Interleukin-12 gene expression in human monocyte-derived macrophages stimulated with Mycobacterium bovis BCG: cytokine regulation and effect of NK cells

Macrophage-derived interleukin-12 (IL-12) is essential for the activation of a protective immune response against intracellular pathogens. In this study, we examined the regulation of IL-12 mRNA expression by monocyte-derived macrophages (MDM) in response to Mycobacterium bovis BCG stimulation. A reverse transcription-PCR assay detected p40 mRNA of IL-12 at 3 h and showed a peak at 6 to 12 h with a subsequent decline. Semiquantitation of mRNA levels by competitive PCR revealed that pretreatment with gamma interferon (IFN-gamma) amplified the expression approximately 100-fold, while pretreatment with tumor necrosis factor alpha (TNF-alpha) or granulocyte-macrophage colony-stimulating factor augmented this expression about 10-fold. In contrast, pretreatment with IL-10 and IL-4 inhibited IL-12 mRNA expression. These results were further confirmed by measuring the p70 bioactive protein level in each conditioned medium by an enzyme-linked immunosorbent assay. Since IL-12 mRNA expression was weak without cytokine pretreatment and IFN-gamma strongly augmented production, we speculated that IFN-gamma might have a role in BCG stimulation of IL-12 mRNA expression. Unexpectedly, the addition of three different kinds of anti-IFN-gamma antibodies and anti-IFN-gamma receptor antibody and the coaddition of anti-TNF-alpha antibody with anti-IFN-gamma receptor antibody all failed to inhibit IL-12 mRNA expression. However, the MiniMACS method used to remove NK cells from a mononuclear cell suspension inhibited the expression of p40 mRNA but not the expression of mRNA of TNF-alpha or IL-1beta. We concluded that the coexistence of NK cells was essential for the induction of IL-12 in MDM stimulated with BCG rather than through the secretion of IFN-gamma.

Age as a prognostic factor for late local recurrence of early tongue cancer treated with brachytherapy

BACKGROUND

We aimed to examine predisposing factors on late local recurrence of early oral tongue cancer (T1-2N0).

METHODS

We analysed 152 patients with no evidence of disease 2 years after interstitial radiation therapy without external radiation.

RESULTS

Multivariate analysis showed age to be the only significant prognostic factor for late local control (p = 0.03). We then examined the influence of age by comparing the results between 36 older patients (age more than, or equal to, 65) and 116 other control patients (age less than 65). Aged patients showed poor local control rates of 62% at 10 years after treatment, whereas the corresponding figures for control patients were 90% (p = 0.003). The cause specific survival rate at 10 years was also lower in elderly patients (75%) than in control patients (93%, p = 0.02).

CONCLUSIONS

Age is a predisposing factor for late local recurrence in patients free from disease 2 years after treatment.

Effect of thoracic irradiation on hepatocyte growth factor in rats lung and in bronchoalveolar lavage fluid of patients with thoracic malignancies

This study aimed to examine the physiological role of hepatocyte growth factor (HGF) after thoracic irradiation. We analysed the changes of HGF protein levels in rat lung following 12 Gy of whole thoracic irradiation. Bronchoalveolar lavage fluid (BALF) was then collected from 11 patients (10 lung cancer and one oesophageal cancer) after completion of radiation therapy. One month after irradiation, the HGF protein level in the lungs of irradiated rats decreased (p<0.05), followed by a remarkable elevation in HGF protein levels 2 (p<0.05) and 3 months (nonsignificant) after irradiation accompanied by the clinical appearance of radiation pneumonitis. Finally, HGF protein levels in the lung returned to their original level 6 months after thoracic irradiation. In humans, HGF protein levels in the BALF in the limited irradiated area were lower than those obtained from unirradiated areas (p<0.05). In conclusion, hepatocyte growth factor production is transiently suppressed in the irradiated area after irradiation.

Activity of KRM 1648 or rifabutin alone or in combination with clarithromycin against Mycobacterium avium complex in human alveolar macrophages

SETTING

The activity of KRM 1648 (KRM), a new benzoxazinorifamycin, and rifabutin (RBT), alone or in combination with clarithromycin (CLA), was evaluated against Mycobacterium avium complex (MAC) that multiplied in human alveolar macrophages (AM).

DESIGN

AM were recovered by bronchoalveolar lavage, incubated in RPMI 1640 medium with 10% human AB serum, infected with four strains of MAC (of non-acquired immune deficiency syndrome [AIDS] origin), and then treated with each drug alone or in combination. After incubation for 7 days, colony forming units in each well were counted on 7H10 agar.

RESULTS

Although concentrations between 0.2 microgram/ml and 20 micrograms/ml of both rifamycins showed clear dose-dependent activities against all MAC strains tested, only 20 micrograms/ml of each drug had modest bactericidal effect. In combination with 2.0 micrograms/ml of CLA, however, 0.2 microgram/ml of both drugs caused a bactericidal response against two of the four MAC strains examined.

CONCLUSION

According to this human alveolar macrophage model of MAC infection, KRM and RBT in combination with CLA was found to be a promising candidate against human pulmonary MAC infection, and deserves clinical evaluation.

Lack of correlation between gallbladder opacification in delayed CT and contrast-associated nephropathy

The objective of our study was to determine the correlation between gallbladder opacification by delayed CT and contrast-associated nephropathy (CAN). Delayed CT after angiography was performed in 269 patients. Gallbladder opacification was defined when the CT value in gallbladder was more than 30 HU. Positive renal dysfunction was recognized as CAN which defined as an increase in serum creatinine level > 0.3 mg/dl and > 20 % on days 1, 3, or 7. Gallbladder opacification appeared in 154 of 269 (57 %) patients and CAN in 35 (13 %) patients. Of 117 patients without gallbladder opacification, 17 CAN (14 %) were recognized, and of 152 patients with gallbladder opacification, 18 CAN (12 %) were recognized. No significant correlation existed between delayed gallbladder opacification and CAN.

Renal cortical retention on delayed CT after angiography and contrast associated nephropathy

The aim of this study was to examine the relationship between renal cortical retention (RCR) of contrast media observed on delayed CT (median delay: 20 h) and contrast associated nephropathy (CAN). We investigated the incidence of both phenomena in 270 patients. CAN was defined as an increase in the creatinine level > 0.5 mg dl-1 (44 mumol l-1) and > 25% on day 1, 3 or 7, while RCR was recognized when CT values for the renal cortex showed either mild RCR (CT value > 50) or severe RCR (CT value > 100). RCR was demonstrated in 127 patients (47%), mild in 78 (29%) and severe in 49 (18%), on delayed CT after angiography. CAN was found in eight patients (3%). Patients with severe RCR showed a higher CAN rate (8%) than other patients (mild RCR: 4%, RCR (-): 1%) (p = 0.02). The type of contrast medium was independently associated with the incidence of RCR (p = 0.0001). Although severe RCR was associated with a higher frequency of CAN than the milder forms of RCR, RCR as such was not always associated with CAN.

[A case of local recurrence of rectal cancer that achieved a complete response with high-dose interstitial brachytherapy]

We report a case of local recurrence of rectal cancer that achieved complete response with high-dose interstitial brachytherapy. The patient was a forty-nine-year-old woman. In September 1995, she underwent abdominoperineal resection of rectum for rectal cancer (T4 N2 M0, moderately differentiated adenocarcinoma). In February 1996, she complained of genital bleeding. MRI examination revealed a mass of 70 x 22 x 20 mm in the pelvis, which was diagnosed to be recurrent rectal cancer with needle biopsy. Interstitial brachytherapy (60 Gy/twelve fractions/six days) was performed, and a complete response was achieved. One year after the treatment, no tumor was detected in the pelvis. No skin erosion, skin ulcer, urinary cystitis, nor ileitis occurred. High-dose interstitial brachytherapy delivers high-dose irradiation to a tumor while keeping the dose to the surrounding normal organs at a low level. This procedure may be an effective modality for local recurrence of rectal cancer.

Microangiographic assessment of collateral vessel formation following direct gene transfer of vascular endothelial growth factor in rats

OBJECTIVE

The development of collateral microvessels following therapeutic angiogenesis with vascular endothelial growth factor (VEGF) was investigated using a new system of microangiography that employs monochromatic synchrotron radiation (SR) and a high definition video system to visualize arteries with a spatial resolution of 30 microns.

METHODS

Ischemia was induced in the hindlimb of 20 rats by excision of the femoral artery, followed by transfection of the plasmid (400 micrograms) encoding VEGF or beta-galactosidase (control) into limb muscles. Microangiography was used to assess the development of collaterals in the ischemic limb four weeks after treatment.

RESULTS

Gene transfer of VEGF produced morphologically similar, but significantly more extensive, collateral networks at the microvascular level as compared with the naturally occurring collateral arteries in the control animals (angiographic score: 0.88 +/- 0.08 versus 0.54 +/- 0.05, p < 0.01). No adverse vascular effects such as hemangiomas and/or arteriovenous (AV) fistulae were observed following VEGF treatment. The vasodilator effect of papaverine was evident in relatively large vessels in both groups. At the microvascular level (diameter < 100 microns), however, papaverine induced significant vasodilation in the VEGF-treated animals, and almost no vasodilation in the controls.

CONCLUSIONS

SR microangiography allowed us to assess the development of small collateral arteries following VEGF-gene transfer. The information obtained may provide new insights regarding the collateral microcirculation and therapeutic angiogenesis.

Lipopolysaccharide-binding proteins and their involvement in the bacterial clearance from the hemolymph of the silkworm Bombyx mori

Proteins having the ability to bind to Escherichia coli K12W3110 (rough (R) mutant) were isolated and purified by affinity precipitation from the larval hemolymph of the silkworm Bombyx mori. These proteins were found to consist of two components with molecular masses of 43 kDa and 40 kDa by SDS/PAGE. They bound to all E. coli R mutants (Ra, Rb1, Rc, Rd1 and Re) and Salmonella minnesota R mutants. However, they did not bind to smooth types of the above bacteria. They bound to both lipopolysaccharide(LPS)-coated and lipid-A-coated microtiter plates and have similar dissociation constants for LPS and lipid A. This indicates that the binding proteins recognize the lipid A portion of LPS and thus, we have named these proteins BmLBP (B. mori LPS-binding proteins). We also found that BmLBP participated in the clearance of E. coli cells injected into the body cavity of the silkworm.

Factors that reverse the persistent depolarization produced by deprivation of oxygen and glucose in rat hippocampal CA1 neurons in vitro

In CA1 pyramidal neurons in rat hippocampal tissue slices, superfusion with ischemia-simulating medium produced a rapid depolarization after 6 min of exposure. The membrane potential eventually reached 0 after 5 min (a persistent depolarization), even when oxygen and glucose were reintroduced. The role of various ions in the reversal of this persistent depolarization after reintroduction of oxygen and glucose was investigated. The peak of the persistent depolarization was decreased in solutions containing reduced Na+ or Ca2+ and in solutions containing Co2+ or Ni2+. In contrast, the depolarization was not affected by reduction of external K+ or Cl- or by addition of tetrodotoxin (TTX), flunarizine, or nifedipine. These results suggest that sustained Na+ and Ca2+ influxes produce the persistent depolarization. The membrane potential recovered after reintroduction of oxygen and glucose in low Ca2+, low Cl-, or K+-rich medium and in TTX- or tetraethylammonium-containing medium, but not in low Na+ or low K+ medium and in flunarizine- or nifedipine-containing medium. Either reduction in extracellular Ca2+ or addition of Co2+ was the most effective in promoting recovery from the persistent depolarization, suggesting that Ca2+ influx has a key role in causing the membrane dysfunction. The peak of the persistent depolarization was reduced by 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX), DL-2-amino-5-phosphonopentanoic acid (AP5), DL-amino-3-phosphonopropionic acid (AP3), or DL-amino-4-phosphonobutyric acid, suggesting that activation of non-N-methyl-D-aspartate (non-NMDA), NMDA, and metabotropic glutamate (Glu) receptors is involved in the generation and maintenance of the persistent depolarization. Among these Glu receptor antagonists, only CNQX or AP5 was able to reduce dose dependently the level of depolarization, suggesting that Ca2+ influx via both alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid/kainate type II receptors and NMDA receptors contributes to the membrane dysfunction. trans-1-aminocyclopentane-1,3-dicarboxylic acid (t-ACPD) did not affect the peak potential of the persistent depolarization, but it dose-dependently restored the membrane potential. AP3 antagonized the protective action of t-ACPD. The membrane potential also recovered after reintroduction when the slice was pretreated by 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid tetraacetoxymethyl ester, ryanodol 3-(1H-pyrrole-2-carboxylate), 8-(diethylamino)octyl-3,4,5-trimethoxybenzoate hydrochloride, and procaine, suggesting that raised [Ca2+]i from Ca2+-induced Ca2+ release pool contributes to the membrane dysfunction. It, therefore, is concluded that raised [Ca2+]i has a dominant role in causing irreversible changes. The increase in [Ca2+]i during the persistent depolarization may be the result of Ca2+ entry via both a leaky membrane and Glu-activated receptor channels as well as Ca2+ released from internal stores.

In vivo function tests of hepatic drug-oxidizing capacity in patients with liver disease

Aminopyrine, antipyrine and trimethadione have been widely used for some time as probe drugs to assess non-selective P450 liver function. They have proved useful in evaluating pre- and post-operative liver function when performing surgery, transplantations, etc., in addition to a general evaluation of liver function and drug interactions. Progress has recently been made both in these non-selective P450 function tests and in the analysis of drug-metabolizing enzymes at a molecular level, which has resulted in more selective P450 function tests. The caffeine (CYP1 A2), chlorzoxazone (CYP2E1), lidocaine (CYP3 A) and midazolam (CYP3 A) function tests and the erythromycin breath test (CYP3 A) are currently being used as specific probes. The future use of these tests needs to be discussed in terms of potential clinical implications.

Mechanisms underlying the rapid depolarization produced by deprivation of oxygen and glucose in rat hippocampal CA1 neurons in vitro

Intracellular recordings were made to investigate the mechanism, site, and ionic basis of generation of the rapid depolarization induced by superfusion with ischemia-simulating medium in hippocampal CA1 pyramidal neurons of rat tissue slices. Superfusion with ischemia-simulating medium produced a rapid depolarization after approximately 6 min of exposure. When oxygen and glucose were reintroduced, the membrane potential did not repolarize but depolarized further, reaching 0 mV approximately 5 min after reintroduction. Simultaneous recordings of changes in cytoplasmic Ca2+ concentration ([Ca2+]i) and membrane potential recorded from 1-[6-amino-2-(5-carboxy-2-oxazolyl)-5-benzofuranyloxy]-2-(2- amino-5-methylphenoxy)-ethane-N,N,N',N'-tetraacetic acid pentaacetoxymethyl ester (Fura-2/AM) loaded slices revealed a rapid increase in [Ca2+]i in all CA1 layers corresponding to the rapid depolarization of the soma membrane. The result suggests that the rapid depolarization is generated not only in the soma but also in the apical and basal dendrites. Application of 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX), DL-2-amino-4-phosphonobutyric acid, and DL-2-amino-3-phosphonopropionic acid or bicuculline did not affect the amplitude and the maximal slope. Reduction in the concentration of extracellular Ca2+ or addition of CNQX or DL-2-amino-5-phosphonopentanoic acid delayed the onset of the rapid depolarization. The amplitude of the rapid depolarization recorded with Cs acetate electrodes in tetraethylammonium-containing medium had a linear relationship to the membrane potential between -50 and 20 mV. The reversal potential was shifted in the hyperpolarizing direction by a decrease in either [Na+]o or [Ca2+]o, whereas the reversal potential was shifted in the depolarizing direction by a decrease in [Cl-]o or using CsCl electrodes. An increase or decrease in [K+]o did not affect the reversal potential. These results indicate that the rapid depolarization is Na+, Ca2+, and Cl- dependent. The lack of effects of changes in [K+]o is probably due to the accumulation of interstitial K+ before generating the rapid depolarization. Prolonged application of ouabain (30 microM) caused an initial small hyperpolarization, a subsequent slow depolarization, and a rapid depolarization. In summary, the present study has demonstrated that the rapid depolarization is voltage-independent and is probably due to a nonselective increase in permeability to all participating ions, which may occur only in pathological conditions. The underlying conductance change is primarily the result of inhibition of Na,K-ATPase activity in the recorded neuron.

Quantitative measurement of HCV RNA in the serum: a comparison of three assays based on different principles

Quantitative measurement of hepatitis C virus (HCV) RNA is useful in patients with chronic hepatitis C, especially with interferon treatment. We examined the clinical usefulness of the AMPLICOR monitor assay, a newly developed assay for quantitative measurement, by comparing it with two other assays with different principles. A total of 48 patients with chronic hepatitis C who were treated with interferon-alpha (IFN-alpha) were studied: 19 were complete responders and 29 were non-responders. Hepatitis C virus RNA was measured quantitatively by AMPLICOR, branched DNA (bDNA) probe, and competitive polymerase chain reaction (C-PCR) assays. An internal quantification standard was used in the AMPLICOR assay. A cDNA competitor with a deletion of 15 base pairs in the middle portion was used in the C-PCR method. The concentration of HCV RNA was significantly correlated between the three assays adopted in this study. Sensitivity of assays was 100% by C-PCR, 90% by AMPLICOR and 69% by bDNA assays. The active quantitative range was best with the C-PCR assay and worst with the bDNA assay. The bDNA assay had a tendency to exhibit lower values for patients with serotype 2 than did the other two assays. The predictive rate of the long-term response to IFN-alpha therapy, before its initiation, was over 75% in all three assays. The predictive rate just after completing IFN-alpha therapy was as high as 80% by C-PCR and the AMPLICOR assays, but was low (58%) with the bDNA assay. The handling of the bDNA and AMPLICOR assays was much easier than the C-PCR assay, which required time and skill. These results indicate that the AMPLICOR assay is a simple and reliable method for measuring the serum concentrations of HCV RNA, and thus is suitable for clinical application.

[Clinical and diagnostic characteristics of Legionella pneumonia]

We have characterized clinical and diagnostic features in 18 cases of Legionella pneumonia. Age average of patients was 62.0 years old (male:female = 14:4) and underlying diseases were observed in 12 patients. Legionella pneumonia were diagnosed in 3, 5, 8 and 9 cases by culture, serum antibody measurement, urinary antigen detection and PCR, respectively. Sixteen cases were caused by L. pneumophila, while the other 2 cases were L. bozemanii pneumonia and L. pneumophila or L. dumoffii pneumonia. Chest X-rays of those patients showed multiple pneumonia shadows in 14 cases, alveolar shadows in 10 cases, pleural effusion in 5 cases. Blood-gas analysis on admission indicated hypoxemia in all cases with abnormal A-a DO2. Laboratory findings showed abnormal data in WBC, CRP, LDH, CPK and liver function tests (ex. GOT, GPT) in most cases. Serum antibody testing showed positive by 5 weeks after onset of pneumonia, but 10 cases of Legionella pneumonia diagnosed by other techniques were judged to be negative. In urinary antigen detection test, 6 and 2 cases showed positive 1 and 4 weeks after onset of pneumonia, respectively. Macrolide antibiotics were administered in all cases during the episode, but delay of macrolide administration was observed in 3 of 4 cases of dead outcome. Serum antibody measurement, urinary antigen detection and PCR, in addition to culture to bacteria, may be required for exact diagnosis of Legionella infection.

Comparison of the long-term results of brachytherapy for T1-2N0 oral tongue cancer treated with Ir-192 and Ra-226

BACKGROUND

The authors report the compatibility of iridium-192 (Ir-192) to Radium-226 (Ra-226) based on the clinical results of three-decades.

METHODS

From 1967 through 1985, 119 patients with early oral tongue cancer (T1-2N0) were treated with conventional Ra-226 needles and 135 patients with Ir-192 hair pins.

RESULTS

Local control rates at 10 years for T1 and T2 tongue cancer were 79% and 61% for patients treated with Ra-226, 83% and 68% with Ir-192. The 10-year cause-specific survival rates for the T1 and T2 patients with Ra-226 were 76% and 63%, and those with Ir-192 were 77% and 68%, respectively.

CONCLUSIONS

Ir-192 showed good possibilities as a substitute for Ra-226 in brachytherapy for early oral tongue cancer.

Effects of ruthenium red on the cellular functions and ultrastructure in intact ferret ventricular muscles

The effects of ruthenium red (RR) on the cellular functions (intracellular Ca2+ handling and contraction) and permeation of the dye through the cell membrane were investigated in intact ferret papillary muscles. The intracellular Ca2+ concentration ([Ca2+]i), measured using aequorin, was simultaneously recorded with tension. The permeation of the dye through the cell membrane was studied with electronmicroscopy. The preparation was continuously stimulated at 0.2 Hz and treated with 50 microM RR at 30 degrees C. [Ca2+]i was increased by electrical stimulation (0.07 and 2 Hz) and rapid cooling (from 30 to 4 degrees C) (RC). In electrical stimulation, RR time-dependently decreased the peak light of aequorin without a significant change in the time course at 30 degrees C. However, in RC, treatment with RR for about 100 min significantly prolonged the decay time of the light signal and increased the peak light. The peak tension in RC was decreased after treatment with RR for a longer time. The pCa-tension relation of skinned preparations was significantly shifted to the right by 50 microM RR. In the RR (50 microM)-treated specimens, mitochondrial outer membranes were darkly stained if OsO4 was used for fixation. Even though the specimen treated with 500 microM RR was fixed without OsO4 and electron staining, the matrices of mitochondria became electron dense. We concluded that RR could penetrate into intact mammalian cardiac myocytes, and that RR inhibits the release of Ca2+ from the sarcoplasmic reticulum in electrical stimulation, inhibits mitochondrial Ca2+ uptake, and decreases the Ca2+ sensitivity of the myofilaments.

Contribution of mitochondria to the removal of intracellular Ca2+ induced by caffeine and rapid cooling at low temperatures in ferret ventricular muscles

We investigated the role of mitochondria in the removal of intracellular Ca2+ which was increased by caffeine (15 mM, Caf), rapid lowering of the solution temperature from 30 to 4 degrees C (rapid cooling, RC), and electrical stimulation (0.07 Hz, ES). For this purpose, the intracellular Ca2+ concentration ([Ca2+]i) was measured using aequorin from the superficial cells of ferret papillary muscles. The three maneuvers induced transient changes in [Ca2+]i with different time courses. The decay time of the aequorin light signal (DT) in the Caf-induced Ca2+ release was significantly prolonged by the inhibitors for Na+-Ca2+ exchanger (Ni2+, Na+-free solution) at higher temperatures (> or = 12 degrees C). In the caffeine application at lower temperatures (< or = 12 degrees C), the inhibitors for mitochondria (ruthenium red, NaN3) significantly prolonged the DT but other inhibitors were ineffective. In the RC-induced Ca2+ release, DT was significantly prolonged by the mitochondrial inhibitors but other inhibitors were not effective. In the ES-induced Ca2+ release, each inhibitor for the sarcoplasmic reticulum (SR) (thapsigargin and 2,5-di(tert-butyl)-1,4-benzohydroquinone) prolonged the DT at all temperatures. The inhibitors for Na+-Ca2+ exchanger slightly prolonged the DT only at higher temperatures, and the mitochondrial inhibitors did not alter the DT at any temperature. These results suggest that mitochondria substantially transport Ca2+ when the Ca2+ uptake by the SR and Na+-Ca2+ exchanger are inhibited and [Ca2+]i is increased with a slower time course.

Ca2+ release induced by rapid cooling and caffeine in ferret ventricular muscles

The Ca2+ release induced by rapid cooling (RC) and caffeine in ferret ventricular muscles was investigated. For this purpose, the author measured the intracellular Ca2+ concentration ([Ca2+]i) using aequorin. Rapid lowering of the temperature of the bathing solution from 30 degrees C to low temperatures after the cessation of electrical stimulation transiently increased [Ca2+]i. The peak of [Ca2+]i was altered depending upon the temperature in RC. [Ca2+]i reached 1.59 microM when the temperature was lowered from 30 to 4 degrees C. Caffeine (15 mM) applied during cooling after the decline of RC-induced intracellular Ca2+ signal caused an increase in [Ca2+]i. The author assumed that the total Ca2+ content in the SR was the sum of the peaks of [Ca2+]i increased by RC (Ca(RC)) and caffeine application (Ca(caf)). The fractional Ca2+ release induced by RC [Ca(RC)/"assumed" total released Ca2+ from the SR(%)] was 63.7% at 4 degrees C. The peak of Ca2+ increased by RC was proportional to the "assumed" total released Ca2+ from the SR. No significant correlation was observed between RC-induced [Ca2+]i change and the [Ca2+]i before RC. However, in Na+-deficient solutions (Li+ or TMA+ replacement), the fractional Ca2+ release induced by RC was decreased; this inhibition shows a dependence upon extracellular Na+ concentration. In contrast, the fractional Ca2+ release by caffeine application after RC was enhanced. These results suggest that: 1) RC releases a fraction of the Ca2+ accumulated in the SR and 2) the mechanism of RC-induced Ca2+ release in mammalian cardiac muscle is different from that of RC-induced Ca2+ release in frog skeletal muscles, which requires an increase in [Ca2+]i before RC. Extracellular Na+ might modify RC-induced Ca2+ release through a change in [Na+]i.

Yield of computed tomography and bronchoscopy for the diagnosis of Mycobacterium avium complex pulmonary disease

Mycobacterium avium complex (MAC) pulmonary disease with nodules and bronchiectasis is increasing. But the usefulness of computed tomography (CT) and bronchoscopy for diagnosis and the significance of MAC isolation from respiratory secretions are still unclear. For a 4-yr period, we prospectively examined the role of bronchoscopy with bronchial washing and transbronchial lung biopsy in 26 patients who had clusters of small nodules in the periphery of the lung associated with ectatic changes of the draining bronchi on the CT scan. None of them was infected with human immunodeficiency virus. Thirteen of the 26 patients (50%) had cultures positive for MAC, six in the sputum and 13 in the bronchial washing. Epithelioid granuloma was demonstrated in eight of 13 patients with culture-positive MAC and in two of 13 patients in whom MAC was culture-negative. Rapidly growing mycobacteria were cultured in the two patients. Seven of the eight biopsy-positive patients received treatment and responded by sputum conversion and/or radiographic improvement. We found that the CT finding was a useful clue to suspect MAC pulmonary disease and that the bronchial washing was more sensitive than the routine expectorated sputum for MAC isolation. Demonstration of granuloma in more than half of the MAC-positive patients would suggest that MAC may have invaded the lung tissue rather than colonized in the airways.

Forensic analysis of eleven cyclic antidepressants in human biological samples using a new reversed-phase chromatographic column of 2 microm porous microspherical silica gel

A high-performance liquid chromatographic method has been developed for the forensic analysis of eleven frequently used cyclic antidepressant drugs (ADSs) (amitriptyline, amoxapine, clomipramine, desipramine, dosulepine, doxepin, imipramine, maprotiline, melitracen, mianserine and nortriptyline) using a recently developed reversed-phase column with 2 microm particles for the analysis of biological samples. The separation was carried out using two different C8 reversed-phase columns (column 1: 100 mm X 4.6 mm I.D., particle size 2 microm, TSK gel Super-Octyl; column 2: 100 mm X 4.6 mm I.D., particle size 5 microm, Hypersil MOS-C8) for comparison. The mobile phase was composed of methanol-20 mM KH2PO4 (pH 7) (60:40, v/v) and the flow-rate was 0.6 ml/min for both columns. The absorbance of the eluent was monitored at 254 nm. When the eleven drugs were determined, the sensitivity with the 2 microm particles was about five times greater than with the 5 microm particles. Retention times on column 1 were shorter than those on column 2. These results show that the new ODS column packing with a particle size of 2 microm gives higher sensitivity and a shorter analysis time than the conventional ODS column packing when applied to the analysis of biological samples.

Coronary vasoconstrictive effects of neuropeptide Y and their modulation by the ATP-sensitive potassium channel in anesthetized dogs

OBJECTIVES

This study examined the coronary vasoconstrictive action of endogenous neuropeptide Y (NPY) during sympathetic nerve stimulation and its modulation by the adenosine triphosphate (ATP)-sensitive potassium (KATP) channel in vivo.

BACKGROUND

Exogenous NPY was characterized by its potent vasoconstrictive effect. However, endogenous NPY has failed to show any vasoconstrictive activity in vivo.

METHODS

We studied 70 anesthetized dogs with vagotomy under beta-adrenergic blockade. Ansae subclaviae stimulation and intracoronary administration of the neurotransmitters (NPY and norepinephrine) were done with or without alpha-adrenergic blockade, NPY antagonist BIBP3226 or KATP channel acting agents. We measured coronary vascular resistance (CVR) and the neurotransmitter levels in systemic arteries and the great cardiac vein, and the amount of overflow (venoarterial difference times myocardial blood flow).

RESULTS

During nerve stimulation, NPY levels correlated significantly with CVR at the highest r value (r = 0.850, p < 0.0001) obtained for the venous level under alpha-blockade, but norepinephrine showed no correlation. Treatment with BIBP3226 abolished the correlation between NPY level and CVR under alpha-blockade. Without alpha-blockade, norepinephrine levels correlated significantly with CVR; however, NPY showed no correlation. The amount of NPY overflow during the stimulation was nearly 1,000-fold lower than norepinephrine overflow. Exogenous NPY had a 100-fold more potent coronary vasoconstrictive action than that of norepinephrine. The KATP channel antagonist glibenclamide enhanced vasoconstriction of NPY, and the agonist pinacidil suppressed it with a predominant effect in the subepicardial region.

CONCLUSIONS

During sympathetic nerve stimulation, the vasoconstrictive actions of NPY are masked by norepinephrine under intact alpha-adrenoceptor conditions, manifest during alpha-blockade and modulated by KATP channel activity.

[Evaluation of mycobacteria growth indicator tube (MGIT) for drug susceptibility testing of Mycobacterium tuberculosis isolates]

Fifty six clinical isolates of Mycobacterium tuberculosis were tested for drug susceptibility in Mycobacteria Growth Indicator Tube (MGIT) containing 0.1 microgram/ml of INH, 1.0 microgram/ml of RFP, 3.5 micrograms/ml of EB and 0.8 microgram/ml of SM. These results were compared with those obtained by testing the same M.tuberculosis isolates by the absolute concentration method using 1% Ogawa egg slant containing 0.1 microgram/ml of INH, 10 micrograms/ml of REP, 2.5 micrograms/ml of EB and 20 micrograms/ml of SM. Fifty six isolates consisted of 18 pansensitive strains, 27 multidrug resistant strains and 11 single drug resistant strains. The results of individual drugs showed excellent agreement between the MGIT and the Ogawa methods, and overall agreement rate of the two methods were 96.4%. The results were just the same for all drugs in 48 out of 56 strains studied. The drug resistance could be observed much earlier by the MGIT method (mean 5.9 days) than by the Ogawa method (more than 21 days). In conclusion, the MGIT system could be a promising new drug susceptibility test which might become available in Japan replacing the Ogawa method.