Interleukin-6 localization and the prognosis of IgA nephropathy

Various cytokines and growth factors may be involved in IgA nephropathy. To clarify whether interleukin-6 was a prognostic factor for this disease, we investigated interleukin-6 positivity of renal biopsy specimens and its relationship with the prognosis. The subjects were 90 patients with IgA nephropathy (42 males and 48 females with a median age of 32.7 +/- 13.8 years). Renal biopsy specimens were stained for interleukin-6 using an enzyme-antibody method. Fifty-two of 90 patients showed glomerular positivity for interleukin-6. Among the patients positive for interleukin-6, 24-hour urinary protein excretion and serum creatinine levels were significantly higher at the time of biopsy than in the patients without interleukin-6 positivity, while creatinine clearance was significantly lower. In the interleukin-6-positive patients without steroid therapy, serum creatinine increased significantly after 1 year (Deltas-Cr; 1.04 +/- 0.45 mg/dl) and creatinine clearance decreased significantly (DeltaCcr; -11.7 +/- 3.2 ml/min) compared to the interleukin-6-negative patients without steroid therapy. Steroid therapy improved 24-hour urinary protein excretion, serum creatinine, and creatinine clearance in the interleukin-6-positive patients, while these parameters worsened without steroid therapy. On the other hand, the IL-6-negative patients showed no differences of clinical parameters irrespective of the presence or absence of steroid therapy. In conclusion, glomerular interleukin-6 positivity may be a prognostic factor and an indicator of the need for steroid therapy in IgA nephropathy.

[Changes in endoscopic features and histological findings of H. pylori-related gastritis with a follow-up over a year after eradication of H. pylori]

This study reviews the cases of patients examined repeatedly by endoscopy with biopsies for over one year after eradication of H. pylori, measured according to the Sydney system. For 81 patients in whom H. pylori was successfully eradicated, the endoscopic features of edema, erythema, friability, exudate, erosion and rugal hypertrophy disappeared or diminished at 1-3 months after the therapy and endoscopic features of nodularity disappeared or diminished 12-15 months after the therapy. In these H. pylori-eradicated patients, the histological findings of inflammation and activity regressed 1-3 months after therapy, and atrophy and intestinal metaplasia regressed in 22(27%) and 28(35%) of the 81 patients examined 12-15 months after therapy. Regression of the atrophic pattern was observed in 38(47%) of these H. pylori-eradicated patients. In some H. pylori-eradicated patients, the regressions of atrophy and intestinal metaplasia were observed over one year after H. pylori eradication therapy. Inflammation and activity in the histological findings were related to the endoscopic findings of edema, erythema, friability, exudate, erosion and rugal hypertrophy.

Spontaneous conception after the birth of infants conceived through in vitro fertilization treatment

OBJECTIVE

To investigate the incidence of spontaneous conception after the birth of infants conceived through IVF in couples with subfertility caused by endometriosis, a mild male factor, or unexplained factors, and to identify clinical conditions related to the occurrence of spontaneous conception.

DESIGN

Retrospective analysis.

SETTING

Department of Obstetrics and Gynecology, Akita University School of Medicine, Akita, Japan.

PATIENT(S)

One hundred forty-two women who conceived through IVF and 25 of the 142 women who subsequently conceived spontaneously.

INTERVENTION(S)

Patient characteristics and IVF data were obtained from hospital records, and follow-up data were collected through telephone interviews.

MAIN OUTCOME MEASURE(S)

Cumulative conception rate.

RESULT(S)

The cumulative conception rate at 60 months after the delivery of infants conceived through IVF was 18%, with most conceptions occurring within 2 years of delivery. Proportional hazard analysis indicated that patient age was the most important clinical variable related to the occurrence of spontaneous conception.

CONCLUSION(S)

This study provides information that will be useful in counseling subfertile couples who have conceived through the use of IVF.

Plasmapheresis for removal of myeloperoxidase antineutrophil cytoplasmic antibodies: a case report

We report on a patient with myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) associated glomerulonephritis who had an elevated MPO-ANCA level and necrotizing crescentic glomerulonephritis on renal biopsy. She was treated by double filtration plasmapheresis and immunoadsorption plasmapheresis combined with steroid therapy and immunosuppressive agents. After plasmapheresis, the MPO-ANCA level decreased, and the cellular crescents were reduced. We conclude that plasmapheresis combined with steroid and immunosuppressive therapy may be useful to decrease the activity of MPO-ANCA associated crescentic glomerulonephritis.

Disappearance of hyperplastic polyps in the stomach after eradication of Helicobacter pylori. A randomized, clinical trial

BACKGROUND

Helicobacter pylori infection is common in patients with hyperplastic gastric polyps.

OBJECTIVE

To study the effect of eradication of H. pylori on the clinical course of patients with hyperplastic gastric polyps.

DESIGN

Single-blind, randomized, controlled trial.

SETTING

University-based gastroenterology outpatient clinic.

PATIENTS

35 patients with H. pylori infection and hyperplastic gastric polyps at least 3 mm in diameter.

INTERVENTION

Patients were randomly assigned to a treatment group (n = 17), which received a proton-pump inhibitor (omeprazole or lansoprazole), amoxicillin, and either clarithromycin or ecabet sodium, or to a control group (n = 18), which received no treatment.

MEASUREMENTS

Patients underwent endoscopy before enrollment and 12 to 15 months after the end of treatment. Serum gastrin levels and titers of IgG to H. pylori were measured.

RESULTS

In the treatment group, the polyps had disappeared by 3 to 15 months (average, 7.1 +/- 1.2 months) after the end of treatment in 12 of all 17 patients (71%) and in 12 of the 15 patients (80%) in whom H. pylori was eradicated. However, 12 to 15 months after the start of the study, no change in polyps or H. pylori status was seen in any controls (P < 0.001). Histologic findings of inflammation and activity, serum gastrin levels, and titers of IgG to H. pylori showed significant regression in the treatment group compared with the control group (P < 0.01).

CONCLUSIONS

Most hyperplastic polyps disappeared after eradication of H. pylori. Thus, eradication should be attempted before endoscopic removal is done in patients with hyperplastic gastric polyps and H. pylori infection.

A case of nephrotic syndrome with rapid spontaneous remission in an elderly patient

In July 1994, a 70-year-old woman was diagnosed as having nephrotic syndrome with proteinuria of 8 to 10 g/day and a serum albumin level of 1.8 g/dl. She was hospitalized in August 1994 for investigation. The urinary findings then normalized, with urinary protein and occult blood both negative and total urinary protein excretion at 0 g/day. A renal biopsy was performed, and spontaneous remission of minimal change nephrotic syndrome was diagnosed. This is an interesting case involving rapid remission of minimal change nephrotic syndrome in an elderly patient.

Precise ultrastructural localization of endothelial leukocyte adhesion molecule-1, vascular cell adhesion molecule-1, and intercellular adhesion molecule-1 in patients with IgA nephropathy

Using light and electron microscopy, we performed an immunohistochemical study of endothelial leukocyte adhesion molecule-1 (ELAM-1), vascular cell adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1 (ICAM-1) in 15 patients with IgA nephropathy to clarify the localization of these adhesion molecules. The normal portions of 2 kidneys removed due to localized carcinoma and 3 biopsies from patients without glomerular disease were used as a control. By light microscopy, ELAM-1, VCAM-1, and ICAM-1 all showed positive staining in IgA nephropathy, with the intensity of staining following the sequence ICAM-1 > VCAM-1 > ELAM-1. ELAM-1 and VCAM-1 showed a patchy distribution of moderate staining in the tissues, including the mesangium, crescents, adhesions, and tubules. In contrast, there was marked linear ICAM-1 staining throughout the vascular walls. ELAM-1 and VCAM-1 were positive on the basolateral surfaces of a few proximal tubular epithelial cells in association with inflammatory cell infiltration, while ICAM-1 was found on the brush border. ICAM-1 was positive in the glomerular capillary walls and interstitial vessels of the control kidney tissue, while ELAM-1 and VCAM-1 were virtually absent. By electron microscopy, ELAM-1 positivity on the urinary surface of the parietal/visceral epithelial cells was often associated with adherent mononuclear cells in the urinary space. VCAM-1 positivity was increased in the perinuclear space and/or cytoplasm of mesangial cells as well as at the mesangial cell-endothelial cell interface. These findings suggest that ELAM-1 and VCAM-1 may be more closely related than ICAM-1 to the major histopathological changes occurring in IgA nephropathy, including mesangial expansion, formation of crescents and adhesions, and tubulointerstitial injury.

Ultrastructural localization of vascular cell adhesion molecule-1 in proliferative and crescentic glomerulonephritis

Recent studies have demonstrated an important role of vascular cell adhesion molecule-1 (VCAM-1) in the pathogenesis of nephritis. In the present study, renal biopsy specimens from patients with proliferative and crescentic glomerulonephritis were subjected to immunoelectron microscopy using an anti-VCAM-1 monoclonal antibody. In control normal kidney tissue, VCAM-1 expression was restricted to the free surface of parietal epithelial cells. In diseased glomeruli, VCAM-1 was expressed on the free surface of parietal and visceral epithelial cells, on the luminal surface of capillary endothelial cells, on infiltrating monocyte/macrophage-like cells, on mesangial cells, and in the matrix of the expanded mesangium. There was also VCAM-1 expression on almost all cell types in the crescents, including macrophage-like cells, fibroblast-like cells, and epithelial cells. Some cells also showed VCAM-1 positivity in the rough endoplasmic reticulum and the perinuclear space. Both the glomerular capillary lumen and urinary spaces of Bowman's capsule contained positive reaction products, which were often associated with exocytosis by the surrounding cells. VCAM-1 was predominantly expressed on the basal and lateral surfaces of a few proximal tubules, but it could not be localized ultrastructurally. These findings suggest that production and secretion of VCAM-1 by both infiltrating monocyte/macrophages and resident glomerular cells may be related to the pathogenesis of proliferative and crescentic glomerulonephritis.

Leuchtenberger bodies in flat adenomas of the colorectal mucosa: a comparison between Japanese and Swedish patients

The dysplastic epithelium of flat colorectal adenomas was found to contain DNA inclusion granules, known as Leuchtenberger bodies (LB). Hematoxylin and eosin-stained sections of 263 colorectal flat neoplastic lesions (i.e., flat adenomas, and flat adenocarcinomas) collected in Japan and Sweden were scrutinized for the presence of such intraepithelial inclusions. LB were recorded in 87.1% of the 263 flat colorectal neoplastic lesions. The frequency of flat colorectal lesions having LB was similar in Japan (160 of 178 or 89.8%) to that in Sweden (69 of 85 flat lesions or 81.2%), suggesting that the occurrence of LB may not be influenced by race or environment. Direct immunoperoxidase detection of nuclear DNA fragmentation and transmission electron microscopy studies indicated that the inclusions contained apoptotic material. The semiquantitative assessment of histochemically labeled apoptotic granules indicated that the number of lesions having moderate to large numbers of apoptotic granules (++/ ) was higher in flat adenomas with high-grade dysplasia, suggesting that the occurrence of these granules may be related to the degree of severity of the dysplastic process. A better knowledge of LB may improve our understanding of the possible relationship between apoptosis, host immune response and carcinogenesis in flat colorectal adenomas.

Flat adenomas and flat adenocarcinomas of the colorectal mucosa in Japanese and Swedish patients. Comparative histologic study

PURPOSE

In recent years, flat adenomas of the colorectal mucosa have been intensively investigated by Japanese pathologists. Results of that work indicate that flat adenomas may antedate the development of colorectal carcinomas. Because of differences in the histologic definition of flat adenomas with severe dysplasia and with intramucosal carcinoma within the group, one single observer having both Western and Asian training in pathology reviewed the material.

METHODS

A total of 287 flat colorectal lesions were reviewed: 109 from the Karolinska Hospital, Stockholm, 137 from the Tokyo Medical and Dental University (TMDU) (which included 5 cases from the Nagoya City University), and 41 from the Cancer Institute (CI), Tokyo. Lesions were histologically classified following strict histologic criteria. Thus, flat adenomas were divided into those having low-grade dysplasia (LGD; having dysplastic cells in the deeper half of the epithelium), high-grade dysplasia (HGD; dysplastic cells were found even in the superficial half of the epithelium), intramucosal carcinoma (dysplastic glands displayed molding with buddings and often a cribriform pattern), and adenocarcinoma (braking through the muscularis mucosa, with neoplastic cells in the submucosal layer or deeper).

RESULTS

Whereas in Stockholm only 14.7 percent of lesions had HGD, as much as 56.9 percent and 56.1 percent, respectively, had HGD at the two Tokyo Hospitals. Intramucosal carcinomas were not found in the Stockholm material but occurred in 2.2 percent of lesions seen at TMDU and in 4.9 percent of those seen at the CI. Notably, only 2.7 percent of the specimens at Karolinska Hospital had invasive adenocarcinoma, but it was seen in as many as 4.4 percent at TMDU and 21.9 percent at the CI.

CONCLUSIONS

This study indicates that there were histologic differences between flat neoplasias of the colorectal mucosa harvested in Stockholm and Tokyo. In Japan lesions were obviously more advanced (in terms of HGD) and more aggressive (in terms of intramucosal and submucosal invasion). The cause for the differences found in those two disparate geographic regions remains poorly understood. The results, however, may help us understand some of the unclear points and discussions appearing in the literature on this subject.

Apoptosis in flat neoplasias of the colorectal mucosa

Intraepithelial and intramacrophageal inclusion granules (Leutchenberger bodies) were found in 83.9% of 174 flat neoplastic lesions of the colorectal mucosa. Flat adenomas with high grade dysplasia and flat adenocarcinomas originating in flat adenomas demonstrated a higher proportion of moderate to large (++/ ) numbers of granules than flat adenomas with low grade dysplasia, indicating that the occurrence of apoptotic granules may be related to the "biological age" of the adenoma. Early studies suggest that these inclusions may be the remains of intraepithelial lymphocytes. A lymphoid follicle aggre-gate subjacent to flat adenomas was recorded in 38% of the cases. Whether the intraepithelial lymphocytes derive from the lymphocytes contained in these satellite lymphoid aggregates remains unclear. Conventional and immunohistochemical stains demonstrated that these inclusions represent apoptotic mate-rial. The possibility that tumor cells from flat neoplastic lesions of the colorectal mucosa inflict apoptosis upon non-epithelial (i.e. foreign) cells has been entertained.

Serotonin uptake and its modulation in rat jejunal enterocyte preparation

In order to determine the properties of the intestinal serotonin (5-HT) transport system, we studied 5-HT uptake by villous cell preparations isolated from the rat jejunum. These enterocytes, probably heterogenous in cell population, accumulated 5-HT against concentration gradient up to a concentration 28 times that in the medium; this accumulation occurred in a temperature-dependent fashion. Most of the uptake was the result of a saturable process at low substrate concentrations. The saturable uptake was inhibited by 1 mM potassium cyanide or 1 mM ouabain or by substitution of other cations and sugars for Na+ in the medium. On the other hand, neither several amino acids nor putrescine had any effect on 5-HT uptake. Kinetic analysis yielded a Km value of 3.63 x 10(-7) M and a Vmax value of 5.76 pmol.10(6) cells-1.min-1 for this uptake process. Imipramine inhibited 5-HT uptake in a concentration-dependent fashion, with a Ki value of 3.66 x 10(-7) M. 5-HT uptake was also inhibited by ethyleneglycol-0,0'-bis(2-aminoethyl)-N,N,N',N'-tetraacetic acid, by verapamil, by N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide and by phorbol 12-myristate 13-acetate. These findings suggest that the present enterocyte preparation had a relatively specific secondary active transport system for 5-HT.

The collagen types in the attachment zone of rotator cuff tendons in the elderly: an immunohistochemical study

OBJECTIVE

The attachment zone of the rotator cuff tendons in the elderly was studied immunohistochemically in order to determine how degenerative changes affected the pattern of collagen fiber distribution.

METHODS

Twenty-seven cuffs with their bony insertion were obtained from 22 postmortem cases of both sexes ranging in age from 52 to 90 years and without a history of shoulder ailments. In addition, 3 cuff specimens from cadavers in the 3rd and 4th decades were examined for comparison. Sections of formalin fixed tissues were stained by peroxidase antiperoxidase (PAP) technique using monoclonal antibodies against types I, II and III collagen.

RESULTS

Degenerative changes affecting the fibrocartilage primarily were characterized by calcification, fibrovascular proliferation and microtears. In addition, they were found in all the cuff tendons of elderly individuals but not in those from younger subjects. Immunohistochemically, the attachment zone in areas without degenerative lesions showed collagen type I labelling strongly in bone but only moderately in the fibrocartilage. The predominant labelling in the fibrocartilage was for collagen type II, and collagen type III labelled principally in perichondrocytic areas. The tide-mark showed inconsistent labelling for any of the collagen types. In the presence of degenerative lesions, the disposition of fiber types was interrupted by calcification and microtears. Collagen type II composition of the fibrocartilage was markedly altered by the presence of fibrovascular tissue which labelled only for collagen type III.

CONCLUSION

We conclude that severe degenerative changes in the cuff tendons of elderly individuals, alter the collagen characteristic of the rotator cuff and that the changes could be associated with impairment of biomechanical properties of the attachment zone, and may give rise to the clinical syndrome of enthesopathy.

Immunohistochemical distribution of type I, II and III collagens in the rabbit supraspinatus tendon insertion

The collagen fibres in the area of attachment of the supraspinatus tendon to bone were studied immunohistochemically in 12 mature female New Zealand white rabbits. The labelling of type I collagen was uniformly prominent in the bone as well as in the fascicles of the tendon proper but inconspicuously scattered in the unmineralised and mineralised zones of the fibrocartilage. Type II collagen, not detected in the tendon proper, was widespread in both zones of the fibrocartilage. Type III collagen, on the other hand, appeared to be confined mainly to the zone of unmineralised fibrocartilage, in addition to its presence in the endotenon of the tendon proper. The region of the tidemark failed to show immunostaining for any of the collagen fibre types. In conclusion, this study demonstrates that, although all the principal fibrous collagen types are constituents of the supraspinatus tendon at its attachment site, the distribution pattern of immunolabelling varies from zone to zone.

[The effect of modified sham-feeding on gastrin-stimulated gastric secretion in patient with duodenal ulcer]

Patients with duodenal ulcer were classified into responders to H2-receptor antagonist and non-responders in whom duodenal ulcer did not heal within three months with the antagonist. In these patients and healthy controls, modified sham-feeding (MSF) test was performed to elucidate the pathophysiological differences between these groups, especially vagal activity of acid output. After tetragastrin 4 micrograms/kg/hr infusion for one hour, MSF was superimposed to the infusion (G + MSF). The acid output of non-responders (8 cases) and controls (8 cases) significantly increased in G + MSF. On the other hand, the acid output of responders (6 cases) significantly decreased. The acid output of non-responders in G + MSF was also significantly higher than that of controls. The results suggest that vagal activity of non-responders is higher than responders, and that there is disturbance of inhibitory mechanism in vagal system.

Characteristics of spermidine uptake by isolated rat enterocytes

Eukaryotic cells require polyamines for growth. The supply of polyamines to growing cells may be increased either by new synthesis or increased uptake. We have recently shown that putrescine uptake by isolated rat enterocytes is energy dependent, saturable, and ouabain insensitive. Although putrescine uptake was inhibited by putrescine and cadaverine, it was not inhibited by equal concentrations of spermine and spermidine. These data indicated that a carrier mechanism separate from that putrescine existed for spermidine and spermine. In the current study spermidine uptake by isolated enterocytes was saturable, temperature dependent, and inhibited by 1 mM KCN. Kinetic analysis resulted in a Km = 2.51 x 10(-6) M and a Vmax = 3.57 x 10(-12) mol.10(6) cells-1.15 min-1. Spermidine uptake was 70% inhibited by 1 mM ouabain. Replacement of sodium by choline, lithium, tetramethylammonium, or N-methyl-D-glucamine also inhibited spermidine uptake. Replacement of Na+ by mannitol or sucrose, however, depressed uptake but not significantly. Spermidine uptake was inhibited by 1 mM ouabain. Spermidine uptake was inhibited by relatively low concentrations of spermine and high concentrations of putrescine; while putrescine uptake was inhibited by relatively high concentrations of both spermine and spermidine. Kinetic data indicated that spermidine and spermine share a carrier that is distinct from the one mediating the uptake of putrescine. While spermidine uptake does not appear to depend on Na+ cotransport, it may be dependent on the electrical gradient established by the Na+-K+-ATPase.

Characteristics of putrescine uptake in isolated rat enterocytes

Polyamines are necessary for the growth of eukaryotic cells and are supplied either by new synthesis or cellular uptake. To our knowledge, no information is available on polyamine uptake by gastrointestinal cells. In the current study, isolated villous enterocytes from the rat accumulated putrescine to an eightfold concentration gradient. Uptake was temperature dependent, saturable, and inhibited by 1 mM KCN. Kinetic analysis showed a Km of 1.23 X 10(-5) M and a Vmax of 2.60 X 10(-10) mol.10(6) cells-1.15 min-1. Enterocytes from the distal one-fourth of the gut showed the highest rate of uptake. Putrescine uptake was inhibited by cadaverine and spermine but not by the amino acids asparagine, AIB, or leucine. Sodium replacement by choline, lithium, N-methyl-D-glucamine, or tetramethylammonium significantly inhibited uptake, but replacement of Na+ by sucrose or mannitol was without effect. The inhibition observed was believed to be due to the ability of the cations to interact in some way with the carrier. Neither ouabain nor digitoxigenin had any effect on uptake. These data indicate that putrescine is accumulated by villous enterocytes by a carrier-mediated process that does not appear to involve Na+ contransport.

Cyclic AMP in gastric juice does not reflect histamine H2 receptor activity in Heidenhain pouch dog

It is strongly believed that cAMP mediates histamine H2 receptor activity, but does not mediate gastrin and acetylcholine stimulation of gastric acid secretion. Therefore, cAMP production could be a marker of H2 receptor activity. Whether endogenous histamine mediates gastrin and/or acetylcholine stimulation, at least partially, remains to be elucidated. If cAMP in the gastric juice reflects H2 receptor activity, we can investigate whether endogenous histamine mediates gastrin and/or acetylcholine stimulation in vivo. In this study, we investigated whether cAMP in the gastric juice reflected histamine H2 receptor activity in the Heidenhain pouch dog in vivo using different kinds of inhibitors of gastric secretion. Our hypothesis was as follows: Upon betazole stimulation, cimetidine, an H2 receptor antagonist, should decrease cAMP output into the gastric juice, but omeprazole, an H+, K+-ATPase blocker, should not, because it blocks at a site more peripheral than the H2 receptor and the production of cAMP. Sixty minutes after betazole administration, 4.0 mumol/kg of cimetidine and 0.18 mumol/kg omeprazole were administered intravenously and they inhibited gastric juice volume to a similar degree, that is, 49.6% and 52.1%, respectively. However, omeprazole caused a greater decrease in cAMP output than cimetidine. Inhibition with 4 mumol/kg/h of cimetidine or 0.2 mumol/kg of omeprazole from the beginning of betazole stimulation also caused similar decreases in gastric juice volume, 66.6% and 60.6%, respectively. Both inhibitors decreased cAMP output into the gastric juice in a similar fashion in the first two 30 minute periods. These results do not agree with our hypothesis.(ABSTRACT TRUNCATED AT 250 WORDS)

The role of carbonic anhydrase in gastric mucosal protection with special reference to H+ back diffusion and concomitant metabolic acidosis induced by acetazolamide

It is suggested that carbonic anhydrase is implicated not only in gastric acid secretion, but in mucosal protection. It was reported that acetazolamide induced gastric mucosal lesions. But acetazolamide also caused concomitant metabolic acidosis by inhibiting H+ secretion from renal tubules. We investigated whether concomitant metabolic acidosis is implicated in gastric mucosal lesions induced by acetazolamide in vivo. We also evaluated the effect of acetazolamide on gastric H+ back diffusion in vivo. Correction of metabolic acidosis with sodium bicarbonate had no effect on the degree of the gastric mucosal lesions. Acetazolamide caused no change in gastric H+ and Na+ flux. These results suggest that metabolic acidosis induced by acetazolamide is not implicated in gastric mucosal lesions. Carbonic anhydrase has no effect on H+ back diffusion but may be implicated in mucosal protection by the disposition of back diffused H+ into the gastric mucosa.

Evaluation of the new giant-biopsy forceps in the diagnosis of mucosal and submucosal gastric lesions

In order to improve the diagnosis of gastric disorders on the basis of biopsy material, we devised larger biopsy forceps (5 mm X 2.5 mm in inside dimensions) which fit into the newer fibergastroscope, GIF-1T (Olympus). Samples from 116 cases yielded 276 specimens; 179 specimens (64.8%) showed the full-thickness of the mucosa with muscularis mucosae, and approximately one-third of the total specimens included a considerable amount of submucosal tissue, but none of them contained parts of muscularis propria. In 4 out of 36 gastric carcinoma cases there was inconsistency between endoscopic and histological recognition of the proximal border of carcinomatous infiltration. Differentiation between adenoma and IIa, and benign and malignant lymphoma were more feasible with our forceps. No complications apart from minor bleeding were seen.

In vitro regeneration of resting lymphocytes from stimulated lymphocytes and its inhibition by insulin

Concanavalin A- (Con A) stimulated mouse lymphocytes were separated from unstimulated cell populations by a bovine serum albumin (BSA) density gradient centrifugation 2 days after the stimulation. The stimulated cells divided, but did not initiate a new round of DNA replication when cultured further in the absence of Con A. The divided cells became similar in various properties to unstimulated lymphocytes during a prolonged incubation, suggesting that they entered the resting state. In the present study, the process toward the resting state of lymphocytes from the proliferating state was manifested by: a) a decrease in a cell volume, b) lowering of protein content, c) a loss of responsiveness to T cell growth factor (Interleukin 2) (TCGF(IL2)) probably as a result of disappearance of TCGF(IL2) receptors, d) disappearance of insulin receptors, and e) a duration of time lag between the addition of Con A and the onset of DNA synthesis. In addition, it was found that insulin was not mitogenic for recently divided lymphocytes, but prevented these cells from entering the resting state. This suggests that there may be an in vivo system that keeps stimulated lymphocytes highly responsive to antigens for at least several days without initiating DNA synthesis and cell division.

In vitro regeneration of resting lymphocytes from stimulated lymphocytes and its inhibition by insulin

Concanavalin A- (Con A) stimulated mouse lymphocytes were separated from unstimulated cell populations by a bovine serum albumin (BSA) density gradient centrifugation 2 days after the stimulation. The stimulated cells divided, but did not initiate a new round of DNA replication when cultured further in the absence of Con A. The divided cells became similar in various properties to unstimulated lymphocytes during a prolonged incubation, suggesting that they entered the resting state. In the present study, the process toward the resting state of lymphocytes from the proliferating state was manifested by: a) a decrease in a cell volume, b) lowering of protein content, c) a loss of responsiveness to T cell growth factor (Interleukin 2) (TCGF(IL2)) probably as a result of disappearance of TCGF(IL2) receptors, d) disappearance of insulin receptors, and e) a duration of time lag between the addition of Con A and the onset of DNA synthesis. In addition, it was found that insulin was not mitogenic for recently divided lymphocytes, but prevented these cells from entering the resting state. This suggests that there may be an in vivo system that keeps stimulated lymphocytes highly responsive to antigens for at least several days without initiating DNA synthesis and cell division.

Dessociation and reconstitution of colicin E3 and immunity substance complex

It has recently been found that so-called native colicin E3, which has been used for studies of its mode of action, is a complex of two kinds of proteins. The complex could be dissociated into the two components in SDS. These components were isolated by gel filtration of 1% SDS followed by treatment with Sowex-2 to remove bounds SDS. One component, characterized by its low molecular weight, prevented colicin E3-induced inhibition of poly(U)-dependent protein synthesis and was designated as immunity substance. The other component (protein A), which was of high molecular weight, had 100-fold higher in vitro ribosome-inactivating activity than native colicin E3, but had lower bacteriocidal activity. Colicin E3 was reconstituted from the two isolated protein components. The reconstituted colicin E3, when compared with protein A, showed a decrease in in vitro activity (inhibition of poly(U)-dependent protein synthesis), but had higher bacteriocidal activity in vivo. Thus complex formation of protein A with immunity substance should play and important role in the bacteriocidal action, but protein A itself might inactivate ribosomes in the interior of the sensitive cells.