Sustained slowing effect of lentils on gastric emptying of solids in humans and dogs

The distal small intestine is an especially potent site for carbohydrate-triggered intestinal inhibition of gastric emptying of solids. Poorly digestible carbohydrates, such as lentils, may escape proximal absorption, travel over time to reach these inhibitory mechanisms, and slow the gastric emptying of a later meal. A slowing effect on gastric emptying may be associated with a lowering effect on postprandial glucose. The aims of this study were to determine (a) whether lentils (a poorly digestible carbohydrate) vs. bread (an easily digestible carbohydrate) eaten as a premeal (with equal amounts of carbohydrates) slow the gastric emptying of a second solid meal taken 4.0-4.5 hours later and (b) whether a slowing effect on the gastric emptying of the second meal is associated with a lower postprandial glucose response. We found that in 7 dogs and 10 humans, gastric emptying of the second meal was delayed after a lentil premeal compared with a bread premeal. However, there was no difference in the glucose response to the second meal under the two conditions.

Prevalence of anti-HCV among Chinese patients with acute and chronic liver disease

To assess whether the hepatitis C virus plays an important role in Chinese patients with acute and chronic liver disease, antibodies to HCV (anti-HCV) were measured by enzyme immunoassay in 67 patients with type A and B acute viral hepatitis, 165 patients with non-A, non-B (NANB) hepatitis, 438 patients with chronic hepatitis, 200 patients with postnecrotic liver cirrhosis, 72 patients with alcoholic liver disease, 55 patients with non-alcoholic fatty liver, 24 patients with toxic and drug-induced hepatitis, and 20 patients with other chronic liver diseases. Anti-HCV was not detected in sera from patients with type A and B acute viral hepatitis, toxic and drug-induced hepatitis, primary biliary cirrhosis, Wilson's disease, or lupoid hepatitis. The anti-HCV prevalence was found to be highest in patients with NANB hepatitis (59% in sporadic and 73.2% in transfusion-associated), 16.4% in non-alcoholic fatty liver, 5.6% in alcoholic liver disease, 6.8% in chronic hepatitis, and 16% in postnecrotic liver cirrhosis. In patients with chronic hepatitis, the anti-HCV prevalence was significantly higher in HBsAg-negative (15/34, 44.1%) than in HBsAg-positive cases (15/404, 3.7%; P less than 0.0001). The results indicate that HCV is a major agent of NANB hepatitis and plays an important role in HBsAg-negative chronic liver disease in Taiwan.

Gastric emptying of solid food is most potently inhibited by carbohydrate in the canine distal ileum

Although glucose sensors regulating the gastric emptying of liquid meals are uniformly distributed throughout the canine small intestine, some data suggest that the distal small bowel more potently inhibits gastric emptying of solid foods. The aims of this study were to compare (a) the inhibition of gastric emptying by glucose sensors in the proximal intestine with the feedback from the distal intestine, (b) these effects on the gastric emptying of solids vs. liquids, and (c) the inhibitory effect of unhydrolyzed starch with glucose. In 7 dogs with chronic duodenal fistulas, the second, third, and fourth quarters of small bowel were perfused via chronically implanted transmural catheters. Gastric emptying of either solids or liquids was tracked by gamma camera while gastric output was diverted out the duodenal fistula and the small bowel perfused with test solutions of glucose (0.06-2.0 mol/L), 0.15 mol/L NaCl, or 8.5% soluble starch. It was found that (a) gastric emptying of solids but not liquids was approximately 3 times more potently inhibited by glucose in the fourth quarter vs. the first or second quarter of small bowel, and (b) only hydrolyzed starch inhibited gastric emptying of solids.

Epidemiology of penicillin-resistant Neisseria gonorrhoeae isolated in Taiwan, 1960-1990

The epidemiology of penicillin-susceptible Neisseria gonorrhoeae isolated in Taiwan from 1960 to 1990 is summarized. The isolation of N. gonorrhoeae less sensitive to penicillin (i.e., with intrinsic resistance) was first reported in 1960. The rate at which organisms less sensitive to penicillin (MIC, greater than or equal to 0.5 microgram/mL) were isolated increased to 17%, 50%, 80.1%, and 88.8% in 1967, 1975, 1984, and 1990, respectively. Penicillinase-producing N. gonorrhoeae (PPNG) first appeared in Taiwan in late 1976, and the first six strains of PPNG isolated were from United States military servicemen who had relocated from Southeast Asia. The percentage of PPNG strains rose to 37.82% in 1982, and has remained high (50%-62%) since 1983. In the present study, resistance of N. gonorrhoeae to spectinomycin (MIC, greater than 32 micrograms/mL), third-generation cephalosporins (MIC, greater than 4 micrograms/mL), or quinolones (MIC, greater than 4 micrograms/mL) has not been found. Strains requiring arginine, hypoxanthine, and uracil for growth, which frequently cause disseminated gonococcal infections, were not isolated. PPNG strains tended to be of the prototrophic auxotype (55%); non-PPNG strains were mostly of the proline-requiring auxotype (48.8%). Two kinds of R plasmids were isolated in the PPNG strains: the 4.4-MD Asian type (82%-95%) and the 3.05-MD Toronto type (5%-18%). All of the PPNG strains possessing Toronto R plasmid were of the same auxotype/serotype (prototrophic/IB). Evidence suggests that the Asian-type R plasmid was imported into Taiwan in 1976, while the Toronto-type R plasmid may have first emerged in Taiwan in 1983.(ABSTRACT TRUNCATED AT 250 WORDS)

Ketamine, Telazol, xylazine and detomidine. A comparative anesthetic drug combinations study in ponies

This study was designed to assess the effects of 5 anesthetic drug combinations in ponies: (1) ketamine 2.75 mg/kg, xylazine 1.0 mg/kg (KX), (2) Telazol 1.65 mg/kg, xylazine 1.0 mg/kg (TX), (3) Telazol 2 mg/kg, detomidine 20 micrograms/kg (TD-20), (4) Telazol 2 mg/kg, detomidine 40 micrograms/kg (TD-40), (5) Telazol 3 mg/kg, detomidine 60 micrograms/kg (TD-60). All drugs were given iv with xylazine or detomidine preceding ketamine or Telazol by 5 min. Heart rate was decreased significantly from 5 min to arousal after TD-20 but only at 60 and 90 min after TD-40 and TD-60 respectively. Respiratory rate was decreased significantly for all ponies. Induction time did not differ between treatments. Duration of analgesia was 10 min for KX, 22.2 min for TX, 27.5 min for TD-20, 32.5 min for TD-40, and 70 min for TD-60. Arousal time was significantly longer with detomidine and Telazol. Smoothness of recovery was judged best in ponies receiving KX and TD-40. All ponies stood unassisted 30 min after signs of arousal.

Genetic organization and regulation of the xylose degradation genes in Streptomyces rubiginosus

The xylose isomerase (xylA) and the xylulose kinase (xylB) genes from Streptomyces rubiginosus were isolated, and their nucleotide sequences were determined. The xylA and xylB genes encode proteins of 388 and 481 amino acids, respectively. These two genes are transcribed divergently from within a 114-nucleotide sequence separating the coding regions. Regulation of the xyl genes in S. rubiginosus was examined by fusing their promoters to the Pseudomonas putida catechol dioxygenase gene and integrating the fusions into the minicircle integration site on the S. rubiginosus chromosome. The expression of catechol dioxygenase was then measured under a variety of conditions. The results indicated that transcription of the xyl genes was induced by D-xylose and repressed by glucose. Data from quantitative S1 mapping were consistent with this conclusion and suggested that xylA had one and xylB had two transcription initiation sites. The transcription initiation site of xylA was 40 bp upstream of the coding region. The two transcription initiation sites of xylB were 20 and 41 bp 5' of its translation initiation codon. Under control of appropriate regulatory elements, the cloned xyl genes are capable of complementing either Escherichia coli xylose isomerase- or xylulose kinase-deficient strains. The deduced amino acid sequence of the S. rubiginosus xylA protein is highly homologous to sequences of other microbial xylose isomerases.

Hemodynamic response of calves to tiletamine-zolazepam-xylazine anesthesia

Six healthy Holstein calves were anesthesized with isoflurane in O2 and instrumented for hemodynamic studies. A saphenous artery was catheterized for measurement of blood pressure and withdrawal of blood for determination of the partial pressure of carbon dioxide (PaCO2), oxygen (PaO2), and arterial pH (pHa). Respiration was controlled throughout the study. The ECG and EEG were monitored continuously. A thermodilution catheter was passed via the right jugular vein into the pulmonary artery for determination of cardiac output and measurement of central venous pressure, pulmonary arterial pressure, and pulmonary capillary wedge pressure. Baseline values (time 0) were recorded following recovery from isoflurane. Tiletamine-zolazepam (4 mg/kg)-xylazine (0.1 mg/kg) were administered IV immediately after recording baseline values. Values were again recorded at 5, 10, 20, 30, 40, 50, and 60 minutes after injection. Changes in left ventricular stroke work index, PaCO2, and pHa were insignificant. Arterial blood pressure and systemic vascular resistance increased above baseline at 5 minutes and then gradually decreased below baseline at 40 minutes, demonstrating a biphasic response. Values for pulmonary capillary wedge pressure, pulmonary arterial pressure, central venous pressure, and PaO2 were increased above baseline from 5 to 60 minutes. Stroke volume, stroke index, and right ventricular stroke work index were increased from 20 or 30 minutes to 60 minutes. Pulmonary vascular resistance increased at 10 minutes, returned to baseline at 20 minutes, and was increased again at 60 minutes. Heart rate, cardiac output, cardiac index, and rate pressure product were decreased at 5 minutes, and with the exception of cardiac output, remained so for 60 minutes. Cardiac output returned to the baseline value at 30 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)

Inhibition of thromboxane formation as the antiplatelet mechanism of 3,4-dihydroxyxanthone and quercetin pentaacetate

3,4-Dihydroxyxanthone and quercetin pentaacetate were shown to inhibit the aggregation and ATP release of washed rabbit platelets induced by collagen and arachidonic acid, but were not induced by PAF. This inhibition was reversible and in a concentration-dependent manner. The thromboxane B2 formation of washed rabbit platelets, which was caused by arachidonic acid and collagen, was also suppressed by both antiplatelet agents. In human platelet-rich plasma, 3,4-dihydroxyxanthone and quercetin pentaacetate inhibited the secondary, but not the primary aggregation induced by ADP and epinephrine. Both antiplatelet agents also inhibited collagen- and arachidonic acid-induced aggregation in whole blood in a dose-dependent manner. It is concluded that the antiplatelet effects of 3,4-dihydroxyxanthone and quercetin pentaacetate are due to the inhibition of thromboxane formation.

Reconstitution of clathrin-coated pit budding from plasma membranes

Receptor-mediated endocytosis begins with the binding of ligand to receptors in clathrin-coated pits followed by the budding of the pits away from the membrane. We have successfully reconstituted this sequence in vitro. Highly purified plasma membranes labeled with gold were obtained by incubating cells in the presence of anti-LDL receptor IgG-gold at 4 degrees C, attaching the labeled cells to a poly-L-lysine-coated substratum at 4 degrees C and then gently sonicating them to remove everything except the adherent membrane. Initially the gold label was clustered over flat, clathrin-coated pits. After these membranes were warmed to 37 degrees C for 5-10 min in the presence of buffer that contained cytosol extract, Ca2+, and ATP, the coated pits rounded up and budded from the membrane, leaving behind a membrane that was devoid of LDL gold. Simultaneous with the loss of the ligand, the clathrin triskelion and the AP-2 subunits of the coated pit were also lost. These results suggest that the budding of a coated pit to form a coated vesicle occurs in two steps: (a) the spontaneous rounding of the flat lattice into a highly invaginated coated pit at 37 degrees C; (b) the ATP, 150 microM Ca2+, and cytosolic factors(s) dependent fusion of the adjoining membrane segments at the neck of the invaginated pit.

A randomized controlled study of low-dose and high-dose terlipressin in the control of acute oesophageal variceal haemorrhage

A randomized controlled trial was designed to investigate whether a high dose of terlipressin could control acute variceal haemorrhage more effectively than a low dose of terlipressin. Forty cirrhotic patients with bleeding oesophageal varices were included, with low-dose terlipressin in 21 patients and high-dose terlipressin in 19 patients. The two groups of patients were similarly matched for all parameters on admission. High-dose terlipressin (84%) seemed to be more effective in the initial control of bleeding than low-dose terlipressin (67%); however this difference was not significant. Complete control of bleeding during 24 h of drug infusion was achieved in 53% of patients receiving high-dose terlipressin and in 48% of those treated with low-dose terlipressin (P greater than 0.05). There were no major complications in either group. Mortality in relation to variceal bleeding and transfusion requirements were similar in the two groups. This study shows that high dose terlipressin is not superior to low dose terlipressin in acute variceal bleeding.

Early chronic administration of propranolol reduces the severity of portal hypertension and portal-systemic shunts in conscious portal vein stenosed rats

We investigated the effects of early chronic administration of propranolol on systemic and splanchnic hemodynamic changes, and the development of portal-systemic shunts in conscious, unrestrained, portal vein stenosed rats. Compared to rats receiving placebo, early chronic propranolol (75 mg kg-1 day-1) administration to rats begun 3 days before portal vein stenosis and then continued for 10 consecutive days, resulted in a significant decrease in both portal pressure (11.8 +/- 1.5 mmHg) and portal-systemic shunts (48 +/- 18%) which were measured 2 to 3 h after the final dose of propranolol (15.2 +/- 1.5 mmHg and 84 +/- 5%, respectively). These beneficial effects were also observed 18 to 24 h after the final dose of chronic propranolol. In rats given propranolol continuously for 5 days starting 5 days after portal vein stenosis, portal pressure (11.8 +/- 1.2 mmHg) was significantly lower than in the placebo group but portal-systemic shunts (76 +/- 14%) were not significantly different. In rats receiving a single dose of propranolol (75 mg/kg) 10 days after portal vein stenosis and measured 2 to 3 h after propranolol administration, portal pressure (12.8 +/- 1.0 mmHg) was significantly lower than in the placebo group. Portal-systemic shunts (72 +/- 17%), however, showed no significant difference from the placebo group. Similar values in portal pressure (13.3 +/- 1.2 mmHg) and portal-systemic shunts (83 +/- 21%) were also observed in rats 18 to 24 h after a single dose of propranolol.(ABSTRACT TRUNCATED AT 250 WORDS)

Prevention of portal hypertension and portosystemic shunts by early chronic administration of clonidine in conscious portal vein-stenosed rats

The hemodynamic effects, including mesenteric-systemic shunts of early chronic administration of clonidine, were studied in conscious, unrestrained, portal vein-stenosed rats. In rats receiving early chronic clonidine (600 micrograms.kg-1.day-1 by gavage), begun 3 days before portal vein stenosis and then administered continuously for 10 consecutive days, portal pressure (10.0 +/- 1.5 mm Hg) and degree of mesenteric-systemic shunts (58% +/- 25%) were significantly lower than in the placebo group (15.2 +/- 1.5 mm Hg and 83% +/- 7%, respectively). The effects were observed either 2 to 3 hr or 18 to 24 hr after the last dose of clonidine. In rats receiving clonidine continuously for 5 days, starting 5 days after portal vein stenosis, portal pressure (11.0 +/- 1.3 mm Hg) was significantly lower than in the placebo group, but mesenteric-systemic shunts (82% +/- 8%) were not significantly different. In rats receiving a single oral dose of clonidine (600 micrograms/kg) 10 days after portal vein stenosis, portal pressure (11.8 +/- 2.1 mm Hg), measured 2 to 3 hr after clonidine administration, was significantly lower than in the placebo group. Mesenteric-systemic shunts (83% +/- 8%), however, were not significantly different from the placebo group. In addition, 18 to 24 hr after a single dose of clonidine, hemodynamic values returned to basal conditions. We also demonstrated that chronic clonidine administration begun before portal vein stenosis can reduce the initial increase in portal pressure after this procedure. We concluded that early chronic clonidine administration reduces the severity of portal hypertension and the development of portosystemic shunts in portal vein-stenosed rats.(ABSTRACT TRUNCATED AT 250 WORDS)

The diagnostic value of the assay of des-gamma-carboxy prothrombin in the detection of small hepatocellular carcinoma

Des-gamma-carboxy prothrombin (DCP) assay was performed by a staphylocoagulase method in 35 consecutive patients with small (less than 5 cm), resectable hepatocellular carcinoma (HCC). They also simultaneously received serum alpha-fetoprotein (AFP) assay. According to diagnostic strategy, patients were divided into two groups. Group I consisted of eight patients who were candidates for a mass screening project for HCC with elevated AFP levels (greater than 20 ng/ml). Five of these patients had an increased DCP level (greater than 6 U/l). Group II included 27 victims of chronic hepatitis B or cirrhosis whose tumors were detected by ultrasonography during regular follow-up. In this group, increased DCP and AFP levels were observed in 11 and 16 cases, respectively. Of 14 patients with smaller HCC (less than 3 cm), only three had elevated DCP levels, while eight patients had an abnormal AFP level. When these two assays were combined, 18 of 27 patients in group II and nine of 14 patients with smaller HCC (less than 3 cm) revealed elevation of one or both of the two markers. A total of 16 out of 35 patients with small HCC had abnormal DCP levels. In conclusion, DCP assay is less sensitive than AFP assay in the detection of small HCC, and the combination of both markers has little complementary effect.

Large intestinal pH and ammonia in rats: dietary fat and protein interactions

Mature male Sprague-Dawley rats were assigned to a 3 x 3 factorial experiment in which they were fed AIN-76A diets supplying 8, 16 and 32% of energy as protein and 12, 24 and 48% of energy as fat. During the 5 mo of feeding, 10 in vivo measurements of intracolonic pH were recorded on each rat with a flexible electrode. The pH ranged from 7.8 to 8.0 near the anus and declined to 7.4 to 7.5 at 12 cm from the anus. The mean percentages of dry matter in the contents of the colon, divided into three approximately equal segments, were as follows: proximal colon, 35; middle colon, 45; distal colon, 58. Ammonia concentrations in luminal fluid rose significantly with higher protein intake in the cecum, proximal colon and distal colon. The concentrations in the distal colon ranged from 39 to 74 mmol/L, depending upon protein intake. Thymidine incorporation by distal colon mucosal cells was higher in rats fed 32% of energy as protein and 48% of energy as fat compared with rats fed 8% of energy as protein and 12% as fat. The evidence suggests that increased intestinal cell proliferation in rats fed the high protein, high fat diet was due to greater concentrations of ammonia in the large intestine resulting from the high protein intake and greater concentrations of non-ionized ammonia resulting from the higher pH associated with increased fat intake. The actual determinations and calculations of ionized to non-ionized ammonia concentrations were compatible with the assumption that the large intestinal cells absorbed more ammonia at higher fat intakes.

Colon mucosal cell damage by ammonia in rats

Colons of male Sprague-Dawley rats were perfused, in situ, with ammonium (NH4+) or sodium (Na+) and acetate (CH3COO-) or chloride (Cl-) to determine the effects of the cations and anions or their interactions on the colon mucosa. Solutions simulating ileal fluid were delivered at 0.4 mL/min at 38 degrees C via cannulae inserted at the cecal-colonic junction. Effluents were collected by cannulae inserted in the anus. In the first experiment, perfusion with the control solution or with the control solution having 35 mmol/L NaCl replaced by equimolar amounts of ammonium acetate, ammonium chloride or sodium acetate showed that only ammonium-containing solutions caused histological damage, loss of mucus, and significant losses of carbohydrate and DNA (P less than 0.05). The losses of carbohydrate and DNA expressed in microgram.cm-1.30 min-1 were as follows: control, 13.4 and 1.0; ammonium acetate, 31.8 and 1.6; sodium acetate, 16.0 and 0.6; ammonium chloride, 24.1 and 1.3, respectively. In the second experiment, perfusion with control fluid containing 35 or 70 mmol/L ammonium acetate at pH 6.8, 7.4 or 8.0 increased carbohydrate and DNA losses into the effluents compared with the pretest period (P less than 0.05), without significant effects related to influent pH. These studies are consistent with the concept that the life span of colon cells is shortened by concentrations of ammonia found in the colon under normal conditions and that ammonia enhances cell proliferation in the colon mucosa.

A randomized controlled trial of quinidine in the treatment of cirrhotic patients with muscle cramps

In an attempt to evaluate the effect of quinidine in the treatment of patients with cirrhosis and muscle cramps, 31 cirrhotic patients with muscle cramps were randomly divided into two groups and given orally 400 mg of quinidine sulfate per day or placebo, respectively. Baseline clinical and laboratory data for these two groups were similar. Four weeks after oral administration of quinidine, the number of cramps significantly decreased from 14.4 +/- 1.7 (mean +/- S.E.) to 4.4 +/- 1.1 episodes (p less than 0.0001), but it remained unchanged in the placebo group (from 11.8 +/- 1.0 to 11.5 +/- 1.5 episodes, p greater than 0.05). In addition, 88% of the 16 patients on quinidine and 13% of the 15 patients on a placebo showed a greater than 50% reduction in the number of cramps during a 4-week treatment period (p less than 0.0001). The peak and trough serum levels of quinidine in patients having received quinidine for 2 weeks were 1.3 +/- 0.1 and 0.7 +/- 0.1 mg/l, respectively. There was a significant relationship between serum quinidine concentrations and attenuation of cramps. No significant adverse effect was observed during the study, except for five (31%) patients who developed mild diarrhea after quinidine therapy. Diarrhea subsided spontaneously or was controlled by medications without the interruption of quinidine therapy. It was concluded that quinidine is a safe and effective drug for the treatment of cirrhotic patients with muscle cramps.

Hyposensitivity to vasopressin in patients with hepatitis B-related cirrhosis during acute variceal hemorrhage

It has been suggested that vasopressin given during hemorrhage may be less effective than when given during a stable state in a portal-hypertensive rat model. This study was designed to evaluate the hemodynamic response to vasopressin infusion in 25 HBsAg-positive cirrhotic patients. Nine patients had active variceal hemorrhage before vasopressin infusion, and the other 16 patients were in a stable condition at the time of infusion. The two groups of patients were similar in baseline values except that a higher heart rate was found in patients with hemorrhage (96 +/- 20 vs. 73 +/- 10 beats/min, mean +/- S.D., p less than 0.01). Thirty minutes after vasopressin infusion (0.66 units/min), hepatic venous pressure gradient significantly decreased in both bleeding and stable patients (from 21 +/- 9 to 18 +/- 9 mm Hg, p less than 0.05; and from 18 +/- 4 to 8 +/- 3 mm Hg, p less than 0.0001, respectively). However, the decrease of hepatic venous pressure gradient was less obvious in bleeding patients as compared with stable patients (4 +/- 3 vs. 9 +/- 2 mm Hg, p less than 0.0001). A significant reduction of hepatic venous pressure gradient after vasopressin infusion was found in five bleeding patients without shock (from a median of 16 mm Hg [range = 12 to 26] to 11 mm Hg [range = 6 to 18], p less than 0.05), but not in four bleeding patients with shock (from 28 [range = 15 to 36] to 25 [range = 18 to 33] mm Hg, p greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Snake skin pattern gastropathy in cirrhotic patients

Gastric mucosal lesions are common in patients with cirrhosis. Among them, snake skin pattern gastropathy (SSPG) is the most distinguishing one. A prospective study was conducted to investigate the incidence of SSPG in cirrhotic patients, the relationship between the degree of portal pressure and SSPG, and the possible association of SSPG with serum levels of gastrin and pepsinogen I. SSPG was found to be significantly more common in 100 cirrhotic patients than in 100 age- and sex-matched healthy controls (41% vs 0%, P less than 0.0001). Hepatic venous pressure gradient and serum gastrin and pepsinogen I levels were measured in 21 cirrhotic patients with SSPG and 25 cirrhotics without SSPG. There was no significant difference in hepatic venous pressure gradient (16.1 +/- 4.4 mmHg vs 16.1 +/- 4.9 mmHg, P greater than 0.05), serum gastrin level (78.0 +/- 26.7 pg/mL vs 80.1 +/- 32.5 pg/mL, P greater than 0.05) and serum pepsinogen I level (69.5 +/- 26.6 ng/mL vs 65.2 +/- 26.1 ng/mL, P greater than 0.05) in cirrhotic patients with or without SSPG. In conclusion, SSPG is common in cirrhotic patients. Portal pressure per se may not be the only factor causing SSPG--other aggressive factors may be needed together to cause the gastropathy. There is no evidence of correlation between serum gastrin or pepsinogen I level and SSPG.

A randomised double-blind placebo-controlled trial of prednisolone therapy in HBeAg and HBV DNA positive Chinese patients with chronic active hepatitis B

Forty-one hepatitis B e antigen (HBeAg) and hepatitis B virus (HBV) DNA positive Chinese patients with chronic active hepatitis B were randomized to receive either prednisolone or placebo oral for 8 weeks. The prednisolone group received 60 mg daily for 2 weeks, 40 mg for 2 weeks, 20 mg for 2 weeks, 10 mg for 1 week and 5 mg for 1 week. In 18 patients receiving prednisolone, serum HBV DNA levels rose during the course of therapy, but dropped abruptly within 1 month of cessation of treatment. Conversely, their serum alanine aminotransferase (ALT) levels decreased during high doses of prednisolone therapy, and then became transiently elevated during the period of withdrawal of prednisolone. At 1 year from initial treatment, the serum HBV DNA and ALT levels were similar between the groups of patients treated with prednisolone or placebo. In the prednisolone treated group, 66.7% of patients became HBV DNA negative, 50% became HBeAg negative, and 33.3% seroconverted to antibody to HBeAg (anti-HBe). In the placebo treated group, 60.9% of patients became HBV DNA negative, 60.9% became HBeAg negative, and 56.5% seroconverted to anti-HBe. Hepatic decompensation was not noted in any of the prednisolone-treated patients. Thus, the effects of the withdrawal prednisolone therapy on serum ALT and HBV DNA levels was temporary, and no differences in serum viral markers or biochemical parameters of liver inflammation between these two groups were noted at the 1 year follow-up period.

Inhibition of gastric emptying by acids depends on pH, titratable acidity, and length of intestine exposed to acid

Exposure of the small intestine to acid inhibits gastric emptying in a dose-related fashion that depends on titratable acidity and pH. Little information is available on the location of this inhibitory mechanism or on the relative contribution of titratable acidity and pH to this feedback control. We hypothesized that the dependence on titratable acidity is related to the length of the intestine exposed to acid and that the dependence on pH is related to the region of the intestine exposed to acid. To test these ideas, we studied 11 dogs with duodenal and jejunal fistulas. The inhibitory effects were tested when different lengths of the small intestine were exposed to test solutions of 0.03, 0.06, and 0.12 meq/ml titratable acidities. pH as an independent covariable was separated from titratable acidity by comparing the inhibition of gastric emptying of lactic acid (pH fixed to 2.4) to HCl (pH 0.96-1.6). Maximal inhibition of gastric emptying by both acids depended on acid exposure of a length of small intestine that was greater than 65 but less than or equal to 150 cm long. When acid was confined to the proximal 15 cm, increasing concentration of HCl (decreasing pH) resulted in increasing inhibition, but this effect was absent with increasing concentration of lactic acid (fixed pH). Inhibition was absent when 0.06 meq/ml HCl was infused into the intestine beyond the midintestine.(ABSTRACT TRUNCATED AT 250 WORDS)

Inhibition of gastric emptying by sodium oleate depends on length of intestine exposed to nutrient

Previously, we reported that inhibition of gastric emptying by glucose or acids depends on the length of gut exposed to the inhibitor [Gastroenterology 95: A877, 1988; Am. J. Physiol. 256 (Gastrointest. Liver Physiol. 19): G404-G411, 1989]. In this study, we hypothesized that feedback control by fat may be similarly regulated. In dogs with chronic intestinal fistulas, we compared the intensity of intestinal feedback when different lengths of the small intestine were exposed to meals of 3, 9, or 27 mM sodium oleate. We found that 1) inhibition of liquid emptying was dose dependent, 2) intensity of negative feedback was dependent on both the concentration of the oleate and the length of gut exposed to fat, 3) full inhibitory effect was achieved with exposure of fat to 150 cm of gut, 4) inhibition from the distal one-half of gut was less potent than that generated from the proximal one-half of gut, and 5) on a molar basis oleate was 20 times as effective as glucose at inhibition of gastric emptying and that this difference was related to the slower rate of fat absorption.

[Study on the effect of various conditions and age to blood platelet aggregation test]

The result of the platelet aggregation test was affected by various conditions. We performed the platelet aggregation test by changing different conditions, including: 1. adding different anticoagulants 2. interval between sampling and standing 3. platelet count 4. the concentrations of different reagents (ADP, Epinephrine and Collagen) respectively and the aggregation rate of blood platelet were compared among different age groups. The best condition for platelet aggregation rate was obtained as follows: 1) Citric acid of 3.8% is the best anticoagulant. 2) Test should be completed within 4 hours upon sample collection. 3) The optimal incubation temperature is between 25 degrees to 37 degrees C. 4) Platelet count of 2 to 4 x 10(5)/microliters gives the most constant result. 5) The optimal concentration for working solution of ADP, collagen and Epinephrine are 5.0 microns, 5.0 micrograms/ml and 50 microM respectively. 6) The aggregation rate of blood platelet increases with age.

Application of a procedure starting with an HIV-I/HIV-2 mixed EIA

A procedure to diagnose the infections by the human immunodeficiency virus type 1 (HIV-1) and type 2 (HIV-2) was proposed. The specimens were first screened by a mixed enzyme immunoassay (EIA) for the presence of antibodies to HIV-1 as well as to HIV-2. Those screened positive were thereafter confirmed and differentiated their antibody reactivities toward the antigens of HIV-1 and HIV-2 by Western blot (WB). This procedure was found to be one hundred percent accurate to diagnose 66 coded specimens with well defined seroreactivities to HIV-1 from Centers for Disease Control (CDC). While its accuracy in HIV-2 antibody testing could not be evaluated in the present study owing to the lack of HIV-2 standard reference specimens. With this procedure, six out of each of two groups of 176 foreigners and 719 individuals who visited the Taipei Municipal Venereal Disease Control Institute (TMVDCI) were screened repeatedly reactive by the mixed EIA. By WB only four of the first six and two of the second six were confirmed HIV-1 positive. Their antibody reactivities toward HIV-2 antigens were either absent or significantly much lower than those toward HIV-1 antigens. Furthermore, none reacted to the env proteins gp160 and gp120 of HIV-2. We therefore concluded that out of the 895 test individuals, only six were confirmed infected with HIV-1. There were neither HIV-2 infections nor dual infections. The similar pathogenicity and trans mission of HIV-2 as of HIV-1 justify an equal appreciation for HIV-2 testing. The present study indicated that a procedure starting with a mixed EIA aimed to diagnose HIV-1 as well as HIV-2 did not have any adverse effects on HIV-1 testing.

Sexual transmission of hepatitis D virus infection in Taiwan

Multivariate analysis of the risk factors for hepatitis D virus infection among 53 men with acute hepatitis D virus superinfection, 59 men with acute exacerbation of chronic hepatitis B and 54 asymptomatic male hepatitis B carriers revealed that sexual contact with prostitutes and use of nondisposable needles were the factors significantly associated with hepatitis D virus infection in Taiwan (odds ratio = 5.5, 95% confidence interval = 3.3 to 9.2; odds ratio = 2.4, 95% confidence interval = 1.3 to 4.4, respectively). The prevalence of antibody to hepatitis D virus antigen among hepatitis B virus carriers with histories of sexual exposure to prostitutes was 10.3% (14 of 136) and the prevalence of hepatitis D virus antigen among the female prostitutes who were hepatitis B virus carriers was 59% (24 of 51). Among those who admitted to sexual contact with prostitutes, testing for hepatitis D virus antigen revealed positive correlations with the frequency of such sexual contacts and with the frequency of history of venereal diseases. Among the female prostitutes, the prevalence of hepatitis D virus antigen had a positive correlation with the frequency of sexual contact and a negative correlation with age. Analysis of serum hepatitis D virus RNA among those with hepatitis D virus antigen revealed that 4 of the 9 with sexual exposure to prostitutes and 3 of the 24 prostitutes were positive. From these findings, we conclude that these two groups are not only at high risk for hepatitis D virus infection but also form a reservoir of this virus.

Systemic and portal haemodynamic changes following triglycyllysine vasopressin plus nitroglycerin administration in patients with hepatitis B-related cirrhosis

We measured the haemodynamic changes following triglycyllysine vasopressin administration and after addition of nitroglycerin in twelve patients with portal hypertension due to hepatitis B-related cirrhosis. A bolus i.v. injection of triglycyllysine vasopressin at a dose of 2 mg reduced the hepatic venous pressure gradient from 18.5 +/- 3.7 (mean +/- S.D.) to 15.6 +/- 4.0 mmHg, p less than 0.001. However, the cardiac index decreased from 4.8 +/- 1.0 to 3.7 +/- 0.8 l/min m2, p less than 0.001; the heart rate decreased from 79 +/- 15 to 71 +/- 13, p less than 0.01; the right atrial pressure increased from 3.2 +/- 1.9 to 5.3 +/- 2.3 mmHg, p less than 0.001; the mean arterial pressure increased from 92 +/- 13 to 103 +/- 13 mmHg, p less than 0.05; and the systemic vascular resistance rose from 939 +/- 182 to 1367 +/- 310 dyn/s cm-5, p less than 0.001. Furthermore, both mean pulmonary arterial pressure and pulmonary capillary wedge pressure showed a significant increase following triglycyllysine vasopressin administration as compared with baseline values (p less than 0.005). The addition of sublingual nitroglycerin at a dose of 0.6 mg returned all the systemic haemodynamic parameters to baseline levels. On the other hand, nitroglycerin administration caused no further change in the hepatic venous pressure gradient. We concluded that although triglycyllysine vasopressin significantly reduced portal pressure in patients with hepatitis B-related cirrhosis, it produced untoward systemic haemodynamic changes similar to those seen with vasopressin. The addition of nitroglycerin improved the detrimental systemic haemodynamic effects produced by triglycyllysine vasopressin without further reducing the hepatic venous pressure gradient.