Role of sulphated tyrosine residue in influencing the biologic activity of human cholecystokinin-33

To evaluate the role of the sulphated tyrosine residue in position 27 in human cholecystokinin-33, parallel bioassay of the sulphated form of human cholecystokinin-33 and the unsulphated form of human cholecystokinin-33 was performed on the pancreatic protein secretion. Both peptides increased the protein output in a dose-related manner. However, the sulphated form possessed a considerably higher activity than the sulphated form. The relative potency of the unsulphated human cholecystokinin-33 compared to that of the sulphated human cholecystokinin-33 (taken as 1.0) was 0.08. From the results, it was suggested that the sulphated tyrosine may play an important role in controlling the activity of the longer molecular forms as well as that of the smaller forms of cholecystokinin.

Effects of intravenous ethanol on hepatic and pancreatic blood flow in dogs

Changes in hepatic and pancreatic blood flow in response to ethanol infusion were determined simultaneously and continuously in anesthetized dogs, using a transit-time ultrasonic flowmeter and a laser-Doppler flowmeter. In addition, the effect of intravenous ethanol on exocrine pancreatic secretion was investigated. With a background infusion of secretin, ethanol (1.3 g/kg body wt) was infused intravenously over a 40-min period. Ethanol infusion significantly increased blood flow in the common hepatic artery (by 49%, at the time of the cessation of ethanol infusion), and this increased flow was maintained for 60 min after the cessation of ethanol infusion. In contrast, blood flow in the portal vein was not altered significantly by ethanol. Pancreatic blood flow and secretion showed no significant difference from those seen in the controls. Our data suggest that intravenous ethanol induces a redistribution of the splanchnic blood flow. The increased hepatic arterial flow seen in response to ethanol may play an important role in preventing ethanol-induced hypoxic liver damage.

Comparative studies on immunoglobulins, complement component (C3), albumin, and immunoglobulin A-containing circulating immune complexes in serum and bile of patients with biliary obstruction

We measured the concentrations of IgA, IgG, IgM, secretory IgA, albumin, complement component (C3), and IgA-containing circulating immune complex (IgA-CIC) in the serum and bile of patients with biliary obstruction. The bile-to-serum (BS) ratio of the concentrations of albumin and IgG increased with the increase in total serum bilirubin. This indicates that the permeability from blood to bile increases with the degree of biliary obstruction, and the blood-bile barrier function breaks down. The BS ratios of IgA and IgM, which are selectively secreted into bile, did not show a significant correlation with total serum bilirubin. The index of the BS ratio to the BS ratio of albumin (BS/BS-Alb index) of IgA and IgM was significantly larger than that of IgG. This indicates that the selective transport of IgA and IgM into bile is present even in patients with obstructive jaundice. Since the BS/BS-Alb index of C3 is larger than that of IgG, and the SGOT correlated directly with the BS ratio of C3, some of the C3 in bile may come from damaged hepatocytes.

Selective accumulation of a new antineoplastic agent, K-18 (human immunoglobulin conjugated melphalan), in Ehrlich carcinoma transplanted in mice

The absorption of K-18 (human IgG conjugated melphalan) through the intestine and its selective accumulation in the tumor were studied. After oral administration of 14C-melphalan and 14C-K-18 to ICR mice with subcutaneously transplanted Ehrlich carcinoma, K-18 was detected at the tumor site by autoradiogram after 48 hrs, but melphalan was not. Immunofluorescence study showed that orally administered K-18 was absorbed from the intestine via both the portal and the lymphatic route. Moreover, immunoperoxidase staining revealed K-18 in cytoplasm of tumor cells, but not in bone marrow cells. These results demonstrate the absorption of K-18 from the intestine after oral administration and its selective affinity for tumor tissue.

[Indications for limited hepatic resection in hepatocellular carcinoma]

Indications for limited hepatic resection in patients with hepatocellular carcinoma were evaluated by retrospective and clinicopathologic analysis of postoperative cases. Particular attention was paid to hepatic functional reserve and long-term prognosis. In our department, in order to estimate the hepatic functional reserve, indocyanine green clearance test (ICG), Child's classification and the oral glucose tolerance test have been applied. For instances, the incidences of hospital deaths were 17% and 19% in cases with an ICG-K value below 0.06 and between 0.06 and 0.08, which were high, compared with 6% and 3% in cases ICG-K values of with 0.08-0.10 and 0.10-0.12. On the other hand, by clinicopathologically analyzing 18 surviving patients or those surviving without recurrence for over 3 years after hepatic resection and 41 cases of small hepatocellular cancer less than 3 cm in diameter, those with capsule formation and without portal tumor invasion, intrahepatic metastasis and capsular invasion had a good long-team prognosis without recurrence even following limited resection. Particularly, patients with a surgical margin of over 1cm between the tumor and cut surface were candidates for long, non-recurrence survival. Form these results, the indications for limited hepatic resection for hepatocellular carcinoma were considered to be on ICG-K value of less than 0.08 in hepatic function and cases without venous invasion and extracapsular tumor invasion. In other cases, it is recommended that limited resection should be followed by multidisciplinary treatment.

[Immunotherapy of gastric cancer]

Two immunotherapeutic methods were developed as adjuvant therapy for gastrointestinal malignancies, one using oral administration of a streptococcal preparation, OK-432, and the other with adoptive immunotherapy (AIT), local transfer of IL2-cultured and autologous lymphocytes, combined with local preadministration of OK-432. Tsuchitani and Nio in our laboratory have revealed experimentally that oral OK-432 stimulates tumor-specific and non-specific immune mechanisms of gut-associated lymphoid tissues and inhibits the growth of some murine syngeneic tumors that were transplanted into cecal patches. The clinical efficacy of oral OK-432 on gastric cancer patients has been examined by a controlled randomized trial involving a total of about 1000 cases. Oral OK-432 (5KE, once a week) was revealed to be significantly effective in curatively resected group but not effective in non-curatively resected group. Ten consecutive patients with peritoneal dissemination of gastric cancer were treated with intraperitoneal OK-432 and AIT. AIT was performed by transferring autologous lymph node-lymphocytes cultured for 13 days with crude IL2 and tumor-extract. The survival of the treated patients was significantly longer (50% survival period exceeded 1 year) than that of historical control (95 cases, 50% survival period was 5 months). These immunotherapeutic methods are expected to be useful for multidisciplinary therapy of gastric cancer by a combination of each method with other therapeutic methods.

The effect of splenectomy on antibody response to lipopolysaccharide (E. coli) immunization

The influence of splenectomy on the antibody response to lipopolysaccharide (LPS: E. coli 0128:B12) was investigated in mice. Splenectomy had little effect on the primary response to the LPS. However, the level of IgG anti-LPS antibodies of splenectomized mice was significantly lower than that of sham-operated mice when the mice were immunized 1, 3, and 7 days after the operation and reimmunized 7 days after the first immunization. There was no significant difference in those immunized 30 days after the operation and reimmunized 7 days later. In mice immunized before splenectomy and reimmunized 30 days after splenectomy, the level of IgG anti-LPS antibodies was low, even in the mice splenectomized 30 days after primary immunization. Our results indicate that splenectomy impairs the antibody response to lipopolysaccharides.

Effect of synthetic human cholecystokinin-33 on exocrine pancreas

Synthetic human cholecystokinin-33 was first evaluated with respect to the biological activity on the pancreatic protein secretion. Human cholecystokinin-33 increased pancreatic protein secretion in a dose-related manner. The relative molar potency of this substance compared to that of synthetic cholecystokinin-8 (taken as 1.0) was 0.92. This study supports the concept that longer molecular forms of cholecystokinin are quantitatively important mediators of biological action of cholecystokinin on the pancreas.

[Statistical analysis of pathological factors influencing prognosis of colorectal carcinoma]

The pathological and follow-up data of 503 patients with colorectal carcinoma have been analysed to assess quantitatively prognostic values of 16 pathological factors and their sub-categories with aid of computer. Besides the routine procedure, Cox's proportional hazards model, Hayashi's quantification theory II, III, Akaike's information criteria, Kendall's rank correlation, relative risk, and linear trend test were used. Regardless of methods used, liver metastasis, peritoneal dissemination, lymph nodes metastasis, depth of penetration, venous and lymphatic invasion emerged as powerful prognostic variables. Most of the analyses indicated that venous invasion contained the largest amount of prognostic information including that of long-term survival. When venous invasion is graded not only by the number of veins involved but also by the depth of invasion, its prognostic capability was comparable with that of staging systems. The values of relative risks calculated for the factors' sub-category were more closely associated with prognosis than five-year survival rates or median survival rates, thus permitting detailed comparison of different categories. We conclude the modern statistical methods are indispensable tool for prognostic factor analysis.

Circulating immune complex, endotoxin, and biliary infection in patients with biliary obstruction

Immunoglobulin A-containing circulating immune complexes, immunoglobulin G-containing circulating immune complexes, and endotoxin were measured in the sera of patients with obstructive jaundice. The bile of patients with percutaneous transhepatic biliary drainage was also cultured for bacteriologic studies. There was a significantly positive correlation between the endotoxin levels and both immunoglobulin A-containing circulating immune complex and immunoglobulin G-containing circulating immune complex. The endotoxin levels of the patients with gram-negative infections were significantly increased compared with those of the patients with sterile cultures. The immunoglobulin G-containing circulating immune complex levels of the patients with bacteria in bile were significantly increased compared with those of the patients with sterile cultures. The immunoglobulin A-containing circulating immune complex levels of the patients with bacteria in bile were slightly increased, but the difference did not reach statistical significance. These results indicate that one of the causes of increased circulating immune complex levels may be endotoxemia in combination with biliary infection in patients with biliary obstruction.

[Development of the surgical therapy of malignant liver tumors]

The development of surgical treatment for malignant liver tumor was reviewed. The developmental process can apparently be divided into four periods. The first period up to 1968 is when surgical trials for liver tumors were started, and much effort was directed toward the establishment of systematic procedures for hepatic resection. The second period starts form 1968, when the Liver Cancer Study Group of Japan was inaugurated to organize investigators participating in the treatment of, and basic research on liver tumors. During this period, the basis for contemporary surgical treatment and sophisticated means of diagnosis such as such as determination of serum AFP level, selective angiography, and liver scintigraphy were established. This period came to an end around 1977 when computed tomography and ultrasonography were developed and popularized. In the third period, a variety of procedures for hepatic resection such as lobectomy, segmentectomy and newly devised echo-guided sub-segmentectomy were performed, based on the close evaluation of hepatic functional reserve. However, analysis of the outcome in patients who had undergone surgery alone suggested the limitations of surgical treatment, leading to the advent of the 4th period two to three years ago. The strategy of therapy in the 4th period has been aimed at multidisciplinary treatment such as transarterial embolization, intratumoral injection of tumoricidal agents, radiotherapy, regional chemotherapy and immunotherapy.

The role of plasma secretin during starvation in dogs

Plasma secretin levels were measured during a 72-hour starvation period in dogs. Plasma secretin rose significantly and insulin levels fell significantly during starvation. Intravenous glucose loading at the end of the 72-hour starvation period suppressed plasma secretin and free fatty acid levels with a concomitant rise of glucose and insulin levels. These findings suggest that secretin might be regulated by plasma glucose and insulin levels and might play a role in lipolysis during starvation.

Exocrine and endocrine stomach after gastrobulbar preserving pancreatoduodenectomy

Exocrine and endocrine stomach was studied serially in 13 patients who had gastrobulbar preserving pancreatoduodenectomy (GPPD). In most of them, acid output temporarily increased just after operation but recovered. Gastrin response level decreased transiently but returned to the preoperative level. A negative correlation was observed between the acid and gastrin levels, which suggests that the negative feedback mechanism between parietal cells and G cells was maintained. Acid and gastrin levels in GPPD were higher than those in conventional pancreatoduodenectomy (cPD) but not remarkably different from those of the controls. No peptic ulcer was detected after the operation. These findings indicated that GPPD poses little problem concerning offensive factors. Postoperative ulcer formation is considered to be prevented by the authors' procedure, which is devised to best preserve defensive mechanisms so that duodenectomy is minimized and the gastrointestinal continuity is reconstructed physiologically from mouth to anus by end-to-end duodenoduodenestomy, end-to-side pancreatojejunostomy, and end-to-side choledochojejunostomy.

[Breast cancer-specific immunity evaluated by a new in vitro method--IL-2 enhanced MLTR]

Peripheral blood lymphocytes from 81 patients with breast cancer were stimulated in vitro with solubilized sonicated autologous tumor extract as an antigen source . The significance of tumor-stimulation (mixed lymphocyte tumor reaction; MLTR) was evaluated with or without the addition of interleukin-2 (IL-2,90 U/ml). As a result, MLTR with the addition of IL-2 (IL-2 enhanced MLTR) showed a higher significance even at a stimulation index (S.I.) of 1.5 than MLTR without IL-2. The values of S. I. in IL-2 enhanced MLTR in preoperative cancer patients were the highest in the patients without lymph node metastasis (n0). The patients with advanced lymph node metastasis (n2) showed a lower response preoperatively but their response was similar to that of the n0-patients 1 to 2 was after operation. These difference were not observed in the blastogenic response to IL-2. These results suggest that IL-2 enhanced MLTR is a useful method to assess the tumor-specific immunological status of the cancer patients.

Plasma levels of secretory IgA in patients with gastric cancer

The levels of plasma secretory IgA were measured in patients with gastric cancer and found to be slightly higher (9.6 +/- 6.2 micrograms/ml) than those in healthy controls (7.0 +/- 2.6 micrograms/ml, 0.05 less than P less than 0.1). Secretory IgA levels in those with hepatic metastases (19.7 +/- 12.2 micrograms/ml) were significantly higher than those in patients without hepatic metastases (P less than 0.001). In the latter, there was no significant relationship between plasma secretory IgA levels and the deepest layer of cancerous invasion or lymph node metastases. The secretory IgA levels in cases of well differentiated tubular adenocarcinoma were significantly higher than those with poorly differentiated adenocarcinoma (P less than 0.05). Although there is small diagnostic value in the detection of gastric cancer by measuring the levels of secretory IgA, high levels of secretory IgA in gastric cancer patients may be indicative of the presence of hepatic metastases.

Sequence of an intestinal cDNA encoding human gastric inhibitory polypeptide precursor

Gastric inhibitory polypeptide (GIP) is a 42-amino acid hormone that stimulates insulin secretion in the presence of glucose. Complementary DNA clones encoding human GIP were isolated from a library prepared with RNA from duodenum. The predicted amino acid sequence indicates that GIP is derived by proteolytic processing of a 153-residue precursor, preproGIP. The GIP moiety is flanked by polypeptide segments of 51 and 60 amino acids at its NH2 and COOH termini, respectively. The former includes a signal peptide of about 21 residues and an NH2-terminal propeptide of 30 amino acids. GIP is released from the precursor by processing at single arginine residues. There is a region of nine amino acids in the COOH-terminal propeptide of the GIP precursor that has partial homology with a portion of chromogranin A as well as pancreastatin.

Effect of synthetic neuromedin U-8 and U-25, novel peptides identified in porcine spinal cord, on splanchnic circulation in dogs

Two novel peptides which exert a potent stimulant effect on rat uterus smooth muscle have recently been identified in porcine spinal cord. These peptides designated neuromedin U-8 and U-25 have been reported to exert a hypertensive effect in rats. But further biological activities are not known. In the present study, the effect of these peptides on blood flow in portal vein, superior mesenteric artery and pancreatic tissue and on blood pressure were examined in dogs, utilizing recently developed ultrasonic transit time volume flow meter and laser Doppler flow meter. Neuromedin Us potently reduced blood flow in superior mesenteric artery. The minimum reductions could be observed even at very small doses of neuromedin U-25 (32 fmol/kg) and U-8 (90 fmol/kg), while the maximal reductions of 48.4 and 51.0% were attained at the doses of 320 pmol/kg (U-25) and 900 pmol/kg (U-8), respectively. These peptides also reduced portal vein blood flow, and the maximal reductions of 42.1 and 37.2% were attained at the doses of 32 pmol/kg (U-25) and 90 pmol/kg (U-8), respectively. On the other hand, blood flow in pancreatic tissue increased slightly with the maximal increases of 13.8% at 3.2 pmol/kg (U-25) and 11.8% at 9 pmol/kg (U-8), respectively. The maximal increases of blood pressure were 5.2% at 320 pmol/kg (U-25) and 4.3% at 90 pmol/kg (U-8). Furthermore, neither neuromedin U-25 nor U-8 influenced the axillary artery blood flow, suggesting their selective effect on splanchnic blood flow. Because of the potent and probably selective activity on splanchnic circulation, neuromedin U-25 and U-8 may well be recognized as physiologically significant novel neuropeptides or hormones.

Suppression of rpoH (htpR) mutations of Escherichia coli: heat shock response in suhA revertants

Temperature-resistant pseudorevertants were isolated from rpoH (htpR) mutants of Escherichia coli K-12 that cannot grow at a high temperature owing to a deficiency in sigma 32 required for the induction of heat shock proteins. Among them was a class of revertants carrying a suppressor mutation, designated suhA, that suppressed all the nonsense and missense rpoH mutations tested. suhA is located at 77 min, about 1 min away from rpoH, on the genetic map. In contrast to the rpoH mutants, the suhA revertants that contained both rpoH (nonsense) and suhA mutations were fully or partially proficient in the induction of heat shock proteins upon exposure to a high temperature. Under these conditions, transcription from two heat shock promoters as determined by operon fusion was transiently activated. In one of the rpoH(Am) suhA revertants studied in detail, an increase in temperature caused the synthesis of significant amounts of sigma 32, accompanied by increased stability and accumulation of rpoH mRNAs. On the other hand, the same mutation (suhA6) only weakly suppressed the rpoH deletion mutant; however, two of the major heat shock genes, dnaK and groE, were apparently induced in the absence of sigma 32. Thus, suhA6 seems to bring about the induction of heat shock genes by at least two mechanisms, one increasing the level of sigma 32 synthesis, and the other activating some transcription factor other than sigma 32.