[Arrested pneumatization of the sphenoid sinus: imaging characteristics].

Objective: To explore and analyze the imaging features of arrested pneumatization of the sphenoid sinus, so as to provide reference for identifying sphenoid lesions. Methods: From May 2018 to September 2019, a retrospective analysis was conducted on 350 patients (183 males and 167 females, aged between 18 and 73 years) who had been completed the sinus CT examination in the outpatient department of Beijing Chaoyang Hospital Affiliated to Capital Medical University. Their imaging data were collected and the CT/MRI characteristics of the sphenoid body were observed. SPSS 26.0 software was used for statistical analysis. Results: The rate of arrested pneumatization of the sphenoid sinus was 2.0% (7/350), which occurred in the pteroid process, the slope region, and the sphenoid sinus body, respectively. CT showed a nondilated mixed-density lesion (7/7) in the pneumatizable sphenoid body. Within these regions, both fat and soft tissue density (7/7) were present. Internal curve calcification was observed in part of the region (3/7). The skull base canal structure was not affected (7/7). MRI showed a clear non-dilated lesion with an adipose signal, and none of the lesions showed medulla dilation or cortical destruction. Conclusions: Arrested pneumatization of the sphenoid sinus is a normal anatomic variation. When non-dilated lesions with clear bony boundaries and internal fatty components are encountered in the vaporizable region of the sphenoid sinus, the possibility of arrested pneumatization of the sphenoid sinus should be considered.

[Current research status and progress in comprehensive diagnosis and treatment of pancreatic cancer in the era of targeted therapy].

The incidence of pancreatic cancer (PC) has continuously shown an upward trend all over the world. It remains one of the most challenging malignant tumors in clinical practice and is characterized by difficult diagnosis in early stages, low surgical resection rate and poor prognosis. Due to its significant genetic heterogeneity, there are notable individual differences in disease progression, clinical efficacy, sensitivity to chemoradiotherapy, and prognosis among PC patients. In-depth study is needed to reveal the molecular biological characteristics of different PC subtypes and their correlation with clinical manifestations and chemoradiotherapy sensitivity, which could contribute to develop corresponding targeted therapeutic strategies.It is not only the fundamental basis for the innovation of PC morphological classification to molecular subtyping, but also a prerequisite for achieving a shift in treatment mode from "standard therapeutic strategy for different diseases" to "treat the same disease with different strategies" .This article reviews several hot issues on the comprehensive diagnosis and treatment of PC in the era of targeted therapy and prospects its future development.

[Potential value of FDG PET-CT in predicting occult lymph node metastasis in clinical stage â A lung adenocarcinoma].

Objective: To investigate the predictive value of (18)F-FDG PET-CT scan for occult lymph node metastasis in patients with stage ⅠA lung adenocarcinoma. Methods: The image and pathological data of 272 patients with stage ⅠA lung adenocarcinoma from October 2006 to September 2015 were retrospectively analyzed. All patients underwent preoperative (18)F-FDG PET-CT scan followed by lobectomy and systematic lymph node dissection. The correlation between occult lymph node metastasis and the maximum standardized uptake value (SUV(max)) of primary tumor as well as other clinicopathological factors was analyzed to screen the risk factors of occult lymph node metastasis in stage ⅠA lung adenocarcinoma. Results: Occult lymph node metastasis was detected in 50 patients (18.4%), with 24 (8.8%) patients of pN1 involvement and 26 (9.6%) of pN2 involvement. Among the 272 patients enrolled, 39 had pure ground glass nodule, 59 had part-solid nodule and 174 had solid nodule. All patients with pure ground glass nodule or nodule≤1 cm were pN0. For the 233 patients with part-solid and solid nodule, no lymph node metastasis was found in T1a stage (tumor length ≤1 cm). Primary tumor SUV(max) (Z=-5.663, P<0.001), nodule type (χ(2)=21.586, P<0.001), tumor location (χ(2)= 12.790, P< 0.001), histological grade (χ(2)= 22.784, P< 0.001) and visceral pleural invasion (χ(2)=5.357, P=0.021) showed significant differences between occult lymph node metastasis group (pN+ ) and non-lymph node metastasis group (pN0). With SUV(max)=2.405 as cut-off value, the sensitivity and specificity for predicting occult lymph node metastasis were 90.0% and 61.7%, the area under curve was 0.761(95%CI=0.700~0.823), and the negative predictive value was 95.8%. Multivariate analysis revealed that SUV(max) >2.405 (P<0.001), central location (P=0.030) and higher histological grade (P=0.024) were independent predictors of occult lymph node metastasis. Conclusions: For clinical stage ⅠA adenocarcinoma, primary tumor SUV(max) > 2.405, central location and higher histological grade were independent risk factors for occult lymph node metastasis. Systematic lymph node dissection may be avoided in lung adenocarcinoma with pure ground glass density, tumor length ≤1 cm or SUV(max) ≤ 2.405, due to the very low probability of nodal involvement.

[The clinical application of gene diagnosis and genetic counseling on hereditary hearing loss].

Objective:To summarize the clinic procedure and experience about gene diagnosis and genetic counseling on hereditary hearing loss, and explore the strategy and principle about gene diagnosis and genetic counseling on hereditary hearing loss.Method:A retrospective analysis was used on the clinical data of 151 cases who aim at genetic counseling. The all cases were divided into 5 groups according to the purpose of genetic counseling, such as the occurrence risk of hearing loss, the etiological analysis, the choice of the intervention way, the examination guidance, the prevention of hearing loss and the usage requirement of Aminogly cosides drugs. The counseling procedure includes the investigation of the etiology and family history, drawing the family pedigree, general physical examination, auditory examination and genetic analysis. Sanger sequencing analysis and/or Targeted nextgeneration sequencing was utilized to detect the deaf-gene mutations. At last, the genetic counseling, fertility guidance and prenatal diagnosis will be made on the basis of the results of gene detection. Result:There are 33 newborns who did not pass the deafgene screening, 9 of them could be diagnosed definitely as hereditary hearing loss, and the other 24 were the carriers of deafgene mutation. Eighty of 104 deaf patients were diagnosed definitely as hereditary hearing loss and the related gene mutation was found. Six objects in the 10 patients with auditory neuropathy are diagnosed as OTOF or SLC17A8 gene mutations before cochlear implantation. Three of 7 reproductive age objects who had family history were recessive deaf-gene carriers, 2 of them carried the same target gene with the mate who receive our fertility guidance and prenatal diagnose. The other 1 object carried the dominant genetic mutation(incomplete dominant heredity). There were 4 pregnant women who did not pass the deaf-gene screening, 1 of them carry the same target gene with the mate. The populations who want to use Aminoglycosides drugs were not diagnosed as carrying any related mitochondrial gene mutation. We carried out the genetic counseling according to the results of gens detection and clinical phenotype.Conclusion:Genetic counseling is based on the different purpose. The analysis of gene diagnosis should be considered to combine with the clinical phenotype. The principle of choosing the objects to make a gene diagnosis includes: ①the all deaf-genes sequencing was applied for the deaf patients. ② the screening target gene sequencing was used for the newborns who did not pass the deaf-gene screening and the mate whose pregnant wife did not pass the deafgene screening. ③the specific target gene sequencing could be used for the patients who has a clear family history or specific phenotype.

Current views of pediatric asthma.

Childhood asthma is influenced by multiple factors including genetic, socioeconomic, socio demographic and environmental factors. The symptoms of childhood asthma are observed to be variable. Some studies reported that asthma prevalence is disproportionately high among socially disadvantaged children. On the other hand, some reports found weak or no association between social disadvantage and childhood asthma. Recent literature showed that growth of health-related quality of life (HRQOL) instruments in the management of childhood asthma. The present review article would discuss the current views and the latest developments in the field of pediatric asthma.

[Study of susceptibility weighted imaging on MR and pathologic findings to distinguish benign or malignant soft tissue tumor].

Objective: To explore the diagnostic performance of susceptibility weighted imaging (SWI)in distinguishing benign or malignant soft tissue tumor, and to study pathological observation. Methods: Sixty-eight patients with soft tissue tumor, who received no previous treatment or invasive examination, received routine preoperative MRI examination and SWI scanning. The graduation and distribution of intratumoral susceptibility signal intensity(ITSS) and proportion of tumor volume were observed.The pathological results were also included for comparative analysis. Results: Fourty of 68 patients were benign and 28 were malignant. 72.5% (29/40) patients with benign soft tissue tumors were ITSS grade 1 and ITSS grade 3 (hemangioma). 89.3%(25/28) patients with malignant soft tissue tumors were ITSS grade 2 and ITSS grade 3. The difference was statistically significant (P<0.01). The distribution of ITSS in patients with benign soft tissue tumors was dominated by peripheral distribution and diffuse distribution (hemangioma), accounting for 90.0% (36/40). The distribution of ITSS in patients with malignant soft tissue tumors mainly distributed in the central region, accounting for 78.6% (22 /28). The difference was statistically significant (P<0.01). The proportion of tumor volume occupied by ITSS in benign soft tissue tumors was <1/3 and> 2/3 (hemangioma), accounting for 90.0% (36/40). The volume of malignant soft tissue tumors were predominantly <1/3 , accounting for 82.1% (23/28). The difference was statistically significant (P<0.01). Conclusion: SWI is sensitive in displaying the vein and blood metabolites in soft tissue lesions, which is helpful for the differential diagnosis of benign and malignant tumors in soft tissue.

Association of tumor necrosis factor-α gene polymorphism with osteoarticular tuberculosis prognosis in a Hebei population.

This study investigated the association of tumor necrosis factor-α (TNF-α)-308, -238, and -863 polymorphisms with osteoarticular tuberculosis (OA-TB) prognosis in a Hebei population. Genomic DNA was extracted from venous blood samples of 120 OA-TB patients and 100 healthy volunteers. TNF-α-308, -238, and -863 were analyzed by PCR-restriction fragment length polymorphism; genotype and allele frequencies were calculated. Serum TNF-α level was significantly higher in OA-TB patients (283.16 ± 51.68 ng/L) than in control (122.54 ± 54.65 ng/L; P < 0.05). Higher frequency of TNF-α-308 GG genotype in healthy volunteers (91.0%) than in OA-TB patients (79.2%) indicated that it was a protective factor against OA-TB (OR = 0.405, 95%CI = 0.147-0.657, P = 0.007). Higher frequencies of TNF-α-308 GA genotype and TNF-α-308 allele (A) in OA-TB patients (20.8 and 10.4%, respectively) than in healthy volunteers (8.0 and 5.0%, respectively) indicated an association with increased risk of OA-TB (OR = 3.112, 95%CI = 1.520-6.343, P = 0.003; OR = 3.109, 95%CI = 1.676-6.538, P = 0.006; respectively). Haplotype association analysis of TNF-α polymorphisms (-308/-238/-863) showed a higher frequency of TNF-α AGA in OA-TB patients (12.1%) than in healthy volunteers (3.5%), indicating that it was a risk factor for OA-TB (OR = 4.201, 95%CI = 1.80-9.91, P = 0.010). TNF-α-308 G/A and TNF-α AGA (-308/-238/-863) were associated with a predisposition to OA-TB, which could aid clinical detection, prevention, and prognosis of OA-TB.

[Clinical, pathological and imaging features of primary pelvic Ewing's sarcoma].

OBJECTIVE: To explore the clinical, pathological and imaging features of Ewing's sarcoma in pelvis and to improve knowledge and diagnosis of the disease. METHODS: A retrospective analysis of the clinical, pathological and imaging data of pathologically confirmed 13 cases of Ewing's sarcoma in pelvis was carried out between May 2008 and March 2016 in the Affiliated Hospital of Hangzhou Normal University, the Third Hospital of Hebei Medical University and the Second Hospital of Hebei Medical University. RESULTS: The median age 13 cases of pelvic primary Ewing's sarcoma was 17 years old.The X-ray and CT imagings showed osteolytic and mixed bone destruction, CT showed mixed type in 10 cases, 8 cases of bone tumors as a flocculent, 10 cases of bone expansion failure, 10 cases of periosteal reaction, the layered 5 cases, radial in 5 cases.Thirteen cases showed soft tissue mass, soft tissue mass was equal or slightly lower density.Four cases showed heterogeneous contrast enhancement.The lesions showed low signal in T1WI and mixed high signal in T2WI of magnetic resonance imaging(MRI). The boundary of the lesions were obscure, and 5 cases had patchy necrosis area, and 9 cases had incomplete false capsule, surrounding soft tissue was violated.Four cases showed heterogeneous contrast enhancement after MRI enhancement scan. CONCLUSIONS: The age of onset of Ewing's sarcoma of the pelvis is more concentrated in about 15 years.The imaging feaures are mixed bone destruction and more bone is swelling and permeability damage, soft tissue mass is larger, bone tumor is cloudy or acicular, periosteal reaction in a layered and radial, most cases show that the false envelope is not complete.Combined with clinical and imaging examination, the diagnosis of the disease can be made.

Epigallocatechin-3-gallate protects retinal vascular endothelial cells from high glucose stress in vitro via the MAPK/ERK-VEGF pathway.

Diabetic retinopathy (DR) is a frequent microvascular complication of diabetes, and one of the most common causes of legal blindness in the world. Epigallocatechin-3-gallate (EGCG) produces an anti-oxidative and anti-inflammatory effect against various human diseases. In this study, we determined the effect of EGCG on a human retinal endothelial cell (HREC) line. The cell viability was determined by a standard MTT assay, while the cell cycle and apoptosis rate were analyzed by flow cytometry. Inflammatory marker expression was detected by enzyme-linked immunosorbent assay. Treatment of HRECs with EGCG (20 and 40 mM) led to a significant decrease in the apoptosis rate (2.35 ± 0.56 and 1.24 ± 0.32%). The culture supernatant of cells treated with high glucose concentrations showed significantly higher levels of TNF-α (598.7 ± 89.7 vs 193.2 ± 38.5 pg/mL; P < 0.001), IL-6 (6.16 ± 0.51 vs 1.61 ± 0.21 ng/mL; P < 0.001), and ICAM-1 (31.6 ± 4.4 vs 14.8 ± 2.9 ng/mL; P < 0.001) compared to the cells in the control group. EGCG decreased the expression level of phosphorylated p38-mitogen activated protein kinase (MAPK) and extracellular regulated kinase (ERK)1/2. Moreover, EGCG was shown to significantly inhibit the expression of vascular endothelial growth factor (VEGF). Therefore, EGCG treatment ameliorated the negative effect of high glucose concentrations on the cell viability and apoptotic rate. The protective effects of EGCG under high glucose conditions may be attributed to the regulation of inflammatory cytokines and inhibition of the MAPK/ERK-VEGF pathway.

Imaging appearance of giant cell tumour of the spine above the sacrum.

Giant cell tumour (GCT) of the spine is rarely encountered in daily clinical practice. Most of the tumours occur at the sacrum instead of at the spine above the sacrum, which has been reported to account for 1.3-9.3% of all spine GCTs. This article is a review of our radiological experience of the diagnosis of spine GCT above the sacrum based on 34 patients at a single institution. The purpose of this pictorial review is to highlight the imaging findings of GCT and to provide clues that may distinguish it from other, more common neoplasms.

Overexpression of Y-box binding protein-1 in cervical cancer and its association with the pathological response rate to chemoradiotherapy.

The aim of this study was to evaluate the expression of Y-box binding protein-1 (YB-1) in nonneoplastic cervical tissue and cervical cancer tissue and to evaluate its relationship with chemoradiosensitivity in the cases of cervical cancer. We performed immunohistochemical studies to examine YB-1 expression among 59 patients with cervical cancer, 30 with cervical intraepithelial neoplasia (CIN), and 30 with cervicitis. The mean YB-1 histological score(HSCORE)values for cervicitis, cervical CIN, and cervical cancer tissues were 22.3, 39, and 84.4, respectively. The mean YB-1 HSCORE value was 80.0 for cervical cancer patients who showed complete pathological response to chemoradiotherapy and 144.3 for cervical cancer patients who showed partial pathological response. Our data showed that the YB-1 expression was the highest in cervical cancer tissue, followed by cervical CIN tissue, and then cervicitis tissues. High YB-1 expression resulted in a lower pathological response rate in patients of cervical cancer than low YB-1 expression did. Our results implied that YB-1 may play a role in the genesis of cervical cancer and that high YB-1 expression decreases the chemoradiosensitivity of cervical cancers.

Occurrence of Chilli veinal mottle virus in Nicotiana tabacum in Yunnan, China.

Flue-cured tobacco (Nicotiana tabacum) is an important crop in Yunnan Province, China. During a survey in July 2010, tobacco plants (N. tabacum cv. Yunyan 85) in the fields near Dali County in the northwest Yunnan Province of China had symptoms of chlorosis along leaf veins and later showed symptoms of white or brown necrosis along the veins. In 10 surveyed fields in Baizhishu Village in the city of Weishan, a commercial tobacco field (10 ha) developed virus-like disease symptoms; the incidence of affected plants ranged from 0.5 to 3%, which caused obvious economic losses. An isolate (YN75) was collected at random from five symptomatic leaves sampled from five plants. Negative staining of crude extracts of the infected leaves and subsequent electron microscopy revealed flexuous rods of 12 to 13 × 750 nm. Pinwheel-like inclusion bodies were abundant in thin sections of infected leaves. The particle size suggested a species of Potyviridae. Thus, the isolate was assayed in double antibody sandwich-ELISA (Agdia, Elkhart, IN) for the presence of Potato virus Y, Tobacco etch virus, and Tobacco vein mottling virus. All antigens gave negative results. Total RNA was extracted from leaves and tested by reverse transcription (RT)-PCR. The primer M4-T (5'-GTT TTC CCA GTC ACG ACT TTT TTT TTT TTT TT-3') was employed for cDNA synthesis described by Chen et al (1). The primer set ChiVMV-F (5'-TAG TTG YGC ATA C (C/G) C AGG AGA GAG-3')/M4 (5'-GTT TTC CCA GTC ACG AC-3') is complimentary to the region of coat protein and 3'-untranslated region of Chilli veinal mottle virus (ChiVMV), respectively. The expected 1,189-bp fragments were amplified from RNA templates and the amplicon was cloned and sequenced (GenBank Accession No. HQ218936). Comparisons of amplicons with the amino acid sequence available in the NCBI database using BLAST showed 91.4% identity with ChiVMV from India (GenBank Accession No. EF213688) and 90.7% with ChiVMV from Taiwan (Accession No. DQ854950). The virus particle size, RT-PCR results, and sequence data revealed that these tobacco plants were infected by ChiVMV. To our knowledge, this is the first report of ChiVMV infecting N. tabacum in China. Reference: (1) J. Chen et al. Arch. Virol. 146:757, 2001.

Molecular characterization of a distinct begomovirus infecting tobacco in Yunnan, China.

Virus isolate Y3V, obtained from tobacco showing leaf curl symptoms in Yunnan, China, had particles with the size and morphology typical of geminiviruses. In reactions with a set of monoclonal antibodies raised against begomoviruses, Y3V was readily differentiated from two previously studied Chinese Begomovirus isolates. The complete nucleotide sequence of a DNA-A-like molecule of Y3V was determined; it comprises 2744 nucleotides and has a typical Begomovirus genome organization. When compared with the DNA-A sequences of other begomoviruses, the total DNA-A of Y3V was most closely related to that of Ageratum yellow vein virus (AYVV) (85% sequence identity), but the Y3V intergenic region differed greatly from those of the other sequences (maximum 70% identity). In contrast, the deduced coat protein of Y3V is most like that of Tomato yellow leaf curl Thailand virus-[1] (TYLCTHV-[1]) (92% amino acid sequence identity). The molecular data show that the Yunnan isolate of Tobacco leaf curl virus is a distinct Begomovirus species, for which the name Tobacco leaf curl Yunnan virus (TLCYnV) is proposed.

Molecular characterization of a novel defective DNA isolated from tobacco tissues infected with tobacco leaf curl virus.

Defective DNA of tobacco leaf curl virus (TLCV) was identified in TLCV-infected tobacco plants. The defective DNA was cloned and sequenced. The sequence showed it was about half the size of the TLCV DNA-A, and was derived from TLCV DNA-A by a large deletion. The defective DNA contained the intergenic region and part of the AC1 (Rep) gene of TLCV, and also novel open reading frames (ORFs). The immunotrapping tests showed the defective DNA was associated with geminate particles, suggesting it could be encapsidated in virus particles. It was transmitted, along with full-length DNA-A, to tobacco plants by grafting and whitefly (Bemisia tabaci).

Telomerase activity is not related to apoptosis in leukemic cell lines.

Any deregulation of apoptosis or an escape from cellular senescence will drive the cells to neoplasia. It remains unclear whether there is a direct linkage between apoptosis and telomerase activity particularly in transformed cell lines. In the present study, we investigated the telomerase activities in three leukemic cell lines (HL-60, U937 and K562) after treating these cells with various doses of antitumor drugs, puromycin or actinomycin D (ActD). Our results showed that HL-60 cells underwent apoptosis rapidly when treated with either 20 microg/ml of puromycin or 5 microg/ml of Act D with more than 60% of the cells becoming apoptotic at 6 hrs and almost 100% at 12 hrs. But telomerase activity analyzed by TRAP assay in these apoptotic cells remained unchanged as compared with the untreated control cells suggesting that whether the cells were apoptotic or not, it had no effect on telomerase activity. However, if lower dosages of the drugs were used, that is, 0.5-1.5 microg/ml of puromycin or 0.01-0.5 microg/ml of Act D, a decrease in telomerase activity was observed at 24-48 hrs, and was completely undetectable at 72 hrs. This decrease in telomerase activity was dose- and time-dependent. The suppression of telomerase activity by low doses of these two drugs is probably due to the inhibitory effect of the drugs on protein translation or RNA transcription rather than direct inhibition of the telomerase activity. Flow cytometry analysis of the cell cycle of the drug-treated cells showed that these drugs unselectively induced apoptosis at all phases of the cell cycle and was unrelated to the changes in telomerase activity. Similar results were observed in U937 and K562 cells except that K562 cells underwent apoptosis more slowly than the former two cell lines.

Studies on contributing factors in temporomandibular disorders.

OBJECTIVE: To better understand the pathogenesis of TMD by studying microtrauma of the temporomandibular joint (TMJ), immune responses within TMJ, and psychosocial factors of the past ten years. METHODS: Condyle and disc movements from 38 patients with temporomandibular disorders (TMD) were observed with the use of videotape recording and soundtape recording techniques after TMJ arthrography. Pathological changes following occlusal trauma were examined using an animal model. Immune complexes in condyle cartilage; antibody to collagen II; and cytokines such as interleukin 1, tumor necrosis factor, and interleukin 6 were detected in synovial fluid of TMD. Psychosocial characteristics were analyzed with the Minnesota Multiphasic Personality Inventory (MMPI) of 80 TMD patients and the Life Events Experience Survey (LEES) of 42 TMD patients. RESULTS: Persistent and recurrent microtrauma did exist within joints of TMD patients, caused by occlusal trauma and occlusal interference. Occlusal trauma in animals could induce condyle and disc degenerative changes that are similar to the findings in TMJ osteoarthrosis patients. Sequestered antigens within cartilage could be exposed to the immune system after joint degeneration. Humoral and cellular immune responses did exist within TMJ and played an important role in the pathogenesis of TMD. Forty percent of TMD patients suffered from psychosomatic disorders, significantly more than in the healthy control. CONCLUSION: Microtrauma of TMJ, immune responses within TMJ, psychosocial factors, and anatomical structures of the TMJ itself are the four main contributing factors of TMD. Possible mechanisms of the interactions of the four factors are presented, and principles of preventing and treating TMD are also suggested.

Orthognathic surgery correction of mandibular hypoplasia accompanying obstructive sleep apnea syndrome.

OBJECTIVE: To examine the surgical correction methods for treating cases of severe mandibular hypoplasia accompanying obstructive sleep apnea syndrome (OSAS). METHODS: Sixteen cases of severe mandibular hypoplasia were studied in which OSAS was documented by polysomnography (PSG) and cephalometric study. The obstructive site was at the base of the tongue. Surgical procedures such as temporomandibular joint (TMJ) reconstruction and bimaxillary, chin, and hyoid bone advancement were performed to improve each patient's profile, function, and occlusion, and to treat the OSAS. RESULTS: There were great improvements in patient's sleep and daytime quality of life. The pre- and postoperative changes of most PSG values and some cephalometric values (SNB, PAS) were statistically significant. CONCLUSIONS: Severe mandibular hypoplasia can cause not only abnormalities in profile and occlusion but also OSAS. The evaluation of OSAS and its treatment effects depend on PSG. It is also very important to confirm the obstructive site in the upper airway by cephalometric study and fiberoptic endoscopy. Orthognathic surgery procedures can advance the maxillary, chin, and hyoid bone, and expand the upper airway simultaneously. These procedures can treat OSAS. Cases of TMJ ankylosis with OSAS should be treated step by step.

[A study on hypotensive mechanism of adrenomedullin (13-52)].

In the present study the hypotensive mechanism of AdM (13-52) was investigated in rats, both in vitro and in vivo. It was found that the hypotensive effect of AdM (13-52) could be partially inhibited by L-NG-nitro-arginine (LNNA), an inhibitor of nitric oxide synthase. The vasodilator effect of AdM (13-52) was dependent on vascular endothelium and inhibited by LNNA in a dose-dependent manner. This LNNA induced inhibitory effect could be reversed with L-Arginine. In addition, the vasodilator effect of AdM (13-52) disappeared with methylene blue (MB), which blocked cGMP formation. Using radioimmunoassay it was shown that LNNA lowered, but AdM (13-52) elevated the vascular cGMP content, while vascular cGMP content was not altered by co-application of AdM (13-52) and LNNA. The above results suggest that the vasodilator effect of AdM (13-52) might be mediated by nitric oxide.

[Tumor necrosis factor in synovial fluids of temporomandibular joint dysfunction syndrome].

With the MTT tetrazolium WEHI 164 clone 13 cell cytotoxicity assay, we measured TNF alpha (tumor necrosis factor) activity in synovial fluids of TMJDS (Temporomandibular joint dysfunction syndrome). We found no detected TNF alpha level from 5 patients with muscle dysfunction, raised TNF alpha levels from 5 of 11 patients with internal derangement and from 9 of 11 patients with organic destruction (osteoarthritis). The findings of biologically active TNF alpha in synovial fluids of TMJDS suggest that TNF alpha may play a role in the pathogenesis of TMJDS.