Determinants of the Clinical Outcomes of Gout During the First Year of Urate-Lowering Therapy

Clinical benefit early in urate-lowering treatment of gout is difficult to document. We examined data from 1,832 gouty subjects treated with either urate-lowering agents or placebo to identify determinants of gout flare incidence and tophus size during year 1 of treatment. Reductions from pretreatment serum urate levels influenced flare frequency and tophus size, but the effect of urate level on flare incidence was biphasic. Lower urate levels were associated with higher flare incidence early in treatment but lower incidence by one year. The complex relationship between urate-lowering and clinical outcome early in treatment has implications for both clinical and investigative approaches to urate-lowering management.     

Determinants of the clinical outcomes of gout during the first year of urate-lowering therapy

Clinical benefit early in urate-lowering treatment of gout is difficult to document. We examined data from 1,832 gouty subjects treated with either urate-lowering agents or placebo to identify determinants of gout flare incidence and tophus size during year 1 of treatment. Reductions from pretreatment serum urate levels influenced flare frequency and tophus size, but the effect of urate level on flare incidence was biphasic. Lower urate levels were associated with higher flare incidence early in treatment but lower incidence by one year. The complex relationship between urate-lowering and clinical outcome early in treatment has implications for both clinical and investigative approaches to urate-lowering management.     

Functional and phylogenetic implications of molar flare variation in Miocene hominoids

Comparative analyses of molar shape figure prominently in Miocene hominoid evolutionary studies, and incomplete understanding of functional and phylogenetic influences on molar shape variation can have direct consequences for the interpretation of fossil taxa. Molar flare is a shape trait whose polarity, phylogenetic distribution, and functional significance have been sources of contention. To clarify the determinants of molar flare variation in the hominoid radiation, a combination of statistical methods was employed to investigate the effects of diet, phylogeny, and geologic age upon several measures of molar shape, to identify interactions among these factors, and to estimate their relative influence. Classic indices of molar crown shape and cusp relief are highly significantly associated with diet and show no clear phylogenetic or temporal patterning. Correlations with diet are insignificant when phylogenetic effects are controlled, a result which is interpreted as an artifact of the distribution of folivory in the Miocene hominoid radiation. Possession of pronounced molar flare was found to be the primitive condition for Miocene hominoids, but molar flare reduction cannot be considered a crown hominoid synapomorphy. Molar flare is strongly correlated with geologic age but differs significantly among dietary categories when the effects of time are controlled. Among contemporaneous taxa, hard-object feeders consistently show the highest levels of flare. Molar flare reduction is hypothesized to arise from realignment of cusp positions to maximize molar shearing and increase working occlusal surface area, while variation in flare among contemporaneous taxa may be due, at least in part, to enamel thickness variation. The pronounced molar flare of Otavipithecus is interpreted as a primitive retention, although alternative dietary and phylogenetic interpretations cannot be excluded. A dramatic reversal of molar flare reduction in Mio-Pliocene hominins is interpreted as a synapomorphy of the crown hominin clade, thus supporting the hominin status of the Lukeino hominine. The last common ancestor of the Pan-Homo clade is predicted to have possessed relatively non-flaring molars, and implications of this hypothesis for early hominin recognition are discussed.     

Flare Associated with LHRH-Agonist Therapy

The most common form of hormonal treatment for prostate cancer is luteinizing hormone-releasing hormone (LHRH)-agonist therapy. During the first 1 to 3 weeks of LHRH-agonist therapy, an initial increase in testosterone is associated with a condition known as "flare." Blockade of flare can be accomplished with a number of agents, including flutamide, bicalutamide, nilutamide, diethylstilbestrol, ketoconazole, and cyproterone acetate. Evidence from the early use of LHRHagonists suggested that flare could be serious in nature, with an exacerbation of pain, increase in uremia, development of neurologic sequelae, and possibly death. These events have been uncommonly reported of late, most probably owing to the use of flare blockade in most patients with advanced disease, as well as the fact that many patients are currently being treated with much earlier disease. Evidence is conflicting as to whether flare makes a difference in less advanced disease. A few reports have noted complications during flare in patients in whom a blockade of flare was not required, including two deaths from one institution. Reported series, however, seem to suggest that with flare blockade, acute complications are extremely uncommon. Evidence suggests that 1) advanced disease should be blocked; 2) blockade should probably include an antiandrogen beginning about 1 week prior to administration of the LHRH-agonist; and 3) that patients without advanced disease but with very high PSA levels should be considered for flare blockade.     

Characteristics of a xenogeneic lymphocyte transfer reaction: its use in the study of graft versus host capability of mouse lymphoid cells from various anatomic sites.

A xenogeneic intradermal lymphocyte transfer test is described in which mouse lymphoid cells from various anatomic compartments were injected intó guinea pigs. Murine peripheral blood lymphocytes and peritoneal exudate (mineral oil induced) cells gave significantly greater responses than did cells from the spleen or non-inflammatory peritoneal exudates. The “flare” reaction, characteristic of the allogeneic lymphocyte transfer test, was absent. Similar experiments conducted with presensitized donor cells produced a marked “flare” reaction, but only with blood and inflammatory exudate lymphocytes. The fact that the flare could be ablated by prior in vitro irradiation of donor cells suggests that the flare reaction is related, at least in part, to the mitosis of these cells in the host. Effects of host manipulations such as prior irradiation and decomplementation suggest that host factors may play a role in the expression of dermal inflammation. It is concluded that this particular xenogeneic transfer response varies with either; a) the number of effector cells in the transferate or; b) the differential ability of a given murine lymphoid population to survive in guinea pig skin or, to varying degrees, a combination of both.     

Plasma profiles in active systemic juvenile idiopathic arthritis: Biomarkers and biological implications

Systemic juvenile idiopathic arthritis (SJIA) is a chronic arthritis of children characterized by a combination of arthritis and systemic inflammation. There is usually non‐specific laboratory evidence of inflammation at diagnosis but no diagnostic test. Normalized volumes from 89/889 2‐D protein spots representing 26 proteins revealed a plasma pattern that distinguishes SJIA flare from quiescence. Highly discriminating spots derived from 15 proteins constitute a robust SJIA flare signature and show specificity for SJIA flare in comparison to active polyarticular juvenile idiopathic arthritis or acute febrile illness. We used 7 available ELISA assays, including one to the complex of S100A8/S100A9, to measure levels of 8 of the15 proteins. Validating our DIGE results, this ELISA panel correctly classified independent SJIA flare samples, and distinguished them from acute febrile illness. Notably, data using the panel suggest its ability to improve on erythrocyte sedimentation rate or C‐reactive protein or S100A8/S100A9, either alone or in combination in SJIA F/Q discriminations. Our results also support the panel's potential clinical utility as a predictor of incipient flare (within 9 wk) in SJIA subjects with clinically inactive disease. Pathway analyses of the 15 proteins in the SJIA flare versus quiescence signature corroborate growing evidence for a key role for IL‐1 at disease flare.     

Potent vasoactive properties of endothelin 1 in human skin.

The effect of the endothelial cell-derived peptide endothelin 1 was investigated in human skin. Intradermal injection of endothelin 1 (1-100 pmol) caused a dose-dependent area of pallor that was associated with a significant reduction in basal skin blood flow, measured by laser-Doppler blood flowmeter (with 1 pmol endothelin, P = 0.012, analysis of variance). The coadministration of endothelin 1 (1-100 pmol) with the neuropeptide vasodilator calcitonin gene-related peptide (CGRP) inhibited the vasodilator response to CGRP (10 pmol) by up to 82.7 +/- 9.2% (with 100 pmol endothelin, P less than 0.001). The response of the prostanoid vasodilator prostaglandin E2 (10 pmol) was inhibited by endothelin in a similar manner. In addition to the vasoconstrictor effects, endothelin 1 produced a dose-dependent flare that surrounded the area of pallor, and this was associated with a significant increase in blood flow (P less than 0.05) within the flare area. The H1 antagonist terfenadine (120 mg po) significantly reduced the flare area associated with endothelin 1: flare 5 min after intradermal endothelin (10 pmol, placebo treated), 668 +/- 405 mm2; terfenadine treated, 201 +/- 257 mm2 (P less than 0.05). The flare was also significantly attenuated when endothelin (10 pmol) was injected into local anesthetic-treated skin. Thus intradermal injection of endothelin in humans causes long-lasting vasoconstriction at the site of injection and a surrounding flare. Results suggest that the flare component is partially histamine dependent and the result of an axon reflex. This study demonstrates the potent activity of endothelin in human skin. It is possible that endothelin could be relevant to the local response of skin to injury.     

A direct in vivo comparison of the inflammatory properties of human C5a and C5a des Arg in human skin

C5a is an 11,000-Da complement-derived inflammatory glycoprotein that has been shown to mediate inflammatory reactions in vitro as well as in vivo in human skin. The C5a degradation product, C5a des Arg, is rapidly formed after exposure of C5a to serum carboxypeptidase N and may represent the relevant C5-derived inflammatory peptide in vivo. To examine the biologic activity of human C5a des Arg in vivo and to compare it with that seen with human C5a, we purified and characterized homogeneous preparations of human C5a and C5a des Arg and injected them intradermally into seven normal volunteers. C5a des Arg exhibited biochemical and biologic properties in vitro that were different from those of C5a. When injected into human skin, C5a des Arg was less potent than C5a, in respect to both minimal dose eliciting wheal and flare reactions and maximal wheal and flare elicited at a given dose, but C5a des Arg still elicited cutaneous wheal and flare reactions at physiologically relevant concentrations. Histologically, C5a des Arg skin test sites showed dense polymorphonuclear neutrophil-rich infiltrates associated with leukocytoclasis, dermal mast cell degranulation, and endothelial cell swelling. These were virtually indistinguishable from reactions elicited by C5a and occurred with concentrations attainable in vivo. Cutaneous wheal and flare reactions elicited by either C5a or C5a des Arg were partially inhibited by H1 antihistamines but were unaffected by selected nonsteroidal anti-inflammatory agents.     

Aqueous flare elevation induced by transcorneal application of highly selective agonists for prostaglandin E2 receptor subtypes in pigmented rabbits: effect of tetramethylpyrazine.

We examined the disruptive effect of highly selective agonists for prostaglandin E2 receptor subtypes (EP1, EP2, EP3 and EP4) on the blood-aqueous barrier, and evaluated the inhibitory effect of tetramethylpyrazine, an active component of Ligusticum wallichii, on the elevation of aqueous flare induced by the EP agonists in pigmented rabbits. Highly selective EP agonists (ONO-DI-004, EP1 agonist; ONO-AE1-259-01, EP2 agonist; ONO-AE-248, EP3 agonist; ONO-AE1-329, EP4 agonist) at 12.5 to 250 microg/ml were transcorneally administered to the eyes of pigmented rabbits using a glass cylinder. Animals were pretreated intravenously with tetramethylpyrazine (10 or 30 mg/kg) 30 minutes before application of the EP2 or the EP4 agonist. Aqueous flare was measured using a laser flare-cell meter. Aqueous flare intensity was expressed as the area under the curve (AUC) in arbitrary units. After administration of ONO-AE1-259-01 or ONO-AE1-329, aqueous flare increased and then gradually decreased. ONO-DI-004 and ONO-AE-248 had almost no effect on aqueous flare elevation. The AUC of eyes in rabbits pretreated with tetramethylpyrazine, 10 or 30 mg/kg i.v., was significantly smaller than that of eyes in rabbits treated with ONO-AEI-259-01 alone. The AUC of eyes in rabbits pretreated with tetramethylpyrazine, 10 or 30 mg/kg i.v., was not significantly smaller than that of eyes in rabbits treated with ONO-AEI-329 only. The results indicated that EP2 and EP4 agonists induced aqueous flare elevation in pigmented rabbits, and that tetramethylpyrazine inhibited the aqueous flare elevation induced by the EP2 agonist but did not suppress the elevation induced by the EP4 agonist.     

Calcitonin gene-related peptide in the eye: release by sensory nerve stimulation and effects associated with neurogenic inflammation

Calcitonin gene-related peptide (CGRP) in the anterior uvea coexists with tachykinins (substance P and neurokinin A) in sensory nerve fibers deriving from the trigeminal ganglion. Mechanical or electrical stimulation of the intracranial part of the trigeminal nerve/ganglion in rabbits produced a marked hyperemia in the anterior segment of the eye, increased intraocular pressure, breakdown of the blood-aqueous barrier and miosis. Simultaneously, CGRP-like immunoreactivity was released into the aqueous humor. This suggests that the highly vasoactive CGRP can be released from sensory nerve fibers to participate in vascular responses. Unlike the tachykinins, CGRP per se was without effect on the pupillary diameter while disrupting the blood-aqueous barrier (resulting in aqueous flare) upon intravitreal injection. In addition, CGRP enhanced the aqueous flare evoked by a minimal eye trauma (infrared irradiation of the iris). The miosis evoked by the intravitreal injection of substance P was more pronounced when CGRP was injected simultaneously, and finally, substance P induced aqueous flare much more effectively when given together with a threshold dose of CGRP.     

The Magnitude and Duration of Itch Produced by Intracutaneous Injections of Histamine

The magnitude and duration of itch sensation produced by intracutaneous injection of histamine were determined for humans with the procedure of magnitude estimation scaling. Thirteen subjects received a 10-μ1 intracutaneous injection of histamine at doses of 0.0001, 0.001, 0.01, 0.1, 1, and 10 μg into the volar forearm; eight of these subjects also received a 100-μg dose. One subject received multiple injections over several weeks to determine the reliability of the magnitude estimates of itch. Following each injection, the area of flare and duration of itch were also determined.

Intracutaneous injection of histamine produced a pure sensation of itch, without pain. The magnitude of itch increased in a dose-dependent fashion. The lowest histamine dose that produced itch greater than the itch produced by vehicle was 0.01 μg. The greatest itch was produced by the 100-μg dose. A power function fitted to the mean magnitude estimates had an exponent of 0.17, indicating a negatively accelerating relation between the magnitude of itch and histamine dose. The one subject who received histamine over several weeks gave fairly reproducible estimates of itch magnitude.

The duration of itch and the area of flare also increased in a dose-dependent fashion. The lowest dose of histamine that produced a duration of itch longer than the itch produced by the vehicle was 0.1 μg, while the 100-μg dose produced the longest duration of itch. Although the area of flare increased with each increase in dose from 0.1 to 10 μg, the areas of flare produced by 10 and 100 μg of histamine did not differ.

These results indicate that humans can scale the magnitude of itch produced by histamine in a dose-dependent manner. In addition, the duration of itch and the area of flare produced by histamine are dose-dependent, confirming results of previous investigators. Intracutaneous histamine is easily quantifiable and may thus be a useful stimulus in neurophysiological studies of the peripheral neural mechanisms of itch.     

Angiotensin converting enzyme has an inhibitory role in CGRP metabolism in human skin

The neutral endopeptidase (NEP) is important for calcitonin gene related peptide (CGRP) degradation, while the role of angiotensin converting enzyme (ACE) remains unclear. By using dermal microdialysis we explored the effect of phosphoramidon (NEP blocker), captopril (ACE blocker) and a mixture of both drugs on the intensity of electrically-induced CGRP-mediated neurogenic flare. The results reveal that phosphoramidon elevated flare intensity, but that this was not further increased by adding captopril. In contrast, neurogenic flare was decreased when the drug mixture was applied in compared to NEP only. Electrically released CGRP levels could be measured directly in perfusates containing phosphoramidon and the mixture. Again, CGRP levels were elevated in phosphoramidon treated sites, and significantly reduced upon adding captopril. These findings suggest that NEP and ACE do not have additive effects regarding neuropeptide degradation. In contrast, inhibition of ACE seems to augment CGRP catabolism.     

Decreased cutaneous sensory axon-reflex vasodilatation below the lesion in patients with complete spinal cord injury

The histamine-induced skin flare response has been considered of practical value in determining the level of a spinal cord lesion, but clinical observations have varied widely with regard to the nature and degree of change below the lesion. We have quantified cutaneous sensory axon-reflex vasodilatation in patients with complete spinal cord injury (SCI) above and below the lesion, and compared the findings with normal subjects. Axon-reflex vasodilatation was induced by intradermal histamine injection, and measured by (a) laser Doppler fluxmetry and (b) tracing the surface area of the flare. Axon-reflex vasodilatation was present in all SCI patients above and below the lesion, but was significantly diminished below the lesion by both measures (pflux rise = 0.0008; pflare = 0.023), and in comparison with controls (by 39%). The flux increase was significantly correlated with the area of flare (r = 0.82; p = 0.02). Axon-reflex vasodilatation and visual analogue scale (VAS) pain scores on histamine injection were not significantly different above the lesion in SCI patients from controls. Baseline laser Doppler flux was not different at any test site in SCI and normal subjects. The cutaneous sensory axon-reflex is thus significantly diminished in SCI patients below the level of the lesion, but the underlying mechanism is unclear. A possible explanation under investigation is that increased basal or reflex sympathetic vasoconstriction mediated via the isolated spinal cord may counteract the vasodilatation produced by the cutaneous sensory terminals.     

Pain, wheal and flare in human forearm skin induced by bradykinin and 5-hydroxytryptamine

Pain was induced in 19 healthy individuals by double-blind injections into the forearm skin of 0.05 ml of physiological saline with or without active substances added. Bradykinin (0.5 nmol), 5-hydroxytryptamine (0.5 nmol) and a mixture of the two substances in half dosage (0.25 nmol + 0.25 nmol) caused significantly more pain than saline (p<0.05). The three test solutions also induced wheal and flare responses significantly more pronounced than saline. Bradykinin induced significantly more pain and more wheal than 5-hydroxytryptamine (p<0.05) but a significantly smaller flare (p<0.01). A dissociation between induced pain and flare was thus demonstrated.     

Vesicle trafficking maintains nuclear shape in Saccharomyces cerevisiae during membrane proliferation

The parameters that control nuclear size and shape are poorly understood. In yeast, unregulated membrane proliferation, caused by deletion of the phospholipid biosynthesis inhibitor SPO7, leads to a single nuclear envelope "flare" that protrudes into the cytoplasm. This flare is always associated with the asymmetrically localized nucleolus, which suggests that the site of membrane expansion is spatially confined by an unknown mechanism. Here we show that in spo7Δ cells, mutations in vesicle-trafficking genes lead to multiple flares around the entire nucleus. These mutations also alter the distribution of small nucleolar RNA-associated nucleolar proteins independently of their effect on nuclear shape. Both single- and multi-flared nuclei have increased nuclear envelope surface area, yet they maintain the same nuclear/cell volume ratio as wild-type cells. These data suggest that, upon membrane expansion, the spatial confinement of the single nuclear flare is dependent on vesicle trafficking. Moreover, flares may facilitate maintenance of a constant nuclear/cell volume ratio in the face of altered membrane proliferation.     

多西紫杉醇修饰的人工晶体与眼组织相容性分析

目的：探讨经多西紫杉醇修饰的人工晶体对眼组织相容性的影响。方法：按照随机数字表法将32 只日本大耳兔分为两组： 实验组通过手术植入表面经多西紫杉醇修饰处理后的疏水性人工晶体,对照组植入疏水性人工晶体。比较两组人工晶体亲水角、 术后24 小时光耀斑块计数以及人工晶体周围组织炎症浸润数。结果：实验组的亲水角小于对照组,差异有统计学意义（P<0.05）。 实验组光耀斑块计数低于对照组,差异有统计学意义（P<0.05）。实验组家兔人工晶体周围组织炎症浸润计数低于对照组,差异有 统计学意义（P<0.05）。结论：人工晶体表面经多西紫杉醇修饰后,其亲水性、与眼组织的组织相容性增加,且可缓解光耀斑炎症感 染和降低并发症的发生,有重要的临床参考价值。     

四氯虫酰胺玉米全株喷雾和喇叭口点施防治草地贪夜蛾的药效评价

评价四氯虫酰胺玉米全株喷雾和喇叭口点施处理对草地贪夜蛾的活性与防效,为草地贪夜蛾综合防控提供技术支持。采用叶片喷雾法,测定了对草地贪夜蛾2龄幼虫毒力;以40%辛硫磷乳油为对照药剂,采用喷雾和喇叭口点施两种方式田间施用10%四氯虫酰胺悬浮剂,药前1 d和药后1 d、3 d、7 d,调查挂牌标记玉米上草地贪夜蛾活虫数,计算防治效果。结果表明:四氯虫酰胺对草地贪夜蛾2龄幼虫具有良好的毒力;10%四氯虫酰胺悬浮剂制剂用量600 g/hm 2喷雾处理后1 d、3 d、7 d对草地贪夜蛾的防效分别为75.90%、91.91%和92.02%,制剂用量300 g/hm 2喇叭口点施处理后1 d、3 d、7 d对草地贪夜蛾的防效分别为82.28%、89.52%和91.23%,40%辛硫磷乳油制剂用量1500 g/hm 2处理,两种施药方式防效均不佳。四氯虫酰胺对草地贪夜蛾具有良好的防治效果,喇叭口点施方式节省药剂可达50%以上,在防治草地贪夜蛾等害虫方面具有广阔的应用前景。     

3种拟除虫菊酯类农药对草地贪夜蛾的毒力测定及田间应用效果评价

评价使用氟氯氰菊酯、溴氰菊酯、高效氯氟氰菊酯喷雾和喇叭口点施处理对草地贪夜蛾的活性与防效,为草地贪夜蛾综合防控提供技术支持。采用喷雾法测定了3种农药原药对草地贪夜蛾3龄幼虫毒力;采用喷雾和喇叭口点施2种方式田间施用5.7%氟氯氰菊酯乳油、25 g/L溴氰菊酯乳油、5.0%高效氯氟氰菊酯乳油,药后第1天、第3天、第7天调查挂牌标记玉米上草地贪夜蛾活虫数,计算防治效果。3种拟除虫菊酯农药对草地贪夜蛾3龄幼虫LC 50值大小顺序依次为氟氯氰菊酯(29.80 mg/L)<高效氯氟氰菊酯(42.39 mg/L)<溴氰菊酯(49.88 mg/L);3种拟除虫菊酯类农药在54.00 g a.i./ha剂量下均能明显降低草地贪夜蛾田间虫口数量,同等剂量防效氟氯氰菊酯乳油>高效氯氟氰菊酯乳油>溴氰菊酯微乳剂。由于草地贪夜蛾低龄幼虫和高龄幼虫取食部位有差异,喷雾法防治低龄幼虫的效果好,喇叭口点施防治高龄幼虫的效果好。拟除虫菊酯类农药对草地贪夜蛾具有较好的防治效果,喇叭口点施方式节省药剂、提高对高龄幼虫的防效,在防治草地贪夜蛾等害虫方面具有广阔的应用前景。     

Thermal self-focusing during solar flares

By solving a nonlinear equation for a heat source with a power proportional to Т ^β (β > 1), it is shown that heat localization in the transverse cross section of a magnetic tube with a classical thermal conductivity occurs in the blowup regime in the form of microstructures—temperature background cells bounded by hot walls with a spatial scale of <100 m. The reduction in the integral X-ray emissivity observed on board of spacecrafts in the early stage of the flare is attributed to thermal self-focusing, i.e., a decrease in the factor of filling of the flare volume with hot plasma due to the narrowing of the hot walls of the microstructure.