Treatment of vitiligo with 308-nm excimer laser: our experience from a 2-year follow-up of 979 Chinese patients.

BACKGROUND: The 308-nm excimer laser had been proved to be a time-efficient and potent therapeutic alternative for the management of vitiligo. Different results had been reported in different ethnic populations. OBJECTIVE: To investigate the efficacy and related contributing factors of 308-nm excimer laser in Chinese vitiligo patients. METHODS: A total of 979 Chinese patients (3478 lesions) with progressive-stage vitiligo who had received 308-nm excimer laser treatment were recruited from the vitiligo clinic of Shandong Provincial Hospital of Dermatology &Venereology from 2012 to 2014. Efficacy of treatment was evaluated at the end of session by two independent dermatologists based on the before and after images taken. Repigmentation was graded on a 4-point scale: grade 1, poor repigmentation (0-25%); grade 2, moderate repigmentation (26-50%); grade 3, good repigmentation (51-75%); grade 4, excellent repigmentation (76-100%). RESULTS: The mean grade of repigmentation was 2.29, 44.22% showed less than 25% repigmentation, 16.27% showed 26-50% repigmentation, 5.95% showed 51-75% repigmentation and 33.55% showed more than 76% repigmentation. The repigmentation of facial lesions was better than lesions located elsewhere (P < 0.0001), the best response was noted in the periorbital region, while lesions on hands and feet showed poor repigmentation (P < 0.0001). The degree of repigmentation was negatively correlated with disease duration (r = -0.268, P < 0.001), age (r = -0.095, P < 0.001) and shape of lesions (r = -0.114, P < 0.001), whereas it was positively correlated with treatment frequency (r = 0.270, P < 0.001). Lesions with concurrent poliosis were more likely resistant to treatments. CONCLUSION: 308-nm excimer laser appears to be an effective and safe treatment in Chinese vitiligo patients. The clinical response and treatment efficacy was affected by many factors such as age, affected anatomical area, shape of the lesion, disease duration and treatment frequencies.

Identification of 32 major histocompatibility complex class I alleles in African green monkeys.

The African green monkey may be an ideal replacement for the rhesus monkey in biomedical research, but relatively little is known about the genetic background of major histocompatibility complex (MHC) class I molecules. In analysis of 12 African green monkeys, 13 Chae-A and 19 Chae-B alleles were identified. Among these alleles, 12 Chae-A and 9 Chae-B were new lineages. The full amino acid length deduced for Chae-A genes is 365 amino acids, but for Chae-B genes, the lengths are 365, 362, 361, and 359 amino acids, respectively. There were 1-3 Chae-A alleles and 2-5 Chae-B alleles in each animal. In African green monkeys, rhesus monkeys, and cynomolgus monkeys, the MHC-A and MHC-B alleles display trans-species polymorphism, rather than being clustered in a species-specific fashion.

[Studies on the production of 16 beta-methyl-11 alpha,17 alpha,21-trihydroxy-1,4-pregnadiene-3,20-dione from 16 beta-methyl-17 alpha,21-dihydroxy-1,4-pregnadiene-3,20-dione-21-acetate by Absidia].

An Absidia sp. 28 strain was shown to have higher activity of 11 alpha-hydroxylation using 16 beta-methyl-17 alpha,21-dihydroxy-1,4-pregnadiene-3,20-dione as a substrate. It was found that 21-acetylization of substrate could increase 11 alpha-hydroxylation rate conspicuously. The yield of the 11 alpha-hydroxylation by this strain was 73% in the conversion of 0.5% concentration of 21-acetated substrate under optimum conditions.

[Two different fermentation techniques of steriod 1,4-dehydrogenation and 11 alpha-hydroxylation].

Two kinds of micro-organism, Arthrobacter sp. AX86(1,4-dehdrogenator) and Absidia sp. A28(11 alpha-hydroxylator) were used in this experiment. Two different fermentation techniques were performed to accomplish the multiple conversional reactions for producing 16 beta-methyl-11 alpha,17 alpha,21-trihydroxy-1,4-pregnadiene-3,20-dione(III) from 16 beta-methyl-3 beta,17 alpha,21-trihydroxy-5 alpha-pregnane-20-one-21-acetate(I): 1) To produce product(III) by means of a two-step fermentation method which were independently performed first by Arthrobacter and next by Absiaia, and 2) the product was obtained by a sequential fermentation system of aforesaid two micro-organisms in a single fermentor without isolation of the intermediates from the mixture. Our results showed that in both fermentation systems high yield of product was obtained. However, according to the technical simplicity, shorter duration of fermentation cycle and efficient yield of product, the second method is better than the first one.

[Histochemical study and classification of facial muscles fibers].

OBJECTIVE: To study the histological and histochemical characteristics of the facial muscle fiber. METHODS: Seven biopsy specimens of the facial muscle from twelve patients were stained with histochemical method. The diameter and the histochemical type of the fibers were analysed by staining of M-ATP ase and NADA-TR. Type I and type II fibers were evaluated respectively by means of computer-assisted image analysis. RESULTS: The fiber diameter is between 24.3-63.9 microns. According to the quantity of fiber I, facial muscles may be classified into three groups: 1. Phasic muscle contains less than 20 percent of type I fibers; 2. Intermediate muscle contains 21 to 40 percent of type I fibers; 3. Tonic muscle contains 41 to 69 percent of type I fibers. CONCLUSION: The results of the study show that the histological and histochemical difference of facial muscles may have significance in facial paralysis restoration.

[Relationship between microsurgical tubal reversal and ectopic pregnancy].

OBJECTIVE: To study the correlation between microsurgical tubal reversal after tubal sterilization and ectopic pregnancy. METHODS: 1029 women who underwent microsurgical tubal reversal were followed up. The causes of ectopic pregnancy were analysed and discussed. RESULTS: 960 intrauterine pregnanciess and 12 ectopic pregnancies occurred. The 12 ectopic pregnancies were all tubal ones, among which 2 had intrauterine pregnancies. The rate of ectopic pregnancy in the 1029 women was 1.17%, and in the pregnant cases was 1.23%. The ratio of intrauterine pregnancy to ectopic pregnancy was 1:80. The rates of ectopic pregnancy in the 1st, 2nd year and 2 years later after tubal reversal were not significantly different respectively among the tubal reversal and among the pregnant cases. The rates of ectopic pregnancy in the 1st and 2nd 6 months after tubal reversal were not statistically different. The early tubal hydrapertubation could only increase the chance of ectopic pregnancy. The sterilization method, reversal mode, and interval between sterilization and reversal were not related to the ectopic pegnancy. CONCLUSION: When the lesion in the sterilized position is completely removed, the sutures being through the tubal mucosa and the early tubal hydrapertubation not carried out, the chance of ectopic pregnancy can not be increased after tubal reversal. The contraception 6 months after tubal reversal is not related to ectopic pregnancy.

[Microbiological production of 3-oxo-bisnorchola-1, 4-dien-22-oic acid from cholesterol by an Arthrobacter 82].

Among nineteen strains of Arthrobacter which showed to be able to decompose cholesterol in preliminary experiments, a strain of Arthrobacter 82 was selected for microbiological production of 3-oxo-bisnorchola-1,4-dien-22-oic-acid (BNC) from cholesterol. The yield is over of 50% weight percent concentration of 0.25% in the presence of cobalt sulfate. The main intermediate in such a conversion process is cholestenone. Lower glucose and higher corn steep liquor concentration were favorable for side chain degradation of cholestenone and more BNC could be produced. BNC was crystallized in acidic solution and obtained by centrifugation. The structure and characteristics of BNC has been identified by means of conventional physical, chemical and spectrometric techniques.

Microsurgical reversal of female sterilization. Long-term follow-up of 117 cases.

A prospective study of 117 consecutive microsurgical reversals of female sterilization from April 1981 to December 1984 was carried out to determine which factors affected the pregnancy outcome. Nylon sutures, 8-0, were placed through the muscularis and mucosal layers. A short abdominal incision was made. The patients were followed for 3.5 to 7.0 years. The term delivery, intra-uterine pregnancy, spontaneous abortion and ectopic pregnancy rates were 81.2%, 83.8%, 1.7% and 1.7%, respectively; two ectopic pregnancies occurred 14 and 24 months after the reversal procedures. We found that the time interval between sterilization and reversal and the methods of sterilization affected the pregnancy outcome. The success rate with intervals of less than five years was much higher than with intervals of more than five years; Pomeroy cases were more reversible than Uchida cases. We did not observe any influence of the anastomosis site on the pregnancy results. The term delivery rates for isthmus-isthmus, isthmus-ampulla and ampulla-ampulla anastomoses were 78.8%, 80.0% and 84.6%, respectively. Patients should be followed for two years at least to determine the pregnancy outcome as well as the occurrence of ectopic pregnancy.

[11 beta-hydroxylation of 16 alpha-methyl-Reichstein's compound S 21-acetate by Curvularia lunata].

The conversion of 16 alpha-methyl-Reichstein's compound S 21-acetate (I) to 16 alpha-methyl-hydrocortisone (II) by the mycelium Curvularia lunata AS3.4381 was studied. Maximal 11 beta-hydroxylating activity of the mycelium was found during cultivation of the microorganism by 24h. Inhibition of the ethanol to the 11 beta-hydroxylating activity was obvious. The yield of 55.4% (II) (W/W) could be achieved during conversion of 0.15% substrate at 72 h.

Dependence of betaine stimulation of vitamin b(12) overproduction on protein synthesis.

The betaine-stimulated differential synthesis of vitamin B(12), i.e., the increase in B(12) per increase in dry cell weight, by Pseudomonas denitrificans was inhibited by rifampin and chloramphenicol but not by benzylpenicillin and carbenicillin at concentrations of antibiotic that inhibit growth. The level of the first enzyme of corrin (and porphyrin) biosynthesis, delta-aminolevulinic acid synthetase, was decreased to a much greater degree by rifampin and chloramphenicol than by the penicillins. These data support the concept that betaine stimulation of B(12) synthesis is a result of its stimulation of synthesis of delta-aminolevulinic acid synthetase, a labile and presumably rate-limiting enzyme of corrin formation requiring continuous induction. In further support of this hypothesis, it was found that chloramphenicol immediately interfered with both vitamin B(12) and delta-aminolevulinic acid synthetase formation, no matter when it was added to the system.

Duck hepatitis B virus and liver diseases.

The presence of duck hepatitis B virus in serum was studied in 61 ducks (24 from Chi-tung county, China, 20 from Changchun, China, and 17 from Chiba, Japan) with relation to liver disease. None of the 37 ducks from Chiba and Changchun was positive for duck hepatitis B virus as assayed by electron microscopy, endogenous deoxyribonucleic acid-polymerase activity, and hybridization with duck hepatitis B virus deoxyribonucleic acid. No liver disease was seen in these ducks. In contrast, viruslike particles were present in the serum of 12 of 24 (50%) ducks from Chi-tung, China. The presence of duck hepatitis B virus in serum was indicated by the hybridization spot test and deoxyribonucleic acid-polymerase activities. A variety of liver diseases including chronic hepatitis and cirrhosis were seen in the livers of a majority of the ducks from Chi-tung. One duck hepatitis B virus-positive duck had multicentric hepatocellular carcinoma with underlying cirrhosis. Comparison of serum duck hepatitis B virus markers and liver disease in the affected flock revealed a tendency for seronegative ducks to have advanced liver diseases. Duck hepatitis B virus infection may be used as an experimental model to test various hypotheses concerning the pathogenesis of hepatitis B virus-associated liver disease in humans.

Effects of atrial pacing site on atrial and atrioventricular nodal function.

The effects of the site used for atrial pacing on atrial and atrioventricular nodal conduction were assesed in 16 patients. In 13 patients, three atrial pacing sites were used: high right atrium, low lateral right atrium, and midcoronary sinus. Two recording sites were used: low septal right atrium, including His electrogram, and high right atrium. Stimulus (S) to high right atrium interval was longest with coronary sinus pacing (76 plus or minus 7 ms) (P less than 0.001), and shortes with high right atrial pacing (41 plus or minus 3 ms) (P less than 0.05). There was no significant difference in stimulus to low septal right atrium from all three pacing sites. Atrial functional and effective refractory periods were not significantly different. Mean low septal right atrium to His was significantly shorter from the coronary sinus (93 plus or minus 8 ms) (P less than 0.001), as compared to high right atrium (139 plus or minus 16 ms), and low lateral right atrium (129 plus or minus 13 ms) pacing. AV nodal functional and effective refractory periods, and the paced rate producing AV nodal Wenckebach were not significantly different when comparing the three sites. Left atrial appendage and high right atrium were similarly compared in three additional patients, and no significant differences were found in conduction times and refractory periods.