Gallbladder emptying to endogenous and exogenous stimulation in chronic pancreatitis patients

OBJECTIVES

The present study was designed to analyze the underlying mechanism of gallbladder motor disturbance in chronic pancreatitis patients.

METHODS

Gallbladder emptying to endogenous (oral test meal, Daiyan 13 g) and exogenous stimulation (iv cerulein, 30 ng/kg for 5 min) was examined by real-time ultrasonography in 12 patients with chronic pancreatitis and 10 normal subjects (controls). Plasma cholecystokinin levels during the endogenous stimulation were measured by bioassay.

RESULTS

In chronic pancreatitis patients compared with controls, the fasting gallbladder volume was significantly increased (29.5 +/- 2.2 vs. 21.5 +/- 2.8 ml), whereas the gallbladder emptying (percent change of the basal volume) to oral test meal was significantly decreased. Neither cholecystokinin secretion induced by the test meal, nor the gallbladder emptying response to intravenous cerulein, differed significantly between the two groups. However, when chronic pancreatitis patients were divided according to pathogenesis, it became clear that gallbladder emptying to intravenous cerulein was significantly greater in patients with alcoholic chronic pancreatitis than in patients with idiopathic pancreatitis.

CONCLUSIONS

Gallbladder emptying during the intestinal phase is generally reduced in patients with chronic pancreatitis, but gallbladder responsiveness to exogenous stimulation might be heterogeneous according to the pathogenesis.

Biochemical and functional characterization of soluble form of IL-5 receptor alpha (sIL-5R alpha). Development of ELISA system for detection of sIL-5R alpha

Interleukin-5 (IL-5) mediates pleiotropic functions in various types of cells through its specific receptor (IL-5R) which is composed of two distinct subunits, alpha and beta. In mice, the alpha subunit (IL-5R alpha) specifically binds IL-5 with low affinity. The beta subunit (IL-5R beta) does not bind IL-5 by itself, but constructs the high affinity receptor with IL-5R alpha. We have isolated cDNA encoding the soluble form of IL-5R alpha (sIL-5R alpha). To elucidate the biochemical and functional properties of sIL-5R alpha, we developed an expression system for sIL-5R alpha cDNA in insect cell line Sf21 using baculovirus expression vector and obtained conditioned medium containing large quantities of mouse sIL-5R alpha. Mouse sIL-5R alpha was purified from the conditioned medium by using anti-IL-5R alpha mAb-coupled beads. Immunoaffinity-purified sIL-5R alpha with an approximate molecular mass of 42 kDa inhibited the binding of 125I-labeled IL-5 to IL-5R. By using purified sIL-5R alpha, we prepared rabbit anti-sIL-5R alpha antibody and developed a sandwich ELISA for detection of sIL-5R alpha. Significant amounts of sIL-5R alpha were detected in sera and ascitic fluids of mice bearing tumors (BCL1 and MOPC104E) that responded to IL-5 for DNA synthesis, but not in sera of normal mice. Interestingly, elevated levels of serum sIL-5R alpha were observed in NZB and NZW mice. The sIL-5R alpha may, therefore, have an immunoregulatory role in vivo.

Modified cell-flow microchannels in a single-crystal silicon substrate and flow behavior of blood cells

Previously reported cell-flow microchannels in a single-crystal silicon substrate (Microvasc. Res. 44, 226-240, 1992) have been modified, and flow behavior of blood cells is described using flow rate-time curves and video pictures. The principal structure (2600 identically sized channels in parallel) was retained to give the same simple quantitative measure of the total flow rate for blood cell suspensions under constant suction. Level areas (terraces) were placed at the entrance and exit sides of the parallel channels level with the channel depth (4.5 microns) so that blood cells just entering into and flowing out of the channels could be more clearly observed under reflecting illumination. Three lengths (10, 20, and 100 microns) of channel were used each with a terrace width of 30 microns. In agreement with calculated values, the resistance to flow at the terrace portion was shown to be nearly equal to that per 10 microns of the channel portion. Clearer pictures were obtained of channel blocking by activated leukocytes and platelet aggregates after addition of each stimulant. Erythrocyte aggregates showed easy transit even through the 100-microns-long channels and through narrow spaces, including gaps probably narrower than 2 microns, which were formed between plugging leukocytes at the terrace portion.

Endometriotic tissues produce immunosuppressive factors

In order to study the possible role of the immune functions in the pathogenesis of endometriosis, effects of supernatants from endometrial and endometriotic tissue cultures on the natural killer (NK) activity were examined by determining the lymphocyte cytotoxicity toward an erythroleukemic cell line (K562). Endometrial and endometriotic tissues were obtained at the time of operation from patients with ectopic endometriosis or uterine myoma. The normal peritoneum and myoma tissues were used as controls. The supernatants obtained by culturing the ectopic endometriotic tissues for 24-48 h had significant (p < 0.01) suppressive effects on NK activity of peripheral blood lymphocytes (PBL) from a healthy woman, compared to the supernatants from the normal peritoneum and the myoma tissues. There was no significant difference between NK activities of PBL from patients with ectopic endometriosis and age-matched healthy women. However, the NK activity in patients with low NK status before surgery was significantly elevated after surgery while that in patients with normal NK status before surgery was not changed. Although PBL from the same healthy women could significantly lyse the endometrial cells, the ability was about-one-third the level at which they could lyse K562 cells. These results suggest that the immunosuppressive factors secreted by endometriotic tissues may be involved in the local implantation and development of ectopic endometriosis.

Mechanism of eosinophil infiltration in the patient with subcutaneous angioblastic lymphoid hyperplasia with eosinophilia (Kimura's disease). Mechanism of eosinophil chemotaxis mediated by candida antigen and IL-5

Kimura's disease is a chronic granulomatous disease of unknown etiology. Although eosinophilia is one of the characteristic features in this disease, little is known about the mechanism of eosinophilia. In the present study it was demonstrated that interleukin-5 (IL-5) was produced and released from the site of a granuloma and lymph nodes after stimulation with candida antigen. It was also shown that peripheral blood eosinophils from patients with Kimura's disease contained a large proportion of hypodense eosinophils and that their viability was prolonged. These results strongly suggest that locally produced IL-5 induced by candida antigen contributes to the eosinophilia in this disease.

Statistical issues on the no-observed-adverse-effect level in categorical response

The determination of the value of the no-observed-adverse-effect level (NOAEL) when observed responses can be categorized by severity (categorical data) and sample sizes are small is discussed. The common situation of only two categories, where only the presence or absence of an effect is observed, is addressed first (dichotomous data). Three tests for dichotomous data are critically examined, including the Brown-La Vange test, a modified version of that test, and Dunnett's multiple comparison test. Although the modified test is an improvement, all three procedures have shortcomings in determining the value of the NOAEL, particularly when the sample size is small. An alternative method is suggested, based on the Akaike information criterion (AIC), which performs well. This method is extended to severity data with an arbitrary number of categories. Use of a dose-response curve for the NOAEL is discussed.

Investigation and research on classification of productive skills (2): Cluster structure of productive skills in the car manufacturing industry

A survey was conducted at a production facility to study the categories of productive skills. In August 1991, a questionnaire survey was given to skilled workers of a car manufacturing company. The number of valid responses was 1,215. The survey items included 133 items in the following three areas: nature of productive skills, human functions and vocational ability necessary for the work, and working conditions. The survey results were analyzed by cluster analysis to verify the hypothesis that skills can be classified based on two axes--sensory motor and intellectual management. Moreover, the analysis results clarify that the structure of "nature of productive skills" in car manufacturing can be divided into maintenance, processing, information analysis and transmission, and parts assembly. The results also show that the internal structure of intellectual management skills, which had been unknown up to this point, consists of five skill clusters: field of technical knowledge, operation of controlling equipment, preparation abilities, analysis and judgment abilities, and measurement.

[Changes in the blood flow in celiac artery and superior mesenteric artery after stellate ganglion block]

We evaluated the effect of stellate ganglion block (SGB) on the blood flow of celiac artery (CA) and superior mesenteric artery (SMA) by using the ultrasonic pulse Doppler technique. The subjects were 15 healthy volunteers (14 males, one female; average 26 years old; 22-38). Right C7-SGB was performed using 5 ml of 1% mepivacaine at the 7th cervical process. Blood pressure, heart rate, mean blood flow velocity and diameter in CA and SMA, were measured after 5 minute rest, before and after SGB. To measure the flow velocity and the diameter of vessels, ultrasonic diagnostic equipment SSA-270A or SSA-260A (Thoshiba CO, Ltd.) with convex electric-phased 3.75 MHz, probe was used. Doppler shiftgrams of the CA and SMA were recorded. Then, we calculated their flow volume and sectional area of vessels. In CA mean blood flow velocity tended to decrease (P < 0.05) and both flow volume and sectional area of vessels tended to increase (P < 0.001). In SMA, mean flow velocity tended to decrease (P < 0.05) and sectional area increased (P < 0.001). But flow volume did not show significant change. Our results indicate that right C7-SGB leads to an increase in the blood flow of CA.

[Establishment and characterization of a CA125-producing human ovarian clear cell carcinoma cell line]

A human ovarian cancer cell line designated "KK" was established from ascites of a patient with ovarian clear cell carcinoma. This cell line was grown for more than 2 years and over 140 passages in medium RPMI1640 containing 10% FCS. Doubling time of this cell line at passage 70 was approximately 4 days and saturation density was 1.1 x 10(5)/cm2. Plating efficiency was approximately 23%. Chromosome analysis revealed aneuploidy with a model number of 67. PAS-positive substances were present in the cytoplasm. CA125 and SLX were detected in both the original tumor and the cultured cells. This cell line is less sensitive to cisplatin than KF cells and IC50 was 0.95 microM.

Recurrent forearm thrombophlebitis after transvenous permanent pacemaker insertion

This report describes a 69-year-old Japanese woman with bilateral forearm thrombophlebitis that developed soon after transvenous permanent pacemaker insertion. Intravenous administration of urokinase and heparin rapidly resolved fever, painful forearm swelling and inflammatory findings. Digital subtraction venograms revealed a brachiocephalic vein thrombosis. A ten-month treatment with warfarin and ticlopidine resulted in the complete restoration of venous flow. Although thrombophlebitis associated with transvenous permanent pacemaker insertion has a relatively low incidence (0.3%), prompt diagnosis and treatment with anticoagulant and/or thrombolytic agents are important for the late clinical outcome in cases with deep venous thrombosis.

[Inhibitory effects of oral administration of ginsenoside Rh2 on tumor growth in nude mice bearing serous cyst adenocarcinoma of the human ovary]

We examined the inhibitory effect of the oral administration of ginsenoside Rh2 (Rh2) on tumor growth in nude mice bearing human ovarian cancer cells (HRA). In the first experiment, it was revealed that daily administration of 30 microM Rh2 significantly inhibited tumor growth. In the second experiment, therefore, various concentration of Rh2 (1, 15, 30, 60, 120 microM) were administered every day for 91 days, beginning the day after tumor inoculation. Treatment with Rh2 resulted in a remarkable retardation of the HRA cell tumor growth. In particular, tumor growth in mice treated with 15, 30 and 120 microM Rh2 was significantly inhibited, compared to that in CDDP treated mice as well as in untreated mice. Consequently, 50% survival in nude mice treated with 15, 30 and 120 microM Rh2 was significantly prolonged, compared to that not only in untreated mice but also in CDDP treated mice. No side effect was observed in any mice treated with Rh2. Red ginseng containing Rh2 has been used exclusively, orally administered. In the present study, we considered that oral administration of Rh2, which is a component of red ginseng, has strong inhibitory effects on human ovarian cancer cell growth in nude mice.

Artificial self-cleaving molecules consisting of a tRNA precursor and the catalytic RNA of RNase P

We synthesized two types of chimeric RNAs between the catalytic RNA subunit of RNase P from Escherichia coli (M1 RNA) and a tRNA precursor (pre-tRNA); one had pre-tRNA at the 3' side to the M1 RNA (M1 RNA-pre-tRNA). The second had pre-tRNA at the 5' side of the M1 RNA (pre-tRNA-M1 RNA). Both molecules were self-cleaving RNAs. The self-cleavage of M1 RNA-pre-tRNA occurred at the normal site (5'-end of mature tRNA sequence) and proceeded under the condition of 10 mM Mg2+ concentration. This reaction at 10 mM Mg2+ was an intramolecular reaction (cis-cleavage), while, at 40 mM and 80 mM Mg2+, trans-cleavage partially occurred. The self-cleavage rate was strictly affected by the distance between the M1 RNA and the pre-tRNA in the molecule. The self-cleavage of pre-tRNA-M1 RNA occurred mainly at three sites within the mature tRNA sequence. This cleavage did not occur at 10 mM Mg2+. Use of M1 RNA-pre-tRNA molecule for the in vitro evolution of M1 RNA is discussed.

Upper airway muscle activity during sustained hypoxia in awake humans

To examine the effects of sustained hypoxia on upper airway and chest wall muscle activity in humans, we measured genioglossus muscle (GG) activity, inspiratory intercostal muscle (IIM) activity, and ventilation during sustained hypoxia in 17 normal subjects and 17 patients with obstructive sleep apnea (OSA). The trial of sustained hypoxia was performed as follows: after an equilibration period of 3 min, isocapnic hypoxia (arterial O2 saturation = 80 +/- 2%) was maintained for 20 min. GG EMG was measured with a fine-wire electrode inserted percutaneously, and IIM EMG was measured with surface electrodes. Ventilatory response to sustained hypoxia was initially increased and subsequently decreased. Stable phasic GG activity during spontaneous tidal breathing was observed in 6 normal subjects and 10 patients with OSA. Responses of GG and IIM activities to sustained hypoxia showed a biphasic response qualitatively similar to the ventilatory response in these 16 subjects. The absolute value of the subsequent decline in GG activity was similar to that of the initial increase, whereas the subsequent decline in IIM activity was smaller than that of the initial increase. Percent GG activity was significantly lower than both percent IIM activity and percent minute ventilation during the decline and plateau phases. There were no significant differences in ventilatory and EMG responses between the normal subjects and the patients with OSA. We conclude that, during wakefulness, upper airway muscle activity declined to a greater extent than inspiratory pump muscle activity during sustained hypoxia.

Isolated coronary ostial stenosis in Takayasu's arteritis: case report and review of the literature

This report describes a rare clinical course of a young Japanese woman with Takayasu's arteritis and a review of the literature. Her first symptom was angina pectoris due to isolated left coronary ostial stenosis, which was relieved by aortocoronary bypass grafting surgery using a saphenous vein graft. At that time, the C-reactive protein was negative and the histopathologic findings of the specimens of the aorta could not confirm aortitis. Although she was free from any cardiovascular symptoms for about fifteen years, syncopal attacks occurred owing to severe stenosis of the major branches of the aortic arch revealed by intravenous digital subtraction arteriograms. Thus, Takayasu's arteritis could be a cause of coronary ostial stenosis in young women even if the inflammatory findings are negative and the major branches of the aortic arch are not involved at operation. In addition, revascularization using internal thoracic arteries might possess a potential risk of coronary insufficiency due to a later involvement of these proximal arteries.

NADPH-diaphorase activity in neurons of the mammalian pancreas: coexpression with vasoactive intestinal polypeptide

BACKGROUND

To provide a morphological basis for understanding the role of nitric oxide in the pancreas, the present study was designed to clarify the localization and distribution of nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) activity, a marker of NO synthase, in the pancreas of several mammalian species, including humans.

METHODS

NADPH-d activity was examined in the rat, guinea pig, dog, and human pancreas by histochemistry. In addition, the possibility of coproduction of NO and vasoactive intestinal polypeptide (VIP) was investigated by a combined use of histochemistry and immunohistochemistry.

RESULTS

In the pancreas, NADPH-d activity was localized in nerve fibers, nerve cell bodies, and the vascular endothelium. Nerve fibers with the enzyme activity were chiefly distributed in the exocrine pancreas and showed species differences in the distribution. Nerve fibers stained for NADPH-d were also observed in the endocrine pancreas, but the enzyme activity was not detected in the islet cells. Part of the nerve fibers and nerve cell bodies coexpressed NADPH-d activity and VIP-immunoreactivity.

CONCLUSIONS

These results suggest that NO may act as a neuronal mediator and an endothelium-derived relaxing factor and may physiologically interact with VIP in the mammalian pancreas.

Comparison of DNA-binding properties between BTEB and Sp1

We have expressed truncated forms of BTEB and Sp1 in Escherichia coli and investigated the DNA-binding properties of the two proteins. The two proteins as well as their chimeric proteins protected the same DNA region in the BTE sequence (a GC box in the P-4501A1 gene) as examined by ortho-phenanthroline-Cu footprinting. The region overlapped nearly perfectly with the GC box consensus sequence. Methylation interference footprinting revealed that all the guanines within the region and two other guanines in the close vicinity interacted with the proteins. Competitive gel mobility shift assay using various synthetic oligonucleotides of the GC box sequences as the competitors demonstrated that BTEB and Sp1 have similar sequence specificities for DNA binding. We have purified the bacterially expressed BTEB and measured the dissociation constant of the BTEB-BTE complex using gel mobility shift assay. The dissociation constant was (3.0 +/- 1.0) x 10(-10) M and was comparable to that of Sp1 binding to a GC box. Taken together, these findings indicate that the binding modes of BTEB and Sp1 to the GC box are similar to each other.

Modulation of sensitivity of human ovarian cancer cells to cis-diamminedichloroplatinum(II) by 12-O-tetradecanoylphorbol-13-acetate and D,L-buthionine-S,R-sulphoximine

The ability of 12-O-tetradecanoylphorbol-13-acetate (TPA) and D,L-buthionine-S,R-sulphoximine (BSO) to modulate cis-diamminedichloroplatinum(II) (CDDP) sensitivity was investigated in human ovarian cancer cell lines sensitive (KF) or with intrinsic resistance (KK and MH) to CDDP. The KK and MH cell lines were derived from ascites of patients with clear-cell carcinoma and serous cystadenocarcinoma of the ovary who both showed clinical resistance to CDDP. The CDDP IC50 value of KK and MH cells was about 4.6- and 10.2-fold higher than that of KF cells. PKC activities in the cytosol and membrane of KK and MH cells were also about 4- to 5-fold higher than those of KF cells. Proliferation of KF, KK and MH cells was inhibited in a dose-dependent manner by TPA. The membrane PKC activities in the KF cells were rapidly activated and down-regulated 24 hr after exposure to TPA, while those in the KK and MH cells were not down-regulated even after exposure to TPA for 24 hr, suggesting that the membrane form of PKC may be involved in the intrinsic resistance. Continuous exposure to 10 nM TPA for 5 days significantly reduced the CDDP sensitivity of KF and KK cells, while exposure to 10 nM TPA for 1 hr significantly elevated that of KK and MH cells. Interestingly, 1-hr exposure to 1 microM TPA induced CDDP-resistance in KK cells. Such changes in CDDP sensitivity by TPA seemed to be linked with those of cellular PKC activity, i.e., when the CDDP sensitivity was reduced by TPA, the cellular PKC rose.(ABSTRACT TRUNCATED AT 250 WORDS)

Different target-site specificities of the hairpin ribozyme in cis and trans cleavages

The hairpin ribozyme cleaves a phosphodiester bond at the 5' side of a 5'GUC3' sequence of an RNA with high efficiency. An RNA having a 5'GUA3' sequence instead of the GUC sequence is a poor substrate for this ribozyme. Here, we show that this is indeed so in a trans-acting ribozyme system, but in a cis-acting ribozyme system this ribozyme cleaves the 5' side of a GUA sequence as efficiently as the wild-type cleaves the GUC sequence. One base substitution in the ribozyme also affected the target-site specificity in the cis-acting system.

[A case report of unroofed coronary sinus with repeated congestive cardiac failure]

We reported a 64-year-old woman with frequent cardiac failure due to unroofed coronary sinus complicated with tricuspid regurgitation (TR). We performed direct suture closure of unroofed coronary sinus and tricuspid annuloplasty with a Carpentier ring (34 T). Immediately after the operation, large amount of pleural effusion accumulated owing to acute left ventricular failure. That cause consists in the scarcity of the left ventricular volume, which was depending on the much left-to-right shunt volume through the unroofed coronary sinus. But her general condition was recovered from acute left ventricular failure for administration of catecholamine, digitalization, and urinative. We think that the echocardiography is valuable to investigation of the existence of unroofed coronary sinus, especially complicated with TR.

IL-5 receptor positive B cells, but not eosinophils, are functionally and numerically influenced in mice carrying the X-linked immune defect

Mouse IL-5 (mIL-5) acts on B cells and eosinophils to induce growth and differentiation through the mIL-5 specific receptor (mIL-5R). The functional high-affinity mIL-5R is a heterodimer composed of alpha and beta chains. We investigated the expression of mIL-5R and the responsiveness of B cells and eosinophils to mIL-5 in X-linked immunodeficient (xid) mice. mIL-5R expression analyzed by using mAbs specific for alpha and beta chains revealed that xid B cells had fewer mIL-5R alpha +mIL-5R beta + than BALB/c B cells. In particular, a decrease in the number of peritoneal mIL-5R+ B cells among Ly-1 B cells (known as B-1 cells) was remarkable. Furthermore, the frequency of precursors of mIL-5 responsive B cells in xid mice was approximately 100-fold lower than that of BALB/c mice. Interestingly, sorted mIL-5R+ peritoneal B cells from xid mice displayed a low response to mIL-5. Intraperitoneal injection of mIL-5 into BALB/c mice induced polyclonal IgM production and an increase in the number of eosinophils. The same regimen failed to induce an increase in the same parameters in xid mice. However, xid mice showed mIL-5-induced eosinophilia in peripheral blood to a similar extent as BALB/c mice. Eosinophils from mIL-5-injected xid mice expressed both alpha and beta chains of mIL-5, and responded to mIL-5 with prolonged in vitro survival.