 shared the highest similarity of 99.91% with Colletotrichum fructicola, corroborating numerous reports of Colletotrichum spp. causing bitter rot of pear on P. pyrifolia (1,2,3,4). C. fructicola was only recently reported as causing bitter rot of P. pyrifolia (4) and to our knowledge, this is the first report of C. fructicola causing bitter rot of P. bretschneideri, which will help producers select the best management practices for this devastating disease. References: (1) P. F. Cannon et al. Stud. Mycol. 73:181, 2012. (2) N. Tashiro et al. J. Gen. Plant Pathol. 78:221, 2012. (3) G. K. Wan et al. Mycobiology 35:238, 2007. (4) B. S. Weir et al. Stud. Mycol. 73:115, 2012.

Cardiac differentiation of human pluripotent stem cells

Due to the extremely limited proliferative capacity of adult cardiomyocytes, human embryonic (pluripotent) stem cell derived cardiomyocytes (hESC-CMs) are currently almost the only reliable source of human heart cells which are suited to large-scale production. These cells have the potential for wide-scale application in drug discovery, heart disease research and cell-based heart repair. Embryonic atrial-, ventricular- and nodal-like cardiomyocytes can be obtained from differentiated human embryonic stem cells (hESCs). In recent years, several highly efficient cardiac differentiation protocols have been developed. Significant progress has also been made on understanding cardiac subtype specification, which is the key to reducing the heterogeneity of hESC-CMs, a major obstacle to the utilization of these cells in medical research and future cell-based replacement therapies. Herein we review recent progress in cardiac differentiation of hESCs and cardiac subtype specification, and discuss potential applications in drug screening and cell-based heart regeneration.

[A correlation study of Tei index and N-terminal pro-brain natriuretic peptide in patients with high-altitude heart disease]

OBJECTIVE

To explore the diagnostic value of Tei index of right ventricle and serum level of NT-proBNP in patients with high-altitude heart disease (HAHD).

METHODS

Right ventricle Tei index and serum NT-proBN level were calculated and tested in 32 local healthy volunteers and 34 cases of HAHD patients hospitalized in our hospital in Golmud city (2808 meters above sea level) from 2008 to 2010, and a correlation study was conducted thereafter.

RESULTS

The pulmonary arterial systolic pressure and right ventricle Tei index, elevated significantly in HAHD patients compared with the control group [(86.61 vs 9.72) mm Hg (1 mm Hg = 0.133 kPa) and (0.90 vs 0.33) respectively, P < 0.05]. Patients diagnosed as mild pulmonary hypertension without alteration in cardiac structure showed higher pulmonary arterial systolic pressure and the Tei index compared with the control group [(57.1 vs 9.72) mm Hg and (0.78 vs 0.33) respectively, P < 0.05]. In addition, the level of serum NT-proBNP was significantly higher in HAHD group than that of control group [(1246.8 ± 512.6) ng/L and (98.6 ± 21.7) ng/L respectively, P < 0.05].

CONCLUSION

Right ventricle Tei index and serum NT-proBNP level are sensitive indicators for right ventricular function and thus of favorable clinical significance for the diagnosis of HAHD.

[Post-marketing re-evaluation about usage and dosage of Chinese medicine based on human population pharmacokinetics]

The usage and dosage of Chinese patent medicine are determined by rigorous evaluation which include four clinical trail stages: I, II, III. But the usage and dosage of Chinese patent medicine are lacked re-evaluation after marketing. And this lead to unchanging or fixed of the usage and dosage of Chinese patent medicine instead of different quantity based on different situations in individual patients. The situation of Chinese patent medicine used in clinical application is far away from the idea of the "Treatment based on syndrome differentiation" in traditional Chinese medicine and personalized therapy. Human population pharmacokinetics provides data support to the personalized therapy in clinical application, and achieved the postmarking reevaluating of the usage and dosage of Chinese patent medicine. This paper briefly introduced the present situation, significance and the application of human population pharmacokinetics about re-evaluation of the usage and dosage of Chinese patent medicine after marketing.

[Key elements of design about PPK of Chinese medicine after marketing]

PPK is a discipline that quantitative investigates the determinants of drug concentration in patient groups. Developing reasonable PPK design of experiment can provides the real objective data for clinical medicationand then promotes the formulating of clinical individualized medication regimens. This paper referenced over all years literatures, and combined with practical work experience. Summarizes of the main points of PPK design of experiment focused on traditional Chinese medicine. The content mainly included choosing research objects, selecting items, designing sample collection steps, blood sample analysis experiments and data analysis schemes.

Electronic properties of edge-functionalized zigzag graphene nanoribbons on SiO2 substrate

Based on first-principles calculations, electronic properties of edge-functionalized zigzag graphene nanoribbons (ZGNRs) on SiO(2) substrate are presented. Metallic or semiconducting properties of ZGNRs are revealed due to various interactions between edge-hydrogenated ZGNRs and different SiO(2)(0001) surfaces. Bivalent functional groups decorating ZGNRs serve as the bridge between active edges of ZGNRs and SiO(2). These functional groups stabilize ZGNRs on the substrate, as well as modify the edge states of ZGNRs and further affect their electronic properties. Bandgaps are opened owing to edge state destruction and distorted lattice in ZGNRs.

[Effects of changes in axis length of patella on patellofemoral contact areas and pressures]

OBJECTIVE

To explore the effects of changes in the length of the patella on patellofemoral contact areas and pressures, to provide a theoretical foundation for treatment of lower pole of patella fracture.

METHODS

Using homemade-loading equipment, pressure sensitive films of 100 mm x 100 mm in size were placed on the force platform, vertically downward load (0-19.6 N) was given. The pressure-sensitive response curve was obtained by computer image analysis of the pressure-sensitive tablets and calculation. Six male left fresh knee specimens from voluntary donation were placed in homemade-test fixed load device, and the double-layer pressure sensitive film was placed on the patellofemoral joint surface; under loading of 196 N at flexion of 0, 15, 30, 45, 60, 75, 90, 105, 120, and 135 degrees for 2 minutes, respectively, the pressure sensitive film was removed as the control group. Patellas were transected cut and in situ fixed by Kirschner wire and steel-wire as in situ fixation group. Bone fragments obtained from the corresponding 1/6 and 2/6 of contralateral patella, were embedded in the interspace between osteotomy with internal fixation with Kirschner wire and steel-wire respectively as lengthening group. Followed by the amputating patella length of 1/6, 2/6, 3/6 from proximal to distal and internal fixation with Kirschner wire and steel wire by turns as a shortening group. Repeat the above steps of each experiment. By image analysis the pressure sensitive film, the patella joint contact area were measured, and patellar contact pressure (including the peak pressure and average pressure) was calculated according to pressure-sensitive response curve.

RESULTS

The actual contact area were significantly smaller in the shortening groups than in the control group at flexion of 30-135 degrees (P < 0.05); the pressure was significantly bigger in shortening 1/6 group at flexion of 0, 15, 60, and 75 degrees, in shortening 2/6 group at flexion of 0 degrees and 75-135 degrees, and in shortening 3/6 group at flexion of 0-30 degrees and 75-135 degrees than in the control group (P < 0.05); the peak pressure was significantly bigger in shortening 1/6 group at flexion of 0, 15, and 60-105 degrees, in shortening 2/6 group at flexion of 0, 15, and 75-105 degrees, and in shortening 3/6 group at flexion of 0, 30, and 60-135 degrees than in the control group (P < 0.05). The actual contact area was significantly smaller in the lengthening groups than in the control group at flexion of 15, 60, and 90 degrees, and it was bigger at flexion of 105, 135 degrees in lengthening 2/6 group than in the control group (P < 0.05); the pressure was significantly bigger in the lengthening groups at flexion of 15-75 degrees than in the control group and it was smaller in the lengthening groups at flexion of 105, 135 degrees, and smaller in lengthening 2/6 group at flexion of 120 degrees (P < 0.05); the peak pressure was significantly smaller in lengthening 1/6 group than in the control group at flexion of 0, 90, and 105 degrees and smaller in lengthening 2/6 group at flexion of 0 degrees (P < 0.05). The actual contact area was significantly bigger in all lengthening groups than in all shortening groups at flexion of 30, 45, and 75-135 degrees (P < 0.05). The pressure was significantly bigger in shortening 1/6 group than in lengthening groups at flexion of 0, 60, and 90 degrees (P < 0.05), in shortening 2/6 group at flexion of 0, 60, and 90-120 degrees (P < 0.05), in shortening 3/6 group at flexion of 0-135 degrees (P < 0.05). The peak pressure was bigger in shortening groups than in lengthening 1/6 group at flexion of 0, 90, and 105 degrees (P < 0.05), bigger than lengthening 2/6 group at flexion of 0 degrees (P < 0.05).

CONCLUSION

To treat comminuted fracture of the inferior pole of patella, the partial resection or the late lengthening after preserving the patella has less effect on knee joint function, especially at the patella to be cut less than 1/6 or after surgery lengthening of less than 1/6, while the latter is better than the former. The patella should be preserved as much as possible. If the patellar partial resection is inevitable, the length resection should be less than 1/6, it also can get satisfactory results.

[Current situation of surgical treatment of inferior polar fracture of patella]

OBJECTIVE

To investigate the advance in surgical treatment of inferior pole fracture of patella and to explore the existing problems and further research directions.

METHODS

Domestic and foreign literature in recent years on patella fracture was extensively reviewed, the surgical treatment of inferior pole fracture of patella was summarized by combining the research findings with clinical experience.

RESULTS

The surgical treatment of inferior pole of patella fractures included retaining the integrity of the patella and partial patellectomy of inferior pole of patella and extending knee installation reconstruction. There were kinds of ways to retain the integrity of the patella, such as circular wire fixation, tension band fixation, NiTi-patella concentrator fixation, basket plate fixation, reforming McLaughlin way and polydioxanone suture net fixation; the latter category is partial patellectomy and extensor device reconstruction. Every surgical way had its advantages and limitations.

CONCLUSION

Most studies tend to retain the integrity of the patella, but some researches have shown that partial resection of inferior pole of patella had no significant effect on knee function. It is important to obtain the security excisional range and elongation range postoperative by experiment for regulating the treatment of comminuted fractures of inferior pole of patella.

High dielectric loss in graphite-coated Ti nanocapsules

Graphite-coated Ti nanocapsules, with Ti nanoparticles as core and onion-like graphite layers as shell, have been prepared by a modified arc-discharge method in ethanol atmosphere, and characterized by means of X-ray diffraction, transmission electron microscopy and Raman spectroscopy. The dielectric properties of the graphite-coated Ti nanocapsules have been investigated in the 2-18 GHz range. An equivalent circuit model was used to interpret the non-linear dielectric resonance behavior of the graphite-coated Ti nanocapsules. The high dielectric loss is mainly attributed to conductance loss and dipole-relaxation loss in the graphite-coated Ti nanocapsules. The graphite-coated Ti nanocapsules exhibit promising properties for application as a new type of shield or absorbent of electromagnetic waves.

Free radical production from the interaction of 2-chloroethyl vesicants (mustard gas) with pyridine nucleotide-driven flavoprotein electron transport systems

The biochemical sequelae to chloroethyl mustard exposure correspond very well to toxic processes initiated by free radicals. Additionally, mustard solutions contain spontaneously formed cyclic onium ions which produce carbon free radicals when reduced electrochemically. Therefore, we hypothesized that the onium ions of sulfur or nitrogen mustards might produce carbon free radicals upon being reduced enzymatically, and that these radicals might constitute a metabolic activation. We set out to document radical production using an in vitro metabolic system and electron paramagnetic resonance (EPR). Our system consisted of NADPH, one of several pyridine nucleotide-driven flavoprotein reductases, cytochrome c as a terminal electron acceptor, various sulfur or nitrogen mustards and the spin trap alpha-[4-pyridyl-1-oxide]-N-tert-butylnitrone in buffer. Reactions were started by adding the reductase to the other materials, vortexing and immediately transferring the mixture to a 10 mm EPR flat cell. Repeated scans on a Bruker ESP 300E EPR spectrometer produced a triplet of doublets with hyperfine splitting constants of a(N)=15.483 G and a(H)=2.512 G. The outcome supported our hypothesis that carbon-centered free radicals are produced when mustard-related onium ions are enzymatically reduced. The EPR results varied little with the chloroethyl compound used or with porcine or human cytochrome P450 reductase, the reductase domain of rat brain neuronal nitric oxide synthase or rat liver thioredoxin reductase. Our results offer new insight into the basis for mustard-induced vesication and the outcome of exposure to different mustards. The free radical model provides an explanation for similarities in the lesions arising from mustard exposure and energy-based lesions such as those from heat, ultraviolet and nuclear radiation as well as damage across tissue types such as skin, eyes or airway epithelium.

Comparison of the phonation-related structures among pig, dog, white-tailed deer, and human larynges

There is an important need for good animal models of the larynx for the study of the physiology of phonation. The dog's larynx has been used as an animal model for more than 2 centuries of phonatory research. However, there is some evidence that the pig larynx has advantages over the dog larynx as a model of phonation. Another larynx that is readily available is the deer larynx. In this comparative study, the laryngeal anatomy and function were examined in 4 species--human, pig, dog, and white-tailed deer. Particular attention was directed to those structures that one would predict could affect phonation, from the anatomic and biomechanical point of view. Although the vocal fold length was similar for all 4 species, the larynges described differed in some phonation-related characteristics. The data suggest that from a structural perspective, the pig larynx is a superior model for phonatory research.

Modeling of chaotic vibrations in symmetric vocal folds

The chaos mechanism of above-range phonation was examined in symmetrically modeled vocal folds by using the traditional two-mass model assumption. The Poincaré map technique was used to display chaotic attractors. This method provided an effective description of irregular vocal-fold movements. The power spectrum, Lyapunov exponent, and Kaplan-Yorke dimension were employed to describe chaotic vibrations in the vocal-fold model. These nonlinear dynamic analyses suggested that, for the positive Lyapunov exponent, chaotic attractors contribute to irregular vocal-fold vibrations. Descriptions of complicated irregular vibrations of the vocal fold yielded evidence of chaos. To investigate the effects of independent parameters such as subglottal pressure, coupling stiffness, and phonation neutral area, bifurcation diagrams based on the Poincaré map were discussed. The results confirmed that the dynamics of the two-mass model was strongly influenced by independent parameters. Nonlinear dynamic methods were expected to provide useful information for better understanding of irregular vocal-fold vibrations as well as of the dynamic mechanism of above-range phonation in excised larynx experimentation.

Vocal Fold Impact Stress Analysis

Vocal fold impact stress (force/area) has been implicated as a factor possibly contributing to the formation of nodules and polyps. The force of impact of a moving body is related to its acceleration. Since the mass of the folds is relatively constant, one expects impact force to be directly proportional to acceleration. A measure that reflects the relative displacement of the vocal folds is photoglottography (PGG). The velocity and acceleration of the folds are easily obtained by calculating the first and second derivatives of the PGG displacement waveform. This study, therefore, compared the second derivative of the PGG signal with simultaneously measured impact stress in an excised canine larynx model. Glottal transillumination (PGG) was measured with a subglottic transducer. A miniature force transducer placed in the midline between the vocal folds measured impact stress at the midglottal position. For nine different larynges, there was a positive and linear relationship between the second derivative of PGG and impact stress. The statistically significant results support the hypothesis that the second derivative of PGG m ay provide a use fulnoninvasive way to estimate relative vocal fold impact stress.

Quantitative study of mucosal wave via videokymography in canine larynges

OBJECTIVES

Vocal fold mucosal wave movements are thought to be important in determining voice characteristics and quality. To see these movements, high-speed cinematography and videostroboscopy have been used clinically; however, these techniques have disadvantages that make them impractical for quantitative measurement of mucosal wave movements. This study explored the feasibility of using line-scan cameras for mucosal wave analysis.

METHODS

An excised larynx bench model was used to examine the effects of elongation and changes in subglottal pressure on the amplitude, frequency, and phase difference of vocal fold mucosal movements as calculated from line-scan images.

RESULTS

The data showed a positive and linear relationship between an increase in subglottal pressure and amplitude of the mucosal wave; elongation of the vocal folds appeared to decrease the amplitude of mucosal wave upheaval at each level of subglottal pressure. Similarly, increase in subglottal pressure had a positive and linear relationship with increase in frequency of vibration; elongation of the vocal folds further increased the frequency at any given subglottal pressure. Phase difference between the movements of the upper and lower margins of the mucosal lips was estimated and did not appear to be significantly affected by changes in subglottal pressure and elongation.

CONCLUSION

The data presented in this study are consistent with relationships that we would expect to be true from currently accepted models of vocal fold vibration.

Diagnosis and management of chronic laryngitis associated with reflux

Chronic laryngitis symptoms are commonly seen in otherwise healthy people. This article reviews recent progress in our understanding and effective treatment of chronic laryngitis. Clinical experience and prospective treatment and outcome studies have demonstrated objective evidence of the efficacy of treating patients with chronic laryngitis symptoms with nocturnal antireflux precautions and acid-suppressing medications. The role of pH testing and most common errors in treatment are reviewed.

Nitric oxide-forming reactions of the water-soluble nitric oxide spin-trapping agent, MGD

The objective of this study was to elucidate the nitric oxide-forming reactions of the iron-N-methyl-D-glucamine dithiocarbamate (Fe-MGD) complex from the nitrogen-containing compound hydroxyurea. The Fe2+(MGD)2 complex is commonly used in electron paramagnetic resonance (EPR) spectroscopic detection of NO both in vivo and in vitro. The reaction of Fe2+(MGD)2 with NO yields the resultant NO-Fe2+(DETC)2 complex, which has a characteristic triplet EPR signal. It is widely believed that only NO reacts with Fe2+(MGD)2 to form the NO-Fe2+(MGD)2 complex. In this report, the mechanism leading to the formation of NO-Fe2+(MGD)2 was investigated using oxygen-uptake studies in conjunction with the EPR spin-trapping technique. We found that the air oxidation of Fe2+(MGD)2 complex results in the formation of the Fe3+(MGD)3 complex, presumably concomitantly with superoxide (O3*-). Dismutation of superoxide forms hydrogen peroxide, which can subsequently reduce Fe3+(MGD)3 back to Fe2+(MGD)2. The addition of NO to the Fe3+(MGD)3 complex resulted in the formation of the NO-Fe2+(MGD)2 complex. Hydroxyurea is not considered to be a spontaneous NO donor, but has to be oxidized in order to form NO. We present data showing that in the presence of oxygen, Fe2+(MGD)2 can oxidize hydroxyurea to yield the stable NO-Fe2+(MGD)2 complex. These results imply that hydroxyurea can be oxidized by reactive oxygen species that are formed from the air oxidation of the Fe2+(MGD)2 complex. Formation of the NO-Fe2+(MGD)2 complex in this case could erroneously be interpreted as spontaneous formation of NO from hydroxyurea. The chemistry of the Fe2+(MGD)2 complexes in aerobic conditions must be taken into account in order to avoid erroneous conclusions. In addition, the use of these complexes may contribute to the overall oxidative stress of the system under investigation.

Finite element modeling of vocal fold vibration in normal phonation and hyperfunctional dysphonia: implications for the pathogenesis of vocal nodules

A computer model of the vocal fold was developed using finite element modeling technology for studying mechanical stress distribution over vibrating vocal fold tissue. In a simulated normal phonation mode, mechanical stress was found to be lowest at the midpoint of the vocal fold and highest at tendon attachments. However, when other modes predominated, high mechanical stress could occur at the midpoint of the vocal folds. When a vocal fold mass was modeled, high shearing stress occurred at the base of the modeled vocal fold mass, suggesting that the presence of a vocal nodule or polyp is associated with high mechanical stress at the margins of the mass. This finding supports a hypothesis that mechanical intraepithelial stress plays an important role in the development of vocal nodules, polyps, and other lesions that are usually ascribed to hyperfunctional dysphonia.

Integrated analyzer and classifier of glottographic signals

Electroglottography (EGG) and photoglottography (PGG) are two plausible methods to study voice production for monitoring the patterns of laryngeal vibrations. It has been suggested that measures such as open quotient and speed quotient calculated from glottographic signals can provide useful information regarding pathological phonation. In this paper, an integrated analyzer and classifier of glottographic signals was implemented. The system makes it possible to calculate the measures from digitized EGG and PGG signals automatically in order to examine vocal fold abnormality. The system developed several techniques to extract features from glottographic signals and proposed a statistical classification method that can possibly aid the diagnosis process. To check the reliability of the system, a training set and a test set of glottographic signals from normal people and patients with recurrent/superior laryngeal paralysis were analyzed and classified by the system. The results showed that the system is a useful tool for quantitative study of phonatory pathophysiology and can be used by the examiner who is interested in the clinical examination of glottographic signals. Moreover, glottographic techniques may have some clinical applications in the quantitative documentation of phonatory function in patients with voice disorders but requires further evaluation before clinical application.

Quantitative measurement of mucosal wave by high-speed photography in excised larynges

The movement characteristics of mucosal waves of the vocal fold are important components in normal phonation. Quantitative studies of the mucosal wave have used stroboscopic techniques from a supraglottic view. The current study measured displacement of mucosal epithelium during experimental phonation by using high-speed photography from an infraglottic view. Effects of thyroarytenoid contraction, increased mean airflow rate, and variation of vocal fold length were examined in canine larynges. Top and bottom vocal fold "lip" amplitude, fundamental frequency, and phase difference were the dependent variables examined. Thyroarytenoid contraction increased the amplitude of the top and bottom lips, decreased the fundamental frequency, and increased the phase difference. Increase in airflow through the glottis decreased the top lip amplitude and phase difference and appeared to increase the fundamental frequency and to decrease the bottom lip amplitude. Vocal fold lengthening decreased the bottom lip amplitude and increased the fundamental frequency and appeared to decrease the top lip amplitude and phase difference.

The dynamics of length change in canine vocal folds

The time courses of vocal fold elongation and contraction have been measured as a function of intrinsic laryngeal muscle activity. The superior and recurrent laryngeal nerves of anesthetized canines were stimulated supramaximally (on-off in all combinations) while the vocal folds were surgically exposed and illuminated for conventional and higher speed (300 frames per second) video recording. Microsutures were placed on various points on the vocal folds to measure elongation and contraction. Vocal fold strain, defined as elongation divided by rest length, ranged from -17% to +45%. The typical time constant for exponential increase or decrease in strain was about 30 ms. This reflects primarily the intrinsic muscle activation times rather than a passive (inertial or viscoelastic) response of cricothyroid joint rotation or translation.

Acoustic measurement of change in voice quality with treatment for chronic posterior laryngitis

Sixteen patients who had symptoms and signs of chronic posterior laryngitis were evaluated before, during, and after treatment with omeprazole and nocturnal antireflux precautions. Data were analyzed for patients who complained of some hoarseness, who had no smoking history, and who completed all of the voice recording protocol. The patients' voices were recorded before, during, and following treatment with omeprazole and nocturnal antireflux precautions. Voice quality was analyzed by perceptual analysis, and acoustic signal data were measured for jitter, shimmer, and signal-to-noise ratio. Measures of jitter, shimmer, and signal-to-noise ratio changed significantly with treatment of posterior laryngitis (p < .01 for change in each of the measures). Acoustic measures showed some trend of deterioration with cessation of treatment, although the overall improvement in acoustic measures of voice quality was still statistically significant after treatment with omeprazole was discontinued. Although perceived abnormality of voice increased and decreased with the magnitude of measured perturbation of the acoustic signal for some patients, the perceptual assessments were not highly correlated with acoustic measures for individual patients, and the perceptual analysis group data did not show a significant change with time during treatment, in contrast to the significance of change in acoustic measures. The data demonstrate that acoustic measures of jitter, shimmer, and signal-to-noise ratio improve significantly with antisecretory and antireflux treatment of chronic posterior laryngitis, and that for individual patients, these are changes that are detected by trained listeners, but not at statistically high levels of confidence.

Detection of free radical metabolite formation using in vivo EPR spectroscopy: evidence of rat hemoglobin thiyl radical formation following administration of phenylhydrazine

The spin-trapping technique in conjunction with a low-frequency electron paramagnetic (or spin) resonance (EPR or ESR) spectrometer was used to detect the hemoglobin thiyl free radical in living rats using a whole body resonator. The hemoglobin thiyl free radical was formed following the intragastric administration of phenylhydrazine at the LD50 dose of 188 mg/kg. The hemoglobin thiyl free radical was then trapped by preinjected 5,5-dimethyl-1-pyrroline N-oxide (DMPO), which formed the DMPO/hemoglobin thiyl-free radical adduct in the blood. The time course of the in vivo formation and disappearance of the spin adduct was followed. The DMPO/hemoglobin thiyl free radical was detected in blood samples using 9.5 GHz (X-band) and 1.1 GHz (L-band) EPR at room temperature and 77 K. Pretreatment of rats with ascorbate and diethylmaleate (DEM) decreased the signal intensity of the DMPO/hemoglobin thiyl free radical spin adduct. The incubation of ascorbate or DEM at 37 degrees C with rat blood containing preformed DMPO/hemoglobin thiyl radical adduct showed that there was no effect of DEM on the free radical concentration, while ascorbate reduced the radical adduct. This study provided direct evidence of the formation of the DMPO/hemoglobin thiyl free radical in vivo and enabled us to study this formation in living animals free of any artifacts that can occur when using ex vivo methods.

Videolaryngoscopic evaluation of laryngeal intubation injury: incidence and predictive factors

Bedside videolaryngoscopy of 73 cardiovascular surgical patients was performed before and after intubation to identify risk factors, incidence, and site of injury to the larynx. Nineteen of 44 patients with abnormal preintubation examination findings had granulation tissue present on a vocal process, compared With 3 of 20 patients who had normal findings on preintubation examination (p < 0.05). Recent smoking history was elicited from 2 of 20 patients who had normal findings on preintubation examination and from 20 of the 44 patients who had abnormal findings on preintubation examination (p < 0.01). Laryngeal nerve paresis was identified in 21 of 64 patients after extubation and was present in 7 patients before intubation. Videolaryngoscopy provides a high-quality permanent record of the laryngeal examination and is easily obtained in the critical care setting. Preintubation videolaryngeal evaluation may identify those at risk for more significant intubation injury.

Does alveolar soft-part sarcoma exhibit skeletal muscle differentiation? An immunocytochemical and biochemical study of myogenic regulatory protein expression

There has been persistent controversy regarding the nature of cell differentiation in alveolar soft-part sarcoma (ASPS) since its first description in 1952. Some studies suggest that ASPS might represent an unusual variant of skeletal muscle tumor. Given the availability of new monoclonal antibodies to probe for skeletal muscle differentiation and the rapid advance in immunocytochemical techniques for deparaffinized, formalin-fixed tissue sections, we wished to test the proposed hypothesis that ASPS might represent a new type of rhabdomyosarcoma. Twelve archival samples of ASPS were retrieved, and we investigated the expression of two myogenic regulatory proteins, MyoD1 and myogenin, as well as other muscle-associated proteins, using sensitive immunocytochemical techniques. Despite the presence of desmin immunostaining in six ASPSs, no tumors were positive for either muscle actin or myoglobin. Most importantly, no specimen showed nuclear expression of MyoD1 or myogenin. In 11 tumors, however, there was considerable granular immunostaining in the tumor cell cytoplasm with the anti-MyoD1 monoclonal antibody 5.8A, a phenomenon observed in various nonmuscle normal and neoplastic tissues with this antibody. To analyze the exact nature of immunostaining of MyoD1 and desmin in ASPS, biochemical analyses using available fresh frozen tumor tissue were performed. Although a 53-kDa band was noted with antidesmin antibody on Western blot analysis, no specific protein band that corresponds to the 45-kDa MyoD1 was detected with antibody 5.8A. These results confirm the presence of desmin in ASPS but argue against authentic expression of MyoD1. They also suggest that the cytoplasmic immunostaining observed with anti-MyoD1 antibody 5.8A most likely represents a nonspecific cross-reaction with an unknown cytoplasmic antigen. Considering the master role that MyoD1 and myogenin play in skeletal muscle commitment and differentiation and the lack of expression of these two proteins in ASPS as determined immunocytochemically and biochemically, we think that the histogenesis of ASPS remains unknown.

Validation of the S-phase specificity of histone (H3) in situ hybridization in normal and malignant cells

Several different methods of measuring proliferation indices have been developed, including measurements of cellular DNA content (flow cytometry), S-phase incorporation of thymidine analogues into DNA (e.g., tritiated thymidine and 5'-bromodeoxyuridine), and immunostaining of cell cycle-restricted proteins (e.g., Ki-67 antigen and PCNA). Theoretical and practical problems with each method have made it difficult to compare absolute proliferation rates among cells of different lineages and degrees of malignancy. More recently, in situ hybridization (ISH) for histone 3 (H3) mRNA has been introduced. We used a double labeling method for comparing H3 mRNA expression and S-phase incorporation of 5'-bromodeoxyuridine (BrdU) to determine if H3 mRNA expression was tightly associated with S-phase in a variety of malignant and nontransformed cell types. In addition, labeling results were compared in methacarn- and formalin-fixed tissues to extend the potential usefulness of H3 ISH, using a postfixation technique for the alcohol-fixed specimens. As expected for a cumulative marker, variation was noted in the percentage of the BrdU-positive cells double labeled with H3 ISH (53-89%), depending on cell type and length of BrdU incubation. In contrast, the percentage of the H3 ISH-positive cell population double labeled for BrdU was independent of the cell type of BrdU incubation time (mean 78%). Similarly, a consistent percentage of H3 ISH-positive cell populations was double labeled for BrdU in normal tissues (mean 97%). These findings support a well-conserved timing mechanism for H3 mRNA expression and DNA replication. We conclude that H3 ISH is an extremely accurate technique for assessment of S-phase cell proliferation indices.

Generation of reactive oxygen species by Co(II) from H2O2 in the presence of chelators in relation to DNA damage and 2'-deoxyguanosine hydroxylation

The generation of reactive oxygen species by Co(II) from H2O2 in the presence of chelators and related DNA damage was investigated by electron spin resonance (ESR), electrophoretic assays, and high-performance liquid chromatography (HPLC). Incubation of Co(II) with beta-alanyl-3-methyl-L-histidine (anserine) and H2O2 generated .OH radicals. Omission of any one component sharply reduced the amount of .OH radicals generated, indicating that anserine modulated the oxidation potential of Co(II) to enhance its capability to generate .OH radicals from H2O2. Formate only moderately decreased the .OH radical generation, while ethanol had no observable effect, indicating that the generation of .OH radical is site specific. The metal ion chelator 1,10-phenanthroline reduced the .OH radical generation, and deferoxamine suppressed it with the formation of deferoxamine nitroxide radical. Electrophoretic assays using both lambda Hind III linear DNA and PM2 supercoiled DNA showed that .OH radicals generated from a mixture of Co(II), H2O2, and anserine caused DNA strand breaks. A mixture of Co(II), H2O2, and 1,10-phenanthroline also caused DNA strand breaks, which were inhibited by sodium azide, indicating that 1O2 was involved in DNA damage. HPLC measurements showed that .OH radicals and 1O2 generated by Co(II) reactions caused 2'-deoxyguanosine hydroxylation to form 8-hydroxy-2'-deoxyguanosine. ESR spin trapping measurements provided evidence for 1O2 generation by Co(II) from H2O2 in the presence of 1,10-phenanthroline. The results indicate that the oxidation potential of Co(II) can be modulated by chelators to facilitate its generation of reactive oxygen species from H2O2. These species may be involved in Co(II)-induced cellular damage.

Chromate-induced chromium(V) formation in live mice and its control by cellular antioxidants: an L-band electron paramagnetic resonance study

A recent note from our laboratory reported that L-band (1.2 GHz) electron paramagnetic resonance spectroscopy can be utilized in detecting the formation of Cr(V) intermediates from chromate-treated whole mice. Since Cr(V) is thought to be one of the key species in the mechanism of chromate's toxicity, we carried out additional measurements with improved sensitivity. The new spectra show partially resolved hyperfine structure from protons that suggests that the Cr(V) ion is ligated to NAD(P)H moieties via oxygens. Using laboratory-synthesized Cr(V) (K3CrO8) as a standard, the yield of Cr(V) formation was estimated to be 153 +/- 12 nmol after intravenous injection of 100 microliters of 100 mM sodium dichromate into mice. Pretreatment of the mice with ascorbic acid and glutathione significantly reduced the Cr(V) formation yield in a dose-related manner, while pretreatment with NADH had the opposite effect. Injection of ascorbic acid also had the effect of enhancing the rate of Cr(V) disappearance in vivo. By comparing these results with in vitro results utilizing L-band as well as X-band (9.6 GHz) measurements, we conclude that L-band spectroscopy can indeed be effectively utilized for following the metabolism of Cr(V) in live mice and that Cr(V) formation can be controlled by utilizing cellular antioxidants in vivo.

Clinical impact of drug addiction in alcoholics

Careful interviewing of alcoholics who wish to undergo alcohol withdrawal programmes reveals that some are past intravenous drug abusers. As these two potentially hepatotoxic types of substance abuse could cause liver disease or influence its clinical course, we studied biological, histological and virological features in 26 alcoholics with a past history of intravenous (i.v.) drug abuse, compared with paired controls (alcoholics without i.v. drug abuse). There were no differences with regard to routine liver test results. In contrast, the former drug abusers had a significantly higher prevalence of serum markers of hepatitis C (76.9%) and hepatitis B viruses (76.9%) than the other patients (16.7 and 12.5%, respectively). Eight patients, all of whom were HBs Ag negative, were positive for serum HBV-DNA; three were former drug abusers and five were not, giving an overall prevalence of HBV markers in the two groups of 80.8 and 25%, respectively. Two former drug abusers had anti-HIV antibodies and one had anti-hepatitis delta virus antibodies. Ten of the 17 former drug abusers who underwent liver biopsy had histological signs of viral infection. These data underline the need for careful interviews of alcoholic patients, together with serological tests for viral infections and histological analysis of the liver, as some will have liver-damaging viral diseases and may be candidates for anti-viral (i.e. interferon) treatment.

Measurement of vocal fold intraglottal pressure and impact stress

Intraglottal pressure was measured according to a previously described hemilarynx procedure. Three phases were identified for intraglottal pressure: an impact phase, in which the vocal folds come into contact and produce a sharp pressure pulse; a preopen phase, in which there is a progressive pressure buildup due to increased exposure of the vocal fold surfaces to subglottal pressure; and an open phase, in which intraglottal pressure becomes aerodynamic and drops gradually from opening to closing. Impact pressure peaks were positively related to subglottal pressure, elongation, and adduction of the vocal folds. The midpoint of the membranous vocal fold received the maximum impact stress. The experimental results match well with analytical predictions and support a current theory of mechanical trauma leading to vocal nodules.

[Significance of brainstem auditory evoked potential determination in chronic renal failure and maintenance hemodialysis patients]

Brainstem auditory evoked potentials (BAEP) were measured in 20 chronic renal failure patients and 8 maintenance hemodialysis patients. The BAEP in chronic renal failure patients was showed that wave I, III, V peak latencies (PL) and I-III, I-V interpeak latencies (IPL) were markedly increased. The significant reductions, although not to normal, of wave III, IV PL and I-III, I-V IPL were recorded in postdialysis (average 4.2 months) compared with that in predialysis. A correlation analysis revealed no consistent relationships between plasma proteins, hemoglobin, urea, creatinine serum electrolytes and BAEP PL or IPL. The authors realize that BAEP could be used as a subjective index in deciding the inner ear and nervous system damage in chronic renal failure, and it also provided an electrophysiologic evidence for the relationship of Kidney and ear in traditional Chinese medicine.

Fundamental frequency and amplitude perturbation in reconstructed canine vocal folds

A submucosal fat autograft was implanted within the cover of injured vocal folds of 5 dogs. The implant occurred 6 weeks after unilateral mucosal excision had been performed. Three months postoperatively the larynges of these animals were excised and their phonation was compared to that of normal dog larynges and to other larynges with mucosal excision (but without fat grafting). Radiated acoustic pressure from the artificially driven larynges was recorded and digitized at 20 kHz with 16-bit resolution. Amplitude and fundamental frequency perturbations were extracted from a segment of phonation to assess the stability of the acoustic signals from the 3 groups. It was found that fat augmentation after mucosal excision reduced amplitude and frequency perturbation measures. There was no significant difference between fat-augmented and normal vocal folds. The acoustic measures were also positively correlated with phonation threshold and phonation efficiency measures reported earlier. The results suggest that submucosal fat autograft implantation within an injured vocal fold cover can restore not only the "ease" of phonation, but also the stability of phonation, which is a component of vocal quality.

A methodological study of hemilaryngeal phonation

An excised hemilarynx setup was developed. The phonatory characteristics of nine excised canine larynges were examined. The left vocal fold of each larynx was then removed and substituted with a vertical plexiglass plate. The larynges were phonated again. Recordings were made of phonation threshold pressure, sound pressure level, average glottal flow, fundamental frequency, and amplitude of vocal fold vibration as observed with a video stroboscope. Measurements were made over a range of subglottal pressures. For the hemilarynx, simultaneous recordings of intraglottal pressure and vocal fold contact area were also made. It was found that amplitude and frequency of vocal fold vibration of the hemilarynx, as well as rates of change of amplitude and frequency as a function of subglottal pressure, were similar to those of the full larynx. Also similar were phonation threshold pressures and ranges of subglottal pressure over which the larynges phonated. The average airflow of the hemilarynx was approximately half that of the full larynx, and the sound pressure level, under similar conditions, was one fourth (about 6 dB less) in the hemilarynx.

Measurement of mucosal wave propagation and vertical phase difference in vocal fold vibration

Examination of the surface wave properties of the vocal fold mucosa is becoming an important part of assessment of vocal function. A key wave property is propagation velocity, which determines the phase delay between the upper and lower margins of the vocal folds. Excised canine larynges were used to measure this phase delay, and therewith propagation velocity. The motion of two flesh points was tracked stroboscopically. Differential displacements between the flesh points were matched to displacements of a model. A least-squared fit of the data to the model provided the numeric values of propagation velocity, which varied from 0.5 m/s to about 2.0 m/s, depending on fundamental frequency. The corresponding phase delay along the medial surface of the vocal folds varied from about 60 degrees/mm to 30 degrees/mm.

The method of time-resolved spin-probe oximetry: its application to oxygen consumption by cytochrome c oxidase

This work broadens the scope and improves the time resolution of spin-probe oximetry, a technique in which small nitroxide spin probes detect oxygen consumption via change in their relaxation properties [Froncisz, W., Lai, C.-S., & Hyde, J. S. (1985) Proc. Natl. Acad. Sci. U.S.A. 82, 411-415]. For rapid oxygen kinetic studies we combined the methodology of spin-probe oximetry with a recently developed loop-gap resonator, stopped-flow EPR system [Hubbell, W. L., Froncisz, W., & Hyde, J. S. (1987) Rev. Sci. Instrum. 58, 1879-1886]. The technique used microliter volumes of reactant solutions. Enzymatic consumption of oxygen by cytochrome c oxidase in the presence of ferrocytochrome c substrate was followed continuously in time under limited-turnover conditions, where the concentration of oxygen consumed often was comparable to or less than the amount of enzyme present. In detecting less than micromolar oxygen concentration changes, we have achieved a time resolution of the order 30 ms when flow is stopped. Oxygen consumption was followed under two different limited-turnover conditions: In the first, the amount of oxygen consumed was limited by available ferrocytochrome c, and the time course of oxygen consumption and its pH dependence were compared with the optically detected ferrocytochrome c consumption. In the second, the oxygen consumed was ultimately limited by the availability of oxygen itself while ferrocytochrome c was regenerated and remained in excess.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical studies in the use of BCG and levamisole in the treatment of glomerulonephritis

Sixty patients with primary glomerulonephritis and nephrotic range proteinuria (most resistant to corticosteroid therapy) were given killed BCG inoculations as a major part of combined therapy with levamisole, 3 of every 7 days, and corticosteroids in 53 patients. Following treatment 80% of patients showed complete or partial remission of proteinuria with significant improvement in urinary protein excretion, serum albumin, blood urea, and serum creatinine. Thirteen of 15 patients followed up for 1-2 years and more had complete remission at the latest review, as did five of six patients followed for less than 1 year. The longer the course of the combined immunostimulant treatment, the lower the recurrence rate. The beneficial effects of retreatment in recurrent cases were much more rapid in onset than on initial treatment. The phagocytic function of monocytes was examined in a separate group of 24 patients with primary glomerulonephritis. Function was found to be significantly depressed but could be returned to normal following BCG inoculation. Associated with the improved monocyte phagocytic function there was a significant decrease in urinary protein excretion.

Immunotherapy for recurrent spontaneous abortions in a Chinese population

The efficacy of immunotherapy for the treatment of recurrent spontaneous abortions was tested in patients selected from the same ethnically homogeneous population of Chinese in Taiwan in whom the immunogenetics of gestational trophoblastic tumors and of recurrent spontaneous abortion had been studied. The patients, who included both primary and secondary aborters, were randomly assigned to three groups: those who were immunized with their own lymphocytes (controls) (49); those who were immunized with their husbands' lymphocytes (39); and those who were immunized with third party lymphocytes (11). The data were analyzed individually for the primary and secondary aborters and collectively for both groups combined. The number of babies born, the number of current pregnancies, and the number of recurrent abortions were not statistically significantly different between the control and the immunized groups, and a similar small number of congenital abnormalities (4-9%) occurred in both the control and immunized groups. The increase in the blocking effect for the mixed lymphocyte reaction was not related to the success of the postimmunization pregnancies. Thus, this study does not show any significant improvement in the rate of livebirths in women immunized with their husbands' lymphocytes or with third party lymphocytes compared to that in a placebo-controlled group of women.

[Clinical observations and studies of BCG in the treatment of primary glomerulonephritis]

Sixty cases of nephrotic type of primary glomerulonephritis (PGN), who were mostly insensitive to the corticosteroids, received killed BCG inoculation as a main measure of combined therapy. After this treatment the complete and approximate remissions accounted for 80% in all. The urinary protein, serum albumin, BUN and SCr all had very significant improvement. As to those with similar pathologic and clinical findings, the therapeutic effects were much better in the BCG group than in the control. 13/15 cases followed up over 1-2 years had complete remission at the latest follow up and 5/6 followed below 1 year did so. The longer the courses of BCG, the lower the recurrence rates. The therapeutic effects of retreatment to those recurrent cases were much more rapid than those of initial treatment. The phagocytic function of the monocyte in another 24 PGN cases was studied. This function was found to be significantly depressed and could be normalized through BCG inoculation.

Reduced stimulating effect on one-way mixed lymphocyte culture by parturient's and neonatal cord blood cells

One-way mixed lymphocyte culture (MLC), using the peripheral blood T, B cells and monocytes of 16 unmarried women who were never pregnant (i.e. nulligravidas) and 18 parturients, and the umbilical venous blood T, B cells and monocytes of 18 newborns as stimulating cells, were used to react with the peripheral mononuclear cells of a type "O" blood of a 29-year-old healthy man. We demonstrated that the stimulating effects were much lower in the parturients and the newborns than in the unmarried nulligravidas. The stimulating indices were significantly different, especially in the B cells. Mean stimulation index was 4.843 in unmarried nulligravidas, 1.249 in parturients and 1.284 in newborns. Our results seem to suggest that pregnancy produces some alternations on both the maternal and the fetal cells, making the maternal and the fetal immune systems fail to recognize each other.