Numerical simulations of microphysical processes in pyro-convective clouds

Hochreichende Konvektion über Waldbränden ist eine der intensivsten Formen von atmosphärischer Konvektion. Die extreme Wolkendynamik mit hohen vertikalen Windgeschwindigkeiten (bis 20 m/s) bereits an der Wolkenbasis, hohen Wasserdampfübersättigungen (bis 1%) und die durch das Feuer hohen Anzahlkonzentration von Aerosolpartikeln (bis 100000 cm^-3) bilden einen besonderen Rahmen für Aerosol-Wolken Wechselwirkungen.Ein entscheidender Schritt in der mikrophysikalischen Entwicklung einer konvektiven Wolke ist die Aktivierung von Aerosolpartikeln zu Wolkentropfen. Dieser Aktivierungsprozess bestimmt die anfängliche Anzahl und Größe der Wolkentropfen und kann daher die Entwicklung einer konvektiven Wolke und deren Niederschlagsbildung beeinflussen. Die wichtigsten Faktoren, welche die anfängliche Anzahl und Größe der Wolkentropfen bestimmen, sind die Größe und Hygroskopizität der an der Wolkenbasis verfügbaren Aerosolpartikel sowie die vertikale Windgeschwindigkeit. Um den Einfluss dieser Faktoren unter pyro-konvektiven Bedingungen zu untersuchen, wurden numerische Simulationen mit Hilfe eines Wolkenpaketmodells mit detaillierter spektraler Beschreibung der Wolkenmikrophysik durchgeführt. Diese Ergebnisse können in drei unterschiedliche Bereiche abhängig vom Verhältnis zwischen vertikaler Windgeschwindigkeit und Aerosolanzahlkonzentration (w/NCN) eingeteilt werden: (1) ein durch die Aerosolkonzentration limitierter Bereich (hohes w/NCN), (2) ein durch die vertikale Windgeschwindigkeit limitierter Bereich (niedriges w/NCN) und (3) ein Übergangsbereich (mittleres w/NCN). Die Ergebnisse zeigen, dass die Variabilität der anfänglichen Anzahlkonzentration der Wolkentropfen in (pyro-) konvektiven Wolken hauptsächlich durch die Variabilität der vertikalen Windgeschwindigkeit und der Aerosolkonzentration bestimmt wird. rnUm die mikrophysikalischen Prozesse innerhalb der rauchigen Aufwindregion einer pyrokonvektiven Wolke mit einer detaillierten spektralen Mikrophysik zu untersuchen, wurde das Paketmodel entlang einer Trajektorie innerhalb der Aufwindregion initialisiert. Diese Trajektore wurde durch dreidimensionale Simulationen eines pyro-konvektiven Ereignisses durch das Model ATHAM berechnet. Es zeigt sich, dass die Anzahlkonzentration der Wolkentropfen mit steigender Aerosolkonzentration ansteigt. Auf der anderen Seite verringert sich die Größe der Wolkentropfen mit steigender Aerosolkonzentration. Die Reduzierung der Verbreiterung des Tropfenspektrums stimmt mit den Ergebnissen aus Messungen überein und unterstützt das Konzept der Unterdrückung von Niederschlag in stark verschmutzen Wolken.Mit Hilfe des Models ATHAM wurden die dynamischen und mikrophysikalischen Prozesse von pyro-konvektiven Wolken, aufbauend auf einer realistischen Parametrisierung der Aktivierung von Aerosolpartikeln durch die Ergebnisse der Aktivierungsstudie, mit zwei- und dreidimensionalen Simulationen untersucht. Ein modernes zweimomenten mikrophysikalisches Schema wurde in ATHAM implementiert, um den Einfluss der Anzahlkonzentration von Aerosolpartikeln auf die Entwicklung von idealisierten pyro-konvektiven Wolken in US Standardamtosphären für die mittleren Breiten und den Tropen zu untersuchen. Die Ergebnisse zeigen, dass die Anzahlkonzentration der Aerosolpartikel die Bildung von Regen beeinflusst. Für geringe Aerosolkonzentrationen findet die rasche Regenbildung hauptsächlich durch warme mikrophysikalische Prozesse statt. Für höhere Aerosolkonzentrationen ist die Eisphase wichtiger für die Bildung von Regen. Dies führt zu einem verspäteten Einsetzen von Niederschlag für verunreinigtere Atmosphären. Außerdem wird gezeigt, dass die Zusammensetzung der Eisnukleationspartikel (IN) einen starken Einfluss auf die dynamische und mikrophysikalische Struktur solcher Wolken hat. Bei sehr effizienten IN bildet sich Regen früher. Die Untersuchung zum Einfluss des atmosphärischen Hintergrundprofils zeigt eine geringe Auswirkung der Meteorologie auf die Sensitivität der pyro-konvektiven Wolken auf diernAerosolkonzentration. Zum Abschluss wird gezeigt, dass die durch das Feuer emittierte Hitze einen deutlichen Einfluss auf die Entwicklung und die Wolkenobergrenze von pyro-konvektive Wolken hat. Zusammenfassend kann gesagt werden, dass in dieser Dissertation die Mikrophysik von pyrokonvektiven Wolken mit Hilfe von idealisierten Simulation eines Wolkenpaketmodell mit detaillierte spektraler Mikrophysik und eines 3D Modells mit einem zweimomenten Schema im Detail untersucht wurde. Es wird gezeigt, dass die extremen Bedingungen im Bezug auf die vertikale Windgeschwindigkeiten und Aerosolkonzentrationen einen deutlichen Einfluss auf die Entwicklung von pyro-konvektiven Wolken haben.

Verknüpfung metallhaltiger Pivalatkomplexe über polyfunktionale organische Brückenliganden

Ziel der hier vorliegenden Dissertation ist es, Übergangsmetallpivalate durch gezielte Substitution monodentater Donorliganden in apikalen Positionen, unter Erhalt ihrer Grundstruktur, zu höherdimensionalen Verbindungen zu verknüpfen. Als Ausgangs-verbindungen dienen dabei [Fe3O(O2C-tBu)6(OH2)3]O2C-tBu und [Ni2(OH2)(O2C-tBu)4(HO2C-tBu)4].rnrnIm ersten Teil dieser Arbeit konnten, in Abhängigkeit der in den Reaktionen eingesetzten Liganden mit [Fe3O(O2C-tBu)6(OH2)3]O2C-tBu, symmetrisch oder asymmetrisch substituierte dreikernige Verbindungen erhalten werden. Deren strukturellen und magnetischen Eigenschaften konnten untersucht werden und die daraus resultierenden magnetostrukturellen Korrelationen auf die folgenden vorgestellten mehrkernigen bzw. höherdimensionalen Verbindungen übertragen werden, die erheblich an Komplexität zugenommen haben.rnDie 0-dimensionalen dreikernigen Einheiten zeigen, abhängig von ihren Fe-O-Bindungslängen in den µ3-Oxo verbrückten Einheiten, unterschiedlich starke antiferro-magnetische Austauschwechselwirkungen. Wenn in den Verbindungen eine längere Fe-O-Bindung und zwei kürzere Fe-O-Bindungen existieren, können diese Typ 2:a zugeordnet werden. Daraus folgt, dass die Daten der magnetischen Suszeptibilität mit zwei unterschiedlich starken Austauschwechselwirkungen (J-Kopplungen) zu simulieren sind. Es liegen eine stärkere J-Kopplung über die kurzen Fe-O-Bindungen und zwei schwächere über die lange Fe-O-Bindung vor (J1 > J2). Existieren hingegen eine kürzere Fe-O-Bindung und zwei längere Fe-O-Bindungen (Typ 2:b) sind nun die magnetischen Suszeptibilitätsdaten nur mit zwei stärkeren und einer schwächeren Kopplung zu simulieren (J1 < J2). Die vorgestellten Verbindungen zeigen alle einen Spingrundzustand S≠0, der durch konkurrierende Wechselwirkungen der Spinzentren in Dreieckssituationen begründet ist. rnDer zweite Teil der Arbeit beschäftigte sich mit dem gezielten Aufbau mehrkerniger Verbindungen, in denen die dreikernige Einheit als Grundmotiv erhalten bleiben konnte. Die Austauschwechselwirkungen der fünf- und sechskernigen Verbindungen konnten in Abhängigkeit der Bindungslängen und basierend auf den Ergebnissen der dreikernigen Einheiten aus dem ersten Teil, bestimmt werden. rnDie Synthesen der 4-Hydroxybenzaldehyd verbrückten Kettenverbindung sowie des über 3,5,3’,5’-Tetramethyl-1H,1’H-[4,4’]bipyrazolyl verknüpften 3-dimensionalen Nickelnetzwerks zeigten die erfolgreiche Umsetzung des „Bottom Up“ Ansatzes. Durch Erhaltung des jeweiligen Grundmotivs der verwendeten Ausgangsverbindung konnten die magnetischen Austauschwechselwirkungen unter Einbeziehung schwacher Wechselwirkungen durch den Raum, mit Hilfe der Theta-Weiss Temperatur, in den Simulationen bestimmt werden.rnrnDamit stellt der „Bottom Up“ Ansatz eine hervorragende Syntesestrategie für den Aufbau höherdimensionaler Verbindungen, ausgehend von zwei- bzw. dreikernigen Übergangs-metallkomplexen, dar.rn

Thermal structure and dynamical modeling of a Mediterranean tropical-like cyclone

In the present work, a detailed analysis of a Mediterranean TLC occurred in January 2014 has been conducted. The author is not aware of other studies regarding this particular event at the publication of this thesis. In order to outline the cyclone evolution, observational data, including weather-stations data, satellite data, radar data and photographic evidence, were collected at first. After having identified the cyclone path and its general features, the GLOBO, BOLAM and MOLOCH NWP models, developed at ISAC-CNR (Bologna), were used to simulate the phenomenon. Particular attention was paid on the Mediterranean phase as well as on the Atlantic phase, since the cyclone showed a well defined precursor up to 3 days before the minimum formation in the Alboran Sea. The Mediterranean phase has been studied using different combinations of GLOBO, BOLAM and MOLOCH models, so as to evaluate the best model chain to simulate this kind of phenomena. The BOLAM and MOLOCH models showed the best performance, by adjusting the path erroneously deviated in the National Centre for Environmental Prediction (NCEP) and ECMWF operational models. The analysis of the cyclone thermal phase shown the presence of a deep-warm core structure in many cases, thus confirming the tropical-like nature of the system. Furthermore, the results showed high sensitivity to initial conditions in the whole lifetime of the cyclone, while the Sea Surface Temperature (SST) modification leads only to small changes in the Adriatic phase. The Atlantic phase has been studied using GLOBO and BOLAM model and with the aid of the same methodology already developed. After tracing the precursor, in the form of a low-pressure system, from the American East Coast to Spain, the thermal phase analysis was conducted. The parameters obtained showed evidence of a deep-cold core asymmetric structure during the whole Atlantic phase, while the first contact with the Mediterranean Sea caused a sudden transition to a shallow-warm core structure. The examination of Potential Vorticity (PV) 3-dimensional structure revealed the presence of a PV streamer that individually formed over Greenland and eventually interacted with the low-pressure system over the Spanish coast, favouring the first phase of the cyclone baroclinic intensification. Finally, the development of an automated system that tracks and studies the thermal phase of Mediterranean cyclones has been encouraged. This could lead to the forecast of potential tropical transition, against with a minimum computational investment.

Global lymphoid tissue remodeling during a viral infection is orchestrated by a B cell-lymphotoxin-dependent pathway

Adaptive immune responses are characterized by substantial restructuring of secondary lymphoid organs. The molecular and cellular factors responsible for virus-induced lymphoid remodeling are not well known to date. Here we applied optical projection tomography, a mesoscopic imaging technique, for a global analysis of the entire 3-dimensional structure of mouse peripheral lymph nodes (PLNs), focusing on B-cell areas and high endothelial venule (HEV) networks. Structural homeostasis of PLNs was characterized by a strict correlation between total PLN volume, B-cell volume, B-cell follicle number, and HEV length. After infection with lymphocytic choriomeningitis virus, we observed a substantial, lymphotoxin (LT) beta-receptor-dependent reorganization of the PLN microarchitecture, in which an initial B-cell influx was followed by 3-fold increases in PLN volume and HEV network length on day 8 after infection. Adoptive transfer experiments revealed that virus-induced PLN and HEV network remodeling required LTalpha(1)beta(2)-expressing B cells, whereas the inhibition of vascular endothelial growth factor-A signaling pathways had no significant effect on PLN expansion. In summary, lymphocytic choriomeningitis virus-induced PLN growth depends on a vascular endothelial growth factor-A-independent, LT- and B cell-dependent morphogenic pathway, as revealed by an in-depth mesoscopic analysis of the global PLN structure.

Critical roles for Rac GTPases in T-cell migration to and within lymph nodes

Naive T cells continuously recirculate between secondary lymphoid tissue via the blood and lymphatic systems, a process that maximizes the chances of an encounter between a T cell and its cognate antigen. This recirculation depends on signals from chemokine receptors, integrins, and the sphingosine-1-phosphate receptor. The authors of previous studies in other cell types have shown that Rac GTPases transduce signals leading to cell migration and adhesion; however, their roles in T cells are unknown. By using both 3-dimensional intravital and in vitro approaches, we show that Rac1- and Rac2-deficient T cells have multiple defects in this recirculation process. Rac-deficient T cells home very inefficiently to lymph nodes and the white pulp of the spleen, show reduced interstitial migration within lymph node parenchyma, and are defective in egress from lymph nodes. These mutant T cells show defective chemokine-induced chemotaxis, chemokinesis, and adhesion to integrin ligands. They have reduced lateral motility on endothelial cells and transmigrate in-efficiently. These multiple defects stem from critical roles for Rac1 and Rac2 in transducing chemokine and sphingosine-1-phosphate receptor 1 signals leading to motility and adhesion.

Feasibility of image-guided radiotherapy based on tomotherapy for the treatment of locally advanced anal carcinoma

The standard of care for locally advanced anal cancer has been concurrent chemoradiation. However, conventional treatment with 3-dimensional radiotherapy is associated with significant toxicity. The feasibility of new radiotherapy techniques such as image-guided radiotherapy (IGRT) in combination with chemotherapy for the treatment of this malignancy was assessed.

Computer-assisted femoral head-neck osteochondroplasty using a surgical milling device an in vitro accuracy study

Surgical navigation might increase the safety of osteochondroplasty procedures in patients with femoroacetabular impingement. Feasibility and accuracy of navigation of a surgical reaming device were assessed. Three-dimensional models of 18 identical sawbone femora and 5 cadaver hips were created. Custom software was used to plan and perform repeated computer-assisted osteochondroplasty procedures using a navigated burr. Postoperative 3-dimensional models were created and compared with the preoperative models. A Bland-Altmann analysis assessing α angle and offset ratio accuracy showed even distribution along the zero line with narrow confidence intervals. No differences in α angle and offset ratio accuracy (P = 0.486 and P = 0.2) were detected between both observers. Planning and conduction of navigated osteochondroplasty using a surgical reaming device is feasible and accurate.

Statistical modeling of the eye for multimodal treatment planning for external beam radiation therapy of intraocular tumors

Ocular anatomy and radiation-associated toxicities provide unique challenges for external beam radiation therapy. For treatment planning, precise modeling of organs at risk and tumor volume are crucial. Development of a precise eye model and automatic adaptation of this model to patients' anatomy remain problematic because of organ shape variability. This work introduces the application of a 3-dimensional (3D) statistical shape model as a novel method for precise eye modeling for external beam radiation therapy of intraocular tumors.

DOCK8 is a Cdc42 activator critical for interstitial dendritic cell migration during immune responses

To migrate efficiently through the interstitium, dendritic cells (DCs) constantly adapt their shape to the given structure of the extracellular matrix and follow the path of least resistance. It is known that this amoeboid migration of DCs requires Cdc42, yet the upstream regulators critical for localization and activation of Cdc42 remain to be determined. Mutations of DOCK8, a member of the atypical guanine nucleotide exchange factor family, causes combined immunodeficiency in humans. In the present study, we show that DOCK8 is a Cdc42-specific guanine nucleotide exchange factor that is critical for interstitial DC migration. By generating the knockout mice, we found that in the absence of DOCK8, DCs failed to accumulate in the lymph node parenchyma for T-cell priming. Although DOCK8-deficient DCs migrated normally on 2-dimensional surfaces, DOCK8 was required for DCs to crawl within 3-dimensional fibrillar networks and to transmigrate through the subcapsular sinus floor. This function of DOCK8 depended on the DHR-2 domain mediating Cdc42 activation. DOCK8 deficiency did not affect global Cdc42 activity. However, Cdc42 activation at the leading edge membrane was impaired in DOCK8-deficient DCs, resulting in a severe defect in amoeboid polarization and migration. Therefore, DOCK8 regulates interstitial DC migration by controlling Cdc42 activity spatially.

Evaluation of radial distribution of cartilage degeneration and necessity of pre-contrast measurements using radial dGEMRIC in adults with acetabular dysplasia

Background The purpose of the present study was to investigate the radial distribution patterns of cartilage degeneration in dysplastic hips at different stages of secondary osteoarthritis (OA) by using radial delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), and to assess whether pre-contrast measurements are necessary. Methods Thirty-five hips in 21 subjects (mean age ± SD, 27.6 ± 10.8 years) with acetabular dysplasia (lateral CE angle < 25°) were studied. Severity of OA was assessed on radiographs using Tönnis grading. Pre- (T1pre) and post-contrast T1 (T1Gd) values were measured at 7 sub-regions on radial reformatted slices acquired from a 3-dimensional (3D) T1 mapping sequence using a 1.5 T MR scanner. Values of radial T1pre, T1Gd and ΔR1 (1/T1Gd - 1/T1pre) of subgroups with different severity of OA were compared to those of the subgroup without OA using nonparametric tests, and bivariate linear Pearson correlations between radial T1Gd and ΔR1 were analyzed for each subgroup. Results Compared to the subgroup without OA, the subgroup with mild OA was observed with a significant decrease in T1Gd in the anterosuperior to superior sub-regions (mean, 476 ~ 507 ms, p = 0.026 ~ 0.042) and a significant increase in ΔR1 in the anterosuperior to superoposterior and posterior sub-regions (mean, 0.93 ~ 1.37 s-1, p = 0.012 ~ 0.042). The subgroup with moderate to severe OA was observed with a significant overall decrease in T1Gd (mean, 404 ~ 452 ms, p = 0.001 ~ 0.020) and an increase in ΔR1 (mean, 1.17 ~1.69 s-1, p = 0.001 ~ 0.020). High correlations were observed between radial T1Gd and ΔR1 for all subgroups (r = −0.869 ~ −0.944, p < 0.001). Conclusions Radial dGEMRIC without pre-contrast measurements is useful for evaluating different patterns of cartilage degeneration in the entire hip joint of patients with hip dysplasia, particularly for those in early stages of secondary OA.

Automatic extraction of the mid-facial plane for cranio-maxillofacial surgery planning

Recently developed computer applications provide tools for planning cranio-maxillofacial interventions based on 3-dimensional (3D) virtual models of the patient's skull obtained from computed-tomography (CT) scans. Precise knowledge of the location of the mid-facial plane is important for the assessment of deformities and for planning reconstructive procedures. In this work, a new method is presented to automatically compute the mid-facial plane on the basis of a surface model of the facial skeleton obtained from CT. The method matches homologous surface areas selected by the user on the left and right facial side using an iterative closest point optimization. The symmetry plane which best approximates this matching transformation is then computed. This new automatic method was evaluated in an experimental study. The study included experienced and inexperienced clinicians defining the symmetry plane by a selection of landmarks. This manual definition was systematically compared with the definition resulting from the new automatic method: Quality of the symmetry planes was evaluated by their ability to match homologous areas of the face. Results show that the new automatic method is reliable and leads to significantly higher accuracy than the manual method when performed by inexperienced clinicians. In addition, the method performs equally well in difficult trauma situations, where key landmarks are unreliable or absent.

Ex vivo assessment of chemotherapy-induced apoptosis and associated molecular changes in patient tumor samples

BACKGROUND: There are inherent conceptual problems in investigating the pharmacodynamics of cancer drugs in vivo. One of the few possible approaches is serial biopsies in patients. However, this type of research is severely limited by methodological and ethical constraints. MATERIALS AND METHODS: A modified 3-dimensional tissue culture technique was used to culture human tumor samples, which had been collected during routine cancer operations. Twenty tumor samples of patients with non-small cell lung cancer (NSCLC) were cultured ex vivo for 120 h and treated with mitomycin C, taxotere and cisplatin. The cytotoxic activity of the anticancer agents was quantified by assessing the metabolic activity of treated tumor cultures and various assays of apoptosis and gene expression were performed. RESULTS: The proliferative activity of the tissue was maintained in culture as assessed by Ki-67 staining. Mitomycin C, cisplatin and taxotere reduced the metabolic activity of the tumor tissue cultures by 51%, 29% and 20%, respectively, at 120 h. The decrease in metabolic activity corresponded to the induction of apoptosis as demonstrated by the typical morphological changes, such as chromatin condensation and nuclear fragmentation. In addition, activated caspase-3 could be verified in apoptotic cells by immunohistochemistry. To verify functional aspects of apoptosis, the induction of chemotherapy-induced cell death was inhibited with the caspase inhibitor z-VAD.fmk. RNA was extracted from the tissue cultures after 120 h of ex vivo drug treatment and was of sufficient quality to allow quantitative PCR. CONCLUSION: The 3-dimensional ex vivo culture technique is a useful method to assess the molecular effects of pharmacological interventions in human cancer samples in vitro. This culture technique could become an important tool for drug development and for the prediction of in vivo drug efficacy.

Syncope

Syncope is defined as an acute, brief and transient loss of consciousness and postural tone with spontaneous and complete recovery. Neurovascular ultrasound has contributed to elucidate the underlying mechanism of different types of syncope. In routine diagnostic work-up of patients with syncope, however, neurovascular ultrasound is not among the first line tools. In particular, an ultrasound search for occlusive cerebro-vascular disease is of limited value because cerebral artery obstruction is a very rare and questionable cause of syncope. Transcranial Doppler sonography monitoring of the cerebral arteries is useful in the diagnostic work-up of patients with suspicion of postural related, cerebrovascular, cough and psychogenic syncope, and in some cases for differentiating focal epileptic seizures from transient ischemic attacks and migraine with aura.

Effects of a divided high loading dose of caffeine on circulatory variables in preterm infants

BACKGROUND: A single high loading dose of 25 mg/kg caffeine has been shown to be effective for the prevention of apnoea, but may result in considerable reductions in blood flow velocity (BFV) in cerebral and intestinal arteries. OBJECTIVE: To assess the effects of two loading doses of 12.5 mg/kg caffeine given four hours apart on BFV in cerebral and intestinal arteries, left ventricular output (LVO), and plasma caffeine concentrations in preterm infants. DESIGN: Sixteen preterm neonates of <34 weeks gestation were investigated one hour after the first oral dose and one, two, and 20 hours after the second dose by Doppler sonography. RESULTS: The mean (SD) plasma caffeine concentrations were 31 (7) and 29 (7) mg/l at two and 20 hours respectively after the second dose. One hour after the first dose, none of the circulatory variables had changed significantly. One hour after the second caffeine dose, mean BFV in the internal carotid artery and anterior cerebral artery showed significant reductions of 17% and 19% (p = 0.01 and p = 0.003 respectively). BFV in the coeliac artery and superior mesenteric artery, LVO, PCO2, and respiratory rate had not changed significantly. Total vascular resistance, calculated as the ratio of mean blood pressure to LVO, had increased significantly one and two hours after the second dose (p = 0.049 and p = 0.023 respectively). CONCLUSION: A divided high loading dose of 25 mg/kg caffeine given four hours apart had decreased BFV in cerebral arteries after the second dose, whereas BFV in intestinal arteries and LVO were not affected.

Activation of T cells by carbamazepine and carbamazepine metabolites

BACKGROUND: T-cell-mediated hypersensitivity is a rare but serious manifestation of drug therapy. OBJECTIVES: To explore the mechanisms of drug presentation to T cells and the possibility that generation of metabolite-specific T cells may provoke cross-sensitization between drugs. METHODS: A lymphocyte transformation test was performed on 13 hypersensitive patients with carbamazepine, oxcarbazepine, and carbamazepine metabolites. Serial dilution experiments were performed to generate drug (metabolite)-specific T-cell clones to explore the structural basis of the T-cell response and mechanisms of antigen presentation. 3-Dimensional energy-minimized structures were generated by using computer modeling. The role of drug metabolism was analyzed with 1-aminobenzotriazole. RESULTS: Lymphocytes and T-cell clones proliferated with carbamazepine, oxcarbazepine, and some (carbamazepine 10,11 epoxide, 10-hydroxy carbamazepine) but not all stable carbamazepine metabolites. Structure activity studies using 29 carbamazepine (metabolite)-specific T-cell clones revealed 4 patterns of drug recognition, which could be explained by generation of preferred 3-dimensional structural conformations. T cells were stimulated by carbamazepine (metabolites) bound directly to MHC in the absence of processing. The activation threshold for T-cell proliferation varied between 5 minutes and 4 hours. 1-Aminobenzotriazole, which inhibits cytochrome P450 activity, did not prevent carbamazepine-related T-cell proliferation. Substitution of the terminal amine residue of carbamazepine with a methyl group diminished T-cell proliferation. CONCLUSION: These data show that carbamazepine and certain stable carbamazepine metabolites stimulate T cells rapidly via a direct interaction with MHC and specific T-cell receptors. CLINICAL IMPLICATIONS: Some patients with a history of carbamazepine hypersensitivity possess T cells that cross-react with oxcarbazepine, providing a rationale for cross-sensitivity between the 2 drugs.