[Effects of Nao-Yi-An granule on activity of cytochrome c oxidase in hippocampus of experimental intracerebral hemorrhagic rats]

OBJECTIVE

To explore the neuronal protective effects of a traditional Chinese medicine complex Nao-Yi-An granule(NYA) on experimental intracerebral hemorrhage(ICH) in rats.

METHODS

Eighty collagenase-induced ICH rats were used. At 12 h, 24 h, 2 d, 4 d, 7 d, cytochrome c oxidase(CO) activity was measured with histochemistry combined with gray scale scanning. Pyramidal cell(PC) counting was also employed following Nissl's staining.

RESULTS

The CO activities in NYA-treated group were less than those in model control group, and the neuronal loss was less in NYA-treated group than that in model control group.

CONCLUSIONS

The neuronal protective mechanism of NYA following ICH may be related with its maintaining activity of cytochrome c oxidase, which contributes to improving cellular aerobic metabolism and increasing energy supply for cells.

[Epidemiological survey and analysis on bronchial asthma in Guangdong Province]

OBJECTIVE

To survey asthma prevalence and risk factors of asthma in Guangdong and then to provide a basic consideration for research and preventive and therapeutic poliaes for control of asthma.

METHODS

Using uniform scheme, procedures and questionnaire, performing stratified-cluster-disproportional-random-sampling survey for the population in six areas: Santou, Shenzhen, Zhanjiang, Shaoguan, Fushan and Guangzhou; quantitative sample the prevalence rate quantitated is 1.5% (P = 0.015, q = 0.985), a sampling number stratified = 178 x 0.985/0.015 = 11,689, if the whole province were stratified into six areas, a total of 70,134 persons were supposed to be investigated, in this survey 71,867 subjects were actually examined; all the original data were inputted into soft discs in the same form of data base structure variable definition table, and then were statistically analyzed with spas 8.0 for windows on P III/450 computer, all the prevalence rates were compared by chi 2 test.

RESULTS

In this survey 676 asthmatics were found, the overall prevalence rate was 0.94%, the ratio of male to female was 1.38:1; the rate of adults was 0.99% and that of children was 0.73%, three groups with higher prevalence were children of preschool period (age < 7 years, 1.03%), young period (age 18-25 years, 1.00%) and senile period (age 66-75 years, 2.99%); the rate of city (Fushan, 1.38%) was higher than that of rural area (Zhanjiang, 0.47%); the rate of old district (1.70%) was higher than that of the new district (0.23%) in Guangzhou and the rate of historic city (Fushan, 1.38%) was higher than that of the newly developed city (Shenzhen, 0.64%); risk factors found among 676 asthmatics, persons keeping pets (cat, dog, fowl, bird) in home were reported by 46.0% (311/676), those keeping cat was 43.1% (134/311), particularly those keeping cat and both cat and dog accounted for 61.7% (192/311). Persons often exposed to side-stream smoke were reported by 54.7%. Asthmatics with allergic rhinititis were reported by 38.2%. The attack contributed to change temperature or to inhale cold air was 41.6% respectively.

CONCLUSION

This survey had basically reflected the distribution, Frequency and intensity of asthma, the overall prevalence rate was 0.94% from which it would be estimated that there could be 670,000 asthmatics in Guangdong; the relative data will provide basis for research work concerned and mass prevention and treatment of asthma.

[Clinical investigation of effects of bizhongxiao decoction (BZX) on rheumatoid arthritis on active phase]

Ninety-six patients with rheumatoid arthritis(RA) on active phase were divided into BZX-treated group(BZXG) and methotrexate-treated group(MTXG). The results showed that after 1-month treatment, symptoms and signs, such as joint tenderness, arthralgia, arthroncus, of patients in BZXG improved notably(P < 0.01 or P < 0.05), while those of patients in MTXG did not improve, there was significant difference between these two groups(P < 0.01 or P < 0.05). After 3-month treatment, these symptoms and signs improved in both groups(P < 0.01 or P < 0.05), but BZX had a better effect than MTX. ESR, CRP, RF, C3, IgG, IgA and IgM decreased significantly in both groups after treatment(P < 0.01 or P < 0.05), ESR, CRP in BZXG decreased more and faster than those in MTXG. In BZXG the obviously efficient rat was 70%, the total efficacy rate was 94%, while in MTXG was 52% and 87% respectively. It is indicated that BZX can improve symptoms and signs of patients with RA, has better and faster effects on acute phase reaction than MTX; and it has anti-immunologic effects similar to MTX, and has no obvious side effect.

[Drug resistance of acute promyelocytic leukemia (APL) to all-trans retinoic acid (ATRA) and its reversion]

OBJECTIVE

To study the mechanism of drug resistance of APL to ATRA and the methods of reversion.

METHODS

ATRA-resistant HL60 cell line and bone marrow (BM) leukemia cells from recurrent APL patients who did not respond to ATRA treatment were used in this study. Multiple drug resistance gene (mdr1) expression was determined by RT-PCR and flow cytometry. Cell proliferation and differentiation were assessed by MTT uptake and NBT reduction respectively.

RESULTS

The response of ATRA-resistant HL60 and APL cells from recurrent patients to the differentiation inducing activity of ATRA was significantly reduced, and ATRA had little effect on cell proliferation. Expression of mdr-1 was nagative in ATRA-resistant HL60 cells. It was negative in resistant APL cells even after ATRA treatment. Arsenic trioxide and homoharringtonine (HHT) could inhibit proliferation of HL60 and ATRA-resistant HL60 cells, indicating no cross-resistance with ATRA. Interferon alpha (IFN-alpha) and PGE1 could significantly inhibit proliferation of ATRA-resistant HL60 cells and restore cell differentiation induced by ATRA.

CONCLUSION

Drug resistance of APL to ATRA is not related to mdr-1. It can be reversed by IFN-alpha. There is no cross-resistance between HHT or arsenic trioxide and ATRA.

The relative frequencies of HLA-DRB1*01 alleles in the major US populations

The frequencies of alleles in the HLA-DRB1*01 family were determined in each of five US populations from a database of 82,979 individuals. Individuals typed as DR1 (or DRB1*01) comprised between 7.6%-21.3% of the individuals in each population group. Fifty-nine DR1 individuals were randomly selected from each group and subjected to high-resolution DNA typing by polymerase chain reaction using sequence-specific oligonucleotide probes. DRB1*0101 was the most common allele in the Caucasian, Asian/Pacific Islander, and Native American groups while the DRB1*0102 allele was found in the majority of African Americans and Hispanics. DRB1*0103 was present at a similar frequency in all populations. DRB1*0104, DRB1*0105, and DRB1*0106 alleles were not observed.

Electrokinetic control of fluid flow in native poly(dimethylsiloxane) capillary electrophoresis devices

Capillary zone electrophoresis (CZE) devices fabricated in poly(dimethylsiloxane) (PDMS) require continuous voltage control of all intersecting channels in the fluidic network in order to avoid catastrophic leakage at the intersections. This contrasts with the behavior of similar flow channel designs fabricated in glass substrates. When the injection plugs are shaped by voltage control and leakage from side channels is controlled by the application of pushback voltages during separation, fluorescein samples give 64 200 theoretical plates (7000 V separation voltage, E = 1340 V/cm). Native PDMS devices exhibit stable retention times (+/- 8.6% RSD) over a period of five days when filled with water. Contact angles were unchanged (+/- 1.9% RSD) over a period of 16 weeks of dry storage, in contrast to the known behavior of plasma-oxidized PDMS surfaces. Electroosmotic flow (EOF) was observed in the direction of the cathode for the buffer systems studied (phosphate, pH 3-10.5), in the presence or absence of hydrophobic ions such as tetrabutylammonium or dodecyl sulfate. Electroosmotic mobilities of 1.49 x 10(-5) and 5.84 x 10(-4) cm2/Vs were observed on average at pH 3 and 10.5, respectively, the variation strongly suggesting that silica fillers in the polymer dominate the zeta potential of the material. Hydrophobic compounds such as dodecyl sulfate and BODIPY 493/503 adsorbed strongly to the PDMS, indicating the hydrophobicity of the channel walls is clearly problematic for CZE analysis of hydrophobic analytes. A method to stack multiple channel layers in PDMS is also described.

[Effects of recombinant human growth hormone on cortical bone of ovariectomized rats]

OBJECTIVE

To study the effects of recombinant human growth hormone on cortical bone of middle femur and vertebra of variectomized rats.

METHODS

Forty 6 month-old SD rats received low or high dose of growth hormone subcutaneously 3 months after ovariectomy for 8 weeks. Bone density and biomechanical strength of the femur were measured, and the thickness of cortical bone of the middle femur and L(2) vertebra was observed. The results were compared with those in estrogen group.

RESULTS

Growth hormone increased the thickness of cortical bone and biomechanical strength and bone density. Estrogen therapy showed no effects on bone density and biomechanical strength of cortical bone.

CONCLUSION

Recombinant human growth hormone can prevent bone loss from cortical bone of ovariectomized rat.

Mitogen-activated protein kinase mediates erythropoietin-induced phosphorylation of the TAL1/SCL transcription factor in murine proerythroblasts

Ectopic expression of the basic helix-loop-helix transcription factor TAL1 (or SCL) is the most frequent gain-of-function mutation in T-cell acute lymphoblastic leukaemia. Gene-knockout studies in mice have demonstrated that TAL1 is required for embryonic and adult haematopoiesis, and considerable evidence suggests it also has important functions in terminal erythroid differentiation. We reported previously that TAL1 phosphorylation is stimulated by erythropoietin in splenic proerythroblasts isolated from mice infected with the anaemia-inducing strain of Friend virus and show here the signalling pathway responsible. Erythropoietin was found to stimulate nuclear mitogen-activated protein kinase activity in addition to TAL1 protein phosphorylation, both of which were quantitatively inhibited by the mitogen-activated protein kinase kinase inhibitor PD 098059 and the phosphatidylinositol 3-kinase inhibitor wortmannin. Tryptic phosphopeptide analysis of radiolabelled TAL1 immunoprecipitated from nuclear extracts of Friend virus-induced proerythroblasts revealed that phosphorylation of Ser(122), shown previously to be a substrate for the mitogen-activated protein kinase ERK1 (extracellular signal-regulated protein kinase) in vitro, was specifically, although not exclusively, increased by erythropoietin and inhibited by wortmannin and PD 098059. These results are consistent with an erythropoietin-stimulated signalling pathway in which there is direct activation of a mitogen-activated protein kinase kinase by phosphatidylinositol 3-kinase and identify TAL1 as one of its nuclear targets. These data suggest, in addition, a specific mechanism by which the principal regulator of erythroid differentiation could enhance TAL1 function, in addition to increasing its expression.

Molecular cloning and characterization of a mouse gene with homology to the Duffy-antigen receptor for chemokines

The Duffy antigen receptor for chemokines (DARC) is a receptor for both CXC and CC chemokines. We have cloned a mouse gene with a predicted amino acid sequence homology of approximately 63% to human DARC and localized this gene to mouse chromosome 1 between the Xmv41 and D1Mit166 loci. We further demonstrated that, like the human gene, the mouse gene exhibits a single intron of 462 bp which interrupts the open reading frame between the codons for the seventh and eighth amino acid residues. Northern blot analyses revealed that putative mDARC mRNA is highly expressed in adult mouse spleen and skeletal muscle and in whole embryos between embryonic days 8.5 to 12. Northern blot analysis of hemangiosarcomas which develop spontaneously in the spleen of the Eker rat reveal expression of mRNAs which hybridize with both DARC and CXCR2 probes, suggesting a potential role of these receptors in the angiogenesis associated with tumor formation.

Relative HLA-DRB1*13 allele frequencies and DRB3 associations of unrelated individuals from five US populations

The frequencies of 30 HLA-DRB1*13 alleles and 15 DRB3 alleles were determined for the 5 major U.S. ethnic populations: Caucasians, African Americans, Asian/Pacific Islanders, Hispanics, and Native Americans. A random sampling (163) of DRB1*13-positive individuals from each self-described ethnic group was selected out of a pool of 82,979 unrelated individuals, providing at least an 80% probability of detecting a rare allele that occurred at 1%. These 815 samples were subjected to allele-level SSOP typing and/or DNA sequencing which identified 11 different DRB1*13 alleles. DRB1*1301 and DRB1*1302 were the most common alleles seen in the five major ethnic groups while DRB1*1304 was not detected among Caucasians and DRB1*1305 was not detected among African Americans. DRB1*13 allele diversity was surprisingly more limited among African Americans compared to both Caucasians and Asian/Pacific Islanders. To determine the extent of DRB1*13-DRB3 associations, 504 of these samples expressing only one DRB3-associated DRB1 allele were subjected to PCR-SSOP typing and 14 DRB1*13-DRB3 haplotypes were detected. The distribution revealed that African Americans were significantly different from Caucasians, Asian/Pacific Islanders, and Hispanics. Allele frequency studies such as this further support previous findings that the distribution of HLA types can differ significantly among different ethnic populations.

Protection of cardiomyocytes by pinacidil during metabolic inhibition and hyperkalemia

The objective of this study is to understand the mechanism underlying the cardioprotective effects of pinacidil, an ATP-sensitive K+ channel (K(ATP)) opener. We examined the effects of 10 microM pinacidil in cultured chicken cardiomyocytes. Pinacidil caused a concentration-dependent delay in metabolic inhibition-induced increase in intracellular calcium concentration ([Ca2+]i) and creatine phosphokinase release, and this action was antagonized by glyburide, a K(ATP) blocker. Neither verapamil, an L-type Ca2+ channel blocker, nor bepridil, a Na+-Ca2+ exchange inhibitor, affected the time course of increase in [Ca2+]i induced by metabolic inhibition. Pinacidil did not have an effect on the amplitude of K+-induced increase in [Ca2+]i, but accelerated the rate of decline following peak stimulation. In contrast, glyburide reduced the amplitude of K+-induced increase in [Ca2+]i and prolonged the rate of decline. These results provide direct evidence that pinacidil protects cardiomyocytes from metabolic inhibition-induced injury by cyanide (CN) through a delay in the onset of increase in [Ca2+]i, rather than by inhibition of the L-type Ca2+-channels or by alteration of Na+-Ca2+ exchange.

[Biomechanical evaluation of five fixation techniques for the lower cervical spine]

OBJECTIVE

This study biomechanically investigated the three-dimensional motion stability of five reconstruction methods in the cervical spine, in order to provide the biomechanical basis for the clinical selection of fixation methods.

METHODS

With eight adult cervical spine fresh specimens, the three-column injury was produced at C(4 - 5) level. The spinal constructs, reconstructed by various techniques including anterior titanium locking screw plate (TLSP), posterior interspinous wiring (IW), combined fixation with the TLSP and IW (TLSP + IW), Roy-Camille plate (RP), and transpedicular screw plate (TP), were tested under six loading modes-flexion, extension, right/left lateral bending, and right/left axial rotation.

RESULTS

The three-dimensional motion stability of either TLSP or IW was less than that of intact cervical spine. The TLSP + IW and RP provided increased stability compared with the intact spine. The stabilizing capabilities of transpedicular screw plate fixation was the best in all loading modes.

CONCLUSIONS

In three-column instability of cervical spine injury, exclusive use of the anterior plate or the posterior interspinous wiring was not supported by the results. The stabilizing capabilities provided by combined anterior and posterior instrumentation and posterior plate were good. The three-column fixation for the cervical spine using transpedicular screw plate fixation offers increased stability significantly over that of other conventional cervical fixation systems.

Effects of Ca2+ channel blockers on Ca2+ loading induced by metabolic inhibition and hyperkalemia in cardiomyocytes

The effects of the L-type (nifedipine and verapamil) and the T-type (mibefradil) Ca2+ channel blockers on the increase in intracellular Ca2+ concentration ([Ca2+]i) induced by NaCN metabolic inhibition and hyperkalemia were examined in chicken cardiomyocytes using fluorescence imaging with Fura-2. NaCN induced a slow and sustained rise in [Ca2+]i, which was not affected by pretreating the cells for 5 min with nifedipine, verapamil, or mibefradil at 100 nM or 10 microM. Pretreatment of the cells with 10 microM nifedipine, verapamil, or mibefradil for 5 min remarkably inhibited the K+-induced increase in [Ca2+]i. These inhibitory effects diminished after 48-h pretreatment with nifedipine or verapamil but not with mibefradil. Ryanodine also induces an increase in [Ca2+]i, and this effect was enhanced by 48-h pretreatment of the cells with 10 microM verapamil but not with 10 microM mibefradil. We conclude that the NaCN-induced increase in [Ca2+]i is independent of the Ca2+ influx though the L-type or T-type Ca2+ channels. Chronic inhibition of the L-type Ca2+ channels but not T-type channels may enhance the ryanodine receptor-mediated Ca2+ release, which may be responsible for the development of tolerance to their inhibitory effects on K+-induced increase in [Ca2+]i.

Multisite pacing as a supplemental treatment of congestive heart failure: preliminary results of the Medtronic Inc. InSync Study

This report describes the initial results of the "InSync" study, a European and Canadian multicenter trial that examines the safety and efficacy of a multisite pacemaker (Medtronic InSync) and of left ventricular pacing leads (Medtronic 2187 and 2188) implanted via a cardiac vein as a supplemental treatment of refractory congestive heart failure. Over a 10-month period, the system was implanted successfully in 68 of the 81 (84%) patients who had been enrolled in the study. The 68 patients were, on average, 66 +/- 10 years old, had a mean left ventricular ejection fraction (LVEF) = 21% +/- 9%, and 63% were in NYHA functional Class III and 37% were in Class IV. No system implant related complication occurred. During follow-up, 7 of 10 patients who exited the study had died, 4 suddenly. There was a clinical benefit among surviving patients, which was corroborated by a significant improvement in NYHA functional class and in the Minnesota Living with Heart Failure Quality of Life Questionnaire Score (MLS) and by a longer distance covered during a 6-minute walk test. This clinical improvement was associated with a significant narrowing of the paced QRS complex during biventricular pacing, a significant decrease in the interventricular mechanical delay, and a trend towards an increase in the duration of ventricular filling. These encouraging preliminary results confirm the feasibility and reliability of this new multisite pacing system in the management of dilated cardiomyopathy and support the continuation of further evaluations of this complementary treatment of refractory congestive heart failure.

[Diagnosis and treatment of tuberculous appendicitis]

OBJECTIVE

To study the diagnosis and treatment of tuberculous appendicitis.

METHOD

12 cases (0.26%) with tuberculous appendicitis diagnosed by histopathological examination selected from 4,652 patients during 1968 to 1997 were analysed retrospectively.

RESULT

The mean age of the patients with tuberculous appendicitis was 35 years, the disease occurred 2 times more frequently in women than in men and was usually secondary to tuberculosis elsewhere in the body (7 cases). There were 7 cases with proliferative lesions, 3 cases with ulcerative lesions and 2 cases with two kinds of lesions. 12 cases were all misdiagnosed preoperatively, 2 cases were diagnosed definitely in the operation. In 12 cases, 7 cases underwent simple appendectomy, 2 cases partial celectomy and 1 case right hemicolectomy, appendectomy and resection of regional lymph nodes were performed on 2 cases, treatment of anti-TB was given postoperatively to 9 patients. All the patients recovered without complications.

CONCLUSION

It's hard to get definite diagnosis of tuberculous appendicitis before operation because of low incidence and non-specific clinical manifestations, so careful observation in the operation and routine histopathological examination must be emphasized. Early operation and postoperative treatment of anti-TB should be advocated in order to prevent from complications.

Care of elderly patients with DNR orders in Singapore--a descriptive study

OBJECTIVE

To describe the demographic profile of a cohort of elderly patients with a 'do-not-resuscitate' (DNR) order at death and to study the specific supportive measures instituted or withdrawn during the DNR period and those in force at the time of death.

METHODS

The case notes of patients who died between October 1996 and March 1997 in the Department of Geriatrics, Alexandra Hospital were studied retrospectively by a single observer.

RESULTS

Only 95 out of an eligible 102 patients' case notes could be retrieved. Seventy-two (75.8%) patients had a DNR status at death. The racial distribution was as follows: 90.3% Chinese, 5.6% Indians, 2.8% Malays and 1.4% Others while their pre-admission domicile were: own home 79.2%, nursing home 19.4% others 1.4%. Those bedbound constituted 48.6% of the cohort while 29.2% had dementia and 43.1% were totally dependent for their activities of daily living. The commonest cause of death was pneumonia while the average duration patients were on the DNR status was 5.1 days before death. The commonest measures instituted during DNR period were as follows: oxygen therapy (38.9%), nasogastric tube insertion and feeding (30.6% and 33.3% respectively), intravenous fluid administration (33.3%), blood investigations (33.3%), opioid use (33.3%) and antibiotic use (29.2%). Measures withdrawn were intravenous fluid administration (36.1%), hourly monitoring of parameters (22.2%), antibiotics (13.9%), high dependency care (12.5%) and nasogastric tube feeding (6.9%).

CONCLUSION

The DNR status is decided late in the course of a patient's illness when he may have been too ill to partake in the decision making process. Even if a DNR status was ordered, a patient might still be subjected to CPR at death.

Antibodies affecting ion channel function in acquired neuromyotonia, in seropositive and seronegative myasthenia gravis, and in antibody-mediated arthrogryposis multiplex congenita

A new autoimmune disease affecting the neuromuscular junction has been defined. Acquired neuromyotonia is associated with antibodies to voltage-gated potassium channels that act, at least in part, by reducing potassium channel function with resulting neuronal hyperactivity. This condition is quite frequently associated with thymoma and, in many cases, antibodies to acetylcholine receptors are present as well as antibodies to VGKC. Improvements in techniques and the availability of cloned DNA and recombinant forms of the AChR subunits have led to new observations concerning the specificity and roles of antibodies in myasthenia gravis. The transfection of a cell line with the epsilon subunit means that we can now accurately compare antibodies reactive with adult and fetal human AChR. This may help to determine the relationship between AChR subunit expression in different tissues and the induction of antibodies that bind specifically to the two forms, as well as to clarify the role of antibodies to fetal or adult AChR in causing ocular muscle symptoms. Serum antibodies from a few mothers with obstetric histories of recurrent arthrogryposis multiplex congenita in their babies specifically inhibit the function of fetal AChR. These observations not only explain the cause of some cases of arthrogryposis multiplex congenita, but also suggest that other fetal-specific antibodies might be responsible for other fetal or neonatal conditions. An animal model has been established to enable us to investigate the role of maternal serum factors in causing such disorders. Seronegative MG has been the subject of many studies from our laboratory over the last ten years. The transience of the effects of SNMG plasmas on AChR function strongly suggests that the plasma antibodies do not bind directly to the AChR, but inhibit function by some indirect mechanism. They do not appear to act via the cAMP-dependent protein kinase pathway, and studies are in progress to investigate the involvement of other second messenger systems.

The effect of thyrotropin receptor antibodies on the proliferation of FRTL-5 cells and the expression of protooncogene c-fos mRNA

OBJECTIVE

Hyperthyroidism and a diffuse goiter are the main symptoms of Graves' disease (GD) associated with autoantibodies to thyroid-stimulating hormone (TSH) receptor (TRAb). The present study was conducted to evaluate effects of autoantibodies in patients with GD (TRAb-IgG) on induction of the proliferation and c-fos mRNA expression in FRTL-5 cells (Fisher rat thyroid cell line).

METHODS

Highly purified IgG fractions were isolated from 11 patients with GD, TRAb-IgG and 15 normal individuals (normal controls) with Protein A Sepharose CL-4B affinity column chromatograph. FRTL-5 cells, which had been grown to subconfluency and deprived of TSH for a few days. Then, these cells were used for measuring cAMP content, 3H-thymidine incorporation in cells and the expression of c-fos mRNA respectively.

RESULTS

After stimulation of TRAb-IgG, the cAMP production and 3H-thymidine incorporation in FRTL-5 cells were much higher than those from normal controls (P < 0.05 respectively). Using 32P labelled v-fos probe by the Northern Blot method, the expression of c-fos mRNA could be induced by IgGs from patients with GD.

CONCLUSIONS

These data suggest that the stimulation of TRAb-IgG followed by cAMP production and 3H-thymidine incorporation is related to the induction of c-fos mRNA and, thus, to the growth of FRTL-5 cells.

[Incorporation of cortical allograft: a biomechanical study]

OBJECTIVE

To explore the changes of biomechanical properties of cortical allograft in different mechanical environments.

METHOD

Cortical allograft was transplanted to each side of the midshaft diaphyseal ulnar of 40 rabbits. The left transplanted allograft underwent normal physiological load, while the right underwent lower load. Animals were killed and specimens taken for examination of bone mineral density, bone porosity and maximal three-point-bend breaking load.

RESULT

The union strength of allograft-host bone junction increased constantly, while the internal creeping substitution led to an initial greater weakening of the cortical allograft itself and the later recovery of its strength. In comparison, the union strength of the normally loaded graft-host surface was significantly higher than that of the lower loaded side at eight and sixteen weeks after transplantation. At the sixteenth week, there was greater bone strength in normally loaded graft than that in less loaded graft.

CONCLUSION

The internal repair would lead to initial greater weakening of cortical allograft and the later gradual recovery of its strength. The effect of physiological load can accelerate the improvement of the biomechanical properties of allograft.

Imprinting at the mouse Ins2 locus: evidence for cis- and trans-allelic interactions

The mouse gene encoding preproinsulin 2 (Ins2) is located on the distal end of chromosome 7 in a region of several hundred kilobases that contains several imprinted genes. The exclusive expression of the Ins2 paternal allele in the visceral yolk sac during the last part of gestation indicates that Ins2 also is imprinted. However, in other tissues in which Ins2 is expressed, both alleles are active at all developmental stages. Taking advantage of two mouse strains carrying different null mutations introduced at the Ins2 locus via homologous recombination in ES cells, we examined whether genes inserted at the Ins2 locus become imprinted and have the same restricted pattern of monoallelic expression. In the first null allele, Ins2 was replaced by LacZ, under the control of the endogenous Ins2 promoter, and a Neo cassette with its own promoter was inserted 3' to LacZ (Zneo allele). In the second null allele, Ins2 and its promoter were replaced by the same Neo cassette (Neo allele). Expression of the maternally and paternally inherited genes was monitored by RT-PCR performed on various reciprocal crosses involving the two mutants and the wildtype alleles. In (Zneo x wildtype) F1 embryos, the pattern of LacZ expression was similar to that of Ins2; i.e., LacZ is expressed in the yolk sac only when paternally inherited, while its expression in the embryo proper is independent of its paternal or maternal origin. For both of the mutant alleles, Neo was transcribed only when paternally inherited, in the yolk sac as well as in the embryo. Unexpectedly, we found that LacZ transcription on the maternal chromosome varied depending on the nature of the allele on the paternal chromosome. While fully expressed in the embryo when the paternal chromosome carries the wildtype allele, the maternally inherited LacZ is extinguished when the paternal allele is the Neo allele. The major conclusion from our results is that individual genes introduced into an imprinted chromosomal domain can become imprinted, indicating the influence of long-range cis-acting effects. In addition, our data suggest that the two parental alleles may "communicate" with each other and influence the transcription at the locus.

A role for Mac-1 (CDIIb/CD18) in immune complex-stimulated neutrophil function in vivo: Mac-1 deficiency abrogates sustained Fcgamma receptor-dependent neutrophil adhesion and complement-dependent proteinuria in acute glomerulonephritis

Mac-1 (alphambeta2), a leukocyte adhesion receptor, has been shown in vitro to functionally interact with Fcgamma receptors to facilitate immune complex (IC)-stimulated polymorphonuclear neutrophil (PMN) functions. To investigate the relevance of Mac-1-FcgammaR interactions in IC-mediated injury in vivo, we induced a model of Fc-dependent anti-glomerular basement membrane (GBM) nephritis in wild-type and Mac-1-deficient mice by the intravenous injection of anti-GBM antibody. The initial glomerular PMN accumulation was equivalent in Mac-1 null and wild-type mice, but thereafter increased in wild-type and decreased in mutant mice. The absence of Mac-1 interactions with obvious ligands, intercellular adhesion molecule 1 (ICAM-1), and C3 complement, is not responsible for the decrease in neutrophil accumulation in Mac-1- deficient mice since glomerular PMN accumulation in mice deficient in these ligands was comparable to those in wild-type mice. In vitro studies showed that spreading of Mac-1-null PMNs to IC-coated dishes was equivalent to that of wild-type PMNs at 5-12 min but was markedly reduced thereafter, and was associated with an inability of mutant neutrophils to redistribute filamentous actin. This suggests that in vivo, Mac-1 is not required for the initiation of Fc-mediated PMN recruitment but that Mac-1-FcgammaR interactions are required for filamentous actin reorganization leading to sustained PMN adhesion, and this represents the first demonstration of the relevance of Mac-1-FcgammaR interactions in vivo. PMN-dependent proteinuria, maximal in wild-type mice at 8 h, was absent in Mac-1 mutant mice at all time points. Complement C3-deficient mice also had significantly decreased proteinuria compared to wild-type mice. Since Mac-1 on PMNs is the principal ligand for ic3b, an absence of Mac-1 interaction with C3 probably contributed to the abrogation of proteinuria in Mac-1-null mice.

Mechanisms of action of anti-GM1 and anti-GQ1b ganglioside antibodies in Guillain-Barré syndrome

Anti-GM1 and anti-GQ1b ganglioside antibodies are found in association with acute and chronic peripheral neuropathies, including Guillain-Barré syndrome. They are believed to arise as a result of molecular mimicry with immunogenic microbial polysaccharides. Although anti-ganglioside antibodies are suspected to play a causal role in neuropathy pathogenesis, the details of this have yet to be proven. The approach in this laboratory to solving this issue has been to generate anti-GM1 and anti-GQ1b monoclonal antibodies from peripheral blood lymphocytes of affected patients and to study their immunolocalization in peripheral nerve and their electrophysiologic effects in animal models in which peripheral nerve sites are exposed to anti-ganglioside antibodies. These data show that anti-ganglioside antibody-reactive epitopes are widely distributed in peripheral nerve and can cause electrophysiologic abnormalities in a variety of model systems; thus, these data support the view that anti-ganglioside antibody-reactive epitopes may directly contribute to neuropathy pathogenesis.

[Investigation on matrix degrading enzymes of lumbar intervertebral discs]

Changes in the macromolecular matrix of the intervertebral disc may predispose to biomechanical failure of the disc. Such changes would involve extracellular enzymes capable of altering the collagen and proteoglycan of the disc matrix. In this study, tritium-labeled type I collagen was used as a substrate to estimate the activity of collagenase in the discs of 41 cases of lumbar disc protrusion (LDP) patients by surgical intervention. The annulus fibrous (AF) and nucleus pulposus (NP) were measured separately. 34 normal discs harvested by autopsy acted as controls. For estimation of relative neutral proteinase content of 6 normal and 16 degenerated lumbar discs, polyacrylamide gelelectrophoresis (PAGE), heat-denatured collagen as a substrate, and photo-density scanning with peak area autocalculating system were adopted. The results presented that both AF and NP of the normal discs had a similar lower collagenolytic activity and a very limited activity of neutral proteinase, while the degenerated discs showed a higher activity, especially in the degenerated NP. The extruded type of LDP got a higher collagenolytic activity in NP than that of the prolapsed LDP. The fact showed that the matrix degrading enzymes play a very important role in the process of lumbar disc degeneration. The difference of disc degeneration is the biochemical basis of different clinical types of LDP. Matrix degrading enzyme system is a very complexed multienzymatic system. Other neutral proteinases may join this system besides the collagenase.

Clinical potential of microchip capillary electrophoresis systems

Clinical interest in the use of capillary electrophoresis (CE) has recently been extended to the microchip environment. Clinical analyses demand careful handling of complex samples that are often limited in quantity and in concentration. The integrated sample handling and analysis capabilities of microchip substrates thus seem ideally suited to clinical applications. This review surveys the development of sample handling (injection, mixing, and reaction) and separation elements on-chip. The integration of these elements to create a variety of clinical analyzers has been demonstrated. The application of microchip CE systems to human serum protein analysis, immunoassay, and DNA studies is reviewed, along with various other clinical applications. In addition, the clinical potential of the lab-on-a-chip concept is discussed.

Identification of four new DR52-associated DRB1 alleles: DRB1*1424, *1425, *1323 and *1324

Four previously unreported DR52-associated DRB1 alleles have been characterized through DNA sequencing, contributing to the diversity of the HLA system. DRB1*1424 is nearly identical to DRB1*1402 in the second exon, except that it contains the "I---A" motif found at codons 67-71 common to the DRB1*15 alleles. DRB1*1425 contains the "A--H" motif, found in DRB1*1401 at codons 57-60, in a sequence otherwise identical with the second exon of DRB1*1307. Compared with DRB1*11012, DRB1*1323 contains three predicted amino acid changes at codons 58 (ala-->glu), 67 (phe-->ile), and 71 (arg-->glu). The sequence of DRB1*1324 is identical to exon 2 of DRB1*1103, except that DRB1*1324 does not contain the GAG at codon 58 characteristic of the DRB1*11 alleles. These new alleles may have arisen through gene conversion, and they contribute to the complexity of the DR6 family.

[Operative treatment of displaced acetabular fractures through the ilioinguinal approach]

To reduce the incidence of ectopic ossification and improve hip joint function after the operative treatment of displaced acetabulum fractures. We surgically treated 12 acetabular fractures which involved anterior column or both anterior and posterior column fractures through the ilioinguinal approach. 10 patients were judged postoperatively to have an anatomic reduction, and 2 had a satisfactory reduction. An average of 3-year follow-up showed excellent results in 8 patients (67%) and good in 4 (33%). Radiographic results indicated excellent results in 8 (67%), patients good in 3 (25%), fair in 1 (8%). The results suggested that the ilioinguinal approach appears to diminish many of the problems associated with utilization of an extrapelvic approach, including the disturbances of the hip abductor system, heterotopic ossification, sciatic palsy, the slow recovery of hip mobility. We conclude that it is not only good for an operative treatment of anterior column fractures but also good for some of posterior column fractures.

Diversity associated with the second expressed HLA-DRB locus in the human population

Although diversity within the HLA-DRB region is predominantly focused in the DRB1 gene, the second expressed DRB loci, DRB3, DRB4, and DRB5, also exhibit variation. Within DRB1(*)15 or DRB1(*)16 haplotypes, four new variants were identified: 1) two new DRB5 alleles, DRB5*0104 and DRB5*0204, 2) a haplotype carrying a DRB1(*)15 or *16 allele without the usual accompanying DRB5 allele, and 3) a haplotype carrying a DRB5(*)0101 allele without a DRB1(*)15 or *16 allele. The evolutionary origins of these haplotypes were postulated based on their associations with the DRB6 pseudogene. Within HLA haplotypes which carry DRB3, a new DRB3(*)0205 allele and one unusual DRB3 association were identified. Finally, two new null DRB4 alleles are described: DRB4(*)0201N, which exhibits a deletion in the second exon, and a second allele, DRB4(*)null, which lacks the second exon completely. Gene conversion-like events and variation in the number of functional genes through reciprocal recombination and inactivation contribute to the diversity observed in the second expressed HLA-DRB loci.

Cytokine-induced meningitis is dramatically attenuated in mice deficient in endothelial selectins

Leukocyte accumulation in cerebrospinal fluid and disruption of the blood-brain barrier are central components of meningitis and are associated with a poor prognosis. Genetically engineered deficiencies or functional inhibition of endothelial leukocyte adhesion receptors P-, or P- plus E-selectins, lead to deficits in leukocyte rolling and extravasation. However, their impact on meningeal inflammation has not been tested previously. An acute cytokine-induced meningitis model associated with significant cerebrospinal fluid leukocyte accumulation (averaging 14,000 leukocytes/microl as early as 4 h) and blood-brain barrier permeability was developed in adult mice. This model was applied to mice deficient in P-selectin and mice doubly deficient in P- and E-selectins. Partial inhibition of cerebrospinal fluid leukocyte influx and permeability was noted in P-selectin-deficient mice. Mice doubly deficient in P- and E-selectins displayed a near complete inhibition of these parameters. Our results suggest that P- and E-selectins cooperatively contribute to meningitis and that functional blocking of both endothelial selectins in conjunction with antibiotics may provide a therapeutic approach for treatment of bacterial meningitis.

Opioid regulation of intracellular free calcium in cultured mouse dorsal root ganglion neurons

Opioid agonists induced an increase in the intracellular free calcium concentration ([Ca2+]i) or an inhibition of K+ (25 mM)-stimulated increase in [Ca2+]i in different subsets of mouse dorsal root ganglion (DRG) neurons. The total neuronal population was grouped into three classes according to somatic diameter and defined as small ( < 16 microns), intermediate (16-25 microns), or large ( > 25 microns) neurons. Substance P-like immunoreactivity was detected mainly in the small and intermediate neurons. The delta, kappa, and mu opioid receptor agonists [D-Ser2,Leu5]enkephalin-Thr (DSLET), U69593, and [D-Ala2, MePhe4, Glyol5]enkephalin (DAMGO) each induced a transient increase in [Ca2+]i in a small fraction ( < 30%) of neurons. The increases in [Ca2+]i were blocked by the opioid antagonist naloxone. The dihydropyridine-sensitive calcium channel blocker nifedipine also blocked the increase in [Ca2+]i induced by 1 microM DSLET. The rank order of potency (percentage of cells responding to each opioid agonist) was DSLET > U69593 > DAMGO. The opioid-induced increase in [Ca2+]i was observed mainly in large neurons, with a low incidence in small and intermediate neurons. Opioid agonists also caused inhibition of K(+)-stimulated increases in [Ca2+]i, which were blocked by naloxone (1 microM). Inhibition of the K(+)-stimulated increase by 1 microM DSLET or U69593 was greater in small and intermediate neurons than in large neurons.

Acute passive anti-glomerular basement membrane nephritis in P-selectin-deficient mice

P-selectin present on surfaces of activated endothelium and platelets mediates neutrophil-endothelial and neutrophilplatelet interactions. The role of P-selectin in vivo was examined in a model of acute passive anti-GBM nephritis in P-selectin-deficient and wild-type mice which was induced by intravenous injection of anti-GBM serum. There were two major differences between P-selectin-deficient and wild-type mice. Firstly, mutant mice had approximately two fold more glomerular PMNs and albuminuria than wild-type animals at the peak of neutrophil influx and proteinuria. Secondly, Lipoxin A4 (LXA4), an eicosanoid which inhibits leukocyte-endothelial adhesion in vitro, and is generated primarily by transcellular biosynthetic routes during P-selectin-mediated platelet-PMN interaction [1], was approximately 60% of wild type levels in nephritic kidneys of P-selectin-deficient mice. Injection of wild-type platelets into P-selectin-null mice restored LXA4 to wild-type levels. The corresponding PMN influx approximated PMN levels in wild-type mice receiving platelets but urine albuminuria remained higher. Although these two P-selectin-dependent events cannot be directly linked, our results point to the importance of considering both platelet and endothelial P-selectin in determining the cellular events in inflammation.

A somatically mutated human antiganglioside IgM antibody that induces experimental neuropathy in mice is encoded by the variable region heavy chain gene, V1-18

IgM paraproteins associated with autoimmune peripheral neuropathy and anti-Pr cold agglutinins react with sialic acid epitopes present on disialylated gangliosides including GD1b, GT1b, GQ1b, and GD3. A causal relationship between the paraprotein and the neuropathy has never been proven experimentally. From peripheral blood B cells of an affected patient, we have cloned a human hybridoma secreting an antidisialosyl IgM mAb, termed Ha1, that shows identical structural and functional characteristics to its serum counterpart. Variable region analysis shows Ha1 is encoded by the same VH1 family heavy chain gene, V1-18, as the only other known anti-Pr antibody sequence and is somatically mutated, suggesting that it [correction of is] arose in vivo in response to antigenic stimulation. In the rodent peripheral nervous system, Ha1 immunolocalizes to dorsal root ganglia, motor nerve terminals, muscle spindles, myelinated axons, and nodes of Ranvier. After intraperitoneal injection of affinity-purified antibody into mice for 10 d, electrophysiological recordings from the phrenic nerve-hemidiaphragm preparation demonstrated impairment of nerve excitability and a reduction in quantal release of neurotransmitter. These data unequivocally establish that an antidisialosyl antibody can exert pathophysiological effects on the peripheral nervous system and strongly support the view that the antibody contributes to the associated human disease.

Nerve growth factor-stimulated nuclear S6 kinase in PC12 cells

Previous work has shown that nerve growth factor (NGF) stimulates the phosphorylation of the ribosomal protein S6 in PC12 cells. In this study, we show that S6 kinase activity is also present in purified PC12 cell nuclei. This activity was increased by treatment of the cells with NGF and, to a lesser extent, by treatment with epidermal growth factor. The NGF-stimulated activity was obtained from nuclear extracts and some of its characteristics described. The increase in activity was prevented by treatment of the cells with rapamycin or with wortmannin, and the overall activity could be precipitated by antibodies directed against the p85SGK. These data indicate that p85SGK is the NGF-stimulated S6 kinase in PC12 cell nuclei. The presence of S6 protein in the nucleus of PC12 cells has been confirmed and evidence is presented that suggests that it is identical to a protein called SMP reported some years ago.

[The direct repair of the defect and grafting with single segment reduction fixation system in the treatment of lumbar spondylolysis and spondylolisthesis]

We designed lumbar spondylolysis and spondylolisthesis single segment reduction fixation system according to neural arch measured in the 46 dried specimen. The biomechanical tests showed that its strength is 1.6 times that of Hefti's technique, 2.7 times that of Salib's technique. It used contacted point lamina by lamina hook as fulcrum, through lever and pedicle screw to pull back olisthetic vertebrae. 18 patients were treated with this method. The displacemen rate was 26.67% before operation and 3.38% after operation. The height of disc was 14.94 mm before operation and 17.08 mm after operation. 15 patients were followed up for 12 months. By Henderson standard, excellent result was moted in 13 patients, good in 1 and fair in 1. We conclude that LSRF has good reduction and rigid fixation and it is a new technique for lumbar spondylolysis and spondylolisthesis.

[Unstable Jefferson variant atlas fractures: an unrecognized cervical injury]

Nine cases of unstable Jefferson variant atlas fractures were treated with nonoperative external immobilization between 1989 and 1993. All of them were studied by plain films and CT scans. Seven cases had three breaks of the atlas ring. One case had unilateral anterior arch fracture, associated transverse ligament tear and quadriplegia. The other case had Jefferson, Hangman, C3pedicle burst fractures and C3,4dislocation. All of the fractures were unstable or potentially unstable. Despite the abnormal open month view in all cases, the plain films showed minimal abnormalities, requiring CT for definite diagnosis. Follow-up for average of 16 months showed the 7 cases showed the fractures healed with good bone bunion, complete mobility and no residual pain.

Opioid-induced increase in [Ca2+]i in ND8-47 neuroblastoma x dorsal root ganglion hybrid cells is mediated through G protein-coupled delta-opioid receptors and desensitized by chronic exposure to opioid

delta-Receptor agonists induce a concentration-dependent increase in intracellular calcium concentration ([Ca2+]i) in ND8-47 cells by activating dihydropyridine-sensitive Ca2+ channels. The role of G proteins in transducing the opioid effect has been studied. Pretreatment of cells with pertussis toxin (100 ng/ml, 24 h) almost completely blocked [D-Ser2,Leu5]enkephalin-Thr (DSLET)-induced increase in [Ca2+]i. Cholera toxin (10 nM, 24 h) had no effect on DSLET-induced response. Pretreatment of the cells with 1 microM DSLET for 1 h resulted in a 30% inhibition of DSLET-induced increase in [Ca2+]i and a 78% inhibition after exposure for 24 h. After 1 h of exposure to DSLET, there was a decrease in agonist affinity with no significant changes in receptor density. Cells exposed to 1 microM DSLET for 24 h demonstrate a nearly 90% decrease in [3H]diprenorphine binding, with a decrease in affinity for agonist at the remaining binding sites. G protein subunits alpha i2, alpha i3, alpha s, and alpha q were detected in ND8-47 cell membranes by western blot; alpha o and alpha i1 were not present. Chronic DSLET treatment had no significant effect on the quantity of each of the alpha-subunits. These results suggest that the DSLET-induced increase in [Ca2+]i mediated through pertussis toxin-sensitive G proteins (probably Gi2 or Gi3) and the attenuation of this response in chronically treated cells is associated with a relatively rapid reduction in receptor affinity to DSLET and a slow reduction in receptor density.

Antisense oligodeoxynucleotide to the Gi2 protein alpha subunit sequence inhibits an opioid-induced increase in the intracellular free calcium concentration in ND8-47 neuroblastoma x dorsal root ganglion hybrid cells

In ND8-47 cells, a neuroblastoma x dorsal root ganglion hybrid cell line, activation of delta-opioid receptors induced an increase in the intracellular free calcium concentration ([Ca2+]i) through dihydropyridine-sensitive calcium channels. This effect was mediated by pertussis toxin-sensitive G proteins. The G protein alpha subunits alpha i2, alpha i3, alpha q, and alpha s were detected using Western blots, whereas alpha o and alpha i1 were not found in ND8-47 cell membranes. To identify the specific G protein alpha subunit(s) responsible for the increase in [Ca2+]i, we treated ND8-47 cells with antisense oligodeoxynucleotides (AS) complementary to the mRNA for each G protein alpha subunit (alpha i2, alpha i3, or alpha s), at a concentration of 10 microM, for up to 6 days and examined their effects on opioid-induced increases in [Ca2+]i and on the levels of G protein alpha subunits. [Ca2+]i was measured in adherent cells using the fluorescent dye fura-2. Treatment of cells with alpha i2-AS (10 microM, for 6 days) resulted in a 73% inhibition of the [D-Ser2,Leu5]-enkephalin-Thr-induced increase in [Ca2+]i. In contrast, pretreatment of cells with alpha i3-AS (10 microM, for 6 days) or alpha s-AS (10 microM, for 6 days) had no effect on the [D-Ser2,Leu5]-enkephalin-Thr-induced responses. Western blots indicated that the levels of alpha i2 were decreased when cells were exposed to alpha i2-AS (10 microM) for 6 days, whereas the levels of alpha i3, alpha s, and alpha q were not affected by this treatment. Treatment of the cells with alpha i3-AS or alpha s-AS for 6 days significantly reduced alpha i3 or alpha s levels, respectively. These results indicate that the opioid-induced increase in [Ca2+]i in ND8-47 cells is mediated by G alpha i2.

Temporal differences in the phosphorylation state of pre- and postsynaptic protein kinase C substrates B-50/GAP-43 and neurogranin during long-term potentiation

The phosphorylation state of two identified neuralspecific protein kinase C substrates (the presynaptic protein B-50 and the postsynaptic protein neurogranin) was monitored after the induction of long term potentiation in the CA1 field of rat hippocampus slices by quantitative immunoprecipitation following 32Pi labeling in the recording chamber. B-50 phosphorylation was increased from 10 to 60 min, but no longer at 90 min after long term potentiation had been induced, neurogranin phosphorylation only at 60 min. Increased phosphorylation was not found when long term potentiation was blocked with the N-methyl-D-aspartate receptor antagonist D-2-amino-5-phosphonovalerate, when only low frequency stimulation was applied or tetanic stimulation failed to induce long term-potentiation. Our data show that both B-50 and neurogranin phosphorylation are increased following the induction of long term potentiation, thus providing strong evidence for pre- and postsynaptic protein kinase C activation during narrow, partially overlapping, time windows after the induction of long term potentiation.

Direct sequencing of SSP-PCR-amplified cDNA to identify new alleles in the DR52-associated DRB1 group: identification of DRB1*1115, DRB1*1117 and DRB1*1319

Low and high resolution sequence specific oligonucleotide probe hybridization patterns were used to design an approach to direct sequencing of allele specific amplified cDNA. Several PCR amplifications were used to derive overlapping sequence fragments to define complete first domain sequences for a single allele. This method has been used to characterize three new DRB1 alleles in the DR52 family, DRB1*1115, DRB1*1117, and DRB1*1319. All three alleles carry polymorphisms previously observed in other DRB alleles and underscore the importance of utilizing a directed sequencing approach for obtaining unambiguous typing results in matching for bone marrow transplantation between unrelated donor and recipient.

Heterogeneity of endothelial cell function for angiotensin conversion in serial-arranged arterioles

The involvement of the endothelial cell in the vasoconstriction induced by angiotensin I and II (AI, AII), and norepinephrine (NE) was studied in microvessels of the hamster cheek pouch before and after the following procedures: endothelial impairment by light-dye treatment, inhibition of angiotensin-converting enzyme (ACE), blockade of endothelium-derived relaxing factor (EDRF) and inhibiting prostaglandin (PG) synthesis. The results showed that in large 2nd-order arterioles, endothelial impairment did not affect the vasoconstrictor activity of AII and NE, nor did it alter ACE activity. However, in small 4th-order arterioles, endothelial impairment significantly reduced angiotensin conversion without altering the vasoconstrictor responses to either AII or NE. Thus, the endothelium plays differential roles in the modulation of local angiotensin conversion in these distinct segments of serial-arranged arterioles. Furthermore, it is unlikely that the vasoconstrictor response to AII in these arterioles is modulated by the endothelium through a pathway involving the release of EDRF or PGs.

Anaesthetic management of a patient with a descending thoracic aortic aneurysm and severe bilateral bullous pulmonary parenchymal disease

The anaesthetic management of the surgical repair of a descending aortic aneurysm in a patient with large, bilateral, pulmonary bullae is described. Anaesthesia for descending aortic surgery normally involves unilateral, positive-pressure ventilation, an option which poses some risk of barotrauma in the presence of bilateral bullae. Patients with bullous disease commonly have severe lung disease and thorough preoperative assessment and preparation are necessary. Intraoperatively, bilateral rupture of the bullae could be catastrophic and preparations should be made for this possibility. In order to diminish this risk, a surgical technique including preemptive collapse of the bulla by minithoracotomy and tube drainage, with use of a bronchial blocker to the affected part of the lung may be used. If rupture occurs, then high frequency jet ventilation may be effective. Use of a double lumen endobronchial tube may be advantageous for patients with either unilateral and bilateral bullae. Anaesthesia for patients with bullae should avoid positive-pressure ventilation and nitrous oxide in order to limit the risk of barotrauma from a ball valve mechanism. In this case, the risk of barotrauma was reduced by performing an inhalational induction of anaesthesia and limiting peak inflation pressures during thoracotomy. It was elected to use positive-pressure ventilation through a double lumen endobronchial tube following chest incision. A high frequency jet ventilator was available but not employed. Anaesthetic management was complicated by the presence of pleural adhesions, surgical approach directly through a bulla, and the requirement for one lung ventilation.

Augmentation of the immune response to influenza vaccine by acetylsalicylic acid: a clinical trial in a geriatric population

The purpose of this placebo-controlled, double-blind, randomized trial was to evaluate the efficacy of oral acetylsalicylic acid (ASA), a comparatively safe, inexpensive biological response modifier, as an adjuvant to influenza vaccination in a geriatric population. 281 healthy adults, 65 years or older, received influenza vaccine and were randomized to ASA or placebo. Serum antibody against influenza A/Beijing and B/Panama, influenza antigen-stimulated blastogenesis and antigen-stimulated interleukin-2 production by peripheral blood mononuclear cells in vitro were increased following vaccination. Blastogenic response and interleukin-2 production increased to a similar extent in the two treatment groups. The proportion of participants with a 4-fold rise in specific antibody directed against influenza A/Beijing was greater among ASA recipients (p < 0.05). This difference was more marked in subjects > 75 years old (p < 0.01).

Opioids acting through delta receptors elicit a transient increase in the intracellular free calcium concentration in dorsal root ganglion-neuroblastoma hybrid ND8-47 cells

The neuronal cell line ND8-47 (neuroblastoma x dorsal root ganglion neuron hybrid) expressed opioid delta-type receptors. We report opioid-induced changes in cytosolic intracellular free calcium ([Ca++]i) in differentiated ND8-47 cells. Delta-opioid receptor agonists induced a transient (< 2 min) increase in [Ca++]i in a concentration-dependent fashion with the potency order: [D-Ser2,Leu5]enkephalin-Thr (DSLET) > or = deltorphin II > [D-Pen2,5] enkephalin. Their effects were blocked by naloxone (IC50 = 20 nM) and naltrindole (IC50 = 2.5 nM). Selective mu and kappa receptor agonists had no effect on [Ca++]i. The subtype specific delta receptor antagonists, 7-benzylidene naltrexone (delta-1) and naltriben (delta-2), were used to characterize further the subtype of delta receptors mediated by this response. Naltriben was more potent than 7-benzylidene naltrexone in antagonizing the DSLET-induced increase in [Ca++]i. The increase in [Ca++]i induced by DSLET was blocked by nifedipine (1 microM) or verapamil (1 microM), and was not observed in the absence of external calcium. Changes in [Ca++]i also were measured in single ND8-47 cells. The percentage of cells responding to DSLET (1 microM), deltorphin-II (1 microM) and [D-Pen2,5]enkephalin (1 microM) were 86, 84 and 37%, respectively. The results suggest that an increase in [Ca++]i induced by opioids is mediated through opioid delta receptors which can activate dihydropyridine-sensitive Ca++ channels.

[Intracellular recordings and electrophysiological properties of neurons of pancreatic ganglia in vitro]

The work was carried out to investigate electrophysiological properties of neurons of cat intrapancreatic ganglia in vitro by means of intracellular recordings. The mean value of resting membrane potential was -58.5 +/- 8.7 mV (chi +/- s chi, n = 35) with a range from -45 to 72 mV. The mean values of membrane input resistance (Rm), time constant (tau) and capacity (Cm) were 68.6 +/- 5.1M omega, 3.4 +/- 0.2 ms and 50.8 +/- 3.9pF (n = 28), respectively. When depolarizing electrotonic potentials induced by intracellular injection of depolarizing current pulses (0.05-0.5nA, 5ms) reached the threshold potential level, all of the neurons could fire action potentials. The threshold, amplitude, overshoot and duration of spikes were 19.2 +/- 0.5mV, 81.0 +/- 1.7mV, 22.6 +/- 0.9mV and 2.9 +/- 0.1ms (n = 35), respectively. The spike was followed by a prolonged after spike hyperpolarization with amplitude of 20.5 +/- 0.8mV (n = 35). In most of neurons, fast excitatory postsynaptic potentials (f-EPSP) or orthodromic action potentials were recorded during stimulation of nerve trunks attached to the intrapancreatic ganglia. The mean values of amplitude, duration of the f-EPSP and conduction velocity of the nerves were 8.9 +/- 0.7mV, 25.8 +/- 1.9ms and 0.48 +/- 0.04m/s (n = 24), respectively. The ongoing synaptic activity was observed in all of cells. Moreover, f-Epsp, was induced by acetylcholine mediated through nicotinic receptors.

Retinoic acid induction of major histocompatibility complex class I genes in NTera-2 embryonal carcinoma cells involves induction of NF-kappa B (p50-p65) and retinoic acid receptor beta-retinoid X receptor beta heterodimers

Retinoic acid (RA) treatment of human embryonal carcinoma (EC) NTera-2 (NT2) cells induces expression of major histocompatibility complex (MHC) class I and beta-2 microglobulin surface molecules. We found that this induction was accompanied by increased levels of MHC class I mRNA, which was attributable to the activation of the two conserved upstream enhancers, region I (NF-kappa B like) and region II. This activation coincided with the induction of nuclear factor binding activities specific for the two enhancers. Region I binding activity was not present in undifferentiated NT2 cells, but binding of an NF-kappa B heterodimer, p50-p65, was induced following RA treatment. The p50-p65 heterodimer was produced as a result of de novo induction of p50 and p65 mRNAs. Region II binding activity was present in undifferentiated cells at low levels but was greatly augmented by RA treatment because of activation of a nuclear hormone receptor heterodimer composed of the retinoid X receptor (RXR beta) and the RA receptor (RAR beta). The RXR beta-RAR beta heterodimer also bound RA responsive elements present in other genes which are likely to be involved in RA triggering of EC cell differentiation. Furthermore, transfection of p50 and p65 into undifferentiated NT2 cells synergistically activated region I-dependent MHC class I reporter activity. A similar increase in MHC class I reporter activity was demonstrated by cotransfection of RXR beta and RAR beta. These data show that following RA treatment, heterodimers of two transcription factor families are induced to bind to the MHC enhancers, which at least partly accounts for RA induction of MHC class I expression in NT2 EC cells.

Hyperselective posterior rhizotomy in treatment of spasticity of paralytic limbs

One hundred and eight patients with spasticity of the paralytic limbs were treated successfully with hyperselective posterior rhizotomy (SPR). Of the 108 patients, 100 had cerebral palsy, 2 hemiplegia, 3 sequelae of cerebral injury, 2 paraplegia and 1 multiple sclerosis. Twelve patients received cervical SPR and 96 lumbosacral SPR. Laminectomy is performed to open the dura and to separate the posterior spinal root into several rootlets. The lower threshold rootlets were divided after electrical stimulation. Follow-up for 6 to 30 months showed that the effective rate of reducing spasticity was over 95% and functional improvement rate over 80%.

ZNC(C)PR affects developmental changes of P46 phosphorylation in rat hippocampus

Protein phosphorylation has been suggested to be correlated with brain development and with the molecular mechanism of behavioral effects of neuropeptides. The present study reports in vitro endogenous phosphorylation of P46, a membrane-associated protein that is changed during development of the rat hippocampus. This study indicated that the degree of endogenous phosphorylation may be correlated with the establishment of synaptic connections. Interestingly, P46 was proved to be identical to a well-known growth-associated protein B-50/GAP-43 in its identical apparent molecular weight, isoelectric point, phosphorylation dependence, and the cross immunoreaction of monoclonal anti-B-50/GAP-43 antibody and P46. Moreover, neonatal administration of neuropeptide ZNC(C)PR could facilitate the developmental progress of P46 endogenous phosphorylation. It is suggested that the changes in P46 phosphorylation could be involved in the cellular mechanism of ZNC(C)PR behavioral effects on learning.