[Perioperative alterations in polymorphonuclear leukocyte function mediated by protein kinase C]

To characterize the perioperative alterations in polymorphonuclear leukocytes (PMN) function mediated by protein kinase C, we studied twenty six patients undergoing gastrointestinal surgery. Seventeen patients with thoracic esophageal cancer were underwent total thoracic esophagectomy through a right thoracotomy (severe surgical stress group). Nine patients underwent cholecystectomy (slight surgical stress group). Measurement of O2- production capacity was used as a reflection of the activity of NADPH oxidase, and the activity of myeloperoxidase-H2O2-halide system was evaluated using luminol-dependent chemiluminescence. O2- production stimulated by phorbol 12-myristate 13-acetate (PMA) was suppressed, reaching a minimum on POD 3. On the other hand, luminol dependent chemiluminescence increased significantly after surgery, reached a maximum on POD 3. These alterations were more remarkable in the severely stressed patients. These results suggest that postoperative PMN signal transduction mechanisms, mediated by protein kinase C, may activate myeloperoxidase-H2-O2-halide system but suppress NADPH oxidase system dependently of the degree of surgical stress, revealing a differential effect of protein kinase C activation on PMN microbicidal activity.

Defense effects of a traditional Chinese medicine (sho-saiko-to) against metabolic disorders during endotoxemia; approached from the behavior of the calcium ion

The present study was carried out as an approach from intracellular Ca2+ to clarify the preventive effects of a traditional Chinese medicine, Sho-saiko-to (Kampo prescription, TJ-9), against various metabolic disorders during endotoxemia. In this experiment, we estimated the cytosolic-free Ca2+ concentration ([Ca2+]i) in liver single cells using a photonic microscope system. The [Ca2+]i in a single liver cell of endotoxin (6 mg/kg, i.p.)-injected mice was greater at 18 h post-intoxication than that in the control, whereas the administration of endotoxinin to TJ-9 (500 mg/kg/d, p.o.)-pretreated mice resulted in a markedly lower level of [Ca2+]i than that in endotoxin-treated mice. In the mice pretreated with TJ-9, the CA(2+)-ATPase activity in liver plasma membrane 18 h after endotoxin injection was markedly increased as compared to that in the endotoxin-treated mice. By contrast, the Ca(2+)-ATPase activity in liver mitochondria was lower in endotoxemic mice pretreated with TJ-9 than in mice given endotoxin alone. State 3 respiration and the respiratory control index (RCI), which are the parameters of mitochondrial function, were 41% and 35% lower, respectively, in the liver of mice given endotoxin than those levels in the control. However, the levels of state 3 and RCI in endotoxin-TJ-9-treated mice were markedly increased as compared to those of the endotoxin-treated mice. These findings suggest the protective effect of TJ-9 in the damage of liver mitochondrial function in endotoxin-poisoned mice.(ABSTRACT TRUNCATED AT 250 WORDS)

[Lipid composition of Helicobacter pylori]

In H. pylori, we examined the composition of total lipids. In thin-layer chromatography, three kinds of glycolipids were detected, which were named as G-1, G-2 and G-3. G-3 contained phosphates in addition to sugars. Total lipids consisted of 6.0% neutral lipids (weight %), 20.6% glycolipids (G-1, G-2) and 73.4% phospholipids (including G-3). Total glycolipids were approximately 25% of total lipids. After methanolysis, cholesterol was detected in the hexane extractable fraction and glucose was detected by GLC in the methanol fraction after trimethylsilylation, in all glycolipids. Therefore, these glycolipids are cholesteryl glycosides. Cholesteryl glycosides are found very rarely in bacteria, and have been detected only in a few species of mycoplasmas and spirochetes.

[Experimental animal models in Mongolian gerbils and mice]

Helicobacter pylori is an emerging candidate agent for the genesis of chronic gastritis and peptic ulcer. There have been many challenges to establish an experimental infection with H. pylori in animals. In recent, several studies reported for animal infection with this organism. One of them was the study using urinary system. The study indicated the ability of H. pylori to induce inflammation without significant low pH condition. Experimental infection in Mongolian gerbils showed that H. pylori could colonize on the surface of the gastric mucosa in animals without human. The study of nude mice by Karita et al. showed several valuable facts concerning the relation between bacterial pathogenicity and potential of bacterial colonization in stomach. The study in which remaining of bacteria was extended showed that colonization of H. pylori was affected by bacterial flora in the stomach.

[Assessment of left ventricular contractility (Emax) and arterial load (Ea) in humans by transesophageal echocardiography and radial artery pressure tracing]

We determined both the slope of the left ventricular end-systolic pressure-volume relation (Emax), which is a measure of contractility independent of loading conditions, and the slope of the arterial end-systolic pressure-stroke volume relation (Ea), which is a measure of arterial load independent of ventricular function, in 10 patients undergoing elective noncardiac surgery. Left ventricular end-systolic volume (Ves) was measured by transesophageal echocardiography and instantaneous left ventricular end-systolic pressure (Pes) was estimated from the dicrotic notch pressure in the radial artery. Emax was calculated during afterload reduction (nicardipine 30 micrograms.kg-1 iv), and the correlation of Emax to either Pes/Ves ratio or MAP (mean arterial blood pressure)/Ves ratio was accomplished in order to investigate whether these indices were clinically useful measurements of ventricular function or not. Ea was also calculated from the data obtained before and 2-3 min after nicardipine iv. The averaged Emax and x-axis intercept (Vo) were 3.11 mmHg.ml-1 and -3.8 ml, respectively. The correlation coefficient obtained between Emax and Pes/Ves was 0.96, and that obtained between Emax and MAP/Ves was 0.97. Ea decreased significantly (P < 0.05) following intravenous nicardipine, demonstrating a decreased arterial load. The direction of changes in Ea was similar to that reported previously in systemic vascular resistance. From these results, we conclude that measurement of Emax (or Pes/Ves, MAP/Ves) and Ea using transesophageal echocardiography and radial artery pressure tracing is feasible and these are a useful tool to estimate left ventricular performance and arterial load during surgery.

A case of Canavan disease: the first biochemically proven case in a Japanese girl

Canavan disease (CD) has only been diagnosed on autopsy or brain biopsy, however, specific biochemical markers, such as N-acetylaspartic acid (NAA) and aspartoacylase activity, have recently been described in CD. We report a case of CD having the above biochemical markers. High levels of NAA were found in her urine, serum and CSF. Fibroblasts did not exhibit aspartoacylase activity. Clinically, she presented progressive psychomotor retardation, cerebellar signs, pyramidal signs and relative megalencephaly. CT and MRI showed findings of leukodystrophy. The evoked potentials showed widespread involvement in the brainstem. Magnetic resonance spectra showed a high level of NAA in the white matter. In Japan, this case is the first of CD determined on the basis of biochemical markers.

Preventive effects of a traditional Chinese medicine (sho-saiko-to) against oxygen toxicity and membrane damage during endotoxemia

The preventive effects of a traditional Chinese medicine Sho-saiko-to (Kampo prescription, TJ-9) were determined from oxygen toxicity and membrane damage in liver during endotoxemia. The liver lipid peroxide level and xanthine oxidase activity 18 h after administration of endotoxin (6 mg/kg, i.p.) to TJ-9 (500 mg/kg/d, p.o.)-pretreated mice were markedly lower than that in endotoxin-treated mice, whereas the administration of TJ-9 significantly increased superoxide dismutase and glutathione peroxide activities in liver of endotoxin-injected mice. In the mice pretreated with a TJ-9, the levels of alpha-tocopherol and nonprotein SH in liver tissue 18 h after endotoxin injection were markedly increased as compared to those in endotoxin-treated mice. Leakages of acid phosphatase and lactate dehydrogenase isozyme in serum were markedly lower in endotoxin-TJ-9-treated mice than those in mice given endotoxin. The administration of TJ-9 clearly prevented the membrane protein damage arising from endotoxin challenge. Kampo prescription Sho-saiko-to thus appears to protect the liver plasma membrane from injury by free radicals which occur in a tissue ischemic state during endotoxemia.

Synthesis and conformational study of peptides possessing helically arranged delta ZPhe side chains

Z-Dehydrophenylalanine (delta ZPhe) possessing four oligopeptides, Boc-(L-Ala-delta ZPhe-Aib)n-OCH3 (n = 1-4: Boc, t-butoxycarbonyl; Aib, alpha-aminoisobutyric acid), were synthesized, and their solution conformations were investigated by 1H-nmr, ir, uv, and CD spectroscopy and theoretical CD calculation. 1H-nmr (the solvent accessibility of NH groups) and ir studies indicated that all the NH groups except for those belonging to the N-terminal L-Ala-delta ZPhe moiety participate in intramolecular hydrogen bonding in chloroform. This suggests that the peptides n = 2-4 have a 4-->1 hydrogen-bonding pattern characteristic of 3(10)-helical structures. The uv spectra of all these peptides recorded in chloroform and in trimethyl phosphate showed an intense maximum around 276 nm assigned to the delta ZPhe chromophores. The corresponding CD spectra of the peptides n = 2-4 showed exciton couplets with a negative peak at longer wavelengths, whereas that of the peptide n = 1 showed only weak signals. Theoretical CD spectra were calculated for the peptides n = 2-4 of several helical conformations, on the basis of exciton chirality method. This calculation indicated that the three peptides form a helical conformation deviating from the perfect 3(10)-helix that contains three residues per turn, and that their side chains of delta ZPhe residues are arranged regularly along the helix. The center-to-center distance between the nearest phenyl pair(s) was estimated to be approximately 5.5 A. The chemical shifts of the delta ZPhe side-chain protons (H beta and aromatic H) for the peptides n = 2-4 indicated anisotropic shielding effect of neighboring phenyl group (s); the effect also supports a regular arrangement of the delta ZPhe side chains along the helical axis.

Decline in plasma membrane Ca(2+)-ATPase activity and increase in cytosolic-free Ca2+ concentration of endotoxin-injected mice livers

The present study describes the activity of Ca(2+)-ATPase in liver plasma membrane and cytosolic-free Ca2+ concentration ([Ca2+]i) in an individual vital cell in mouse liver 18 h after endotoxin administration. Ca(2+)-ATPase activity in liver plasma membrane in the poisoned mice was markedly decreased to 28% of that in the control. The membrane protein damage in liver was found mostly in the molecular weight (M.W.) regions near 60,000-150,000 in endotoxemic mice, and was markedly injured near 140,000 (M. W. of Ca(2+)-ATPase in liver plasma membrane). The level of [Ca2+]i in liver cells in endotoxin-poisoned mice was greater at 18 h postintoxication than that of the control. These findings suggest the possibility that the depression of Ca(2+)-ATPase activity in liver plasma membrane in mice may contribute to membrane damage caused by the endotoxin, and that the increase of [Ca2+]i in liver cytoplasm may partially explain various endotoxin-induced metabolic disorders.

Demonstration of antigen-specific immune response against Streptococcus sanguis

The genetic control of Streptococcus sanguis antigen response was studied. Mice sensitized with inactivated S. sanguis organisms antigen-injected at the base of the tail developed footpad swelling. Those with an I-Ak,q,r region of H-2 showed a strong footpad response, whereas those with an I-Ab,d,s region showed a weak response to S. sanguis cell wall antigen. Footpad response was mediated by CD4+,8- T cells by using in vitro monoclonal antibody treatment. Similar evidence of genetic control was obtained with an in vitro T cell proliferation assay. However, quantitation of antibodies against S. sanguis showed that antibody production was not controlled by H-2. These results indicated that both in vivo footpad swelling and in vitro T cell proliferation responses were functions of helper (CD3+,4+,8-) T cells and controlled by the I-A region of H-2.

Effect of KB-2796, a new diphenylpiperazine Ca2+ antagonist, on glutamate-induced neurotoxicity in rat hippocampal primary cell cultures

The effects of the novel calcium channel antagonist KB-2796, other calcium channel antagonists, an N-methyl-D-aspartate (NMDA) antagonist, non-NMDA antagonists, Mg2+, a Ca(2+)-chelator and a calcium channel agonist on neurotoxicity induced by a 10-min application of 100 microM glutamate were studied in rat hippocampal primary cell cultures. KB-2796 (0.1 and 1 microM), flunarizine (1 microM), nimodipine (10 microM), MK-801 (0.01-1 microM), Mg2+ (10 mM) and EGTA (10 mM) significantly prevented the neurotoxicity, but 6-cyano-7-nitro-quinoxalinedione (CNQX) (10 microM) and 6, 7-dinitro-quinoxalinedione (DNQX) (10 microM) did not. Bay K 8644 (10 and 100 nM) enhanced the neurotoxicity. These findings indicate that KB-2796 protects the neuronal cell from the glutamate-induced neurotoxicity, presumably by blocking the Ca2+ influx into brain neurons.

[Nosocomial infections]

A big problem of nosocomial infections is some refractory infections, so that present important nosocomial infections are deep infections by MRSA and weakly virulent gram-negative bacilli such as Pseudomonas aeruginosa, which are not susceptible to many antimicrobial agents. It is also noteworthy that MRSA can infect to both immunonormal and immunocompromised patients, although clinical signs of that infection are much more severe in the latters. On the other hand, weakly virulent bacilli can infect to only immunocompromised patients. Immunocompromised states are divided into two categories, namely general and local deficiencies. The mechanism of general immunodeficiency is mainly depend upon leukopenia or diminishment of phagocytic activity of them, and that of local immunodeficiency is bases on formation of biofilms which protect bacteria from phagocytosis and killing effect of antimicrobial agents. In this paper, it is emphasized that both countermeasure for nosocomial infections and adequate use of antimicrobial agents or immunomodulators are necessary to decrease number of patients with hospital infections.

Development and evaluation of capture enzyme-linked immunosorbent assays for detection of immunoglobulin G and M antibodies to group A streptococcal antigens

Capture enzyme-linked immunosorbent assays (ELISAs) were developed to detect immunoglobulin G and M antibodies to group A streptococcal (GAS) antigens, streptolysin O, streptokinase, and group A carbohydrate. The sensitivities and the specificities of the IgM capture ELISAs to each GAS antigen were high enough to distinguish the patients with GAS infections (diagnosed as GAS pharyngitis or scarlet fever) from the control groups (healthy people and patients with pharyngitis from whom GAS could not be isolated). On the other hand, the specificities of the IgG capture ELISAs were not very effective in diagnosis of GAS infections. When the capture ELISA and an indirect ELISA detecting IgM antibodies to group A carbohydrate were compared, false-positive reactions due to rheumatoid factor occurred in the indirect ELISA, but did not occur in the capture ELISA. These results indicate that the capture ELISA works better than the indirect ELISA in detecting the IgM antibody, and that the IgM capture ELISA to GAS antigen provides a rapid and highly reliable serodiagnosis for GAS infections employing only a single serum.

[Biopsy diagnosis for gastric lymphoma--usefulness and limitation of AgNOR staining]

Sixteen cases of resected gastric lymphoma were classified into 3 groups based on the easiness of the diagnosis; mucosa associated lymphoid tissue lymphoma (MALToma) 4 cases, superficial type lymphoma 5 cases and ulcerative (mass forming) type lymphoma 7 cases. Sixty seven of pre-operative biopsy reports and 44 biopsy specimens were analyzed. Although lymphoma cells retrospectively obtained in 92%, 69% and 88% of biopsy specimens, the definite diagnosis was only made in 7%, 24% and 38% of endoscopic biopsy. Mean AgNOR number per nucleus in resected specimens were as follows; chronic inflammation 1.20 +/- 0.02, MALToma 1.39 +/- 0.23, superficial lymphoma 2.44 +/- 0.50 and ulcerative lymphoma 3.44 +/- 0.55. They correlated well to proliferating cell nuclear antigen positive rates (r = 0.776, p < 0.01). Supposing that lesions showing 2.0 or more AgNOR dots in biopsy specimens are lymphoma, diagnostic rate improves to 69% in superficial lymphoma and to 88% in ulcerative lymphoma. Biopsy specimens from MALToma never showed 2.0 or more AgNOR dots. These results suggest that application of AgNOR to the biopsy diagnosis is useful in superficial and ulcerative lymphoma and has limitation in MALToma of the stomach.

[Effectiveness of a community-based education program on blood pressure reduction for cardiovascular disease prevention]

To evaluate the effectiveness of lifestyle modification community-based programs on blood pressure reduction, blood pressure changes were examined according to frequency of attendance at these adult classes. The subjects were 1,017 men and women aged 40-69 who participated in a survey from 1985 to 1987, whose blood pressure was > = 140 mmHg for systolic, and/or > = 90 mmHg for diastolic and/or with antihypertensive medication use in the earlier 1981-1984 surveys. Adult classes were conducted eleven times between 1982 and 1987, emphasizing primarily reduction of salt intake, weight control if necessary, and alcohol modification. Blood pressure changes between 1981-1984 and 1985-1988 were examined in relation to the number of classes attended, stratified by antihypertensive medication use. In the group with no medication use in both surveys (n = 347), there was a significantly larger decline in systolic and diastolic blood pressures with an increase in the number of classes attended (p < 0.001). A similar trend was observed in other groups: a starting medication group (n = 198), a quitting medication group (n = 100) and a continuous medication group (n = 372). The blood pressure trend in the no medication group remained significant after controlling for age, initial blood pressure, follow-up years and the number of follow-up screenings attended. For the no medication group, there was no significant association between the number of classes attended and changes in relative weight index and alcohol intake. The proportion of persons reporting dietary modification of reduction in salt was larger, and mean 24-hour urine sodium excretion was smaller, with increasing number of classes attended in the 1985-1988 surveys. Furthermore, the proportion of persons who were able to reduce salt intake between the two survey periods was higher with an increase in the number of classes attended. Mean urine sodium excretion was smaller in those who reported reduction of salt intake than those who did not. Although this study is not a randomized controlled trial, these results suggest that a community-based education program of adult classes can be effective in reduction of blood pressure levels through modification of diet.

Urinary excretion of N-acetyl-beta-glucosaminidase and beta-galactosidase by patients with epilepsy

In an effort to detect active renal tubular dysfunction in 74 epileptic patients being treated with antiepileptic drugs (AEDs), we measured the urinary activity of two lysosomal enzymes, N-acetyl-beta-glucosaminidase (NAG) and beta-galactosidase (beta-gal). The heterogeneity of the types of seizures and therapeutic regimens permitted us to examine the potential differences in AED effects. We also examined the chronological changes in the urinary excretion rates of NAG and beta-gal in 132 healthy controls, aged 3 months to 37 years. Increased NAG excretion rates (defined as > or = 2 S.D. compared with age-matched controls) were found in 36.5% of the patients. Valproic acid was highly associated with this increase, and in combination with potassium bromide caused the highest levels of NAG excretion. Among the patients taking carbamazepine, only 11.1% exhibited high levels of NAG in urine. Children under 1 year of age showed higher levels of NAG excretion than older patients. In spite of the abnormally high urinary excretion of NAG, we could not detect any signs of renal dysfunction by urinalysis and measurement of blood urea nitrogen and serum electrolytes. We cannot exclude the possibility that the increased levels of urinary NAG in epileptic patients might be due to renal tubular enzyme induction by AEDs.

Perioperative alterations in polymorphonuclear leukocyte function of gastrointestinal surgery

To characterize the alteration of perioperative polymorphonuclear leukocytes (PMNs) function in surgical stress, we studied twenty six patients undergoing gastrointestinal surgery. Seventeen patients with thoracic esophageal cancer underwent total thoracic esophagectomy through a right thoracotomy (severe surgical stress group). Nine patients underwent cholecystectomy (slight surgical stress group). Phagocytic oxygen-dependent microbicidal activity in the esophagectomy patients significantly increased postoperatively, by measuring O2- production (35.3 +/- 7.0 nmol/10(6) cells/ml/20 min on postoperative day 1 vs. 28.6 +/- 6.2 preoperatively, p < 0.01) and luminol-dependent chemiluminescence (99.5 +/- 29.9 x 10(5) cpm/10(5) cells on postoperative day 3 vs. 67.5 +/- 12.8 preoperatively, p < 0.01). On the other hand, only a slight change was seen in the cholecystectomy patients. We conclude that the postoperative PMN function in terms of oxygen-dependent microbicidal activity significantly increases when the degree of surgical stress is sufficient. In order to gain insight into the mechanism of PMN activation, we specifically analyzed the expression of complement receptors. Up-regulation of complement receptors were seen in the esophagectomy patients, which parallels the activation of PMN microbicidal activities. It was suggested that phagocytic PMN function in severe surgical stress significantly increases postoperatively, in part, based on the upregulation of cell surface complement receptors.

Intestinal disaccharidases in the house musk shrew, Suncus murinus: occurrence of sucrase deficiency

1. Disaccharidase activities of the small-intestinal brush border membrane were studied in six laboratory lines of the house musk shrew, Suncus murinus. 2. Sucrase activity was detected in all shrews of one line, but not in any shrew of three lines. In the other two lines it was found in some shrews, but not in the others. 3. Maltase, isomaltase, trehalase and lactase activities were found in all shrews of all the lines examined. 4. Sucrase was normally associated with isomaltase to form an enzyme complex. 5. Detergent-solubilized isomaltase, whether associated with sucrase or not, was inhibited by antibodies against rabbit sucrase-isomaltase to almost the same extent as the rabbit one, suggesting that isomaltase is not affected by a mutation(s) in sucrase.

[Plasma lipid peroxides in the operation of esophageal cancer]

Lipid peroxides are formed by autooxidation of polyunsaturated fatty acids found primarily in cell membranes. An increase level of lipid peroxides in the tissue therefore reflects membrane damage. We reported that water immersion restraint rats caused significant increase of gastric mucosal lipid peroxide which reflected on gastric mucosal injury. The gastric mucosal injury is also known as the post-operative complication due to physical stress. So we studied plasma lipid peroxide and its related substances in the operation of esophageal cancer. Lipid peroxide levels increased significantly in pre- and post-operation but temporal decrease was found during the operation. Vitamin E is thought to be an important structural component of biologic membranes and is believed to act as a free radical scavenger in lipid peroxidation. Vitamin E also increased in the patients of esophageal cancer and decreased significantly during the operation. Superoxide dismutase changed frequently during the operation but there was no deficit tendency in its changes. Catalase levels also changes frequently and showed temporal but statistical elevation after the operation. These results indicated that lipid peroxidation may contribute to the development of organic damage in the operation of esophageal cancer.

[Hemorheological effect of KB-2796, a new Ca2+ antagonist]

The hemorheological effect of KB-2796, 1-[bis(4-fluorophenyl)methyl]-4-(2,3,4,-trimethoxybenzyl)piperazine dihydrochloride, was studied in guinea pigs and rabbits in comparison with those of flunarizine (FNZ) and pentoxifylline (PXF). KB-2796 and FNZ at 10-100 microM dose-dependently prevented crenation of rabbit erythrocytes induced by the Ca2+ ionophore A23187. After incubation of guinea pig whole blood at 37 degrees C, blood micropore-filterability decreased and blood viscosity increased with the progress of erythrocyte crenation. After a 4-hr incubation, KB-2796 inhibited erythrocyte crenation and decreased blood filterability at a concentration of 30 microM, and it increased blood viscosity at 10 microM. Treatment with FNZ (30 microM) and PXF (100 microM) also inhibited erythrocyte crenation and decreased blood filterability. Intravenous administration of KB-2796 at 3 mg/kg significantly inhibited the decrease of blood micropore-filterability after occlusion of the bilateral carotid arteries in rabbits. Although FNZ (3 mg/kg, i.v.) had no effect, PXF (3 mg/kg, i.v.) produced significant inhibition. These results suggest that KB-2796 prevents increase of blood viscosity and decrease of blood filterability by inhibiting the crenation of erythrocytes and suggest that this effect may be useful for the improvement of hemorheology in ischemic disease.