CIS-19, a novel platelet activating factor receptor antagonist: in vitro and in vivo studies

The effects of CIS-19 (cis-2-(3,4-dimethoxyphenyl)-6-isopropoxy-7-methoxyl-1-(N-methylforma mido)-1,2, 3,4-tetrahydronaphthalene) was determined in vitro in rabbit platelets and in vivo in rats and guinea-pigs. CIS-19 inhibited in a selective and concentration-dependent manner the aggregation and ATP release reaction of rabbit platelets induced by PAF (4 nM). The IC50 values of CIS-19 on PAF-induced aggregation of washed platelets and platelet-rich plasma were 11.3 +/- 2.7 and 16.8 +/- 3.0 microM respectively. BN52021 also inhibited PAF-induced aggregation of washed platelets with an IC50 value of 11.7 +/- 2.8 microM. CIS-19 inhibited [3H]PAF (4 nM) binding to washed rabbit platelets with an IC50 value of 1.5 +/- 0.2 microM. The concentration-response curve of PAF-induced aggregation of washed platelets was shifted rightwards by CIS-19 with pA2 and pA10 values of 7.1 (6.8-7.3 for 95% confidence limit) and 6.1 (5.8-6.2) respectively. The thromboxane B2 formation of washed platelets caused by AA, collagen or thrombin was not affected by CIS-19 of concentrations below 400 microM. CIS-19 (25 microM) completely blocked PAF-induced, but not collagen- or thrombin-induced [3H]inositol monophosphate formation of washed platelets. When CIS-19 (2.5 and 5 mg/kg) was injected i.v. into the femoral vein, it did not affect the blood pressure of rats, but antagonized PAF (2.5 micrograms/kg, i.v.)-induced hypotensive shock either preventively or curatively. CIS-19 (2.5 and 5 mg/kg) also blocked PAF (50 ng/kg)-induced, but not AA (50 micrograms/kg)-induced, bronchoconstriction in guinea-pigs. It is concluded that CIS-19 is an effective PAF receptor antagonist not only in vitro, but also in vivo.

Transcriptional regulation of precore and pregenomic RNAs of hepatitis B virus

Hepatitis B virus (HBV) infection, either acute or chronic, has been one of the leading health problems in the world. To understand the HBV life cycle and disease process, we set out to study the regulation of viral gene expression. In this paper, we report the characterization of the HBV core promoter: two 3.5-kb transcripts, precore and pregenomic, are made from it. The latter is itself a template for viral genome replication and also encodes viral proteins essential for both viral replication and virion assembly. We identify a short sequence (from nucleotides [nt] 1744 to 1851, referred to as the basic core promoter [BCP]) that is sufficient to direct correct initiation of both precore and pregenomic messages. In addition, the two appear to be regulated in a coordinate manner. Sequences upstream of the BCP (from nt 1636 to 1744, referred to as the core upstream regulatory sequence [CURS]), have a strong stimulating effect on the BCP. Addition of the CURS to the BCP leads to a dramatic increase in both the transcription of two 3.5-kb messages and the production of 42-nm virions from transiently transfected hepatoma cells. The CURS stimulates the BCP in a position- and orientation-dependent manner. Therefore, it is unlikely that the effect is mediated through enhancer II, which has been localized to the same sequence. Deletion analysis of the CURS suggests that it contains multiple regulatory elements that control the BCP in an interactive manner. In accord with this hypothesis, the CURS is found to be bound with many distinct protein factors in footprinting experiments. Among these elements, box alpha (from nt 1646 to 1668) and box gamma delta (from nt 1671 to 1703) are two regulatory elements which individually stimulate promoter activity more than 100-fold.

Prevalence of genital human papillomavirus infections in patients at a sexually transmitted diseases clinic

The human papillomavirus was detected in cervicovaginal cells by the polymerase chain reaction in 14 of 37 (37.8%) patients attending a sexually transmitted disease (STD) clinic and in 6 of 43 healthy young women (14.0%) undergoing routine gynecologic examinations who served as controls. The results indicated that even the more malignant types of human papillomaviruses were not uncommon among the control group, and that the prevalence of human papillomavirus infection was significantly higher in STD clinic patients than in the control group. These findings confirm the suggestion that factors other than human papillomavirus infections may be involved in the pathogenesis of cervical cancer.

Intraneural anatomy of the median nerve provides "third web space" donor nerve graft

To determine the feasibility of using the fascicular group to the third web space as a source of nerve graft material for bridging of median nerve gaps, a study of the intraneural anatomy of the median nerve was carried out in 23 fresh cadaver specimens. The pattern of plexus formation between the third web-space group and the remainder of the median nerve was determined. The average length of the third web-space fascicular group that could be separated from the median nerve proper prior to plexus intermingling was 24.5 cm. Cross-sectional areas of the graft and the remaining nerve were 4.43 mm2 and 13.76 mm2, respectively. The number of nerve fibers in the third web-space group was 4,847 and in the remaining median nerve, 13,486. Between February, 1989 and October, 1991, this technique has been used on 11 patients to provide donor nerve material for nerve gaps of 3 to 6 cm in the median nerve.

Possible transplacental transmission of human papillomaviruses

OBJECTIVE

The objective of this study was to examine the possibility of intrauterine human papillomavirus infection of fetuses by transplacental transmission of human papillomavirus before delivery.

STUDY DESIGN

Specimens of cervicovaginal cells and peripheral blood mononuclear cells were obtained from 52 consecutive pregnant women in the third trimester of pregnancy. Cord blood specimens were also obtained from the neonates born to these mothers. Presence of human papillomavirus types 16 and 18 deoxyribonucleic acid was analyzed by an in vitro enzymatic deoxyribonucleic acid amplification method.

RESULTS

Human papillomavirus type 16 deoxyribonucleic acid was found in 6 (11.5%) cervicovaginal and in 9 (17.3%) peripheral blood mononuclear cell specimens. Seven cord blood specimens from neonates born to mothers who were positive for peripheral blood mononuclear cell human papillomavirus type 16 deoxyribonucleic acid were found to contain human papillomavirus type 16 deoxyribonucleic acid. One cervicovaginal and two peripheral blood mononuclear cell specimens contained human papillomavirus type 18 deoxyribonucleic acid, but none of the cord blood specimens contained human papillomavirus type 18 deoxyribonucleic acid.

CONCLUSION

These results seem to suggest possible transplacental transmission of the virus and the potential association of such transmission with the status of human papillomavirus in peripheral blood mononuclear cells.

[Metastasis in oral squamous cell carcinoma]

A precise evaluation of the presence of metastasis is mandatory in the management of head and neck malignancies. Squamous cell carcinoma is the most common malignant tumor of the oral cavity, representing slightly more than 90% of all oral malignancies. The present study included 330 consecutive patients with oral squamous cell carcinoma seen at the Oral and Maxillofacial Surgery Division of the Department of Dentistry, Veterans General Hospital-Taipei from June 1975 to December 1990. Among these cases, the tongue (31.2%) was the most frequently involved site. According to AJCC staging system, 37.3% of the patients were at stage IV, the highest among stages of patients. The overall incidence of regional lymph node metastasis was 49.4%. The incidence of regional lymph node metastasis was significantly correlated with the location of the primary tumor, especially the low metastatic rate of palate and lip carcinoma (p less than 0.05). Distant metastases were detected in 14 (4.2%) cases. The rate of distant metastasis increased with the advance of staging (6.2% for stage III and IV, p less than 0.05). The lungs were the most common sites of distant metastasis. Due to the poor awareness and socio-economic condition of the patients, a majority of them presented with advanced diseases. The distant metastasis rate was low since all the patients were not kept followed up till death, nor was any autopsy study carried out.

Human papillomaviruses and small cell carcinoma of the uterine cervix

The in vitro DNA amplification technique of polymerase chain reaction was used to evaluate the possible presence of human papillomavirus (HPV) in small cell carcinoma of the uterine cervix. None of the 12 cases examined contain detectable amounts of either HPV type 16, 18, 31, or 33 DNA. On the other hand, HPV types 16 and 18 DNA were found in 14 (93.3%) and 9 (60.0%) of 25 invasive cervical squamous carcinoma tissues. The results seem to suggest that these types of HPV are not present or are present in extremely small quantities in cervical small cell carcinoma. Such an absence of HPV DNA makes it unlikely that these types of HPV play any etiological role in the pathogenesis of cervical small cell carcinoma.

Surgical management of resistant idiopathic congenital clubfoot

For neglected clubfeet or clubfeet resistant to conservative treatment, there is an increasing tendency towards early and tailored release. From November 1983 to November 1987, we operated on 37 children with 53 neglected or resistant clubfeet which included 23 with limited release and 30 with radical release. Their ages ranged from 4 months to 8 years with an average age of 1 year 5 months. Operative treatment was indicated if the clubfeet had been neglected or had shown no corrective change after 12 weeks of intensive plaster treatment. We used the Cincinnati incision for one-stage release. The average follow-up was 3.5 years (range 2-5.5 years). Evaluation criteria included physical, functional and roentgenographic findings. The results were good or excellent in 96% of the feet based on the modified Magone rating scale. There was no significant difference in the operation results between different age groups. Both the limited and the radical release groups had a high rate of satisfaction. The limited procedure only effectively improved the tibio-calcaneal angle to a significant degree (p less than 0.01), while the radical operation changed every angle significantly (p less than 0.01). Complications included calf muscle atrophy in 4 feet, overcorrection in 3 feet, undercorrection in 3 feet, superficial skin necrosis in one foot, pin tract infection in one foot and residual metatarsal adductus in one foot. In conclusion, neglected or resistant clubfeet can be treated by early and adequate release with a high rate of success. Complications can be avoided by a thorough understanding of their pathoanatomy and by a meticulous surgical approach and release.

Elevated levels of soluble interleukin 2 receptor and tumor necrosis factor in nasopharyngeal carcinoma

Depressed cell-mediated immunity as a measure of the mitogenic response of mononuclear cells in patients with nasopharyngeal carcinoma is well documented, but the mechanism is still unclear. The enzyme-linked immunosorbent assay was used to measure soluble interleukin 2 receptor and tumor necrosis factor levels in 295 patients with nasopharyngeal carcinoma and 97 age-matched control subjects. Soluble interleukin 2 receptor levels in patients with nasopharyngeal carcinoma were elevated and correlated with clinical staging. Higher soluble interleukin 2 receptor levels were found in patients with bone metastasis but not in patients with intracranial involvement. The levels of tumor necrosis factor in nasopharyngeal carcinoma were higher than in control subjects but did not correlate with clinical staging. These data suggest that soluble interleukin 2 receptor levels might be more useful than soluble tumor necrosis factor levels that indicate tumor bulk. Soluble interleukin 2 receptor serves as a blocking factor that competes with interleukin 2 function, resulting in a decreased mitogenic response in patients with nasopharyngeal carcinoma. The usefulness of the levels of soluble interleukin 2 receptor to monitor the efficacy of treatment in patients with nasopharyngeal carcinoma with bone metastasis requires further study.

Congenital central alveolar hypoventilation syndrome (Ondine's Curse): effectiveness of early home ventilation for normal development

An 8 month old Caucasian girl, with congenital central alveolar hypoventilation syndrome (Ondine's Curse), was discharged with her home ventilation managed by her parents. Her subsequent neurophysical development assessed at 22 months of age was satisfactory.

Endolymphatic sac surgery for Meniére's disease. A cumulative study of twelve years' experience

This paper analyzes a total of 861 endolymphatic-mastoid shunt procedures (ELS) during 12 years. The review of long-term results following surgery for patients with intractable Meniére's disease indicates that ELS often provides temporary remission of severe disabling symptoms. Overall results, according to AAOO criteria, showed long-term vertigo control in 71.90% of cases. Using AAO-HNS guidelines, vertigo was completely or substantially controlled in 85.89% of the cases. In addition, hearing gains were frequently sustained and hearing deterioration often prevented over the years. A positive dehydration test and/or fluctuating hearing indicate a greater likelihood of hearing improvement after surgery. Furthermore, these findings augment our previous studies that comparable results can be obtained regardless of method employed. Thus, ELS is still indicated as a primary choice of surgical treatment when surgery is mandatory. Finally, there seem to be chronological peaks of recurrence of symptoms at about 2 years and again at 6 or more years after ELS. This not only accentuates the efficacy of revision surgery, but opens new areas of investigation into the underlying etiology of this elusive disease.

Early effects of cranial irradiation on hypothalamic pituitary function

Hypothalamic pituitary functions were studied in 25 patients before and 6 months after cranial irradiation with or without radiosensitizing chemotherapy for nasopharyngeal carcinoma. The estimated average total dose was 5,000 cGy to the hypothalamus and pituitary gland. The radiosensitizing chemotherapy used was endoxan, 4900 +/- 873 mg and/or methotrexate 113 +/- 30 mg. All patients had normal pituitary function before radiotherapy. Six months after radiotherapy, there was a significant increase in baseline serum thyrotropin (TSH) and follicle-stimulating hormone (FSH) levels. The TSH response to thyrotropin-releasing hormone (TRH) was significantly increased, suggesting primary hypothyroidism due to neck irradiation. The peak serum TSH response to TRH became delayed in 21 patients, suggesting a defect in TRH release. In male patients who did not receive radiosensitizing chemotherapy, the FSH response to luteotropic hormone-releasing hormone (LHRH) increased while the luteinizing hormone (LH) response decreased. But in male patients who also received radiosensitizing chemotherapy, both the FSH and LH responses to LHRH increased. The adrenocorticotropic hormone (ACTH) response to ovine corticotropin-releasing hormone (CRH) did not change, while the integrated cortisol response increased. The growth hormone (GH) response to growth hormone-releasing hormone (GRH) did not change. The GH response to insulin tolerance test (ITT) increased and may be explained by the more severe hypoglycemia induced by the same dosage of insulin after radiotherapy or the recovery from the previous wasting caused by radiotherapy. There was no significant increase in serum prolactin. In conclusion, we demonstrated impairment of the hypothalamus-pituitary-endocrine gland axes as early as 6 months after cranial irradiation with or without chemotherapy.

A forearm free flap based on an occluded radial artery: its salvage and avoidance

The salvage of a radial forearm free flap based on an occluded radial artery is reported. Circulation to the flap was restored by resection and reconstruction of the nonpatent arterial segment within the flap. A simple test is recommended for preoperative assessment of forearm radial artery patency in which proximal pulsation is felt after distal compression of the radial artery at the wrist.

3 x 3 single-mode star coupler made from 2 x 2 couplers

An optical network made from two 3-dB and one 1.76-dB 2 x 2 single-mode couplers can perform as a 3 x 3 star coupler. One version is particularly suitable for polarization-preserving components and requires adjustment of the phase in one arm; it can also perform the three-point discrete Fourier transform by suitable adjustment of other phases. Experimental verification of the principle is presented.

[Histological study of hydroxylapatite mixed with collagen as osseous implant in mandible]

By using five Taiwan Macaca monkeys as experimental animals, three bony defects about 5 x 5 x 3 mm in size were created at each of their buccal region of mandible. Bovine skin collagen and particulate hydroxylapatite were used as implant materials. The artificial defects implanted with hydroxylapatite/collagen mixture were experimental group and the defects implanted with collagen or without any implantation were control groups. The monkeys were sacrificed at the time of 1,2,3,6,9 months after implantation surgery and were injected with tetracycline according to the above intervals at one week before being sacrificed. The specimens were divided into two parts, one of which was decalcified and stained with hemotoxylineeiosin for observation under optic light microscope, the other without decalcification was made into ground section for observation under fluorescent microscope. The result revealed that the healing processes of the two control groups were similar with each other. Bone formation was delayed in HA/Collagen group because it took almost five months to achieve complete bony repair of the mandibular defect. However bone formation at the HA/Collagen implant site was earlier than that at the pure HA implant site in our similar study. What's the role of collagen that played during bone formation still needed further investigation. The tissue response was good without obvious inflammatory cells infiltration. Clinical application of block form of dried HA/Collagen mixture was suggested for it was easier to handle and could decrease the flow of HA particles after implantation.

Unified study of color sampling

In this study, we unify some previous research work on the design of optimal color sensors and the reconstruction of color signals from color samples. We show that they are all based on a simple linear vectorspace representation derived from the Karhunen-Loeve (K-L) expansion theorem. We also show how this idea works by two simulation examples. We believe that the theoretical results derived in this study may prove useful both in machine and human color vision research.

Basal joint reconstruction in a punch injury of the hand

Severe hand trauma caused by an industrial accident resulted in composite tissue loss in the basal joint area of the right hand. The crushed metacarpal bone was replaced, and ligamentous and capsular reconstruction was performed with flexor carpi radialis tendon and additional tendon graft. We present our experience, with a follow-up of one year and eight months.

One-stage salvage of fractured nasal prosthesis with immediate calvarial bone grafting

An open fracture of a nasal prosthesis usually means the primary removal of the prosthesis and a secondary reconstruction. A case with this problem was treated by a one-stage reconstruction using a calvarial bone graft.

Three successful digital replantations in a patient after 84, 86, and 94 hours of cold ischemia time

Three successful digital replantations were performed on a patient after 84, 86, and 94 hours of prolonged cold ischemia time. Both the intraoperative and postoperative courses were smooth. Functional evaluation 8 months after operation revealed a normal speed of sensory recovery and nail growth. The atrophic changes in all three replants are mild. Total active movement was 45, 100, and 70 degrees in the replanted left thumb, left index finger, and right thumb, respectively. There is no cold intolerance. The overall functional result is satisfactory. Replantation of an amputated digit that is properly cooled immediately after injury should be attempted in selected patients even after prolonged ischemia time.

Simultaneous determination of gastrodin and its metabolite by HPLC

A rapid and specific HPLC method for the simultaneous determination of gastrodin and its metabolite gastrodigenin (p-hydroxybenzyl alcohol) in rat plasma, bile, liver, urine and faeces is described. The separation was achieved by using a reversed phase column (YWG-C18) eluted with methanol-water (2.5:97.5 v/v). Phloroglucinolum was used as internal standard and the peaks were detected at UV 221 nm. The protein precipitation with ethanol was a very simple and rapid method for sample preparation. The gastrodin and gastrodigenin were quantitated by measuring the peak-height ratios. There was a linear concentration range of 10-320 micrograms/mL in the assay for both compounds. The coefficients of variation (within-day) for samples spiked with gastrodin and gastrodigenin were 2.94% and 3.08%, respectively. The method demonstrated a high specificity and was suitable for use in pharmacokinetic studies.

On the solution of equations for feel-better hemodialysis

In this paper, a scheme for "feel better" or optimal hemodialysis (OPTHD) based on a two-compartmental model has been proposed. Contrary to the conventional constant blood flow dialysis (CVTHD), this scheme suggests that the blood flow rate should vary in stages in order to avoid or minimize the disequilibrium syndromes during dialysis. A set of equations for computing the intracellular and extracellular solute concentrations during the OPTHD operation is developed and the computed results are illustrated. Comparing to the CVTHD, the OPTHD has the advantages of operating at a lower and smoother solute concentration difference between compartments for the same length of dialysis time, or it may achieve the same specific degree of blood cleansing within a shorter period of dialysis time.