Impact of Valvular Thickness on Stroke Recurrence in Medically Treated Patients with Stroke

BACKGROUND

It remains controversial whether left-sided valvular thickening (VaT) is a risk factor for ischemic stroke. Little is known about the relationship between VaT and the recurrent adverse event rate in medically treated patients with stroke.

METHODS

We examined the outcomes of 627 noncardioembolic stroke patients who were double-blindly assigned to either warfarin or aspirin therapy and assessed VaT using transesophageal echocardiography. Endpoints were recurrent ischemic stroke or death from any cause. The Cox proportional hazards model was used to adjust for covariates.

RESULTS

VaT was present in 57.3% of the patients (359/627), 34.6% (271/627) involving the aortic valve and 46.4% (291/627) involving the mitral valve. There was no difference in the time to primary endpoints between those with and without VaT of the aortic valve (p = 0.49; hazard ratio, HR: 1.17; 95% CI: 0.74-1.85; 2-year event rates: 18.9 vs. 13.2%) or mitral valve (p = 0.66; HR: 0.91; 95% CI: 0.60-1.38; 2-year event rates: 16.9 vs. 14.7%). Among the patients with VaT, there was no significant difference in the time to primary endpoints between those treated with warfarin and those with aspirin (p = 0.13, HR: 0.65, 95% CI: 0.37-1.14, 2-year event rates: 15.2 vs. 22.7% for the aortic valve; p = 0.22, HR: 0.70, 95% CI: 0.40-1.23, 2-year event rates: 14.2 vs. 19.6% for the mitral valve).

CONCLUSIONS

VaT does not appear to increase recurrent adverse event rates in medically treated patients with ischemic stroke, regardless of warfarin or aspirin therapy.

Anti-CD25 treatment and FOXP3-positive regulatory T cells in heart transplantation

The interleukin-2 receptor alpha chain (IL-2Ra, CD25) plays a major part in shaping the dynamics of T cell populations following immune activation, due to its role in T cell proliferation and survival. Strategies to blunt the effector responses in transplantation have been developed by devising pharmaceutical agents to block the IL-2 pathways. However, such strategies could adversely affect the CD25(+)FOXP3(+)T regulatory (T reg) populations which also rely on intereukin-2 signaling for survival. The present study shows that a cohort of heart allograft recipients treated with Daclizumab (a humanized anti-CD25 antibody) display FOXP3 expression patterns consistent with functional T regulatory cell populations. High levels of FOXP3 were observed to correlate with lower incidence of and recovery from acute rejection, as well as lower levels of anti-donor HLA antibody production. Therefore, T reg populations appear fully functional in patients treated with Daclizumab, even when 5 doses were administered. By comparison, patients treated with fewer doses or no Daclizumab had a higher incidence of acute rejection, antibody production and graft failure. Therefore, our data indicates that Daclizumab treatment does not interfere with the generation of regulatory T cells and has a beneficial effect on heart allograft survival.

Hypermethylation of the nel-like 1 gene is a common and early event and is associated with poor prognosis in early-stage esophageal adenocarcinoma

The nel-like1 (NELL1) gene maps to chromosome 11p15, which frequently undergoes loss of heterozygosity in esophageal adenocarcinoma (EAC). NELL1 promoter hypermethylation was examined by real-time methylation-specific polymerase chain reaction in 259 human esophageal tissues. Hypermethylation of this promoter showed highly discriminative receiver-operator characteristic curve profiles, clearly distinguishing esophageal squamous cell carcinoma (ESCC) and EAC from normal esophagus (NE) (P<0.001). NELL1 normalized methylation values were significantly higher in Barrett's metaplasia (BE), dysplastic Barrett's (D) and EAC than in NE (P<0.0000001). NELL1 hypermethylation frequency was zero in NE but increased early during neoplastic progression, to 41.7% in BE from patients with Barrett's alone, 52.5% in D and 47.8% in EAC. There was a significant correlation between NELL1 hypermethylation and BE segment length. Three (11.5%) of 26 ESCCs exhibited NELL1 hypermethylation. Survival correlated inversely with NELL1 hypermethylation in patients with stages I-II (P=0.0264) but not in stages III-IV (P=0.68) EAC. Treatment of KYSE220 ESCC and BIC EAC cells with 5-aza-2'-deoxycytidine reduced NELL1 methylation and increased NELL1 mRNA expression. NELL1 mRNA levels in EACs with an unmethylated NELL1 promoter were significantly higher than those in EACs with a methylated promoter (P=0.02). Promoter hypermethylation of NELL1 is a common, tissue-specific event in human EAC, occurs early during Barrett's-associated esophageal neoplastic progression, and is a potential biomarker of poor prognosis in early-stage EAC.

The initial stability and contact mechanics of a press-fit resurfacing arthroplasty of the hip

Finite element analysis was used to examine the initial stability after hip resurfacing and the effect of the procedure on the contact mechanics at the articulating surfaces. Models were created with the components positioned anatomically and loaded physiologically through major muscle forces. Total micromovement of less than 10 μm was predicted for the press-fit acetabular components models, much below the 50 μm limit required to encourage osseointegration. Relatively high compressive acetabular and contact stresses were observed in these models. The press-fit procedure showed a moderate influence on the contact mechanics at the bearing surfaces, but produced marked deformation of the acetabular components. No edge contact was predicted for the acetabular components studied.

It is concluded that the frictional compressive stresses generated by the 1 mm to 2 mm interference-fit acetabular components, together with the minimal micromovement, would provide adequate stability for the implant, at least in the immediate post-operative situation.

The role of the surface amorphous layer of articular cartilage in joint lubrication

Articular cartilage is a complex soft tissue that performs multiple functions in the joint. In particular, the amorphous layer that covers the surface of articular cartilage is thought to play some role in lubrication. This study aimed to characterize the surface amorphous layer (SAL) using a variety of techniques, including environmental scanning electron microscopy, transmission electron microscopy, white light interferometry, and biochemical analysis of its composition. Friction tests were conducted to investigate the role of the SAL in lubrication. A protocol to remove successfully the SAL without damaging the underlying cartilage was developed and the material removed from healthy cartilage was found to contain approximately equal quantities of glycosaminoglycan (GAG), protein, and lipid. Cartilage-on-cartilage friction tests were conducted on fresh, healthy cartilage with and without the SAL, under both dynamic and static operating conditions. Removal of the SAL was not found to change the friction coefficient. However, subsequent staining of specimens indicated that the SAL had replenished during the test following loading. The replenished SAL was characterized and found to contain lipids and sulphated GAGs with undetectable protein. This study revealed experimental evidence of surface layer replenishment in articular cartilage. It was postulated that the surface layer regeneration mechanism was purely mechanical and associated with movement of GAGs and lipids through the cartilage matrix during deformation, since the experimental set-up did not contain any means of biochemical activation.

Cloning of a cDNA encoding the Saussurea medusa chalcone isomerase and its expression in transgenic tobacco

Chalcone isomerase (CHI; EC 5.5.1.6) is a key enzyme in the flavonoid biosynthesis pathway. We isolated a CHI gene (SmCHI) from a cDNA library derived from Saussurea medusa (Asteraceae) cell cultures. The cDNA and genomic sequences of SmCHI are the same; in other words, this gene is intronless. The coding region of the gene is 699 bp long, and its deduced protein consists of 232 amino acids with a predicted molecular mass of 24 kDa and a pI of 4.7. The deduced amino acid sequence of SmCHI shares 79.3% identity with CHI from Callistephus chinensis, a familial relative to S. medusa; this homology is higher than those with CHI's from any other plant species. A functional bioassay for SmCHI was performed by transforming Nicotiana tabacum plants in the sense or antisense orientation under the regulation of the cauliflower mosaic virus (CaMV) 35S promoter. Transgenic tobacco plants overexpressing sense SmCHI produced up to fivefold total flavonoids over wild-type tobacco plants, mainly due to an enhanced accumulation of rutin. Transgenic tobacco plants with antisense SmCHI accumulated smaller amounts of flavonoids; this is apparently brought about by suppressed expression of the endogenous CHI gene. CHI activities also positively correlated with the amounts of total flavonoids accumulated in the transgenic plants. It is concluded that overexpression of SmCHI can be used as a useful approach to increase flavonoid production in transgenic plants.

Hip resurfacing arthroplasty: the evolution of contemporary designs

Metal-on-metal hip resurfacing is considered by many as the most significant recent development in hip arthroplasty. It preserves proximal femoral bone stock, optimizes stress transfer to the proximal femur, and offers inherent stability and optimal range of movement. The early results of hip resurfacing in the 1970s and 1980s were poor and the procedure was largely abandoned by the mid-1980s. The expectation that these prostheses would be easy to revise was not often fulfilled. The large diameter of the articulation combined with thin polyethylene cups or liners resulted in accelerated wear and the production of large volumes of biologically active particulate debris, leading to bone loss and implant loosening. Failure has been attributed to other factors, mainly avascular necrosis of the femoral head. However, this concern has not been confirmed by retrieval studies. The failure of early hip resurfacings was essentially a consequence of the use of inappropriate materials, poor implant design, inadequate instrumentation, and crude surgical technique. It was not an inherent problem with the procedure itself. The renaissance of metal-on-metal articulations for total hip arthroplasty enabled the introduction of new hip resurfacings and most of the major implant manufacturers have already introduced such systems. Early results are encouraging and complications commonly seen in the 1970s and 1980s, such as early implant loosening and femoral neck fracture, now appear to be rare. Whilst early results should be regarded with caution, modern metal-on-metal hip resurfacing potentially offers the ultimate bone preservation and restoration of function in appropriately selected young patients.

Observation of a fast electron beam emitted along the surface of a target irradiated by intense femtosecond laser pulses

A novel fast electron beam emitting along the surface of a target irradiated by intense laser pulses is observed. The beam is found to appear only when the plasma density scale length is small. Numerical simulations reveal that the electron beam is formed due to the confinement of the surface quasistatic electromagnetic fields. The results are of interest for potential applications of fast electron beams and deep understanding of the cone-target physics in the fast ignition related experiments.

BACH1 is a DNA repair protein supporting BRCA1 damage response

The link between defects in BRCA1 and breast cancer development may be best understood by deciphering the role of associated proteins. BRCA1 associated C-terminal helicase (BACH1) interacts directly with the BRCA1 C-terminal BRCT repeats, which are important for BRCA1 DNA repair and are mutated in the majority of BRCA1 familial cancers. Thus, BACH1 is a likely candidate for mediating BRCA1 DNA repair and tumor suppression functions. Although previous evidence using overexpression of a dominant negative BACH1 has suggested that BACH1 is involved in BRCA1-DNA repair function, our results using BACH1 deficient cells provide direct evidence for involvement of BACH1 in DNA repair as well as for localizing BRCA1. Following DNA damage BACH1 is modified by phosphorylation, displays a BRCA1-like nuclear foci pattern and colocalizes with gamma-H2AX. Given that the BACH1/BRCA1 complex is unaltered by DNA damage and the intensity of BRCA1 foci is diminished in BACH1 deficient cells, BACH1 may serve to not only facilitate DNA repair, but also maintain BRCA1 in DNA damage foci.

Transcriptional profiling suggests that Barrett's metaplasia is an early intermediate stage in esophageal adenocarcinogenesis

To investigate the relationship between Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC), we determined gene expression profiles of discrete pathological stages of esophageal neoplasia using a sequence-verified human cDNA microarray. Fifty one RNAs, comprising 24 normal esophagi (NE), 18 BEs, and nine EACs were hybridized to cDNA microarrays. Five statistical analyses were used for the data analysis. Genes showing significantly different expression levels among the three sample groups were identified. Genes were grouped into functional categories based on the Gene Ontology Consortium. Surprisingly, the expression pattern of BE was significantly more similar to EAC than to NE, notwithstanding the known histopathologic differences between BE and EAC. The pattern of NE was clearly distinct from that of EAC. Thirty-six genes were the most differentially modulated, according to these microarray data, in BE-associated neoplastic progression. Twelve genes were significantly differentially expressed in cancer-associated BE's plus EAC (as a single combined tissue group) vs noncancer-associated BE's. These genes represent potential biomarkers to diagnose EAC at its early stages. Our results demonstrate that molecular events at the transcriptional level in BE are remarkably similar to BE's-associated adenocarcinoma of the esophagus. This finding alarmingly implies that BE is biologically closer to cancer than to normal esophagus, and that the cancer risk of BE is perhaps higher than we had imagined. These findings suggest that changes modulated at the molecular biologic level supervene earlier than histologic changes, and that BE is an early intermediate stage in the process of EAC.

Control of filamentation induced by femtosecond laser pulses propagating in air

Filamentation formed by self-focusing of intense laser pulses propagating in air is investigated. It is found that the position of filamentation can be controlled continuously by changing the laser power and divergence angle of the laser beam. An analytical model for the process is given.

Demonstration of bulk acceleration of ions in ultraintense laser interactions with low-density foams

Ion acceleration inside low-density foams irradiated by ultraintense laser pulses has been studied experimentally and theoretically. It is found that the ion generation is closely correlated with the suppressed hot electron transport inside the foams. Particle-in-cell simulations suggest that localized electrostatic fields with multi peaks around the surfaces of lamellar layers inside the foams are induced. These fields inhibit hot electron transport and meanwhile accelerate ions inside the foams, forming a bulk acceleration in contrast to the surface acceleration at the front and rear sides of a thin solid target.

Elevation of serum albumin levels in nagase analbuminemic rats by allogeneic bone marrow cell transplantation

We investigated the feasibility of correcting the congenital absence of albumin in Nagase analbuminemic rats (NARs) by allogeneic bone marrow cell transplantation (BMT). Seven-week-old male NARs were used as recipients, and 6- to 8-week-old male Sprague-Dawley (SD) rats were used as allograft donors. NARs were divided into three groups: a BMT group (n=10) in which bone marrow cells were infused into the liver; a hepatocyte transplantation (HCT) group (n=8) in which hepatocytes were transplanted into the liver, and a control group (n=8) in which PBS was injected into the portal vein. Serum albumin levels were measured as an indicator of the function of the grafted cells, and the phenotypic characteristics of the engrafted cells in the recipient's liver were assessed with immunohistochemical and immunofluorescence techniques. At 8 weeks after cell transplantation, the serum albumin levels of the BMT group and HCT group were significantly higher than in the control group. The hepatocyte-like cells derived from bone marrow cells expressed albumin in liver of the NARs. According to this result, bone marrow cells can differentiate into hepatocyte-like cells in vivo. The results show that BMT is an effective treatment for congenital analbuminemia in a rat model and suggest that allogeneic BMT can be used as an efficient therapy for hereditary metabolic diseases.

Spontaneous lymphocyt ic thyroiditis in interferon regulatory factor-1 deficient non-obese diabetic mice

Interferon regulatory factor-1 (IRF-1) is a transcription factor involved in interferon-mediated immune reaction, CD8+ T cell differentiation and development of T helper 1 immune reaction. We have recently demonstrated that IRF-1 is pivotal in iodine-induced lymphocytic thyroiditis (LT) in non-obese diabetic (NOD) mice. However, it remains unclear whether the mechanism involved in spontaneous LT is identical with iodine-induced LT in NOD mice. To determine the role of IRF-1 in spontaneous LT, we used IRF-1 deficient NOD mice as well as IRF-1 +/+ and +/- mice which were free from treatments for LT induction, and LT was evaluated at 24 weeks of age. IRF-1 +/+, +/- and -/- mice developed LT spontaneously, and there were no differences among the 3 IRF-1 genotypes in the incidence and severity of LT. Whereas both CD4+ and CD8+ T cells were present in the diseased thyroid of IRF-1 +/+ mice, CD8+ T cells were absent in the thyroid of IRF-1 -/- mice. MHC class II antigen expression was induced in the inflamed thyroid of IRF-1 -/- mice comparable to IRF-1 +/+ mice. There was a selective reduction in the number of CD8+ T cells in the spleen of IRF-1 -/- mice. IFNgamma production, but not IL-10, by concanavalin A-stimulated splenocytes was significantly reduced in IRF-1 deficient mice. These results suggest that IRF-1 plays only a minor role in spontaneous LT in NOD mice and, furthermore, the mechanism involved in spontaneous LT is different from that of iodine-induced LT in NOD mice.

Emission direction of fast electrons in laser-solid interactions at intensities from the nonrelativistic to the relativistic

The emission direction of outward-ejecting fast electrons generated in laser-solid interactions by 30 fs laser pulses is measured for laser intensities varying from the nonrelativistic to the relativistic. For an s-polarized incident laser beam at nonrelativistic intensities, the ejected electrons are close to the polarization direction of the laser beam. With the increase of the laser intensity, the ejected electrons are still mainly within the polarization plane, but turn away from the laser polarization direction towards the opposite direction of the incident laser beam. At relativistic intensities, electrons eject towards the direction of the reflected laser beam. The increasing ponderomotive force acceleration with the laser intensities might be responsible for the observed changes.

Energetic electrons emitted from ethanol droplets irradiated by femtosecond laser pulses

We investigate the angular distribution and the energy spectrum of hot electrons emitted from ethanol droplets irradiated by linearly polarized 150-fs laser pulses at an intensity of 10(16) W/cm(2). Two hot electron jets symmetrically with respect to the laser propagation direction are observed within the polarization plane. This is due to the spherical geometry of droplets in the intense laser field. The maximum energy of the hot electrons is found to be more than 600 keV. Particle-in-cell simulations suggest that the resonance absorption is the main mechanism for hot electron generation.

Critical roles of CD30/CD30L interactions in murine autoimmune diabetes

CD30/CD30L is a member of tumour necrosis factor (TNF) receptor/TNF superfamily and has been implicated in immune-regulation. A genetic study has also suggested a possible implication of CD30 in spontaneous autoimmune diabetes in NOD mice. In this study, we investigated the involvement of CD30/CD30L in the development of diabetes in NOD mice. Flow cytometric analysis showed that CD30 and CD30L were highly expressed on CD4+ or CD8+ T cells in the spleen and pancreatic lymph node of younger NOD mice. In addition, islet-specific CD4+ or CD8+ T cell lines expressed CD30 and CD30L. Administration of a neutralizing anti-CD30L monoclonal antibody (mAb) from 2 to 10 week of age completely suppressed the development of spontaneous diabetes in NOD mice. In addition, the treatment with anti-CD30L mAb also inhibited the development of diabetes induced by adoptive transfer of spleen cells from diabetic NOD mice or islet-specific CD4+ or CD8+ T cell lines into NOD-SCID mice. Furthermore, anti-CD30L mAb inhibited T cell proliferation in response to islet antigens. These results suggested that CD30/CD30L interaction plays important roles in both induction and effector phases of autoimmune diabetes in NOD mice.

Effect of aggregate size in cell cultures of Saussurea medusa on cell growth and jaceosidin production

Cell suspension cultures of Saussurea medusa were grown in shake flasks and a 5-l stirred tank bioreactor. Biomass and jaceosidin distribution in cell aggregates of different sizes were investigated during the cultivation period. The results showed that on day 10, jaceosidin accumulation showed an increase with increasing size of the cell aggregate to 4 mm in diameter, with the highest jaceosidin accumulation being 12.2 mg/g. An inverse tendency was observed with cell aggregates larger than 4 mm in diameter, with the lowest accumulation being 3.1 mg/g. However, all of the cell aggregates, despite their size, synthesized almost the same amount of jaceosidin at day 12. Oxygen diffusion limitation and cell-cell contact may explain this behavior. In comparison with cells cultivated in shake flasks, decreased biomass and decreased jaceosidin concentration were observed when the cells were cultivated in a stirred tank bioreactor. The sublytic effects caused by the hydrodynamic stress in combination with insufficient nutrients in the bioreactor may cause cell damage.

Blast waves produced by interactions of femtosecond laser pulses with water

The behaviors of the blast waves produced by femtosecond laser-water interactions, and the blast waves induced by laser self-focusing in air, have been investigated using optical shadowgraphy at a maximum intensity of 1 x 10(16) W/cm(2). The temporal evolution of the blast wave launched by the water plasma can be described by a planar blast wave model including source mass. An aneurismlike structure, due to the quick propagation inside a hollow channel formed by laser self-focusing, is observed. The expansion of the channel in air is found to agree with a cylindrical self-similar blast wave solution.

Nucleotide sequences of the coat protein and readthrough protein genes of the Chinese GAV isolate of barley yellow dwarf virus

The nucleotide sequences of the coat protein (CP) and readthrough protein (RTP) genes of the Chinese GAV isolate of Barley yellow dwarf virus (BYDV) were determined. The CP and RTP genes of GAV isolate comprised 600 and 1374 nucleotides, respectively. When the CP and RTP gene sequences of GAV isolate were compared with those of BYDV isolates MAV-PS1, P-PAV, NY-SGV and Cereal yellow dwarf virus RPV (CYDV-RPV), the highest similarity (97.2%) between the CP genes of GAV and MAV-PS1 isolates was observed, while the RTP genes of these two isolates shared a lower similarity (87.8%). The results of the alignment of the deduced amino acid sequences of RTP showed that the sequence diversity observed was located at the C terminus.

[A study of millimeter wave's clinical and immunological effects on oral lichen planus patients]

OBJECTIVE

The aim of this study is to observe clinical effects of the millimeter wave on oral lichen planus (OLP) and its immune mechanisms.

METHODS

30 patients with OLP were randomized into the millimeter wave group and the control group. 15 patients in the millimeter wave group were treated with millimeter wave (7.1 mm, 43 GHz, 10 mW/cm2) radiation, while the other 15 patients in the control group were just given soothing treatment. Either before or after the therapy procedure, the clinical manifestations and the T-cell sub-grouping in the peripheral circulation of each patient were double-blindly evaluated.

RESULTS

The pain-soothing effect in the patients treated with millimeter wave was much more obvious than that of the control group (P < 0.01). The peripheral blood CD8+ percent of millimeter wave group decreased greatly (P < 0.05), while no obvious CD8+ change was observed in the control group (P > 0.05). The millimeter wave group's CD4+/CD8+ improvement was also much more obvious than that of the control group (P < 0.05), and its CD4+/CD8+ ratio was completely recovered to the normal level.

CONCLUSION

Millimeter wave can effectively relieve OLP patients' pain, and can regulate OLP patients' cellular immune condition. Millimeter wave might provide a new treatment method for OLP.

Striatal neuronal loss or dysfunction and choline rise in children with attention-deficit hyperactivity disorder: a 1H-magnetic resonance spectroscopy study

Twelve previously untreated boys suffering from attention-deficit hyperactivity disorder (ADHD) were investigated by using proton magnetic resonance spectroscopy (1H MRS) before and after one dose (10 mg) of methylphenidate. Pre- and post-methylphenidate spectra were acquired bilaterally in the globus pallidus. Peaks of N-acetylaspartate (NAA), choline (Cho), myo-inositol, glutamate and creatine (Cr) were measured and the ratios of the peaks were calculated and compared with data from ten matched controls. In children having ADHD, NAA/Cr ratio decreased significantly in the bilateral striatum while Cho/Cr ratio showed a mild unilateral increase. One oral dose of methylphenidate did not affect the ratios significantly. These findings suggest that the striatum was bilaterally involved in pediatric ADHD patients. Approximately 20-25% of neurons may have died or may be severely dysfunctional. There seems to be a mild hyperactivity of the cholinergic system.

[Mannose-binding lectin gene site mutations and the susceptibility of rheumatic heart disease]

OBJECTIVE

To investigate the relationship between mannose-binding lectin (MBL) gene exon 1 site mutations and chronic rheumatic heart disease (CRHD).

METHODS

Polymerase chain reaction (PCR) and restrictive fragment length Polymorphism (RFLP) were used to investigate the MBL exon 1 alleles in 36 patients with CRHD and 39 normal people.

RESULTS

No C and D alleles of MBL gene were found in both groups. Eleven patients had A/B alleles, 1 patient had B/B alleles, 15 normal people had A/B alleles but none of the 39 normal people had B/B alleles. Statistic analyses showed no significant difference between CRHD group and normal group. But when the age of heart-disease-symptom-onset (HDSO) of the CRHD group were considered, we found that the mean HDSO age of patients with B allele was 30 +/- 14 years and the mean HDSO age of patients with AA homozygous was 37 +/- 11 years. P < 0.05.

CONCLUSION

MBL gene mutations may not be a main factor of the pathogenesis of CRHD, but MBL deficiency may facilitate the development of CRHD in younger people and accelerate the progress of CRHD. This is consistent with the phenomenon that the most susceptible people of rheumatic heart disease are teenagers.

[The etiology and clinical characteristics of central diabetes insipidus, a retrospective study of 408 cases]

OBJECTIVE

To study the etiology and clinical characteristics of central diabetes insipidus (CDI).

METHODS

The clinical data of 408 cases with CDI treated in Peking Union Medical College Hospital between 1956 and 2000, including 113 cases caused by tumors in sella region, were analyzed retrospectively. Follow-up for three months to 16 years was made to 35 cases of CDI without etiological diagnosis during the first visit.

RESULTS

Most of the cases among children and youngsters fell ill at the age of 8-12 years, while most of the adult cases fell ill at the age of 25-35 years. Idiopathic CDI accounted for 52%. CDI caused by tumor in sella region accounted for about 33% among the child and youngster cases, among which germinoma made up about 65%. CDI caused by tumor in sella region accounted for about 22% in adult cases. Trauma-induced CDI accounted for 11% among adult cases, and about 5% among child and youngster cases. All the CDI cases caused by histiocytosis X, accounting for 3%, were children. A correct diagnosis was made within the period of two years' follow-up among 86% of the cases. For those with brain tumors, the long-term survival rate reached 80% with radiotherapy and/or operation performed without delay.

CONCLUSION

GH deficiency accompanied with growth failure is a potential indicator of CDI caused by space occupying lesion in sella region. A sudden alleviation of polydipsia may indicate the dysfunction of adrenal cortex. MRI is the most valuable examination means for tumor in sella region. Regular clinical follow-up with serial brain MRI may discover the covert tumor in sella region in cases diagnosed originally as idiopathic CDI. The cases without a correct diagnosis during the first visit should be followed-up every 3 to 6 months. The prognosis of the patients with CDI without tumor is satisfactory after ADH replacement. Radiotherapy is the most effective treatment of germinoma in sella region.

Flavonol glycosides from the stems of Trigonella foenum-graecum

Two kaempferol glycosides [kaempferol 3-O-beta-D-glucosyl(1-->2)-beta-D-galactoside 7-O-beta-D-glucoside and kaempferol 3-O-beta-D-glucosyl(1-->2)-(6"-O-acetyl)-beta-D-galactoside 7-O-beta-D-glucoside] as well as the quercetin glycoside [quercetin 3-O-beta-D-glucosyl(1-->2)-beta-D-galactoside 7-O-beta-D-glucoside] were isolated from the stems of Trigonella foenum-graecum L. (Leguminosae) along with a known kaempferol glycoside, lilyn [kaempferol 3-O-beta-D-glucosyl(1-->2)-beta-D-galactoside]. Their structures were established by analysis of chemical and spectral evidence.

Mapping the ion kinetic energy in a helium microwave plasma orthogonal acceleration time-of-flight mass spectrometer

The ion kinetic energy of a helium microwave plasma is studied using an orthogonal acceleration time-of-flight mass spectrometer. The ions produced in the plasma are extracted into the mass spectrometer in an 'off-cone' mode (i.e. the helium plasma plume is off the sampler cone), and enter the repelling zone in the x-direction, which is perpendicular to the flight tube. The information of ion initial kinetic energy was obtained from both theoretical calculations and experimental results. The potential influence of two x-direction steering plates (X-steering plates) on the ion energy and signal intensity was examined. The influence of gas composition on the ion kinetic energy was also investigated. The calculated results show that ions with different m/z have different velocity and kinetic energy when they enter the ion modulation zone, and lighter ions have higher velocity and lower kinetic energy. The experimental results obtained demonstrate that the ion signals of different m/z produced with an 'off-cone' sampling helium microwave plasma show similar trends as calculated with the potential difference of the X-steering plates, revealing their narrow kinetic energy distribution in the x-direction. Under typical operating conditions, the x-direction kinetic energy of ions detected mostly range from about 14.9 eV for (7)Li(+) to 16.8 eV for (208)Pb(+).

[Frequency-specific responses of human brain to peripheral transcutaneous electric nerve stimulation: a functional magnetic resonance imaging study]

The purpose of the present investigation was to determine the responses of human brain to transcutaneous electric nerve stimulation (TENS) at different frequencies by functional magnetic resonance imaging (fMRI) examinations covering the whole brain of eleven healthy volunteers. Each subject received TENS at acupoints ST36 and SP6 of the left leg at the frequencies of 2 and 100 Hz. Frequency-specific responses were found in motor-related areas, thalamus, limbic system and associated cortex to stimulation of the two frequencies, while the primary somatosensory areas were activated by both. Therefore, it appears that 2 and 100 Hz TENS act through different neuro-pathways in the central nervous system.

[Studies on regulation of glutamine synthetase activity from Streptomyces lincolnensis]

Glutamine synthetase in crude extracts from Streptomyces lincolnensis growing under different nitrogen sources were studied. The results showed that NH4+ in high concentration repressed the biosynthesis of the enzyme. To determine whether Streptomyces lincolnensis has undergone covalent modification, a comparison of the glutamine synthetase isolated from cells grown on different nitrogen sources was made. No significant difference was observed in specific activity, pH optima, divalent cation response, and ultraviolet absorption spectra. Glutamine synthetase activity was not influenced by ammonia shock or snake venom phosphodiesterase treatment. Under these conditions, the activity of glutamine synthetase from K. aerogenes was markedly changed. There was therefore no evidence for enzymatic adenylylation of glutamine synthetase from Streptomyces lincolnensis. Glutamine synthetase was subject to feedback inhibition by end products of glutamine metabolism. Cumulative feedback inhibition of the Mn(2+)-dependent glutamine synthetase activity was demonstrated. These results suggest that glutamine synthetase from Streptomyces lincolnensis is an allosteric enzyme.

Early changes of arginine vasopressin and angiotensin II in patients with acute cerebral injury

OBJECTIVE

To study the changes and clinical significance of arginine vasopressin (AVP) and angiotensin II (AT-II) in patients with acute moderate and severe cerebral injury.

METHODS

The early plasma concentration was checked by radioimmunoassay in 47 cases of acute moderate and severe cerebral injury, 30 cases of non-cerebral injury and 30 healthy volunteers.

RESULTS

The early plasma concentrations of AVP (50.23 ng/L +/- 15.31 ng/L) and AT-II (248.18 ng/L +/- 82.47 ng/L) in cerebral injury group were higher than those in non-cerebral injury group (AVP for 30.91 ng/L +/- 11.48 ng/L and AT-II for 120.67 ng/L +/- 42.49 ng/L, P<0.01). The early plasma concentrations of AVP and AT-II in cerebral injury group were also obviously higher than those of the volunteers (AVP for 5.16 ng/L +/- 4.23 ng/L and AT-II for 43.11 ng/L +/- 16.39 ng /L, P<0.001). At the same time, the early plasma level of AVP (58.90 ng/L +/- 18.12 ng/L) and AT-II (292.13 ng/L +/- 101.17 ng/ L) was higher in severe cerebral injured patients than moderate cerebral injured ones (AVP for 36.68 ng/L +/- 12.16 ng/L and AT-II for 201.42 ng/L +/- 66.10 ng/L, P<0.01). The early level of AVP and AT-II was negatively related to the GCS scales in acute cerebral injury. The early plasma concentrations of AVP (45.98 ng/L +/- 13.48 ng/L) and AT-II (263. 28 ng/L +/- 80.23 ng/L) were lower in epidural hematoma group than those of subdural hematoma and cerebral injury group (AVP for 64.12 ng/L +/- 15.56 ng /L and AT-II for 319.82 ng/L +/- 108.11 ng/L, P<0. 01).

CONCLUSIONS

AVP and AT-II may play an important role in pathophysiologic process in the secondary cerebral injury. The more severe the cerebral injury is, the higher the early level of AVP and AT-II will be. The early plasma level of AVP and AT-II may be one of the severity indexes of cerebral injury.

Adenomatous polyposis coli (APC) gene promoter hypermethylation in primary breast cancers

Similar to findings in colorectal cancers, it has been suggested that disruption of the adenomatous polyposis coli (APC)/beta-catenin pathway may be involved in breast carcinogenesis. However, somatic mutations of APC and beta- catenin are infrequently reported in breast cancers, in contrast to findings in colorectal cancers. To further explore the role of the APC/beta-catenin pathway in breast carcinogenesis, we investigated the status of APC gene promoter methylation in primary breast cancers and in their non-cancerous breast tissue counterparts, as well as mutations of the APC and beta- catenin genes. Hypermethylation of the APC promoter CpG island was detected in 18 of 50 (36%) primary breast cancers and in none of 21 non-cancerous breast tissue samples, although no mutations of the APC and beta- catenin were found. No significant associations between APC promoter hypermethylation and patient age, lymph node metastasis, oestrogen and progesterone receptor status, size, stage or histological type of tumour were observed. These results indicate that APC promoter CpG island hypermethylation is a cancer-specific change and may be a more common mechanism of inactivation of this tumour suppressor gene in primary breast cancers than previously suspected.

[Surgery of the skull base assisted by sinus endoscope]

OBJECTIVE

To explore the feasibility and clinical value of the endoscopic operations around the skull base.

METHODS

A retrospective study was made of 44 cases treated by endoscopic operations. Twenty-five cases underwent intranasal endoscopic operations.

RESULTS

Forty of 44 cases were cured by one-stage surgery. One case of cartridge foreign body clamped in clivus was not successfully removed; only window operation and puncture biopsy were done in another case of pituitary adenoma; high cranial pressure has not been completely reduced after operation in the third case with relapsing craniopharyngioma a companied with obstructive hydrocephalus. One case of sphenoidal malignant adenoma involving saddle based and extended laterally was partly resected. Complications were follows: cerebrospinal fluid rhinorrhea in 2 cases, diabetes insipidus in 1 case, all of them were cured by conservative treatment; nasal septum perforation in 1 case, without any treatment.

CONCLUSIONS

The endoscopic skull base surgery by intranasal approach is feasibility. Intranasal approach has direct path, slight wound and no wound in face. Combined with operation microscope, sinus endoscope can make up for its limits.

Absence of BAT-26 instability in gastric intestinal metaplasia

BAT-26 instability, a sensitive marker for the high-frequency microsatellite instability (MSI-H) phenotype, was analyzed in samples of gastric cancer and in adjacent intestinal metaplastic mucosae. Although all MSI-H gastric cancer samples showed BAT-26 instability, as assessed using 12 dinucleotide microsatellite markers, BAT-26 instability was not found in the adjacent intestinal metaplastic mucosa in any of the samples.

Synthetic studies of antitumor natural products superstolides A and B. Construction of C20-C26 fragment of superstolide A

[structure: see text] The C20-C26 portion of the antitumor macrolide superstolide A was synthesized by employing Brown's asymmetric crotylboronate methodology.

[Effects of aspirin on ferritin expression and resistance to oxidative damage in endothelial cells]

OBJECTIVE

To explore the mechanism of Aspirin induced ferritin synthesis on resistance to oxidative damage in endothelial cells.

METHODS

Using cultured endothelial cells, we measured the effect of aspirin with different incubative time (4 - 24 h) and different concentration (0.1 - 3 mmol/L), salicylic acid and indomethacin induced ferritin expression by ELISA kit, and observed the change of lactate dehydrogenase (LDH) release rate, malondialdehyde (MDA) and cellular viability after preincubating the cell for 8 h with aspirin on resistance to hydrogen peroxide toxicity. Statistical analysis using a one-way analysis of variance.

RESULTS

Aspirin at low concentration (0.1 mmol/L) induced significant increase ferritin expression in a concentration-dependent fashion: (5.8 +/- 0.3) ng/10(6) cell (0.1 mmol/L As), (6.4 +/- 0.4) ng/10(6) cell (0.5 mmol/L As), (7.0 +/- 0.7) ng/10(6) cell (1 mmol/L As), (7.4 +/- 0.4) ng/10(6) cell (2 mmol/L As), (7.7 +/- 0.5) ng/10(6) cell (3 mmol/L As), significant for all values: P < 0.05 versus normal control. Induction of ferritin levels by aspirin (1 mmol/L) was also time dependent: (5.8 +/- 1.0) ng/10(6) cell (4 h, but P > 0.05 vs control), (6.5 +/- 1.0) ng/10(6) cell (8 h, P < 0.05 vs control) and (7.8 +/- 0.8) ng/10(6) cell (24 h). Preincubating the cells with aspirin (0.1 mmol/L) reduced LDH release rate by 50%, toxicity reduction by 40%, and significant decrease MDA production. Aspirin induced cytoprotection from H(2)O(2) damage was also in a concentration dependent fashion. The cytoprotection of aspirin was mimicked by exogenous iron-free apo-ferritin but not iron-load ferritin. Salicylic acid and indomethacin failed to increase ferritin expression.

CONCLUSION

Aspirin could induce significant increase ferritin synthesis at low concentration (0.1 mmol/L). Ferritin induction by aspirin was specific in nonsteroidal anti-inflammatory drugs.

[The sonochemical-degradation mechanism of toluene in aqueous solution]

The sonochemical degradation of toluene in the airproof aqueous solution was studied, and the mechanism and course of degradation was explored. It was found that the sonication time had great effect on the removal rate of toluene, and the degradation followed a pseudo-first-order kinetic law, and 90%-95% of toluene was removed only after being irradiated for 40 min, types of dissolved gas and pH also had some effects. After aqueous solution was analyzed pH and scanned UV-wavelength and identified components with SMPE-GC-MS, results confirmed that radical-oxidation controlled the sonochemical-oxidation of toluene, and main middle-products included benzaldehyde, bibenzyl, dibutyl phthalate, et al., final products were carbon dioxide and water.

Involvement of transcriptional enhancers in the regulation of developmental expression of yellow gene

Upstream regulatory region and flanking DNA of yellow gene were isolated and cloned from a Drosophila genomic library. A vector containing yellow gene and regulatory elements was constructed using the recombinant DNA technique. Then this vector was integrated into Drosophila genome by genetic transformation. Using both FLP/FRT and Cre/LoxP site-specific recombination systems, two new yellow alleles were created at the same position in the genome of transgenic flies. Results from genetic and molecular analysis indicated that transcriptional enhancers regulate the developmental expression of the transgene. Furthermore, interactions between new-created yellow alleles were observed. Such interactions can influence markedly the expression of yellow gene during development. This effect may also be a form of enhancer-mediated gene expression.

Assessing the resectability of pancreatic ductal adenocarcinoma: comparision of dual-phase helical CT arterial portography with conventional angiography

OBJECTIVE

To evaluate the respective value of dual-phase helical CT arterial portography (CTAP) and conventional angiography in preoperative predicting resectability of pancreatic ductal adenocarcinoma.

SUBJECTS AND METHODS

Tumor resectability was prospectively evaluated in 54 patients with pathologically proven pancreatic ductal adenocarcinoma who later underwent surgery. Both dual-phase helical CT scanning and selective angiography were obtained in each patient preoperatively. For optimal enhancement of pancreas and major peripancreatic vessels, two catheters connected to an automatic injector via a Y-shaped tube were placed selective angiography, one in celiac trunk, the other in superior mesenteric artery. Then the patient underwent dual-phase helical CTAP of pancreas and liver. The criteria of irresectability for CTAP include: tumor diameter > or = 5 cm, extrapancreatic invasion, distant metastases and vascular involvement (occlusion, stenosis or semicircular encasement of superior mesenteric artery, hepatic artery, splenic artery, celiac axis; portal vein, superior mesenteric vein or splenic vein). The results of both modalities were correlated with findings from surgery or pathology.

RESULTS

Thirty-eight of 54 patients had nonresectable disease. In prediction the irresectability, sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy were 94.7%, 100%, 100%, 88.9%, 96.3% respectively for helical CTAP and 63.2%, 93.89%, 96.0%, 51.7%, 72. 2% respectively for selective angiography. In assessing vascular involvements, dual-phase helical CTAP was also superior to selective angiography.

CONCLUSION

Dual-phase helical CTAP is superior to angiography in assessing resectability of pancreatic ductal adenocarcinoma. The combination of the two modalities may further improve overall creatic