[Diagnosis and treatment strategies of 56 cases of middle ear myoclonus]

Objective: To analyze the clinical characteristics and treatment of middle ear myoclonus. Methods: Fifty-six cases of middle ear myoclonus were enrolled in Shandong Provincial ENT Hospital, Shandong University from September 2019 to August 2021, including 23 males and 33 females. The age ranged from 6 to 75 years, with a median age of 35 years; Forty-seven cases were unilateral tinnitus, nine cases were bilateral tinnitus. The time of tinnitus ranged from 20 days to 8 years. The voice characteristics, inducing factors, nature (frequency) of tinnitus, tympanic membrane conditions during tinnitus, audiological related tests, including long-term acoustic tympanogram, stapedius acoustic reflex, pure tone auditory threshold, short increment sensitivity test, alternate binaural loudness balance test, loudness discomfort threshold, vestibular function examination, facial electromyography, and imaging examination were recorded. Oral carbamazepine and/or surgical treatment were used. The patients were followed up for 6-24 months and the tinnitus changes were observed. Results: Tinnitus was diverse, including stepping on snow liking sound, rhythmic drumming, white noise, and so on. The inducing factors included external sound, body position change, touching the skin around the face and ears, speaking, chewing and blinking, etc. Forty-four cases were induced by single factor and 9 cases were induced by two or more factors. There was no definite inducing factor in 1 case. One patient had tinnitus with epilepsy. One case of traumatic facial paralysis after facial nerve decompression could induce tinnitus on the affected side when the auricle moved. Tympanic membrane flutter with the same frequency as tinnitus was found in 12 cases by otoscopy, and the waveform with the same frequency as tinnitus was found by long-term tympanogram examination. There were 7 patients with no tympanic membrane activity by otoscopy, the 7 cases also with the same frequency of tinnitus by long-term tympanogram examination, but the change rate of the waveform was faster than that of the patients with tympanic membrane flutter. All patients with tinnitus had no change in hearing. One case of tinnitus complicated with epilepsy (a 6-year-old child) was treated with antiepileptic drug (topiramate) and tinnitus subsided. One case suffered from tinnitus after facial nerve decompression for traumatic facial paralysis was not given special treatment. Fifty-four cases were treated with oral drug (carbamazepine), of which 10 cases were completely controlled and 23 cases were relieved; 21 cases were invalid. Among the 21 patients with no effect of carbamazepine treatment, 8 patients were treated by surgery, 7 patients had no tinnitus after surgery, 1 patient received three times of operation, and the third operation was followed up for 6 months, no tinnitus occurred again. The other 13 cases refused the surgical treatment due to personal reasons. Conclusions: Middle ear myoclonus tinnitus and the inducing factors manifestate diversity. Oral carbamazepine and other sedative drugs are effective for some patients, and surgical treatment is feasible for those who are ineffective for medication.

Gut microbiome is more stable in males than in females during the development of colorectal cancer

AIMS

Gut microbial alterations have great potential to predict the development of colorectal cancer (CRC); however, how gut microbes respond to the development of CRC in males and females at the community level is unknown. We aim to investigate the differences of gut microbiota between the male and female.

METHODS AND RESULTS

We reanalysed the dataset in a published project from a sex perspective at the community level by characterizing the gut microbiome in patients (including males and females) from three clinical groups representative of the stages of CRC development: healthy, adenoma, and carcinoma. The results indicated that the microbial α-diversity showed no significant difference in the male gut but had decreased significantly in the female gut with the development of CRC. In males, a significant difference in the microbial β-diversity was only observed between the healthy and carcinoma subgroups. However, significant community deviations were detected with the development of CRC in females. The microbial community assembly processes changed from deterministic to stochastic in males, whereas they became increasingly deterministic in females with the development of CRC. Moreover microbial co-occurrence associations tended to be more complicated in males; rare species were enriched in the co-occurrence network of the male gut, whereas key species loss was observed in the co-occurrence network of the female gut.

CONCLUSIONS

The microbial communities in the male gut were more stable than those in the female gut, and microbial community assembly in the gut was sex dependent with the development of CRC. Our study suggests that sexual dimorphism needs to be considered to better predict the risk of CRC based on microbial shifts.

SIGNIFICANCE AND IMPACT OF THE STUDY

To the best of our knowledge, this is the first report showing how gut microbes respond to the development of CRC in males and females at the community scale.

Gene Therapy for Catecholaminergic Polymorphic Ventricular Tachycardia by Inhibition of Ca2+/Calmodulin-Dependent Kinase II

BACKGROUND

Catecholaminergic polymorphic ventricular tachycardia (CPVT), an inherited cardiac arrhythmia characterized by adrenergically triggered arrhythmias, is inadequately treated by current standard of care. Ca²⁺/calmodulin-dependent protein kinase II (CaMKII), an adrenergically activated kinase that contributes to arrhythmogenesis in heart disease models, is a candidate therapeutic target in CPVT. However, translation of CaMKII inhibition has been limited by the need for selective CaMKII inhibition in cardiomyocytes. Here, we tested the hypothesis that CaMKII inhibition with a cardiomyocyte-targeted gene therapy strategy would suppress arrhythmia in CPVT mouse models.

METHODS

We developed AAV9-GFP-AIP, an adeno-associated viral vector in which a potent CaMKII inhibitory peptide, autocamtide-2-related inhibitory peptide [AIP], is fused to green fluorescent protein (GFP) and expressed from a cardiomyocyte selective promoter. The vector was delivered systemically. Arrhythmia burden was evaluated with invasive electrophysiology testing in adult mice. AIP was also tested on induced pluripotent stem cells derived from patients with CPVT with different disease-causing mutations to determine the effectiveness of our proposed therapy on human induced pluripotent stem cell-derived cardiomyocytes and different pathogenic genotypes.

RESULTS

AAV9-GFP-AIP was robustly expressed in the heart without significant expression in extracardiac tissues, including the brain. Administration of AAV9-GFP-AIP to neonatal mice with a known CPVT mutation (RYR2^R176Q/+) effectively suppressed ventricular arrhythmias induced by either β-adrenergic stimulation or programmed ventricular pacing, without significant proarrhythmic effect. Intravascular delivery of AAV9-GFP-AIP to adolescent mice transduced ≈50% of cardiomyocytes and was effective in suppressing arrhythmia in CPVT mice. Induced pluripotent stem cell-derived cardiomyocytes derived from 2 different patients with CPVT with different pathogenic mutations demonstrated increased frequency of abnormal calcium release events, which was suppressed by a cell-permeable form of AIP.

CONCLUSIONS

This proof-of-concept study showed that AAV-mediated delivery of a CaMKII peptide inhibitor to the heart was effective in suppressing arrhythmias in a murine model of CPVT. CaMKII inhibition also reversed the arrhythmia phenotype in human CPVT induced pluripotent stem cell-derived cardiomyocyte models with different pathogenic mutations.

Hierarchical and stage-specific regulation of murine cardiomyocyte maturation by serum response factor

After birth, cardiomyocytes (CM) acquire numerous adaptations in order to efficiently pump blood throughout an animal's lifespan. How this maturation process is regulated and coordinated is poorly understood. Here, we perform a CRISPR/Cas9 screen in mice and identify serum response factor (SRF) as a key regulator of CM maturation. Mosaic SRF depletion in neonatal CMs disrupts many aspects of their maturation, including sarcomere expansion, mitochondrial biogenesis, transverse-tubule formation, and cellular hypertrophy. Maintenance of maturity in adult CMs is less dependent on SRF. This stage-specific activity is associated with developmentally regulated SRF chromatin occupancy and transcriptional regulation. SRF directly activates genes that regulate sarcomere assembly and mitochondrial dynamics. Perturbation of sarcomere assembly but not mitochondrial dynamics recapitulates SRF knockout phenotypes. SRF overexpression also perturbs CM maturation. Together, these data indicate that carefully balanced SRF activity is essential to promote CM maturation through a hierarchy of cellular processes orchestrated by sarcomere assembly.

Dietary Intake is Positively Associated with Cognitive Function of a Chinese Older Adults Sample

OBJECTIVE

The relationship between cognitive function and dietary intake in older adults was under-studied in China. This study examined this relationship in a Chinese sample while controlling for the effects of sleep quality and socio demographic confounders.

METHODS

The sample consisted of 340 Chinese older adults (age > 60) who were randomly selected from Wuhan city in central China. Cognitive function was assessed by the Mini-mental State Examination [MMSE], sleep quality by the Pittsburgh Sleep Quality Index [PSQI], and dietary intake by frequencies of intake of meat products, fruits, fish/seafood/aquatic products, nuts and mushroom/algae over the past year. First, confirmatory factor analysis (CFA) was conducted to evaluate the measurement properties of cognitive function, dietary intake, and sleep quality. Second, structural equation modeling (SEM) was conducted to examine the relations of cognitive function, dietary intake, and sleep quality.

RESULTS

Dietary intake was found to be positively related to cognitive function. Older age, lower education status, monthly income, and living alone or without a spouse were significantly associated with poorer cognitive function. SES status had an indirect effect on cognitive function via dietary intake.

CONCLUSION

Dietary intake may be critical to maintain normal cognitive function of older adults in China.

Isotropic-nematic transition for hard rods on a three-dimensional cubic lattice

Using grand-canonical Monte Carlo (GCMC) simulations, we investigate the isotropic-nematic phase transition for hard rods of size L×1×1 on a three-dimensional cubic lattice. We observe such a transition for L≥6. For L=6, the nematic state has a negative order parameter, reflecting the co-occurrence of two dominating orientations. For L≥7, the nematic state has a positive order parameter, corresponding to the dominance of one orientation. We investigate rod lengths up to L=25 and find evidence for a very weakly first-order isotropic-nematic transition, while we cannot completely rule out a second-order transition. It was not possible to detect a density jump at the transition, despite using large systems containing several 10^{5} particles. The probability density distributions P(Q) from the GCMC simulations near the transition are very broad, pointing to strong fluctuations. Our results complement earlier results on the demixing (pseudonematic) transition for an equivalent system in two dimensions, which is presumably of Ising type and occurs for L≥7. We compare our results to lattice fundamental measure theory (FMT) and find that FMT strongly overestimates nematic order and consequently predicts a strong first-order transition. The rod packing fraction of the nematic coexisting states, however, agree reasonably well between FMT and GCMC.

Analysis of Cardiac Myocyte Maturation Using CASAAV, a Platform for Rapid Dissection of Cardiac Myocyte Gene Function In Vivo

RATIONALE

Loss-of-function studies in cardiac myocytes (CMs) are currently limited by the need for appropriate conditional knockout alleles. The factors that regulate CM maturation are poorly understood. Previous studies on CM maturation have been confounded by heart dysfunction caused by whole organ gene inactivation.

OBJECTIVE

To develop a new technical platform to rapidly characterize cell-autonomous gene function in postnatal murine CMs and apply it to identify genes that regulate transverse tubules (T-tubules), a hallmark of mature CMs.

METHODS AND RESULTS

We developed CRISPR/Cas9/AAV9-based somatic mutagenesis, a platform in which AAV9 delivers tandem guide RNAs targeting a gene of interest and cardiac troponin-T promoter-driven Cre to RosaCas9GFP/Cas9GFP neonatal mice. When directed against junctophilin-2 (Jph2), a gene previously implicated in T-tubule maturation, we achieved efficient, rapid, and CM-specific JPH2 depletion. High-dose AAV9 ablated JPH2 in 64% CMs and caused lethal heart failure, whereas low-dose AAV9 ablated JPH2 in 22% CMs and preserved normal heart function. In the context of preserved heart function, CMs lacking JPH2 developed T-tubules that were nearly morphologically normal, indicating that JPH2 does not have a major, cell-autonomous role in T-tubule maturation. However, in hearts with severe dysfunction, both adeno-associated virus-transduced and nontransduced CMs exhibited T-tubule disruption, which was more severe in the transduced subset. These data indicate that cardiac dysfunction disrupts T-tubule structure and that JPH2 protects T-tubules in this context. We then used CRISPR/Cas9/AAV9-based somatic mutagenesis to screen 8 additional genes for required, cell-autonomous roles in T-tubule formation. We identified RYR2 (Ryanodine Receptor-2) as a novel, cell-autonomously required T-tubule maturation factor.

CONCLUSIONS

CRISPR/Cas9/AAV9-based somatic mutagenesis is a powerful tool to study cell-autonomous gene functions. Genetic mosaics are invaluable to accurately define cell-autonomous gene function. JPH2 has a minor role in normal T-tubule maturation but is required to stabilize T-tubules in the failing heart. RYR2 is a novel T-tubule maturation factor.

[Ultrahigh-frequency hearing thresholds in middleaged and elderly healthy adults]

Objective:To investigate the ultrahigh-frequency(UHF) hearing thresholds in middle-aged and elderly healthy subjects .Method: Healthy subjects(age range: 50-69 ) were divided into two groups,i.e.50-59 year-old group and >59-69 year-old group.Each subject was tested with both conventional-frequency(0.25,0.50,1.00,2.00,4.00,6.00 and 8.00 kHz) and ultrahigh-frequency(9.0,10.0,11.5,12.5,14.0,16.0,18.0,and 20.0 kHz) audiometry.UHF was performed twice to evaluate the reliability.The best hearings among 20-29 aged healthy adults were considered as normal controls.Results:Seventy five middle-aged and elderly subjects were included,with 39 subjects(78 ears) being 50-59 years old and 36(72 ears) being >59-69 year-old.Eighteen subjects(36 ears) aging from 20 to 29 were considers as controls.For the conventional-frequency,the hearing thresholds in middle-aged and elderly people were significantly higher than those in young people(all P<0.05),especially at ≥4 kHz.Although the conventional-frequency thresholds in >59-69 year-old group were higher than those in 50-59 year-old,the difference was significant just at 4 kHz(P<0.05).The UHF thresholds in middle-aged and elderly people were significantly higher than those in young people(all P<0.05).The thresholds at 9,10,11.5 and 12.5 kHz in >59-69 year-old people were significantly increased than those in 50-59 year-old counterparts(all P<0.05).Hearing threshold at ≥12.5 kHz couldn't be detected in some subjects in middle-aged and elderly group.The response rate at UHF in >59-69 year-old people were just higher than that in 50-59 year-old counterparts (P>0.05),and none responded at 18 and 20 kHz.The standard deviations(SDs) for <14 kHz in 50-59 year-old and for <11.5 kHz in >59-69 year-old subjects,were both higher than that in 20-29 year old counterparts.Above 6 kHz,the SDs in 50-59 year-old subjects were significantly higher than those in >59-69 year-old subjects(all P<0.05).Conclusion:For middle-aged and elderly people,the hearing loss may occur from 4 kHz.Hearing thresholds at UHF were increased with age,and it might be used as an early indicator for age-induced hearing loss.However,the UHF sensitivity decreased as the frequency increased beyond 14 kHz.

Cortical glutamate levels decrease in a non-human primate model of dopamine deficiency

While Parkinson's disease is the result of dopaminergic dysfunction of the nigrostriatal system, the clinical manifestations of Parkinson's disease are brought about by alterations in multiple neural components, including cortical areas. We examined how 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) administration affected extracellular cortical glutamate levels by comparing glutamate levels in normal and MPTP-lesioned nonhuman primates (Macaca mulatta). Extracellular glutamate levels were measured using glutamate microelectrode biosensors. Unilateral MPTP-administration rendered the animals with hemiparkinsonian symptoms, including dopaminergic deficiencies in the substantia nigra and the premotor and motor cortices, and with statistically significant decreases in basal glutamate levels in the primary motor cortex on the side ipsilateral to the MPTP-lesion. These results suggest that the functional changes of the glutamatergic system, especially in the motor cortex, in models of Parkinson's disease could provide important insights into the mechanisms of this disease.

Intraputamenal Infusion of Exogenous Neurturin Protein Restores Motor and Dopaminergic Function in the Globus Pallidus of MPTP-Lesioned Rhesus Monkeys

The neurorestorative effects of exogenous neurturin (NTN) delivered directly into the putamen via multiport catheters were studied in 10 MPTP-lesioned rhesus monkeys expressing stable parkinsonism. The parkinsonian animals were blindly assigned to receive coded solutions containing either vehicle (n = 5) or NTN (n = 5, 30 μg/day). Both solutions were coinfused with heparin using convection-enhanced delivery for 3 months. The NTN recipients showed a significant and sustained behavioral improvement in their parkinsonian features during the treatment period, an effect not seen in the vehicle-treated animals. At study termination, locomotor activity levels were increased by 50% in the NTN versus vehicle recipients. Also, DOPAC levels were significantly increased by 150% ipsilateral (right) to NTN infusion in the globus pallidus, while HVA levels were elevated bilaterally in the NTN-treated animals by 10% on the left and 67% on the right hemisphere. No significant changes in DA function were seen in the putamen. Volumetric analysis of putamenal NTN labeling showed between-subject variation, with tissue distribution ranging from 214 to 744 mm3, approximately equivalent to 27–93% of area coverage. Our results support the concept that intraparenchymal delivery of NTN protein may be effective for the treatment of PD. More studies are needed to determine strategies that would enhance tissue distribution of exogenous NTN protein, which could contribute to optimize its trophic effects in the parkinsonian brain.

Intraputamenal infusion of exogenous neurturin protein restores motor and dopaminergic function in the globus pallidus of MPTP-lesioned rhesus monkeys

The neurorestorative effects of exogenous neurturin (NTN) delivered directly into the putamen via multiport catheters were studied in 10 MPTP-lesioned rhesus monkeys expressing stable parkinsonism. The parkinsonian animals were blindly assigned to receive coded solutions containing either vehicle (n = 5) or NTN (n = 5, 30 microg/day). Both solutions were coinfused with heparin using convection-enhanced delivery for 3 months. The NTN recipients showed a significant and sustained behavioral improvement in their parkinsonian features during the treatment period, an effect not seen in the vehicle-treated animals. At study termination, locomotor activity levels were increased by 50% in the NTN versus vehicle recipients. Also, DOPAC levels were significantly increased by 150% ipsilateral (right) to NTN infusion in the globus pallidus, while HVA levels were elevated bilaterally in the NTN-treated animals by 10% on the left and 67% on the right hemisphere. No significant changes in DA function were seen in the putamen. Volumetric analysis of putamenal NTN labeling showed between-subject variation, with tissue distribution ranging from 214 to 744 mm3, approximately equivalent to 27-93% of area coverage. Our results support the concept that intraparenchymal delivery of NTN protein may be effective for the treatment of PD. More studies are needed to determine strategies that would enhance tissue distribution of exogenous NTN protein, which could contribute to optimize its trophic effects in the parkinsonian brain.

Evidence for a distinct group of nestin-immunoreactive neurons within the basal forebrain of adult rats

Nestin is an intermediate filament protein serving as a marker for neuroprogenitor and stem cells. Here we report that a cluster of previously unrecognized nestin immunoreactive (nestin-ir) neurons was located in the medial septum-diagonal band of Broca (MS-DBB) of the basal forebrain in adult rats. Nestin-ir neurons were exclusively located in the MS-DBB and intermingled with choline acetyltransferase-ir (ChAT-ir), parvalbumin-ir (PV-ir), or nicotinamide adenine dinucleotide phosphate (NADPH)-diaphorase reactive (NADPHd-reactive) neurons. However, there was no colocalization between nestin-ir and PV-ir in single neurons in MS-DBB; only about 35% of nestin-ir neurons were ChAT-ir, and 8%-12% of nestin-ir neurons were NADPHd-reactive. Morphologically, nestin-ir neurons showed a larger size of somata than that of ChAT-ir or PV-ir neurons and the distribution of nestin-ir neurons spread across the rostro-caudal extent of the MS-DBB. Moreover, retrograde tracing revealed that a significant portion of these nestin-ir neurons projected to the thalamus and hippocampus. These results, for the first time, provide strong evidence that there exists a cluster of previously unrecognized nestin-ir neurons in MS-DBB of the basal forebrain in adult rats and that these nestin-ir neurons are distinguishable from ChAT-ir, PV-ir, and NADPHd-reactive neurons.

Expression of central glucocorticoid receptors after peripheral nerve injury contributes to neuropathic pain behaviors in rats

Peripheral glucocorticoid receptors (GRs) play a significant role in the anti-inflammatory effects of glucocorticoids; however, the role of central GRs in nociceptive behaviors after peripheral nerve injury (neuropathic pain behaviors) remains unknown. Here we show that the development of neuropathic pain behaviors (thermal hyperalgesia and mechanical allodynia) induced by chronic constriction nerve injury (CCI) in rats was attenuated by either the GR antagonist RU38486 (4 = 2 > 1 = 0.5 microg) or a GR antisense oligonucleotide administered intrathecally twice daily for postoperative days 1-6. The development of thermal hyperalgesia and mechanical allodynia after CCI also was prevented in adrenalectomized rats, whereas the GR agonist dexamethasone (100 microg/kg) given subcutaneously twice daily for postoperative day 1-6 restored CCI-induced neuropathic pain behaviors in the adrenalectomized rats. Mechanistically, CCI induced a time-dependent and region-specific expression of neuronal GRs primarily within the spinal cord dorsal horn ipsilateral to nerve injury, which showed a time course parallel to that of the development of neuropathic pain behaviors. Moreover, the expression of neuronal GR after CCI was mediated in part through an elevated spinal level of interleukin-6 (IL-6) and protein kinase Cgamma (PKCgamma), because intrathecal treatment with an IL-6 antiserum, a PKC inhibitor (cheryrithrine), or PKCgamma knock-out substantially reduced the expression of neuronal GRs as well as neuropathic pain behaviors after CCI. These findings indicate a central role of neuronal GRs in the mechanisms of neuropathic pain behaviors in rats and suggest a potential role for GR antagonists in clinical management of neuropathic pain.

[The clinical features of multiple-trauma patients APACHE II score system]

The clinical features of 76 multiple-trauma patients in the intensive care unit were observed with acute physiology and chronic health evaluation (APACHE II) system. The results showed that the mean value of APACHE II scores in 76 patients was 18.4; the mean duration of staying at the ICU was 91.5 hours. Six patients died in the ICU (7.9%), 13 patients were complicated with MODS (17.1%), and 10 patients developed ARDS (13.2%). As APAHCE II scores increased, the duration of the patient staying at the ICU lengthened and the mortality went up.

[Investigation on skin retrograde degeneration after tissue expansion]

OBJECTIVE

To study the effects of tissue expansion on tissue damage and retrograde degeneration.

METHODS

9 cases of conventional intermittent tissue expansion (CITE) and 9 cases of continuous pressure-controlled tissue expansion (CPTE) were chosen for the study. In creating of the expanded flaps, tissue samples were taken for histopathology, molecular biology and transmission electron microscope (TEM) examinations.

RESULTS

Capillary bleeding, elastic and reticular fiber proliferation, arteriole thrombosis, fibroblast apoptosis and collagenolysis were observed after expansion. Retrograde degeneration was obvious in CITE group and acute lesion was obvious in CPTE group.

CONCLUSION

Expansion stimulation induces tissue damage and retrograde degeneration, which indicates that the time for conventional intermittent expansion should be shortened and too fast continuous expansion is harmful.

Abnormal migration phenotype of mitogen-activated protein kinase-activated protein kinase 2-/- neutrophils in Zigmond chambers containing formyl-methionyl-leucyl-phenylalanine gradients

Time-lapsed video microscopy and confocal imaging were used to study the migration of wild-type (WT) and mitogen-activated protein kinase-activated protein kinase 2 (MK2-/-) mouse neutrophils in Zigmond chambers containing fMLP gradients. Confocal images of polarized WT neutrophils showed an intracellular gradient of phospho-MK2 from the anterior to the posterior region of the neutrophils. Compared with WT neutrophils, MK2-/- neutrophils showed a partial loss of directionality but higher migration speed. Immunoblotting experiments showed a lower protein level of p38 mitogen-activated protein kinase and a loss of fMLP-induced extracellular signal-related kinase phosphorylation in MK2-/- neutrophils. These results suggest that MK2 plays an important role in the regulation of neutrophil migration and may also affect other signaling molecules.

Leukocyte-specific gene 1 protein (LSP1) is involved in chemokine KC-activated cytoskeletal reorganization in murine neutrophils in vitro

Leukocyte-specific gene 1 protein (LSP1) is a cytoskeletal-associated protein of leukocytes that in vitro cross-links F-actin into extensively branched bundles of mixed polarity. In this study, we examined chemotaxis and superoxide production in neutrophils prepared from wild-type (WT) and Lsp1 knockout mice. Compared to WT neutrophils, Lsp1-/- neutrophils showed impairment in both migration speed and chemotaxis direction during chemokine KC-directed chemotaxis. When examined by confocal microscopy, chemotaxing Lsp1-/- neutrophils showed abnormal morphologies. They had discontinuous primary actin-rich cortexes and large membrane protrusions. When stimulated by phorbol 12-myristate 13-acetate (PMA), Lsp1-/- peritoneal neutrophils produce more superoxide than WT. The data presented suggest that LSP1 plays important roles in the regulation of neutrophil morphology, motility, and superoxide production.

[Survey on the growth of interpupillary distance of Chinese children aged 5 to 17 years]

OBJECTIVE

To investigate the interpupillary distance (IPD) of Chinese children for stipulating the sizes for children spectacle frames.

METHOD

The IPD of 10171 children aged 5 to 17 years old was measured with a caliper in four cities.

RESULTS

The IPD was positively correlated with the age increase from 5 to 17 years. The IPD in males was larger than that in females. The differences of IPD between males and females in the age groups of 5 to 9 and 10 to 15 years were statistically significant (F = 400.97, P < 0.01).

CONCLUSIONS

There are two peak periods of the growth of IPD in Chinese children at 5 to 9 and 10 to 15 years. The IPD in males reaches adult level at age 15 and in females at age 13. The differences of the IPD between male and female and among 4 cities have no practical meaning in stipulating the sizes of children spectacle frames.

A mouse model of galactose-induced cataracts

Galactokinase (GK; EC 2.7.1.6) is the first enzyme in the metabolism of galactose. In humans, GK deficiency results in congenital cataracts due to an accumulation of galactitol within the lens. In an attempt to make a galactosemic animal model, we cloned the mouse GK gene (Glk1) and disrupted it by gene targeting. As expected, galactose was very poorly metabolized in GK-deficient mice. In addition, both galactose and galactitol accumulated in tissues of GK-deficient mice. Surprisingly, the GK-deficient animals did not form cataracts even when fed a high galactose diet. However, the introduction of a human aldose reductase transgene into a GK-deficient background resulted in cataract formation within the first postnatal day. This mouse represents the first mouse model for congenital galactosemic cataract.

P47(phox)-deficient NADPH oxidase defect in neutrophils of diabetic mouse strains, C57BL/6J-m db/db and db/+

Deficiencies in neutrophil NADPH oxidase proteins have been demonstrated in humans with chronic granulomatous disease. However, no spontaneous mutation in murine NADPH oxidase has been reported. In this study we report that neutrophils from the diabetic mouse strains, C57BL/6J-m heterozygous lean (lepr(db/+)) and homozygous obese (lepr(db/db)) mice produced no superoxide on stimulation. An absence of intact p47(phox) but not other oxidase proteins was observed in both mouse strains through the use of immunoblotting. Molecular analysis by reverse transcriptase-polymerase chain reaction identified three abnormal p47phox mRNA transcripts. Sequencing of genomic DNA of p47(phox) revealed a point mutation at the -2 position of exon 8, which is consistent with aberrant splicing of the p47(phox) transcript. These results indicate that the C57BL/6J-m db/db and db/+ mice are the first spontaneously derived murine model of NADPH oxidase deficiency involving a p47(phox) mutation.

[A case of fetal valproate syndrome with intractable wheezing due to submucosal tumor below the vocal cord]

A full-term baby was born to an epileptic mother treated with two anti-epileptic drugs, sodium valproate and phenobarbital, throughout the pregnancy. She was given no information about the risk of teratogenesis of these drugs. At birth the patient was hypotonic and had clinical features specific for the fetal valproate syndrome. After a viral infection at three months of age, he had intractable and persistent wheezing. Suspecting the presence of congenital respiratory tract abnormality, we performed tracheobronchoscopy, which revealed a relatively big submucosal tumor on the left trachial wall below the vocal cord. Dyspnea and wheezing were remarkably improved by tracheolaryngotomy, but he died suddenly and unexplainedly at seven months of age.

Construction and application of MCBL plate for facilitation of chromosome recombination in fungi

A medium with camphor and benomyl MCBL plate was designed and constructed based on the proposed mechanism that d-camphor could induce the fusion of nuclear membrane while benomyl could induce the nondisjunctional recombination of chromosome in fungi. This so-called co-induction plate consisted of 0.1% d-camphor (W/V) and 0.5 microgram/L benomyl contained in Czapek's minimal medium. The precautions to be taken in the construction procedure of this plate was described in detail. One typical example of intergeneric fusion-cross, Aspergillus niger x Trichoderma reesei, was investigated, comparing the ratios of genotypes and phenotypes of fusant progenies produced by the co-induction of MCBL plate and by the step-by-step induction with camphor and benomyl separately. The results showed that the heterodiploid state was extremely transient and the recombinant haploid was hardly obtained when induced by the routine step-by-step method, whereas the ratios of apparent diplodization and nondisjunctional recombinant haplodization among all types of varied segregates on MCBL plate were greatly improved, compared with those on the routine plates containing single reagents, which indicated that the transient heterodiploid could be grasped and transformed further into nondisjunctional recombinant haploid when co-induced on the MCBL plate. The age of regenerated mycelium to be induced was found to have a dominant influence on the co-induction effects of MCBL plate. The mechanism of co-induction by MCBL plate and its promising applications were discussed.

MPTP-Induced pallidal lesions in rhesus monkeys

Dopamine neurons in the substantia nigra of the midbrain are the primary neuronal population affected by 1-methyl-4-phenyl-1,2,3, 6-tetrahydropyridine (MPTP) toxicity, which produces the pathological and behavioral features of Parkinson's disease in nonhuman primates and man. We have identified another injury site in magnetic resonance imaging (MRI) brain scans in 13 of 37 rhesus monkeys taken 10-12 months after administration of this neurotoxin via the right carotid artery. Focal lesions, ranging in volume from 6.75 to 60 mm3 in the rostral globus pallidus region, were seen on the right side of the brain in these 13 animals in addition to the midbrain effects. While no significant differences were seen between globus pallidus lesioned and nonlesioned animals in the severity of MPTP-induced parkinsonian symptoms, the response to levodopa was muted in pallidal-lesioned animals. To confirm the role of neurotoxicity in producing the lesions, brain scans from an additional 12 monkeys were evaluated during the acute period following exposure to either MPTP (n = 6) or saline (n = 6). Focal lesions in the rostral globus pallidus were seen as early as 2-4 h following a carotid artery infusion in two of six MPTP recipients, but no evidence of injury was seen in saline recipients. The globus pallidus includes important components of the neural circuitry regulating motor functions. The present results indicate that in addition to midbrain dopamine neurons, a focal region of the rostral globus pallidus is selectively vulnerable to MPTP toxicity.

[Study on the effect of human herpesvirus 6 on replication of Epstein-Barr virus]

OBJECTIVE

To examine the effect of human herpesvirus 6(HHV-6) on the replication of Epstein-Barr virus (EBV) in cell lines.

METHODS

Both EBV-infected Raji cells and EBV-transformed lymphoblastoid cell lines (LCL) were infected with HHV-6. Immunofluoresence assay (IFA) with monoclonal antibodies (MAb) against HHV-6 was applied to confirm the infection of HHV-6 in the two cell lines. Expression of EBV antigen was examined by IFA using human anti-EBV serum.

RESULTS

Following HHV-6 infection, cytopathic effects (CPE) were observed in Raji cells but not in LCL. HHV-6 were detected in both cell lines by IFA with anti-HHV-6 MAb, but not in controls. EBV antigens were detected by IFA with human serum against EBV in both HHV-6 infected cell lines.

CONCLUSION

Data in this study suggest that HHV-6 promotes the expression of EBV antigen and may contribute to the pathogenesis of nasopharyngeal carcinoma in cooperation with EBV.

[The intergeneric compatibility of heredity and expression for cellulase genomes between Aspergillus niger and Trichoderma reesei]

By using the developed display techniques of cellulase isozymes and the RAPD-PCR analysis guided by a deduced universal sequence of cellulase genes, the polymorphisms of genomic DNA fingerprints and cellulase isozymes were compared among three typical stable recombinants (3a, 3b, A7-1) and their two parents (Aspergillus niger AMS11, Trichoderma reesei QM9414) in order to provide the molecular evidence of gene recombination, to demonstrate the compatibility of heredity and expression of intergeneric genomes, and to assay on the molecular fundamentals of hybridization dominance. The results showed that in these recombinant strains the recombinantal fingerprints of genomic DNA could be stablly hereditary and the expression of recombinantal CMCase (carboxymethylcellulase) and beta GLase (beta-glucosidase) could be compatibly enhanced. The diversity of molecular fundamentals of cellulase hybridization dominance were (1) the compatible co-existence and enhanced expression of some hereditary beta GLase-coding genes from two parents in recombinant 3b; and (2) the compatibly enhancement of expression between the hereditary genes encoding beta GLase and CMCase from two parents, resulting in the dramatic increase of proteins of corresponding isozymes in recombinants 3a and A7-1. Based on these, a proposal model for the double synergism on cellulase activity in vitro and on its biosynthesis in vivo mediated by beta GLase was suggested. A practical method for assaying on the molecular fundamentals and the stability of hybridization dominance of recombinants was thereby established in this study.

The role of p38 MAP kinase in TGF-beta1-induced signal transduction in human neutrophils

Transforming growth factor-beta 1 (TGF-beta 1) is the strongest chemoattractant yet described for human neutrophils. It activates neither phospholipase C nor phospholipase D. It does not induce rises in intracellular calcium, degranulation, or superoxide production. The signaling pathways utilized by TGF-beta 1 are largely unknown. This report demonstrates that TGF-beta 1 activates p38 MAP kinase. The kinase inhibitor SB203580 blocks the chemotactic responses as well as actin polymerization induced by TGF-beta 1. Potential cellular targets of the p38 MAP kinase pathway which could mediate these function are discussed.

Hybridization dominance of kinetics in recombinant ATH-1376 obtained via protoplast fusion between Aspergillus niger and Trichoderma reesei

Comparisons of the kinetics of mycelium growth, cellulase biosynthesis, and the degradation of filter paper to accumulate reducing-sugar by the filtrates of cultures were carried out among the recombinant strain ATH-1376 and its two parents, Aspergillus niger AMS11 and Trichoderma reesei QM9414. The results showed that both the specific mycelium growth rate and the cellulase biosynthesis rate of the recombinant were dramatically dominant over those of the two parents. In addition, the negative correlation between the specific mycelium growth rate and the cellulase biosynthesis rate of the recombinant ATH-1376 was much lower than those of its parents. In terms of the amount of reducing-sugar accumulated from the hydrolysis of filter paper by culture filtrates, there were great differences among the three different treatments, i.e., fermentation filtrate of single parental strain, mixture of the fermentation filtrates from two parental strains with different ratios (v:v), and filtrate from the mixed culture of the two parental strains. Out of these, the second approach, particularly with the ratio of 1:1, was best for the accumulation of reducing sugar. Within various tested periods of enzymic hydrolysis, the amounts of reducing-sugar produced by the recombinant were 1.19 to 2.26 times as much as the maximum amounts produced in parallel by the mixture of filtrates (1:1) from separate fermentations of the two parental strains. These results suggested that constructing the engineered strains with hybridization dominance of these two typical genera of far-heredity could be effective to overcome the great deficiencies of routine mixculture, single-strain fermentation, or double fed-batch fermentations.

[Scalp expansion in treatment of scalp defect with skull exposure]

We repaired the scalp defect and skull exposure with scalp expansion. The technique consisted of two stages. First, expander was implaned an then N. S injected to its enough volume. The size of the expander was estimated by the formula that 1 cm2 needs 4 ml expansive volume. The incision was made at normal skin. Second flap was transferred. The expander was removed and the external skull which was necrotic severed. There were five patient with eight flaps at all, followed up for 6 months to 1 year. The hair grew. The results were satisfactory. This method not only treated the disease, but also avoided alopecia.

High expression and activation of MAP kinase-activated protein kinase 2 in cardiac muscle cells

Recently, three mammalian mitogen-activated protein (MAP) kinases, ERK, SAPK/JNK, and p38/HOG-1 have been identified, each with apparently unique signal transduction pathways. The p38 MAP kinase mediates an intracellular stress-activated signaling pathway by regulating down-stream molecules, such as MAP kinase-activated protein (MAPKAP) kinase 2. To study the tissue specificity of MAPKAP kinase 2, mRNA blots containing multiple human tissues were hybridized with a specific oligonucleotide probe corresponding to human MAPKAP kinase 2. The Northern blot analysis revealed that two mRNA species of MAPKAP kinase 2, with sizes of 4.8 and 3.3 kb, were expressed in high levels in both human heart and skeletal muscle tissues. To better understand how MAPKAP kinase 2 is regulated in myocardium, cultured rat cardiac myoblast (H9c2) cells were stimulated with heat shock, H2O2-induced oxidative stress, or phorbol ester (PMA). Enzymatic activity of cellular MAPKAP kinase 2 in the cell lysates was evaluated using an in vitro kinase assay. Exposure of H9c2 cells to heat shock or oxidative stress induced a transient increase of cellular MAPKAP kinase 2 activity, which reached its peak level within 5 min. In contrast, stimulation of H9c2 cells with PMA, a potential myocardial hypertrophic factor, induced a sustained increase of cellular MAPKAP kinase 2 activity that was detectable for over 1 h. In addition, in vitro protein phosphorylation analysis with recombinant MAPKAP kinase 2 showed that small heat shock protein (hsp25) served as a major substrate molecule for the kinase in H9c2 cells and the protein phosphorylation of cellular hsp25 was stimulated by H2O2-induced oxidative stress or PMA treatment in intact H9c2 cells. Moreover, exposure of H9c2 cells to H2O2-induced oxidative stress or PMA rapidly activated cellular p38 MAP kinase as detected by the induced protein phosphorylation of the kinase. Taken together, these results strongly suggest that MAPKAP kinase 2 may be involved in stress-activated signal transduction in myocardium.

LSP1 is the major substrate for mitogen-activated protein kinase-activated protein kinase 2 in human neutrophils

In intact cells, mitogen-activated protein kinase-activated protein (MAPKAP) kinase 2 is rapidly activated by various cytokines, stresses, and chemotactic factors. The small heat shock protein p27 has been shown to be a substrate for MAPKAP kinase 2. Recently, we identified a novel substrate, designated p60, for MAPKAP kinase 2 in human neutrophils (Zu, Y.-L., Ai, Y., Gilchrist, A., Labadia, M. E., Sha'afi, R. I., and Huang, C.-K. (1996) Blood 87, 5287-5296). To further understand the signaling pathway of MAPKAP kinase 2, we have purified p60 from a heat-treated neutrophil lysate by DEAE-cellulose chromatography and SDS-polyacrylamide gel electrophoresis. Microsequencing of five peptides derived from purified p60 indicates that p60 is lymphocyte-specific protein 1 (LSP1). Furthermore antibodies specific for human and mouse LSP1 react with human and mouse p60. The sequence of human LSP1 indicates two serine residues at positions 204 and 252 as potential phosphorylation sites. The amino acid sequences surrounding these two sites are in agreement with the consensus sequence (Xaa-Xaa-Hyd-Xaa-Arg-Xaa-Xaa-Ser-Xaa-Xaa) for phosphorylation by MAPKAP kinase 2. Both serine residues in human LSP1 and the corresponding conserved serine residues in mouse LSP1 are in the basic C-terminal F-actin binding domain. Various fusion proteins of wild type and truncated mouse LSP1 with glutathione S-transferase were tested for their capacity to be phosphorylated by MAPKAP kinase 2. The results indicate that LSP1 is a substrate for MAPKAP kinase 2 in vitro and that the phosphorylation sites are located in the basic C-terminal domain of LSP1. Because both the small heat shock proteins and LSP1 are F-actin binding proteins, these results suggest a role for MAPKAP kinase 2 in the regulation of cytoskeletal structure or function.

Fine structure of the human galactokinase GALK1 gene

Defects in the human GALK1 gene result in galactokinase deficiency and cataract formation. We have isolated this gene and established its structural organization. The gene contains 8 exons and spans approximately 7.3 kb of genomic DNA. The GALK1 promoter was localized and found to have many features in common with other housekeeping genes, including high GC content, several copies of the binding site for the Sp1 transcription factor, and the absence of TATA-box and CCAAT-box motifs typically present in eukaryotic Pol II promoters. Analysis by 5'-RACE PCR indicates that the GALK1 mRNA is heterogeneous at the 5' terminus, with transcription sites occurring at many locations between 21 and 61 bp upstream of the ATG start site of the coding region. In vitro translation experiments of the GALK1 cDNA indicate that the protein is cytosolic and not associated with the endoplasmic reticulum membrane.

[Endoscopic control during facelifting]

The endoscopic techniques were just recently applied to aesthetic surgery. The paper reports 22 cases of video endoscopic facelift that have been performed since April 1994. The operative results were satisfactory. Clinical experience with forehead plasty, resection of corrugator and procerus muscle and other cosmetic procedures using endoscopic technique is presented.

Activation of MAP kinase-activated protein kinase 2 in human neutrophils after phorbol ester or fMLP peptide stimulation

In response to extracellular stimulation, one of the earliest events in human neutrophils is protein phosphorylation, which mediates signal transduction and leads to the regulation of cellular functions. Mitogen-activated protein (MAP) kinases are rapidly activated by a variety of mitogens, cytokines, and stresses. The activated MAP kinases in turn regulate their substrate molecules by phosphorylation. MAP kinase-activated protein (MAPKAP) kinase 2, a Ser/Thr kinase, has been shown to be phosphorylated by p38 MAP kinase both in vivo and in vitro. Phosphorylation of the Thr-334 site of MAPKAP kinase 2 results in a conformational change with subsequent activation of the enzyme. To better define the role of MAPKAP kinase 2 in the activation of human neutrophils, its enzymatic activity was measured after stimulation by either a phorbol ester (phorbol myristate acetate [PMA]), a potent protein kinase C activator, or the tripeptide fMLP, which is a chemotactic factor. The in vitro kinase assays indicate that both PMA and fMLP stimulated a transient increase in the enzymatic activity of cellular MAPKAP kinase 2. The induced kinase activation was concentration-dependent and reached a maximum at 5 minutes for PMA and 1 minute for fMLP. To identify potential substrate molecules for MAPKAP kinase 2, a highly active kinase mutant was generated by mutating the MAP kinase phosphorylation site in the C-terminal region. The replacement of threonine 334 with alanine resulted in a marked augmentation of catalytic activity. Analysis of in vitro protein phosphorylation in the presence of the active kinase indicates that a 60-kD cytosolic protein (p60) was markedly phosphorylated and served as the major substrate for MAPKAP kinase 2 in human neutrophils. Based on the MAPKAP kinase 2 phosphorylation site of Hsp27, a competitive inhibitory peptide was synthesized. This competitive inhibitory peptide specifically inhibited MAPKAP kinase 2 enzymatic activity, as well as the in vitro and in vivo kinase-induced p60 phosphorylation. To assess the contribution of MAPKAP kinase 2 in neutrophil function, the oxidative burst response after manipulation of endogenous kinase activity was measured. Intracellular delivery of the competitive inhibitory peptide into human neutrophils reduced both PMA- and fMLP-stimulated superoxide anion production. Thus, the results strongly suggest that MAPKAP kinase 2 is involved in the activation of human neutrophils.

Research on soft-tissue expander permeability to metronidazole and procaine

This in vitro study was designed to determine if in fact silicone expanders are readily permeable to metronidazole and procaine. The expanders were filled with 0.2% metronidazole or 2% procaine through the filler valves and then immersed wholly in normal saline. At several intervals over 120 hours, a certain amount of the surrounding saline was sampled and the drug levels subsequently determined. In this study, the silicone expanders were indeed readily permeable to the drugs, as measured with an ultraviolet spectrophotometer. A consistent diffusion curve was demonstrated. The rate of diffusion of a drug is inversely proportional to its molecular weight; i.e., the smaller the given drug's molecular weight, the greater is its ability to permeate an expander. In view of this, in the course of expansion, 0.2% metronidazole could be used in clinical expansion instead of normal saline, and a certain amount of antibiotic would diffuse out of the expander to prevent and control the infection.

[The application of expanded delto-pectoral flaps in the faciocervical region]

The delto-pectoral flap has been used to repair burned scar in the faciocervical region for some years. However, its limited size restricts its application. Furthermore, direct transfer of the flap may result in a swelling and inexpressive face and the donor site needs skin grafting. To avoid the above disadvantages, we have tried pre-expansion of the flap. In this article, the authors report the experiences in the application of the method to eighteen cases, including the surgical procedure, the applied anatomy, and typical cases as well. Also included in the article are the comparison between various therapies to the burned scar of the face, the key points for successful pre-expansion of the delto-pectoral flap, accurately maintaining the desired position. The method has been proved to have many advantages and can be widely applied.

An attempt on using the method of R-Q double-factor analysis to identify and group fusants

A subsequent numeric taxonomy method for identifying and grouping the fusants was explored on the basis of characterization of the protein profiles of the fusants. By these two means, several typical excellent candidates of recombinants could be searched out quickly. Among the fusants from a definite fusion-cross, the different sister-strains were regarded as the samples of observation (n = N), the positions of the all bands of protein profiles as the objects (p = P), and the photometer-scanning area of the specific band as the experimental value (X) (zero was taken when the specific band of a certain strain was absent). The genetic multirelationships among the inter- and intra-sister-strains in terms of the positions and contents of the protein bands after fusion recombination occurred from this definite fusion-cross could therefore be determined on the same orientational factor-plate by using the computer program of the R-Q double-factor method to analyze this data matrix (Xnxp). These sister-strains could then be identified and grouped from the deduced heredity relationship between the fusants and parents.

Mouse galactokinase: isolation, characterization, and location on chromosome 11

Elevated galactose levels can be caused by several enzyme defects, one of which is galactokinase. Galactokinase deficiency cause congenital cataracts during infancy and presenile cataracts in the adult population. We have isolated the mouse cDNA for galactokinase, which shares extensive amino acid sequence homology, 88% identity, with a recently cloned human galactokinase. It is expressed in all tissues examined. In an interspecific backcross analysis galactokinase maps to the distal region of mouse chromosome 11, a region that is homologous to human chromosome 17q22-25. The availability of the mouse gene provides an opportunity to make a knockout model for galactokinase deficiency.

Comparison of the enzymatic activities of human galactokinase GALK1 and a related human galactokinase protein GK2

The GALK1 cDNA encoding human galactokinase was recently cloned and its cognate GALK1 gene shown to be involved in galactokinase deficient galactosemia. Previously, a separate human galactokinase cDNA, GK2, was cloned by complementation of a galactokinase deficient yeast mutant; however, the galactokinase activity of GK2 was not demonstrated in mammalian cells. To compare the relative galactokinase activity of GALK1 and GK2, their corresponding cDNAs were expressed in COS cells. Northern blot analysis indicated that both cDNAs were transcribed into mRNA transcripts of the expected size; however, only the GALK1 cDNA produced high levels of galactokinase activity. This result would suggest that GALK1 is the major enzyme for galactose metabolism while the role of GK2 remains uncertain.

Cloning of the galactokinase cDNA and identification of mutations in two families with cataracts

Galactokinase is an essential enzyme for the metabolism of galactose and its deficiency causes congenital cataracts during infancy and presenile cataracts in the adult population. We have cloned the human galactokinase cDNA, which maps to chromosome 17q24, and show that the isolated cDNA expresses galactokinase activity in bacteria and mammalian cells. We also describe two different mutations in this gene in unrelated families with galactokinase deficiency and cataracts. The availability of the cloned galactokinase gene provides an important reference to identify mutations in patients with galactokinase deficiency and cataracts.

[A preliminary observation of EcochG and cochlear morphology after cervical sympathectomy in guinea pigs]

In order to examine the effect of sympathetic nerve on the inner ear, we observed the changes of EcochG and ultrastructure of the hair cells before and after cervical sympathectomy in 13 guinea pigs. We also compared the results with those of the contralateral side (as a normal control group). We found that there were morphologic changes in the stereocilia of the hair cells in the surgical side. No changes were found in the thresholds, amplitudes and latencies of EcochG. It seems that the effect of the morphologic changes are too small to be detected in the electrophysiologic experiments.

Characterization of an autoinhibitory domain in human mitogen-activated protein kinase-activated protein kinase 2

Mitogen-activated protein (MAP) kinase-activated protein kinase 2, a Ser/Thr kinase, is phosphorylated and activated by MAP kinase. Sequence analysis of a clone isolated from the human HL-60 cell line revealed a 370-amino acid protein with a proline-rich N terminus, a highly conserved catalytic domain, and a C-terminal region containing a MAP kinase phosphorylation site. To better understand how the kinase is regulated, mutation analysis was used to map the functional domain(s). The wild type recombinant kinase had a low basal activity as detected by phosphorylation of a substrate peptide derived from the N terminus of glycogen synthase. Deletion of the proline-rich N terminus showed little effect on the basal activity. Deletion of the C terminus resulted in a marked increase in catalytic activity either with or without the pretreatment of the kinase by MAP kinase. Further analysis indicated that amino acid residues 339-353 in the C-terminal region were acting as an autoinhibitory domain. A synthetic peptide (RVLKEDKERWEDVK-amide) derived from this autoinhibitory domain inhibited the kinase activity in a concentration-dependent manner. These results suggest a regulatory model for the kinase.

[Anatomy and clinical application of transcervicothoracic polyphyletic blood supply skin flap]

Transcervicothoracic skin flap was used to repair the faciocervical scars left after burns in 56 cases. Anatomy and clinical application proved that the transverse cervical artery branches out a constant skin artery before it enters the trapezius muscle and this artery, after crossing the clavicle, is divided into two branches, one extending outwards, and the other downwards. The internal thoracic artery branched out an intercostal perforator on the spot 1 cm to the parasternum. The perforator extended along the intercostal plane and belonged to the direct skin artery. The rate for perforation between the second and third ribs was the highest and the diameter of the perforator the greatest. The thoracoacromial skin artery perforated through the medialsemis between the greater pectoral muscle and the deltoid muscle, and extended toward the shoulder, supplying the skin of the infraclavicular, deltoid and upper greater pectoral regions with blood. Anatomy and contrast examination showed that there are extensive anastomoses between the three groups of blood vessels. On the basis of these anastomotic branches, transregional skin flaps can be designed to repair faciocervical damages. These flaps were successfully used in the 56 cases, with 32 cases having the the branch of cervical segment of the trasverse cervical artery as the pedicle, and 24, the second and third perforators of the internal thoracic artery as the pedicle. It was proved that the transregional flaps can be successfully transferred regardless of the sites of the pedicles.