Extracellular matrix remodeling in oral submucous fibrosis: its stage-specific modes revealed by immunohistochemistry and in situ hybridization

BACKGROUND: Oral submucous fibrosis (OSF) is a chewing habit-related pre-cancerous condition of the oral mucosa affecting predominantly south Asians. It is histopathologically characterized by epithelial atrophy and fibrosis of the subepithelial connective tissue. Fibrosis extends all the way into the muscle layer, leading to difficulty in mouth opening. However, the dynamics of extracellular matrix (ECM) remodeling with OSF progression is largely unknown. METHODS: Forty biopsy specimens of OSF and 10 of normal buccal mucosa were examined for expression/deposition modes of eight ECM molecules by histochemistry, immunohistochemistry, and in situ hybridization. RESULTS: In the early stage of OSF, tenascin, perlecan, fibronectin, collagen type III were characteristically enhanced in the lamina propria and the submucosal layer. In the intermediate stage, the ECM molecules mentioned above and elastin were extensively and irregularly deposited around muscle fibers. In the advanced stage, such ECM depositions decreased and were entirely replaced with collagen type I only. Their gene expression levels varied with progression of fibrosis, but the mRNA signals were confirmed in fibroblasts in the submucosal fibrotic areas. CONCLUSIONS: The results indicate that the ECM remodeling steps in OSF are similar to each phase of usual granulation tissue formation. Restricted mouth opening may be a result of loss of variety of ECM molecules including elastin into the homogeneity of collagen type I replacing muscle fibers.     

Endocrinology: High incidence of embryo transfer cancellations in patients with polycystic ovarian syndrome

This study was aimed at assessing the outcome of in-vitro fertilization(IVF) and embryo transfer in patients with polycystic ovariansyndrome (PCOS). The results of IVF and embryo transfer in PCOSpatients (PCOS group, 78 cycles of 26 patients) were comparedwith those of a control group (423 cycles in 202 patients withoutmale factor; age and ovarian stimulation protocol were matched).Although the pregnancy rate per transfer was not different inthe two groups of patients (25 versus 34%, PCOS versus controlgroup), the PCOS group had a significantly lower pregnancy rateper follicle aspiration (19 versus 31%, P < 0.05). A notableresult was a significantly higher incidence of embryo transfercancellations in the PCOS group (22 versus 8%, P < 0.01),which resulted from unpredictable failure of either oocyte recoveryor fertilization. The incidence of unexplained complete failureof fertilization was significantly higher in the PCOS group(18 versus 5%, P < 0.01). These results may reflect a reducedquality of the oocytes in the PCOS group, and there was a subgroupof PCOS patients who repeatedly produced poor results of treatment.Although the ovarian stimulation regimen best suited to PCOSpatients remains to be determined, special care should be takenduring ovarian stimulation, especially when the PCOS patientshad experienced unexplained failure of oocyte recovery or fertilizationin the previous treatment cycle(s).     

Case Report: Gianotti-Crosti Syndrome Associated with Human Herpesvirus-6 Infection

We report a case of Gianotti-Crosti syndrome associated with human herpesvirus-6 (HHV-6) infection. An eight-month-old girl developed monomorphous papules on her cheeks, buttocks, and extremities after the subsidence of exanthema subitum. Viral antibody analysis confirmed primary HHV-6 infection. HHV-6 may be added to the list of causative agents of Gianotti-Crosti syndrome.     

血清载脂蛋白A1,B100含量测定在冠心病诊断中的价值

分别采用联合火箭免疫电泳技术和酶法对49例冠心病患者和50例健康人血清载脂蛋白 A_1(apoA_1),载脂蛋白 B_(100)(apoB_(100)),以及血清总胆固醇(TC)、甘油三酯(TG),高密度脂蛋白胆固醇(HDL—ch)的含量进行了测定。结果冠心病患者血清 apoB_(100)(0.99±0.26g/L)明显高于健康人(0.62±0.18g/L);而apoA_1/apoB_(100)比值(1.22±0.35)则明显低于健康人(2.12±0.49);TC,TG,HDL-ch 的含量亦有统计学意义。提示,在预示冠心病危险因素的各种脂类及脂蛋白中,以 apoB_(100)增高 apoA_1/apoB_(100)比值降低最为灵敏,最为准确,且高于单纯测定TC,TG 和 HDL-ch。     

体外循环中血浆内皮素、血管紧张素Ⅱ和前列环素的变化及临床意义

目的:分析体外循环心内直视手术中血浆内皮素、血管紧张 和前列环素的变化及临床意义。 方法 :应用放免法分别于 7个时点测定 30例心内直视手术病人血浆内皮素、血管紧张素 和前列环素 (终产物 6 - keto-PGF1α)水平。结果 :血浆内皮素水平在转机时高于术前 (P <0 .0 5 ) ,转流中逐渐升高 ,停转流时达高峰 (P <0 .0 1) ,术后 2 h及 2 4 h逐渐降低 ,但仍高于术前 (P <0 .0 5 )。血管紧张素 水平在转机时高于术前 (P <0 .0 5 ) ,转流 30 min降低 ,主动脉开放时升高 ,停转流时达高峰 (P <0 .0 1) ,术后 2 4 h呈下降趋势 ,但仍高于术前 (P <0 .0 5 )。 6 - keto- PGF1α在转流即刻显著升高 ,以后各时点降低。结论:体外循环期间血浆内皮素、血管紧张素 水平显著增高 ,6 - keto- PGF1α水平逐渐降低。体外循环期间加入内皮素、血管紧张素 拮抗剂或前列环素合成剂有利于心功能恢复