Bronchial hyperresponsiveness in asthmatic children. Correlation with macrophages and eosinophils in broncholavage fluid.

Bronchial responsiveness assessed by histamine bronchial challenge testing in 22 children with chronic stable asthma was compared with the number of inflammatory cells per milliliter of broncholavage fluid obtained by fiberoptic bronchoscopy. Hyperresponsiveness was closely correlated with increased counts of eosinophils and macrophages and with the ratio of eosinophils to macrophages. There was no correlation of neutrophil or lymphocyte counts with bronchial hyperresponsiveness and none of the cell types was correlated with airway obstruction. Our findings support the hypotheses that macrophages may be important in the development of bronchial hyperresponsiveness in children with asthma and that they may modulate bronchial responsiveness both directly and by recruitment of eosinophils.

Reproductive and sexual risk factors and human papilloma virus infection in cervical cancer among Hong Kong Chinese.

In this case-control study of cervical neoplasia in Hong Kong, 48 dysplasia and 68 cancer patients were matched with 116 surgical in-patient controls. The cases had an earlier age at first intercourse and more sex partners than the controls. The cases' husbands also had more sex partners and were less likely to use condoms regularly. In a multiple regression model the odds ratio were 6.0 (95% Confidence Interval 2.5-14.6) for the husband having more than one sex partner, 4.0 (1.5-10.7) for the woman having more than one sex partner, and 1.15 (1.05-1.28) per year younger for the woman's age at first intercourse. The odds ratio of 5.4 for women whose partners did not habitually use condoms was not significantly different from 1.0. In a sub-sample, 37% of cancer patients and 18% of dysplasia patients, but only 6% of gynaecological controls, showed a positive DNA hybridization to Human Papilloma Virus (Type 16). These findings suggest that cervical cancer and dysplasia are sexually transmitted in our population, with a possible viral aetiology.

Uterine leiomyosarcoma diagnosed during treatment with agonist of luteinizing hormone-releasing hormone for presumed uterine fibroid.

Medical treatment with an LH-RH agonist may be used in selected cases of uterine fibroids. Although rare, rapid increase in uterine or fibroid volume may suggest an underlying leiomyosarcoma that would require prompt surgical intervention. Close monitoring of the response to treatment with an LH-RH agonist is essential.

Prevalence of Toxoplasma gondii antibodies in the Chinese population of Hong Kong.

Sera from 2,499 randomly selected Chinese inhabitants of Hong Kong were tested for the presence of Toxoplasma gondii antibodies using the indirect fluorescent antibody test. The over-all prevalence was 9.8%. The prevalence was significantly higher in the 10 to 19 and 30 to 39 year age group and the highest level of titres was found in the 20 to 29 group. There was no significant difference in prevalence between the male and female population and between the rural and city dwellers. The distinctly low prevalence of toxoplasmosis in Hong Kong can probably be attributed to the absence of cats in most domestic households and the preference of the people to eat well-cooked meat (commonly beef and pork).

Study of acute trichinosis in Ghurkas: specificity and sensitivity of enzyme-linked immunosorbent assays for IgM and IgE antibodies to Trichinella larval antigens in diagnosis.

The enzyme-linked immunosorbent assay (ELISA) was successfully applied to detect IgE antibodies against parasitic antigens by using an additional antibody layer to attain an amplification effect. The sera of 18 Gurkha patients with clinical manifestations of acute trichinosis and 35 Chinese with other parasitic infections were tested for antibodies to Trichinella spiralis by IgE-, IgM- and IgG-ELISA, IgG-radioimmunoassay (RIA) and indirect haemagglutination test (IHA). ELISAs for detection of IgE and IgM antibodies provided a 100% specific and sensitive diagnosis. Although IHA, IgG-RIA and IgG-ELISA detected antibodies in 94% of patients, non-specific reactions were also observed in the two last named methods. Muscle biopsies were positive in only 56% of patients.

Genetic lesion in the carcinogenesis of cervical cancer.

Allelic loss at specific chromosomal loci was demonstrated in carcinoma of the cervix (CaCx) obtained from Hong Kong Chinese by restriction fragment length polymorphism analysis. Altogether 12 patients with CaCx, 7 with cervical intraepithelial neoplasia (CIN) and 7 with normal cervical tissues were studied. Polymorphic DNA markers for chromosome 3 were used and the tumour and constitutional genotypes of the above patients were compared. Loss of heterozygosity (LOH) was found in 10 out of 12 informative cases with CaCx at RAF-1 locus (3p25) and in 10 out of 11 cases at D3S3 (3p14). Further study on patients with cervical intraepithelial neoplasia showed LOH at both 3p25 and 3p14 in four out of five cases. In normal cervical tissues, no LOH was demonstrated at both loci. Our data suggest that the deletion events occurring on the short arm of chromosome 3 at 3p25 and 3p14 are early events in the development of carcinoma of cervix. Since recessive genes have been reported to reside within or close to these 2 loci, important genes may have been lost or inactivated in the genesis of this tumour. Moreover, human papillomavirus (HPV) type 16, 18 or 33 was found in 8/12 of the carcinomas and 4/7 of CIN using Polymerase Chain Reaction and/or Southern Blot hybridization, confirming the close association with human papillomavirus. Whether the observed genetic lesions in the short arm of chromosome 3 in cervical "premalignant" and malignant lesions and their consistent association with high risk HPV represent independent events in the development of carcinoma of cervix will be discussed.

Biological characteristics of a newly established human cervical carcinoma cell line.

A new cell line, designated CC2/CUHK2, was established from a squamous carcinoma of the uterine cervix from a Chinese patient. The cell line grew well without interruption for over 12 months and over 90 passages. The doubling time of CC2/CUHK2 was 72 hours at passage 57. When seeded at a density of 1.5 x 10(3) cells per 25 cm2 tissues culture flask, the plating efficiency was 2.15%. Chromosome analysis showed a range of 30 to 130 with a modal number of 75. Immunoperoxidase staining of keratin showed positive reaction. Most of the CC2/CUHK2 cells showed weak nuclear staining of HPV capsid antigens with the ABC detection system. Analysis of the DNA samples extracted from the cervical cancer cells showed the presence of HPV type 16 DNA.

Characteristics of a cell line established from a Chinese patient with a squamous carcinoma of the uterine cervix.

A new cell line, CC3/CUHK3, was established from a squamous carcinoma of the uterine cervix from a Chinese patient. Light microscopy of the cell line revealed keratin and electron microscopy demonstrated tonofilaments and desmosomes, thereby confirming its epithelial nature. The population doubling time of CC3/CUHK3, estimated from the exponential growth phase of the growth curve established from the cell line was 42 hours. When the tumour cells were inoculated into athymic mouse, a tumour, microscopically diagnosed as a well-differentiated carcinoma, developed. These cells are highly invasive in vitro.

Integration of HPV-16 DNA in cervical carcinoma cell line CC3/CUHK3 and its xenografts.

A recently established cell line, designated CC3/CUHK3, derived from a squamous cell carcinoma of the uterine cervix of a Hong Kong Chinese patient was investigated for its association with human papillomavirus (HPV) by Southern blot hybridization studies. A "grafted tumour" or xenograft of CC3/CUHK3 has also been successfully established in athymic mice, which showed similar histology to that of the original biopsy. The epithelial nature of the xenografts, like the original biopsy. The epithelial nature of the xenografts, like the original tumour specimen, was also confirmed by transmission electron microscopy which demonstrated the presence of desmosomes and tonofilaments. Moreover transmission electron microscopic examination revealed no HPV particle in either the tumour biopsy or the xenograft tissues. Analysis of the DNA samples extracted from the cervical cancer cell line and the xenograft tissues derived from it showed the presence of HPV type 16 DNA. No DNA sequence related to HPV type 6, 11, or 18 was demonstrated. The viral DNA was found to be integrated into the cellular genome at multiple sites as single copy or head-to-tail tandem repeats. Deletion or rearrangement of the HPV DNA had probably occurred on or subsequent to integration. Viral sequence deletion has also been observed in the grafted tumours derived from CC3/CUHK3.

Diffuse uterine leiomyomatosis with hemorrhage.

A 28-year-old woman with primary infertility and severe menorrhagia underwent a hysterectomy after failed hormonal therapy for multiple leiomyomas. The postoperative pathologic findings established the diagnosis of diffuse uterine leiomyomatosis, which demonstrated histologic, immunohistochemical, and ultrastructural similarity to leiomyomas of the uterus. The rapid growth of the tumor coincided with the administration of clomiphene citrate, an estrogenic agonist. As with the common leiomyoma, intralesional hemorrhage in this case of diffuse leiomyomatosis was associated with norethindrone acetate treatment given after the cessation of clomiphene therapy.

Zinc concentration in umbilical cord tissue and cord plasma in appropriate-for-gestational-age babies.

Zinc concentration in cord plasma was determined in 148 healthy appropriate-for-gestational-age babies delivered at various gestational ages. Zinc concentration in cord tissue was also determined in 62 of these babies. There was a significant rise in the cord tissue zinc concentration just after the 35th week of gestational age; thereafter the levels remained relatively unchanged. The cord plasma zinc concentration decreased slightly with increasing gestational age, but these changes were not significant. There was a statistically significant positive correlation between cord tissue zinc concentration and birth weight. No correlation was found between cord plasma zinc concentration and birth weight or cord tissue zinc concentration.

Learning group: facilitating the adaptation of new nurses to the specialty unit.

BACKGROUND: The nursing shortage creates major problems in finding qualified, experienced nurses in the critical care area. METHOD: A learning group was formed to expedite the new nurses' acquisition of skills and knowledge needed to care for critical care patients. RESULTS: After 4 months of continuing education provided in the learning group, all group members had demonstrated their interest in learning. They also had demonstrated they were able to perform different procedures and skills according to the standards listed in the trauma intensive care unit nurses' manual. CONCLUSION: The learning group is able to facilitate quicker adaptation and smoother transition of new nurses to the trauma intensive care unit. The continuing education provided by the learning group demonstrated support from the workplace and peers to the new nurses.

Immunohistochemical detection of proliferating tumor cells in cervical cancer using monoclonal antibody Ki-67.

Monoclonal antibody Ki-67 identifies cells in G1, S, G2, and M phases of the cell cycle. In this cytokinetic study, Ki-67 was used to characterize tumor cells in human cervical cancer specimen. This immunohistochemical study showed that Ki-67 staining gave a brown nuclear reactivity dispersed heterogeneously in a tumor cell population and correlated well with the mitotic activities of tumor cells. The finding suggested that Ki-67 staining provides an easily countable index for the study of proliferating cell populations in cervical cancer.

The oral health of children with clefts--a review.

A review of the studies of the caries prevalence and periodontal health of patients with cleft lip and palate (CLP) revealed that only five investigations of caries prevalence in CLP patients included children. One reported that CLP children did not have a higher caries prevalence in the permanent dentition, whereas more recent studies have reported a higher caries prevalence in both the primary and permanent dentitions of CLP children than in those of noncleft children. However, there is wide variation in the teeth examined and the method of presenting data on caries prevalence. Six papers have reported on the periodontal health of adult CLP patients, and only one has done so on that of children. The adult CLP patients had poorer oral hygiene and more gingivitis, but there is no conclusive evidence that they have a higher risk of developing periodontal disease. No data on the oral hygiene of CLP children were available, but it has been emphasized that they have significantly more gingivitis than noncleft children, especially in the maxillary anterior teeth.

The development of an expert computer system on medical consulation.

In order to master fuzziness and uncertainty in solving human problems, an expert system shell SYSTEM Z-II which can handle both exact and inexact reasoning has been successfully developed. This paper describes how the Z-II system shell works in building a medical consultation expert system which accepts fuzzy human concepts and uncertain factors. This expert system ABVAB in the domain of "Abnormal Vaginal Bleeding" is described to demonstrate the power and flexibility of such system. The methods of approach in the development and testing of this system are presented together with the results.

Serum ceruloplasmin, plasma copper concentration and copper to ceruloplasmin ratio in cervical carcinoma.

Several studies have shown that plasma/serum copper and ceruloplasmin concentrations are increased in various carcinomas. We determined serum concentrations of ceruloplasmin and plasma copper concentration to evaluate the clinical usefulness of these tests in patients with cervical carcinomas. There was a significantly higher ceruloplasmin concentration in patients with cervical carcinoma compared to healthy controls. Plasma concentrations of copper were not significantly different in the two groups of subjects. The copper to ceruloplasmin ratio was lower in cancer patients than in control subjects. There was a significant increase in the serum concentrations of ceruloplasmin with increasing FIGO stage of cancer. Copper concentration in advanced tumours (FIGO stage 3) were significantly higher compared to control subjects or FIGO 1 and 2. Copper to ceruloplasmin ratio was lower in FIGO stage 2 and 3 patients compared to stage 1 or control subjects. Ceruloplasmin can also discriminate between large tumours which are inoperable and early cervical carcinomas better than copper or copper to ceruloplasmin ratio.

Determinants of birth-weight in the new territories of Hong Kong.

Weights of babies born in the Prince of Wales Hospital, Hong Kong, in its first 2 years of operation were studied, and compared with previous reports. Birth-weight in Hong Kong appears to have increased significantly in recent years. The method of data collection effects reference standards of birth-weight. The effect of different methods of data collection and statistical treatment of data for providing reference standards of birth-weight are discussed. In this series average birth-weight increased by 6.8 g per year of maternal age, 13.3 g per cm of maternal height, 42.5 g per previous baby and 104.9 g per week of gestational age; males were 110 g heavier than females. The effects of parity became significant at 35 weeks, and that of maternal age and height at 36 weeks; the effect of fetal sex was significant from 38 weeks onwards.

Do chronic urinary tract infections induce cancer in the rat fed nitrate and aminopyrine?

Seven out of one hundred male rats in the experimental group developed malignant tumours after 18 months, during which period they were given nitrate and aminopyrine in the drinking water and had chronic urinary tract infections induced by known strains of E. coli. In the control animals, no lesions were observed in the two un-infected groups given nitrosamine precursors in the drinking water or water alone. However, two out of fifty control animals in the infected group, not administered nitrosamine precursors, developed malignant lymphoma. All rats were maintained on Purina rat chow. Our data appear to suggest that chronic urinary tract infection did induce tumour production in the rat.