Interleukin-3 or immunoglobulin E promotes expression of protein kinase C delta gene in murine mast cells

We reported previously that protein kinase C delta (PKCdelta) is the main isoenzyme in various types of murine mast cells. In the present study we investigated the regulation of expression of PKCdelta gene in murine mast cells in vitro and in vivo. The mRNA expressions of PKCdelta were promoted in response to interleukin-3 (IL-3) or immunoglobulin E (IgE) in mouse mastocytoma P-815 cells. In addition we have evaluated the mast cells which express PKCdelta mRNA in IgE-dependent passive cutaneous anaphylaxis reaction, using in situ hybridization with the antisense riboprobe in skin. These results indicate that mast cell activation can induce a marked promotion in steady state levels of PKCdelta mRNA.

An alternative continuous caudal block with caudad catheterization via lower lumbar interspace in adult patients

BACKGROUND

Continuous caudal block with caudad catheterization has not yet been mentioned in literatures. We designed a preliminary study to investigate the feasibleness of this technique, spread of contrast medium under fluoroscopy, and its clinical effectiveness.

METHODS

Ten patients were subjected to epidural block (caudal) for elective anal or vaginal procedures. The entry of the epidural needle was made at the L4-5 interspace either with midline or paramedian approach. Through an 18 G Touhy needle with its bevel facing caudally an epidural catheter was threaded until a length of 10 cm was beyond the point of entry. The presence or absence of paresthesia during the passage of catheter and the ease with which the catheter was inserted were recorded. After the procedure, the course on which the catheter traversed and the spread of the medicinal substance in the epidural space were visualized and studied fluoroscopically using 1 and 3 ml iohexol (omnipaque 300 mg/ml) as contrast medium respectively. Then the patients were brought to operating rooms for anesthesia and surgery. Sensory anesthetic level and motor blockade were evaluated fifteen min after 11-15 ml of 2% lidocaine had been injected through the epidural catheter. During anesthesia vital signs were closely monitored, and adverse reaction if any was evaluated and managed.

RESULTS

The insertion of the epidural catheter was considered easy and caused no paresthesia in nine patients. Catheter insertion encountered moderate resistance and induced paresthesia in one patient. Yet, the catheter was advanced successfully to the expected length. In radiological study with contrast medium, the course of the epidural catheter was not always traceable, while the spread of the contrast medium was clearly identified. Epidural spread occurred in eight patients, left paravertebral spread in one patient, and right retrorectal spread in another one patient. As to clinical assessment, adequate sensory blockade with local anesthetic was gained in 8 patients with well-preserved motor function of the lower limbs. In one patient the caudal block worked well after the withdrawal of the catheter 5 cm in length. Spinal anesthesia was supplemented in one patient due to failure of the caudal block.

CONCLUSIONS

Continuous caudal block with caudawise catheterization via lower lumbar interspaces is feasible (eight of 10 patients in this study) with respect to technique and clinical effect. Paravertebral and retrorectal migrations of the catheter may occur in spite of smooth catheterization. Either migration might lead to a failure of caudal block.

Immunohistochemical study of 3beta-hydroxysteroid dehydrogenase/delta5-delta4 isomerase in the rat cardiovascular system

The enzyme complex 3beta-hydroxysteroid dehydrogenase (3beta-HSD) is involved in the biosynthesis of all classes of active steroids. It is known that the enzymatic activity of 3beta-HSD is present not only in classical steroidogenic tissues, but also in many peripheral tissues including cardiac tissue. To determine whether 3beta-HSD is present in rat non-steroidogenic tissues, we examined cardiovascular tissues including the ventricle, atrium, aortic arch, abdominal aorta, and inferior vena cava by immunohistochemistry and Western blotting using polyclonal antibody raised against a synthetic peptide of human placental 3beta-HSD. By Western blotting, protein bands immunoreactive for anti-3beta-HSD were detected at molecular weights of 42 and 37 kDa in both the ventricle and atrium, whereas only a 37 kDa band was recognized in both the aortic arch and abdominal aorta. By immunohistochemistry, immunoreactivity for 3beta,-HSD was detected in both the ventricular and atrial cardiocytes, while immunostaining was also found, though faintly, in the smooth muscles of the aortic arch, abdominal aorta, and inferior vena cava. These results suggest that cardiocytes may synthesize the steroidogenic 3beta,-HSD enzyme.

Intracerebral hemorrhage in a young woman with arteriovenous malformation after taking diet control pills containing phenylpropanolamine: a case report

Administration of phenylpropanolamine (PPA) is a rare cause of intracerebral hemorrhage. We present the case of a young female patient with arteriovenous malformation who suffered an intracerebral hemorrhage after ingestion of diet pills containing PPA. The literature on PPA-related intracerebral hemorrhage is also reviewed. This is the first report of PPA-associated intracerebral hemorrhage in a patient with pathology-proven arteriovenous malformation of the brain. Because intracerebral hemorrhage may develop as a side effect of PPA when patients take the manufacturer's recommended dose, especially in patients with vascular abnormalities, we conclude that this medicine should be prescribed carefully and patients should be closely monitored by experienced physicians. Furthermore, its use should be contraindicated in patients who have, or possibly have, a family history of vascular abnormalities.

Functional expression of the bovine herpesvirus 1 alkaline deoxyribonuclease (UL12) in Escherichia coli

Sequence analysis within the unique long segment of the bovine herpesvirus 1 (BHV-1; infectious bovine rhinotracheitis virus) genome identified an open reading frame whose deduced protein product of 487 amino acids exhibited homology to alkaline deoxyribonucleases (DNases) of other herpesviruses. To determine this BHV-1 gene product has nuclease activity, the gene designated UL12 was inserted into the vector pET-28a(+) and expressed in Escherichia coli as an oligohistidine-tagged protein. Upon induction with isopropyl beta-D-thiogalactopyranoside E. coli BL21 (DE3) [pLysS] cells carrying this recombinant plasmid produced a 57-kDa protein, the molecular mass of which was in accordance with the prediction from the DNA sequence. The recombinant UL12 protein purified by nickel-chelating affinity chromatography exhibited both exonuclease and endonuclease activity, each with an alkaline pH optimum.

Dioxin contents in fly ashes of MSW incineration in Taiwan

Fly ashes from three municipal solid waste (MSW) incinerators in Taiwan were collected and segregated into different fractions for determining the physical and chemical properties and dioxin contents. Analysis of ashes with each fraction indicated that fine particles had higher dioxin contents than large particles. Dioxin homologue components of ashes generated from large-scale mass burn MSW incinerator were less toxic than that from small-scale batch incinerators, and contained less non-2,3,7,8 PCDD/Fs. Correlation analysis did not reveal a consistent trend between dioxins content and ashes' physical properties, while strong positive correlation was found between dioxins content and chloride content. Positive correlation between dioxin content and heavy metals content such as copper and zinc in the fly ash was also established.

The peripheral analgesic effect of meperidine in reducing propofol injection pain is not naloxone-reversible

BACKGROUND AND OBJECTIVES

Meperidine is frequently used in general anesthesia and perioperative analgesia. In addition to its opioid action, meperidine possesses some local anesthetic properties. A preliminary study using the tourniquet venous retention technique found meperidine to be more effective in reducing propofol injection pain than fentanyl or morphine, both of which were slightly better than placebo. This study was undertaken to evaluate whether this peripheral analgesic effect of meperidine is affected by naloxone.

METHODS

In a randomized, double-blind manner, after venous occlusion with a tourniquet, meperidine 40 mg was given intravenously to patients in group A (n = 31), meperidine 40 mg followed by naloxone 0.04 mg to group B (n = 32), meperidine 40 mg followed by naloxone 0.2 mg to group C (n = 30), and normal saline placebo to group D (n = 30). The venous retention of drug(s) was maintained for 1 minute, followed by tourniquet release and intravenous administration of propofol 100 mg. Pain assessment was made immediately after the propofol injection.

RESULTS

All three groups given meperidine had significantly less propofol injection pain (P < .01 ) than the group given saline placebo, and there was no difference among groups A, B, and C.

CONCLUSION

The peripheral analgesic effect of meperidine in reducing propofol injection pain is not mediated by its opioid activity.

Comparison of intravenous retention of fentanyl and lidocaine on local analgesia in propofol injection pain

BACKGROUND

With a tourniquet on arm for arresting venous blood flow, we evaluated the efficacy of intravenous (i.v.) retention of fentanyl and lidocaine in reducing the pain on i.v. propofol injection during general anesthesia.

METHODS

One hundred and twelve patients were studied. Following a venous occlusion by a tourniquet inflated to 70 mmHg, patients in Group A (n = 38) received normal saline (NS) 3 ml, while those in Group B (n = 37) and in Group C (n = 37) respectively received fentanyl 150 micrograms or 3 ml and 2% lidocaine 3 ml (60 mg). The venous retention of drug was maintained for 1 min, followed immediately by tourniquet release and propofol 100 mg i.v. injection over 20 s.

RESULTS

Both fentanyl and lidocaine treatments (Groups B and C) were significantly better than placebo (Group A) in reducing pain on propofol injection (p < 0.005). Lidocaine 60 mg was more effective than fentanyl 150 micrograms in reduction of pain associated with i.v. propofol (p < 0.001). Injection of fentanyl itself caused pain in 28% of patients as compared to 2% in the lidocaine group. Mild local skin erythema was noted in 14% of patients with fentanyl venous retention versus 0% of patients with lidocaine venous retention.

CONCLUSIONS

Intravenous retention of fentanyl 150 micrograms, although less effective than that of lidocaine (p < 0.001), showed local analgesic effect in reducing the pain on propofol injection. The hypothetic mechanisms of action were speculated.

Purification of the infectious bovine rhinotracheitis virus alkaline deoxyribonuclease expressed in Escherichia coli

Nucleotide sequence analysis within the unique long segment of the infectious bovine rhinotracheitis virus (IBRV) genome identified an open reading frame of 1461 base pairs whose deduced polypeptide of 487 amino acids exhibited homology to alkaline deoxyribonucleases of other herpesviruses. To determine whether this IBRV gene product has nuclease activity, the gene designated UL12 was inserted into the vector pET-28a(+) and expressed in Escherichia coli as an oligohistidine-tagged protein. Upon induction with isopropyl beta-D-thiogalactopyranoside E. coli BL21 (DE3)[pLysS] cells harboring this recombinant plasmid produced a 57-kDa protein, the molecular mass of which was in accordance with the prediction from the nucleotide sequence. A one-step purification procedure using metal affinity chromatography resulted in a homogeneous preparation of this recombinant protein. The purified protein exhibited both exonuclease and endonuclease activities, each with an alkaline pH optimum.

The UL2 open reading frame of bovine herpesvirus 1 encodes a uracil-DNA glycosylase

Sequence analysis within the unique long segment of the bovine herpesvirus 1 (BHV-1) genome previously identified an open reading frame (ORF), designated UL2, whose deduced polypeptide of 204 amino acids contained a consensus uracil-DNA glycosylase (UDGase) signature sequence. To determine whether the BHV-1 UL2 ORF product has UDGase activity, we positioned the UL2 sequence down-stream of the T7 promoter on the vector pET-28b(+) and expressed it in Escherichia coli. Upon induction with isopropyl beta-D-thiogalactopyranoside these cells produced a 23-kDa protein, the molecular mass of which was in accordance with the prediction from the nucleotide sequence. A one-step purification procedure using nickel-chelating affinity chromatography resulted in a homogeneous preparation of this protein, which displayed specific UDGase activity in an in vitro enzyme assay. These results provide evidence that the BHV-1 UL2 gene does encode a UDGase.

Endothelial F-actin changes in the alkali burned rabbit cornea

The healing mechanism of corneal endothelium after alkali burn was not completely understood. Rabbit cornea was burned with 1N sodium hydxoside for 1 minute. Endothelial F-actin was stained with NBD-phallacidin in regular sequence to find out the details of endothelial healing after alkali burn. F-actin was completely destroyed leaving a sharp margin against the unaffected area 1 hour after the burn. In the 3, 5 and 7 day specimens, highly active F-actin reactions were noted at the wound margin. New multiple F-actin layers, arising from the intact endothelium near the wound margin, were noted in the 9 day specimen. In the 8 1/2 month specimen, the endothelial defected area was covered by large primitive cells, each of which showed F-actin fiber bundles in the cytoplasm with a large nuclear shadow. Nearly all of the large primitive cells showed F-actin fibers arranged in shapes of cell junctions. Twelve months after the burn, endothelial defects were not found. Nearly all of the endothelial cells were normal in size and shape except for some mushroom-like projections toward the anterior chamber in some areas. Nineteen months after the burn, the endothelial cells were normal. Endothelial wound healing process can be continued even 1 year after the alkali burn in rabbit cornea.

Soluble interleukin-2 receptor and cellular profiles in bronchoalveolar lavage fluid from patients with bronchial asthma

BACKGROUND

To elucidate the role of T-cell activation in the physiologic changes and cellular infiltrations in the bronchial tree of patients with symptomatic bronchial asthma, we measured the concentration of soluble interleukin-2 receptor (sIL-2R), cellular compositions and IL-2R expression on cells in bronchoalveolar lavage (BAL) fluid. We also measured physiologic parameters, including a provocation concentration of histamine required to reduce the forced expiratory volume in 1 second by 20% of the prechallenge baseline (PC20).

RESULTS

The concentration of sIL-2R and the ratio of IL-2R expression on CD3 positive lymphocytes were significantly higher in BAL fluid from 20 patients with symptomatic bronchial asthma than concentrations in fluid from nine healthy controls (p < 0.01) and six asymptomatic patients with bronchial asthma (p < 0.05). The concentration of sIL-2R correlated with the percentage of IL-2R expression on CD3 positive lymphocytes (rs = 0.709, p < 0.01). There was no difference in sIL-2R concentration of BAL fluid between the healthy control and the patient with asymptomatic bronchial asthma. Among the inflammatory cells recovered in BAL fluid, the percentages of eosinophils showed significant positive correlation with the concentration of sIL-2R in BAL fluid in the patients with bronchial asthma. The concentration of sIL-2R significantly correlated with forced expiratory volume one second, peak expiratory flow rate, and PC20 when observed in all study subjects, but not in the patients with bronchial asthma.

CONCLUSION

We conclude that T-cell activation within the bronchial tree appears to have a role in the infiltration of eosinophils into the bronchial tree, which may lead to enhanced bronchial hyperreactivity in patients with bronchial asthma.

Hyperamylasemia following cardiopulmonary bypass

In order to study the occurrence of postbypass hyperamylasemia, 75 patients undergoing cardiopulmonary bypass (CPB) were studied from March 1989 to January 1990. There were 49 males and 26 females. Among them, 27 had congenital heart disease, 30 had valvular disease, and 18 had coronary artery disease. There were 27 patients with at least one elevated serum amylase sample after operation. Thus, the overall incidence of hyperamylasemia was 36%. As compared with the preoperative data (1.3%), there was a statistically significant difference in the occurrence of hyperamylasemia (p less than 0.05). Three patients had overt clinical pancreatitis postoperatively. There was no positive correlation between the serum amylase level and the occurrence of pancreatitis (p greater than 0.05). Forty-two cases had a significant elevation of the amylase creatinine clearance ratio (ACCR) after CPB. However, there was no significant difference between the groups with pulsatile and nonpulsatile CPB (p greater than 0.05). Three patients (4%) died in our series. The causes of death were heart failure in two and fulminant pancreatitis associated with low cardiac output in one. Although our experience in dealing with pancreatitis improved survival, mortality was still high (33.3%) in our series. Nevertheless, there was no apparent correlation between mortality and postbypass hyperamylasemia (p greater than 0.05). Logistic regression analysis was used to analyze the risk factors of the occurrence of hyperamylasemia, and the analysis revealed that patients with coronary artery disease were susceptible to postbypass hyperamylasemia. Our studies indicate that the use of total serum amylase or ACCR to monitor for the occurrence of pancreatitis in postbypass patients is inadequate.(ABSTRACT TRUNCATED AT 250 WORDS)

The TATA-dependent and TATA-independent promoters of the Drosophila melanogaster actin 5C-encoding gene

The major cytoskeletal actin of Drosophila melanogaster, actin 5C, is encoded by a gene (act5C) that has two promoters which are differentially controlled and possess distinct sets of regulatory elements. The distal basal promoter has a TATA motif, but the proximal does not. The distal strong positive domain, centered at nucleotide -290, can be shifted and fused directly to the distal basal promoter without losing its activity. It can also activate heterologous basal promoters containing either TATAAAT or TATTTAA signal when directly fused to them, but cannot activate the basal proximal promoter, which is TATA-less. When the entire distal regulatory region, which includes a remote enhancer-like region, is fused to the proximal promoter, it does not increase the proximal promoter activity. Fusion of the distal strong negative domain to the proximal promoter does not inhibit activity. Thus, all the three major strong regulatory domains of the distal promoter are unable to act on the proximal promoter.

Subpleural block in patients with multiple rib fractures

Multiple rib fractures result in agonizing pain as well as impaired pulmonary functions. Mechanical ventilations are frequently indicated for those with poor respiratory reserves. Regional anesthesia has been advocated for easing pain and discomfort. We evaluate the efficacy of subpleural block in the treatment of multiple rib fractures. Ten patients who sustained multiple rib fractures were observed on the arrival of emergent service. One sustained flailed chest with respiratory distress which necessitated mechanical ventilation in intensive care unit. Subpleural block with 20 ml 0.5% bupivacaine was done to each patient. The location of catheter was identified by the injection of contrast medium. Serial visual analogue pain scale, arterial blood gas, and pulmonary function test were taken before and after subpleural block. Pulmonary function test significantly improved after subpleural block. Pain relief was immediate and desirable. The case in ICU weaned from ventilator 3 days later. There were no major complications after subpleural block. Inadvertent epidural spread and recurrent laryngeal nerve blocks were detected both clinically and radiologically without sequela noted. Subpleural block is effective both in pain relief and in improving pulmonary functions. Image intensifier is essential to subpleural block in order to prevent the misplacement of catheter. We recommend subpleural block to be an alternative approach of regional anesthesia in patients with multiple rib fractures.

Positive and negative regulatory elements mediating transcription from the Drosophila melanogaster actin 5C distal promoter

The major cytoskeletal actin gene of Drosophila melanogaster, the actin 5C gene, has two promoters, the distal one of which controls synthesis of actin in a tissue- and developmental stage-specific manner. This very strong promoter has widely been used for expression of heterologous genes in cultured cells. To locate functional regulatory elements in this distal promoter, mutants of the promoter were fused to the bacterial chloramphenicol acetyltransferase gene and assayed for transient expression activity in cultured Drosophila embryonic Schneider line 2 cells. The results showed that the upstream end of the promoter extends to 522 bp from the transcription start site. In addition, there are two remote activating regions about 2 kb upstream. Between -522 and -379 are two regions that exert a strong negative effect. Downstream from these negative regions are at least six positive regions and a TATA element. The strongest positive determinant of the promoter was identified at -320 as AAAATGTG by footprinting and by a replacement experiment. When the relevant region was replaced by a synthetic sequence containing this element in a random context, the transient expression activity was restored. The sequence TGTATG located at -355 was also identified as a positive element by a similar replacement approach. Apparently the very high activity of this promoter is the result of the combined activities of multiple factors.

Regulatory elements mediating transcription from the Drosophila melanogaster actin 5C proximal promoter

The major cytoskeletal actin gene of Drosophila melanogaster, the actin 5C gene, has two promoters, the proximal one of which controls constitutive synthesis of actin in all growing tissues. To locate regulatory elements required for constitutive activity of the proximal promoter, mutants of this promoter were fused to the bacterial chloramphenicol acetyltransferase gene and assayed for transient expression activity in cultured Drosophila embryonic Schneider line 2 cells. An essential regulatory element has been located 313 base pairs upstream from the cap site. Deletion of this element lowered expression to one-third of the wild-type level. The element has the sequence AAGTTGTAGTTG, as shown by protein-binding footprinting with the reagent methidiumpropyl-EDTA-Fe(II). This element is probably not a general one, since it was not detected in a search of the published 5'-flanking sequences of 27 Drosophila genes. In addition to this regulatory element, there are five GAGA elements in the actin 5C proximal promoter, some or all of which are essential for the promoter activity as shown by an in vivo competition assay. Although this promoter has no classical TATA element, there is an essential promoter region about 35 base pairs upstream from the cap site that could be a TATA surrogate. The promoter also shows sequences homologous to the alcohol dehydrogenase factor 1-binding site and to the core of the vertebrate serum response element, but mutations of these sites did not affect promoter activity in transient expression assays.

The optimal dose of atropine via the endotracheal route

Fifty ASA class I or II patients, undergoing general or gynecological surgery under general anesthesia with endotracheal intubation, were randomly divided into five groups. Group I received 10 ug/kg atropine intravenously, group II to V received 10 ug/kg, 20 ug/kg, 30 ug/kg, 40 ug/kg, respectively via endotracheal route through an epidural catheter. All were given five manual deep breaths after the injection of atropine. The maximum increase in heart rate (MIHR) and the time to maximum heart rate (TMHR) were evaluated. There was no marked MIHR in group II. Group III had a MIHR similar to that of group I (17.5/min vs 20/min, p greater than 0.05), but had a longer TMHR than group I (120 sec vs 82.5 sec, p less than 0.005). Groups IV and V had greater MIHR than group I (28.7 and 29.5 vs 20/min, p less than 0.005), and a TMHR similar to that of group I (85 and 90.2 vs 82.5 sec, p greater than 0.05). For emergency procedures, if atropine must be given without an intravenous catheter, 30 ug/kg or more given endotracheally can achieve an effect comparable to that of 10 ug/kg given intravenously.

Squamous carcinoma of the nasopharynx

Nasopharyngeal carcinoma is an unusual neoplasm among squamous cell carcinomas of the head and neck. The tumor is rare in most parts of the world but is strikingly common in several Asian subpopulations, notably Chinese in Hong Kong and Guangdong Province. The Epstein-Barr virus is intimately related to the disease and elicits the formation of antibodies that are useful for diagnosis and follow-up study. The virus has not been conclusively shown to cause nasopharyngeal cancer, however.Histologically, nasopharyngeal carcinoma is anaplastic in 75% of cases and better differentiated in 25% of patients. All tumors are treated by high-dose irradiation to the primary site and both sides of the neck. Surgical treatment, in the neck only, is reserved for irradiation failures. The prognosis is better in patients younger than 40 years, in patients without clinical cervical nodal involvement and, unexpectedly, in patients with anaplastic tumors.

Quantitative autoradiography, electron microscopy, and granulometry of endocrine cells in the rabbit colon

A high-resolution autoradiographic study was conducted on 268 thin sections of endocrine cells in the rabbit colon following injection of (3H) L-dopa. Using quantitative autoradiography, silver-proteinate impregnation, granulometry, and statistical analysis of cell populations by the Falck procedure, three cell types were identified--EC, L; and H--as well as a single cell with distinct ultrastructural characteristics. For the first time, a fine quantitative estimation of the handling ability of amine precursor related to the cross-sectional areas of each cell type was obtained, using a Kontron Digiplan image analyzer. All cells studied showed the ability to take up the precursor. Labeling indices were 6.63, 2.15, and 2.14 for EC, L, and H, respectively. These data and silver-proteinate impregnations provide good criteria for differentiating EC from H cells despite morphological similarities. After critical analysis of granule diameters, L cells were considered to be pluripotential in secretory activity.