Analysis of the α/β T-cell receptor repertoire by competitive and quantitative family-specific PCR with exogenous standards and high resolution fluorescence based CDR3 size imaging

The characterization of the human T-cell receptor (TCR) repertoire in various physiological and pathological conditions has become an important tool in studies of the immune response. Therefore, a number of PCR based strategies for the semiquantitative analysis of the TCR repertoire have been described. Family specific amplification of TCR cDNA has been employed in a number of studies often with contradictory results. We have developed a strategy utilizing exogenous standards with homologous primer binding sites for the quantitative analysis of the α/β T-cell receptor repertoire. This system allows the detection of even minute differences in T-cell populations based on quantitative PCR (Q-PCR) and competitive PCR (C-PCR). Results presented here demonstrate that expansions of T-cell subsets as defined by the specificity of the variable gene segments can be readily monitored when exceeding 1% of the total repertoire. In addition, the proposed method reveals direct information of CDR3 size heterogeneity and can be used to estimate the T-cell repertoire complexity and monitor clonal expansions. We discuss variables such as cell number and experimental conditions influencing accuracy and reproducibility of the analyses. We have used this protocol based on non-radioactive techniques for characterization of the fine specificity of the T-cell repertoire in peripheral and organ-infiltrating T-lymphocytes. The analyses revealed information about polyclonal or clonal expansion of T-cells in vivo and in vitro following various stimuli such as superantigenic stimulation of T-cell subsets as well as antigen-driven shaping of the α/β T-cell repertoire in autoimmune and infectious diseases.     

Hyperplastic foci in chronic liver disease: Their proliferative activity assessed by nucleolar organizing region

In the cirrhotic and precirrhotic liver, there may be small foci with increased cellularity and amphophilic cytoplasm. These are microscopic lesions that do not form macroscopically detectable nodules, which differ from the macroscopically apparent nodules of dysplastic nodules. In the present study, we assessed the proliferating activity of 12 hyperplastic foci in 11 patients with cirrhosis or chronic hepatitis, by staining for agyrophilic nucleolar organizing regions (AgNOR). The mean AgNOR count per nucleus in the hyperplastic foci ranged from 0.96 to 1.36 (mean, 1.13; SD 0.12), and from 0.81 to 1.06 (mean, 0.94; SD 0.08) in the controls. The AgNOR count In the hyperplastic foci was significantly higher than that In the controls (P> 30.01). Small hyperplastic foci show Increased proliferative activity. Further study on these foci is required to clarify their relation to hepatocarcinogenesis.     

Role of the 2 adenine (g.11293_11294insAA) insertion polymorphism in the 3' untranslated region of the factor VII (FVII) gene: molecular characterization of a patient with severe FVII deficiency

Polymorphic variants in the gene encoding factor VII (F7) affect the plasma levels of this coagulation protein and modify the clinical phenotype of FVII deficiency in some patients. In this study we report the in vitro functional analysis of a novel polymorphic variant located in the 3' untranslated region of F7: g.11293_11294insAA. To determine whether this variant regulates FVII expression, we initially compared an expression vector containing FVII cDNA with g.11293_11294insAA with the FVII wild-type (WT) construct. The kinetics of mRNA production showed that the insertion decreases the steady-state FVII mRNA levels. To assess whether the insertion influences the phenotype of FVII-deficient patients, we evaluated its effect on the expression of FVII in a patient with severe FVII deficiency (undetectable FVII activity and antigen) carrying two additional homozygous missense variations (p.Arg277Cys and p.Arg353Gln). The two substitutions alone reduced the expression of FVII activity and antigen in vitro, but with the insertion polymorphism in our expression vector the patient's phenotype of undetectable plasma FVII was recapitulated. The insertion polymorphism in the 3' untranslated region of F7 is another modifier of FVII expression that might explain the poor genotype-phenotype correlation in some FVII-deficient patients.     

Neuronal responses to horizontal neck deflection in the group X region of the cat's medullary brainstem

Summary Neuronal responses to natural stimulation of neck proprioceptors were studied in the region of the small cell group x in the dorsolateral medullary brainstem of slightly anesthetized and paralyzed cats. Stimulation consisted of horizontal trunk rotations about C₁ with the head fixed in space. Out of 74 neurons recorded, 92% showed an increase in discharge rate with ipsilateral neck stretch and a decrease with contralateral stretch (Type N I responses); 8% showed the reverse response pattern (Type N II responses). In the primary head-to-trunk position, almost all neurons had tonic activity that probably stemmed from prestretched neck proprioceptors. Responses to sinusoidal stimulation and position trapezoids showed a static (position-sensitive) as well as a dynamic (essentially velocitysensitive) component. The relative weight of the two components varied considerably among the neurons. It was not possible to distinguish discrete neuronal populations on the basis of the dynamic characteristics. There was no evidence of a convergent input from other receptor systems, such as the horizontal canal system. Several neurons responded to muscle tapping and showed an increase of the velocity component following systemic injection of succinylcholine. We take this as evidence that they may receive input from muscle spindle receptors.Supported by the Deutsche Forschungsgemeinschaft, SFB 70/U4     

颈静脉孔区的显微解剖及定位标志研究

目的:研究颈静脉孔区的显微外科解剖,探讨寰椎横突(TPA)、头侧直肌、二腹肌沟、颈静脉突等解剖标志在颈静脉孔区病变手术中的定位意义。方法:成人头颈标本15例,男13例,女2例,红色乳胶灌注颈总动脉和椎动脉。手术显微镜下(×3～×30)逐层显露颈静脉孔区结构,明确该区显微解剖特征、相关的解剖标志及其定位意义。结果:颈静脉孔区多数重要的解剖结构均可以TPA为参照标志予以明确。二腹肌后腹位于其浅层。TPA的后方为枕下三角,三角内有椎动脉、椎静脉丛和颈1神经通过。头侧直肌起始于TPA的外表面,止于枕骨颈静脉突的下表面,可作为确定颅外颈静脉孔的解剖标志。茎突位于TPA的前方,颈内静脉、迷走神经、副神经、舌下神经穿行于茎突与TPA之间,颈内动脉位于颈内静脉的前内侧。二腹肌、颈静脉突、颈动脉嵴对定位面神经、颈静脉孔及舌咽神经等结构具有重要意义。结论:颈静脉孔区解剖结构复杂,利用寰椎横突、头侧直肌、二腹肌沟、颈静脉突等解剖标志有助于明确此区域重要的解剖结构,避免术中不必要的损伤。     

经额入路行蝶鞍区肿瘤手术的应用解剖

目的　为经额入路蝶鞍区肿瘤切除术提供解剖学资料。方法　采用解剖技术对 35个甲醛固定 ,红色明胶动脉灌注的尸头标本蝶鞍区的有关结构进行观察。结果　两侧视神经管颅口内缘间距为 11.0 9± 2 .2 2mm ,视交叉前缘至交叉前沟前缘间距为 7.0 2± 1.86mm。垂体上面与鞍隔平面有三种位置关系 :垂体上面通过鞍隔孔露出鞍隔平面以上者 3例 ( 8.75% ) ,在鞍隔平面以下者 13例 ( 37.14% ) ,与鞍隔平面平齐者 19例 ( 54.2 9% )。两侧颈内动脉在穿经海绵窦上壁处间距为 13.2 5± 2 .4 8mm ,大脑前动脉发起处 ,两侧颈内动脉之间距为 17.86± 1.55mm。结论　经额入路蝶鞍区肿瘤切除术主要是通过交叉前间隙 ,在颈内动脉之间的区域操作 ,手术中要保护颈内动脉、视神经等结构 ,以减少并发症的发生     

邻位皮瓣修复颌面部组织缺损30例

目的：探讨颌面部病变切除后遗留的创面或因外伤造成的组织皮肤缺损（不能或不宜直接缝合）的修复方法。方法：在颌面部组织缺损设计原则上尽量利用邻位组织瓣为主,必要时也选用远处组织瓣或舌瓣,腭瓣等来修复之,其中应用鼻唇沟瓣15例,鼻唇沟瓣旋转灵活,主要用于上,下唇组织缺损修复,颊部旋转皮瓣10例,用于修复颊面部小型洞穿性缺损;邻位颈部瓦合式皮瓣整复5例较大的颊面部组织缺损,供瓣区创面可行全厚皮片游离移植。结果：30例皮瓣转移全部成活,术后随访1年,面部形态及功能满意,结论：颌面部组织缺损修复宁近勿远,就近取材,邻位皮瓣移位方便,手术操作简单,是最为理想的颌面部组织缺损创面修复方法之一。     

充满型及非充满型胆囊结石粘膜病理形态及核仁组成区的研究

目的：探讨充满型及非充满型胆囊结石粘膜组织病理学的差异及相应外科治疗措施,方法：收集1995年10月至1996年10月期间的胆囊结石标本做常规病理染色及嗜银蛋白染色分析。结果：发现充满型及非充满型结石组胆囊粘膜不典型发生率及AgNOR数目均有显著差异。结论：一经诊断为充满型胆囊结石,特别是中老年肥胖妇女,应早期手术切除病变胆囊。     

螺旋CT三维成像对颌面部骨折的诊断价值

目的　探讨螺旋 CT三维成像对于颌面部骨折的诊断价值。方法　对 2 5例颌面部外伤患者进行螺旋 CT薄层扫描和三维重建成像。结果　螺旋 CT三维成像能够立体地显示骨折的位置、形态、范围和类型。结论螺旋 CT三维成像对于显示颌面部骨折的空间关系具有重要的诊断价值