Longitudinal changes of plasma pancreatic enzymes and hormones in experimental pancreatolithiasis in dogs

Plasma pancreatic enzymes and hormones were longitudinally observed after producing partial obstruction of the major pancreatic duct in dogs to study an initial state of chronic pancreatitis or pancreatolithiasis. Fasting plasma immunoreactive cationic trypsin was elevated during the first six months and then decreased in a subgroup with pancreatic calculi, marked fibrosis, or duct dilatation when compared with the corresponding opposite at the end of the 12-month period. Similar but less prominent changes were found in fasting plasma immunoreactive pancreatic polypeptide (IRPP). Plasma amylase, glucose, or immunoreactive insulin or glucagon (IRG) show no significant variation. Plasma IRG and IRPP responses to intravenous insulin were reduced in the subgroups with marked pancreatic changes towards the end of the 12-month period. These results suggest that plasma pancreatic enzymes and hormones remain elevated as long as pancreatic damage is mild and then start to decline as the damage progresses in chronic pancreatitis or pancreatolithiasis.

Sensitive method for determination of nicorandil in human plasma by reversed-phase high-performance liquid chromatography with ultraviolet detection

A sensitive method for the determination of nicorandil, an anti-anginal drug, has been developed. The method involves solid-phase extraction of the drug and an internal standard using a Bond-Elut PH extraction column, liquid-liquid extraction with methyl acetate and dichloromethane, and reversed-phase high-performance liquid chromatography on a mu Bondapak C18 column with an ultraviolet detector. The limit of determination in plasma was 3 ng/ml and the intra-day coefficient of variation (n = 7) was less than 10%.

Serum pancreatic stone protein in pancreatic diseases

Serum pancreatic stone protein (PSP) was determined in sera of pancreatic and nonpancreatic diseases using enzyme immunoassay specific to human PSP to study the diagnostic and pathophysiological significance of PSP. Serum PSP in acute pancreatitis (mean +/- SD = 1075.4 +/- 2849.1 ng/mL, n = 33) was significantly higher than that in controls (78.6 +/- 31.8 ng/mL, n = 37, p < 0.01), chronic pancreatitis (156.8 +/- 82.8 ng/mL, n = 32, p < 0.05), and pancreatic cancer (148.468.8 ng/mL, n = 26, p < 0.05). No significant difference was found between noncalcified and calcified chronic pancreatitis. Serum PSP levels were significantly higher in chronic renal failure under hemodialysis (1796.0 +/- 1492.9 ng/mL) than in other diseases such as peptic ulcer, liver cirrhosis, gallstone, and diabetes mellitus. Low but significant correlation was obtained between serum PSP and serum immunoreactive trypsin (r = 0.22, p < 0.05). Increased serum PSP levels in acute pancreatitis and chronic renal failure suggest that serum PSP levels reflect reflex from pancreatic secretion, release from damaged pancreatic acinar cells, or retention in circulation, and can be useful for diagnosis of acute pancreatitis, but not chronic calcified pancreatitis.

Separation and characterization of dermatan sulfate in normal human urine

Dermatan sulfate excreted in normal human urine was isolated and characterized by TLC and cellulose acetate strip electrophoresis after cetylpyridinium chloride precipitation and pronase digestion. In these separation methods, dermatan sulfate and chondroitin sulfate were extracted and then monitored by sensitive HPLC methods with post column fluorometric derivatization coupled with chondroitinase ABC, ACII and B digestion. From the results, we demonstrated that human urinary dermatan sulfate contains iduronic acid as its major uronic acid (80-90% of total uronic acid), and is composed mainly of repeated mono-sulfated disaccharide units [Di-4S (structure shown in Fig. 1), 89%] and small numbers of di-sulfated disaccharide units (Di-diSB, 7% and Di-diSE, 1%).

Effect of a new synthetic trypsin inhibitor on taurocholate-induced acute pancreatitis in rats

The effect of a novel synthetic trypsin inhibitor, 4-sulfamoylphenyl 4-guanidinobenzoate methanesulfonate (ONO-3307), on severe acute pancreatitis was studied by changing its timing, frequency, and dose in trypsin-taurocholate-induced acute experimental pancreatitis in rats. Rats were divided into four groups according to difference of ONO-3307 administration: group A, 2 mg/0.5 ml of ONO-3307 s.c. 1 h before and after induction of pancreatitis; group B, 2 mg/0.5 ml s.c. 1 and 3 h after; group C, 4 mg/1 ml s.c. 1 h before; group D, 4 mg/1 ml s.c. 1 h after. The survival rate at 24 h was significantly improved in group A (75% in A vs. 17% in control; p < 0.01) and in group B (57 vs. 29%; p < 0.05), but not in group C or D. Amylase and immunoreactive trypsin in serum and ascites of the treated were significantly lower than those of controls in both groups A and B. The survival rates were improved dose dependently when ONO-3307 was administered 1 h before and after induction of pancreatitis. ONO-3307 showed favorable effects on the initial stage of severe acute pancreatitis when given in divided doses to maintain the effective serum levels.

Inhibitory effect of intraduodenal infusion of loxiglumide on pancreatic exocrine secretion

Inhibitory effect of loxiglumide (D,L-4-(3, 4-dichlorobenzoylamino)-5-(N-3-methoxypropyl-pentylamino)-5- oxo-pentanoic acid, CAS 107097-80-3) on exocrine pancreatic secretion was compared between intraduodenal and intravenous administration. Doubling doses of intravenous cholecystokinin octapeptide (CCK-8) resulted in a dose-dependent increase of pancreatic secretion from 50 to 400 ng/kg/h. Both intraduodenal and intravenous loxiglumide of 5 and 10 mg/kg/h produced a dose-dependent inhibition of the pancreatic protein secretion to all doses of CCK-8. Cumulative increment of pancreatic protein output was inhibited by 79% and 77% at 10 mg/kg/h of intraduodenal and intravenous loxiglumide, respectively. Extents of the inhibition were similar to each other between the two routes of loxiglumide infusion. However, plasma levels of loxiglumide after intraduodenal administration were about half of those observed after intravenous administration of the corresponding dose, although plasma CCK levels were not different. Intraduodenal loxiglumide is as effective as intravenous loxiglumide in inhibitory potency on pancreatic secretion. Therefore, possible therapeutic indications of oral loxiglumide could be expected.

The effect of somatostatin analogue octreotide on amylase secretion from mouse pancreatic acini

To clarify whether somatostatin has an inhibitory effect on pancreatic acinar cells, we studied the effect of a long-acting analogue of somatostatin, octreotide, on amylase secretion from isolated mouse pancreatic acini. Octreotide (100 nM) had no inhibitory effects on amylase secretion stimulated by secretin or vasoactive intestinal polypeptide (VIP), while reducing the increase of cyclic adenosine 3',5'-monophosphate (cAMP). On the other hand, octreotide inhibited synergistic amylase secretion induced by secretin or VIP in combination with cholecystokinin (CCK). Octreotide also reduced synergistic amylase secretion by secretin or VIP in combination with calcium ionophore A23187. CCK and A23187 did not alter the increase of cAMP induced by secretin and the inhibitory effect of octreotide on cAMP production. Octreotide did not significantly inhibit amylase secretion stimulated by dibutyryl cAMP (dbcAMP) alone, but reduced synergistic amylase secretion by dbcAMP+A23187. Results obtained above reveal that octreotide has a direct inhibitory effect on amylase secretion from mouse pancreatic acini and probably affects stimulus secretion coupling at a point distal to the production of cAMP, besides inhibiting adenylate cyclase.

Measurement of uptake and incorporation of nucleic acid precursors by preimplantation mouse embryos after development in vivo and in vitro

PURPOSE

To assay DNA and RNA synthesis by developing mouse embryos in vitro and in vivo, we measured the uptake and incorporation of 3H-thymidine and 3H-uridine by morulae and blastocysts. We also evaluated the effect of adding EDTA to the culture medium on the uptake and incorporation of nucleic acid precursors by blastocysts.

RESULTS

Thymidine and uridine incorporation increased after morulae developed into early blastocysts both in vitro and in vivo. However, the rates of uptake and incorporation were significantly lower by embryos grown in vitro than by those grown in vivo. The ratios of incorporation to total uptake were similar in embryos grown in vitro and in vivo. EDTA (100 microM) added to the culture medium significantly increased the incorporation of uridine into RNA by blastocysts grown in vitro (P < 0.01) but did not increase the total uptake of uridine.

CONCLUSION

These observations showed that both DNA and RNA synthesis increased during the early development of preimplantation embryos and that those activities were reduced in embryos undergoing development in vitro. The results also suggested that through the mechanism of EDTA effect in embryo culture remains unknown, it appeared to reduce the retardation of RNA synthesis by embryos cultured in vitro through a selective stimulation of uridine incorporation.

Evaluation of measurement of fetal crown-rump length from ultrasonically timed ovulation and fertilization in vitro

To assess with accuracy the development and maturity of the fetus, we evaluated fetal growth in 46 pregnant women who had conceived subsequent to ultrasonically timed ovulation. Fetal crown-rump length (CRL) was measured at gestational ages that differed by about 1 day from those previously reported. The variance in CRL measurements at each gestational age was small, and the data were normally distributed. The CRL growth curves of this and previous studies were tested using measurements from 7 pregnancies derived from in vitro fertilization (IVF). The data from IVF pregnancies were consistent with our curve, having 1 day difference to those previously reported. The gender of the fetus did not influence the CRL during the first trimester. The results suggest that fetal growth is uniform during the first trimester.

Pancreatic stone predominantly composed of fatty acid calcium

A 41-year-old man with chronic pancreatitis and pancreatic stones predominantly composed of fatty acid calcium is reported. He had complained of occasional abdominal pain for 10 years and visited the hospital because of a severe attack of abdominal pain. Laboratory data supported a diagnosis of pancreatitis. Computed tomography (CT) showed a high-density area in the head of the pancreas, and the CT number of this high-density area was lower than usual for pancreatic stones. Ultrasonography and endoscopic retrograde pancreatography showed a cystic lesion with small pancreatic stones in the head of the pancreas and irregular dilatation of the main pancreatic duct. Pancreaticojejunostomy and resection of pancreatic cyst were carried out for repeated episodes of abdominal pain under the diagnosis of chronic pancreatitis. The pancreatic stones obtained at surgery were proved to be mainly composed of fatty acid calcium after analysis of chemical composition of the stones. Fatty acid calcium was sometimes found in the biliary stones but never in the pancreatic stones.

Effects of calmodulin inhibitors on amylase secretion from rat pancreatic acini

To investigate the role of calmodulin in stimulus-secretion coupling in pancreatic acinar cells, we studied the effects of W-7, a calmodulin inhibitor, and KN-62, a specific inhibitor of Ca2+/calmodulin-dependent protein kinase II (Ca2+/CaM kinase II), on amylase secretion from rat pancreatic acini. Calmodulin inhibitor (W-7, 100 microM) and Ca2+/CaM kinase II inhibitor (KN-62, 10 microM) reduced amylase secretion stimulated by cholecystokinin (CCK) or carbachol. W-7 and KN-62 also inhibited amylase secretion stimulated by both calcium ionophore (A23187) and phorbol ester (12-O-tetradecanoylphorbol-13-acetate, TPA). To clarify the role of calmodulin in the interaction of intracellular mediators, pancreatic acini were permeabilized with streptolysin O. Following permeabilization, amylase secretion was stimulated by submicromolar free Ca2+, and this Ca(2+)-dependent amylase secretion was enhanced by guanosine 5'-[gamma-thio]triphosphate (GTP gamma S), TPA or cyclic adenosine 3',5'-monophosphate (cAMP). W-7 and KN-62 had no effects on amylase secretion stimulated by Ca2+ alone, but inhibited the enhancement in Ca(2+)-dependent amylase secretion by GTP gamma S, TPA or cAMP. These data suggest that calmodulin plays an important role in Ca(2+)-dependent amylase secretion from pancreatic acinar cells and in the interaction between Ca2+ and other intracellular messengers.

Transvaginal ultrasound-guided follicular aspiration in the management of anovulatory infertility associated with polycystic ovaries

STUDY OBJECTIVE

To investigate whether or not transvaginal ultrasound (US)-guided follicular aspiration can effectively induce ovulation and facilitate pregnancy in anovulatory patients with polycystic ovaries (PCO).

DESIGN

Eight patients with polycystic ovarian disease (PCOD) and 10 patients with PCO were participants who failed to ovulate by the medical therapies. Most of persistent follicles were punctured, and their contents were thoroughly aspirated during the midluteal phase. The same ovarian stimulation regimen as used in the previous cycles were administered in the cycles after the aspiration.

MAIN OUTCOME MEASURES

Evidence of ovulation and a subsequent pregnancy was ultrasonically monitored after the aspiration, and the responsiveness of pituitary gonadotropins to gonadotropin-releasing hormone was tested in these patients.

RESULTS

The ovulation rates were 87.5% per patient, 52.6% per cycle monitored in PCOD patients and 100% per patient, 63.3% per cycle monitored in PCO patients, respectively. Half of the patients both with PCOD and PCO achieved pregnancy after the aspiration. A significant decrease (P less than 0.05) of the basal and peak levels of serum luteinizing hormone was observed after the aspiration.

CONCLUSIONS

The US-guided follicular aspiration seems to be a new surgical method for treating anovulatory patients with PCO.

[Diagnostic value of serum level of alpha 2-macroglobulin-trypsin complex in pancreatic diseases using a colorimetric assay with a synthetic chromogenic substrate]

We measured serum level of alpha 2-macroglobulin-trypsin complex (alpha 2M-T complex) using a colorimetric assay with a synthetic chromogenic substrate, D-gamma-tert-butyloxy-Gly-Arg-3-carboxy-4-hydroxyanilide dihydrochloride. Serum level of alpha 2M-T complex was greater in acute pancreatitis patients than in chronic pancreatitis or pancreatic cancer patients. In severe acute pancreatitis patients, both mean level and frequency of abnormal value of serum alpha 2M-T complex were significantly greater than in mild acute pancreatitis patients (13.1 +/- 12.9 vs 2.9 +/- 3.5 U/L, p less than 0.01; 100 vs 41%, p less than 0.01). In conclusion, the determination of serum level of alpha 2M-T complex can be useful for the diagnosis of severe acute pancreatitis.

Elevation of serum phospholipase A2 in patients at an intensive care unit

To evaluate the organ specificity of pancreatic phospholipase A2 (PLA2) and the diagnostic value of the elevation of serum PLA2 levels in patients with serious diseases not involving the pancreas, we studied the organ distribution of PLA2 in autopsy specimens and serum level of PLA2 in patients who required admission to an intensive care unit (ICU). PLA2 was measured by a specific radioimmunoassay (RIA), using monoclonal antibody against human pancreatic PLA2. Organ distribution of PLA2 revealed that the pancreas showed a much higher content of pancreatic PLA2 immunoreactivity than any other organ. An abnormally high value of serum PLA2 was observed in 18 of 30 patients (60%) at ICU. Both serum PLA2 and pancreatic isoamylase were elevated in 11 patients (37%). Of 11 patients with hyperphospholipasemia and hyperamylasemia, serum creatinine was elevated in five patients and blood urea nitrogen in nine patients. Serum PLA2 levels did not always rise comparably to serum creatinine and blood urea nitrogen levels. Serum PLA2 values showed the best correlation with serum lactate dehydrogenase levels among routine blood-chemistry tests. The elevation of serum PLA2 was ascribable to renal dysfunction or ischemic pancreatic damage secondary to circulatory collapse with multiple organ failure.

Determination of human urinary hyaluronic acid, chondroitin sulphate and dermatan sulphate as their unsaturated disaccharides by high-performance liquid chromatography

A method for the determination of hyaluronic acid (HA), chondroitin sulphate (CS) and dermatan sulphate (DS) was developed. HA, CS and DS were converted to the corresponding unsaturated disaccharides by digestion with chondroitinase ABC and/or chondroitinase AC-II and determined by high-performance liquid chromatography with fluorimetric detection using 2-cyanoacetamide as a post-column derivatization reagent. The calibration graphs for the unsaturated disaccharides were linear over the range 2 ng - 2 micrograms for each unsaturated disaccharide. This method was applied to the analysis of normal human urine.

[A prospective trial of the mass survey for pancreatic cancer using serum markers and ultrasonography]

We designed a prospective trial of the mass survey for pancreatic disease, especially pancreatic cancer in consecutive 2576 subjects undergoing periodical health examination during 1989. In order to detect abnormality of the pancreas we measured serum amylase, elastase-1 and SPan-1 as serum markers and used ultrasonography (US). When abnormal elevation of serum markers or abnormal findings of US were obtained at the first screening, re-examination or further examination using ERCP, CT and endoscopic US were performed. Frequencies of elevated amylase, elastase-1 or SPan-1 were 0.9%, 3.4% or 1.7%, respectively. However, no pancreatic diseases were detected among the cases of elevated serum markers after subsequent further examination. Frequency of abnormal US findings of pancreas were 2.3% (59/2576), including dilatation of main pancreatic duct, cystic lesion, space occupying lesion and calcification. Subsequent further examinations on subjects with abnormal US revealed 8 cases of pancreatic diseases including one small pancreatic cancer. US may be an efficient tool of mass survey for pancreatic cancer in the health examination at present.

Dissociation of serum fructosamine from fasting plasma glucose or hemoglobin A1c in diabetics

To evaluate serum fructosamine as an indicator for diabetic control, serum fructosamine (FRA), glycosylated hemoglobin (HbA1c) and fasting plasma glucose (FPG) were simultaneously measured in 452 diabetics in stable diabetic control. We divided the measured FRA according to the degree of deviation from the expected FRA into three types, hyper-FRA, normo-FRA and hypo-FRA. In the hypo-FRA to HbA1c group, frequencies of male (70 vs 35, 43%) and of nephropathy (61 vs 30, 18%) were higher and mean total serum protein (6.5 vs 7.4, 7.4 g/dl) and albumin (3.4 vs 4.1, 4.0 g/dl) were lower than those in the other two corresponding groups. Correlation was also poorer in the insulin-treated group than the others. These results probably reflect conditions of diabetic control and complication, and protein metabolism. Similar tendencies were observed in case of FPG. Therefore, the discrepancy of FRA gives a clue to detect poor control and complications of diabetes.

[The evaluation of ultrasonic oocyte collection techniques for IVF-ET--comparing the transabdominal and transvaginal methods]

In order to evaluate the effectiveness and safety of ultrasonic oocyte collection for IVF-ET, a comparative study was performed on the results of IVF-ET by the transabdominal and transvaginal methods in 145 cycles of 51 patients. The oocyte collection rate for the transvaginal method was significantly higher than that for the transabdominal method (77.1% vs. 68.7% per follicle, p less than 0.01). The majority of the oocytes were collected in three follicular flushings. The fertilization rate for oocytes collected by the transabdominal method was significantly higher than that for those collected by the transvaginal method in cases of tubal damage and endometriosis (81.1% vs. 65.6% per oocyte, p less than 0.01). There was no significant difference between the signs of complications seen with the two methods. Six successful pregnancies were obtained by IVF-ET in our hospital (4 cases by the transabdominal method, and 2 cases by the transvaginal method). Two of these cases have already delivered full term healthy male infants. In conclusion, these results indicate that ultrasonic oocyte collection has been established as the most effective method for IVF-ET by means of either the transabdominal or the transvaginal methods.

Effects of chaetoglobosin J on the G-F transformation of actin

It was shown that substoichiometric concentrations of chaetoglobosin J, one of the fungal metabolites belonging to cytochalasins, inhibited the elongation at the barbed end of an actin filament. Stoichiometric concentrations of chaetoglobosin J decreased both the rate and the extent of actin polymerization in the presence of 75 mM KCl, 0.2 mM ATP and 10 mM Tris-HCl buffer at pH 8.0 and 25 degrees C. In contrast, stoichiometric concentrations of cytochalasin D accelerated actin polymerization. Chaetoglobosin J slowly depolymerized F-actin to G-actin until an equilibrium was reached. Analyses by a number of different methods showed the increase of monomer concentration at equilibrium to depend on chaetoglobosin J concentrations. F-actin under the influence of stoichiometric concentrations of chaetoglobosin J only slightly activated the Mg2+-enhanced ATPase activity of myosin at low ionic strength. It is suggested that when the structure of the chaetoglobosin-affected actin filaments is modified, the equilibrium is shifted to the monomer side, and the interaction with myosin is weakened.