Inhibition of mixed lymphocyte reaction by thoracic duct lymph: removal of inhibitory effect by thoracic duct drainage in lung cancer.

The inhibitory effect of the thoracic duct lymph of a patient with lung cancer on the "one-way" mixed lymphocyte reaction without cytoxicity is unequivocally demonstrated. The effect seems to be dose related. A moderate inhibition of mixed lymphocyte reaction is still observed, even if the responding cells are preincubated in the thoracic duct lymph for 1 hr only prior to the addition of stimulating cells. The inhibitory effect of thoracic duct lymph on the mixed lymphocyte reaction is no longer evident when the material is added 1-4 days after the beginning of culture. These observations suggest that the mechanism of the inhibitory effect of thoracic duct lymph may be a simple attachment of inhibitory factors to the receptor sites on the responding lymphocytes, causing interference in cell to cell interaction. The inhibitory effect of thoracic duct lymph collected 1 week after the thoracic duct drainage on mixed lymphocyte reaction is significantly lower than that of thoracic duct lymph collected at the beginning of the procedure. This indicates that the blocking effect of thoracic duct lymph can be easily removed by this technique; which is technically feasible in man. The interrelationship of the tumor-specific blocking factor, thoracic duct drainage, and tumor growth pattern are discussed with respect to the potential usefulness of this procedure as adjuvant immunotherapy in the management of patients with neoplastic diseases.     

BDNF blocks caspase-3 activation in neonatal hypoxia-ischemia

Hypoxic-ischemic (H-I) injury to the brain in the perinatal period often leads to significant long-term neurological deficits. In a model of neonatal H-I injury in postnatal day 7 rats, our previous data have shown that cell death with features of apoptosis is prominent between 6 and 24 h after H-I and that neurotrophins, particularly BDNF, can markedly protect against tissue loss. During brain development, caspase-3 is required for normal levels of programmed cell death. Utilizing an antibody specific for the activated form of caspase-3, CM1, we now show that caspase-3 is specifically activated in neuronal cell bodies and their processes beginning at 6 h and peaking 24 h following unilateral carotid ligation and exposure to hypoxia in postnatal day 7 rats. Caspase-3 activation began to occur in cortex at 6 h and in striatum and hippocampus at 12-18 h. Caspase-3 activation was also observed in developing oligodendrocytes. Intracerebroventricular injection of BDNF prior to H-I injury almost completely abolished evidence of H-I-induced caspase-3 activation in vivo. Utilizing a specific molecular marker of an apoptotic pathway, these findings demonstrate that H-I injury to the developing brain is a strong apoptotic stimulus leading to caspase-3 activation, that BDNF can block this process in vivo, and that the ability of BDNF to inhibit caspase activation and subsequent apoptosis likely accounts in large part for its protection against neuronal injury in this model.     

A study on the expression of TGF-beta 1/T beta R II in laryngeal carcinoma]

OBJECTIVE: To explore the expression of TGF-beta 1/T beta R II in laryngeal carcinoma. METHOD: Immunohistochemical study using SP kit in 53 cases. RESULT: The expression of TGF-beta 1 was decreased in carcinoma tissues when compared with peri-cancer controls (P < 0.05). There wasn't difference in T beta R II expression when compared with peri cancer controls (P > 0.05). But it was correlated with the stage, differentiation and lymph node metastasis of laryngeal carcinoma. CONCLUSION: TGF-beta 1/T beta R II may involve in the histogenesis and development of laryngeal carcinoma. The decreased expression of TGF-beta 1/T beta R II may serve as an important molecular marker of laryngeal carcinoma.     

Pneumatization of perpendicular plate of the ethmoid bone and mucocele]

OBJECTIVE: To find out the prevalence of pneumatization of perpendicular plate of the ethmoid bone, and to discuss the diagnosis and management of perpendicular plate mucocele (nasal septal mucocele). METHODS: The CT data from 32 patients with septal deviation were reviewed, and an unusual case of perpendicular plate mucocele was reported. RESULTS: Six cases (6/32, 18%) were found to have pneumatization of perpendicular plate of the ethmoid bone, with 2 located in the anterior portion (frontal-septal pneumatization), and 4 located in the posterior portion (spheno-septal pneumatization). A patient with perpendicular plate mucocele was treated by the technique of marsupialization under nasal endoscope. This patient was followed-up for 10 months without recurrence. CONCLUSION: As a kind of variation of nasal septum, the clinical significance of pneumatization of perpendicular plate should be emphasized. We reported the first case of perpendicular plate mucocele, originated possibly from the pneumatization of perpendicular plate of the ethmoid bone. Marsupialization under endoscope was considered to be the initial management for this unusual disease.     

Study of neurological mechanism of lidocaine's suppression to tinnitus via microdialysis]

OBJECTIVE: To elucidate the neurological mechanism of lidocaine's suppression to tinnitus. METHODS: Thirty-four Wistar rats weighing 300-350 grams were randomly divided into IC group (n = 17) and AC group (n = 17), according to microdialysis region. Each group was randomly subdivided into saline treatment group (n = 4), salicylate treatment group (n = 6), and salicylate + lidocaine treatment group (n = 7). Using in vivo microdialysis technique coupled with microbore HPLC-electrochemical detection, the present study first monitored the 5-HT release in IC and AC in salicylate-induced tinnitus animal models, and then, examined the effects of lidocaine on salicylate-induced 5-HT changes in IC and AC. The statistical analysis was performed using two-way ANOVA for repeated measures of raw data with time and treatment condition as main effects. Individual time-point values between no more than two groups were compared with the unpaired Student's t-test. The accepted level of significance was 0.05, two-tailed. RESULTS: The 5-HT level increased to a maximum of 268% +/- 27% (mean +/- s) basal level in IC 2 h after salicylate application and of 277% +/- 24% basal level in AC around 3 h after application. And then, the 5-HT level gradually decreased to 157% +/- 16% of baseline in IC and 180% +/- 18% of baseline in AC by the end of the sixth hour. Saline did not alter the IC and AC dialysate 5-HT level in control rats. Two-way ANOVA with repeated measures indicated a significant effect of the condition factor [F (1, 8) = 413.949, P < 0.000001 in IC group; F(1,8) = 192.184, P < 0.000001 in AC group]. The increases of 5-HT levels in salicylate treatment groups were significantly reduced to 85% +/- 8% basal level in IC and 92% +/- 26% basal level in AC after local infusion of 1% lidocaine (P < 0.05). Compared with corresponding control value at that time (unpaired student t-test). Two-way ANOVA with repeated measures showed a significant difference between the salicylate group and salicylate + lidocaine group [P < 0.000001 with F(1, 11) = 329.267 for the condition factor in IC subgroup; P < 0.000001 with F(1, 11) = 133.844 for the condition factor in AC subgroup]. CONCLUSION: The suppression of lidocaine to tinnitus may be associated with the decrease of 5-HT level in IC and AC.     

小儿耳蜗植入后电诱发复合动作电位的阈值及其临床应用

目的：研究应用神经反应遥测（neural response telemetry,NRT)技术，测试电诱发复合动作电位（electrically-evoked compound action potential,ECAP)阈值以指导小儿人工耳蜗映射调图的策略与时机。方法：应用NRT3．0软件对辐值增长函数进行线性拟合，确定ECAP阈值。比较6例儿童植入者在术后1、2、3个月ECAP阈值的变化，同时比较了7例儿童术中、术后ECAP阈值的差异。结果：ECAP幅值增长函数在接近阈值或进入饱和时不再呈线性。术后ECAP阈值保持稳定。各导电极的术中ECAP阈值比术后阈值平均高约15CL，二者有显著性相关（R2＝0．9154）。结论：应选取幅值增长函数的直线段部分进行拟合以确定ECAP阈值。术后应用ECAP阈值指导小儿映射调图时，测试一次ECAP阈值即可。术中ECAP阈值可用作开机时映射图的C值。     

女性睡眠呼吸暂停低通气综合征临床特点

OBJECTIVE: To realize the characteristics of symptoms and polysomnography in women with sleep apnea-hypopnea syndrome (SAHS) compared with that of male patients. METHODS: The symptoms and polysomnography were compared between men and women with SAHS and among mild (5 to 19 events/h), moderate (20 to 39 events/h), severe (> or = 40 events/h) of female patients. RESULTS: Female patients were older than that of male(51.1 +/- 11.2 yr versus 43.9 +/- 10.1 yr). The mean body mass index(BMI) for women was (27.8 +/- 3.9) kg/m2 and (28.1 +/- 3.8) kg/m2 for men. Women with higher AHI snored more severely, and female had a lower apnea hypopnea index (AHI) and apnea index (AI) but higher hypopnea index (HI) than did male. In addition, the respiratory events during non-rapid eye movement for men were significantly higher than that for women. CONCLUSION: Female patients are older than male but not more adipose. SAHS and respiratory events during NREM sleep are less severe in women.     

妊娠合并肺动脉高压23例分析

目的 探讨合并肺动脉高压(PH)妇女能否妊娠及妊娠的适宜时间。方法 回顾性分析1997～2002年在我院诊治的23例合并有PH的孕妇，分析PH的分类，妊娠结局。结果 3例合并原发性肺动脉高压(PPH)孕妇，2例在剖宫产术中死亡，1例在孕早期终止妊娠后存活。14例因合并风湿性心脏病(风心病)致PH的孕妇，妊娠至足月行剖宫产者10例，1例早产，3例引产，无一例孕妇死亡。6例因合并先天性心脏病(先心痛)致PH的孕妇，轻度PH孕妇3例，均妊娠至足月；重度PH孕妇3例，2例死亡，1例存活。结论 PPH患者应避免妊娠。风心病致PH的孕妇，依心功能、PH高低及血氧饱和度决定是否终止妊娠。对先心病致PH者，最好在手术或药物治疗后妊娠；患Eisenrnenger’s综合征妇女禁止妊娠。