Intestinointestinal inhibitory reflexes: effect of distension on intestinal slow waves

The motor response induced by intraluminal distension of the small intestine has been well investigated. However, little is known of the myoelectrical response to intraluminal distension. The aim of this study was to investigate the effects of oral- and anal-side distension on jejunal slow waves in dogs. The study was performed in 10 healthy female hound dogs implanted with three pairs of electrodes on the jejunum and an intestinal fistula. The first study session was designed to investigate the effects of anal-side distension on jejunal myoelectrical activity in fasting state. The protocol consisted of a 30-min baseline recording, a 30-min recording during anal-side balloon distension located 5 cm distal to the most distal pair of electrodes, and another 30-min recording after distension. The second session was designed to investigate the effect of oral-side distension with the balloon 5 cm proximal to the most proximal pair of electrodes. Jejunal slow waves were severely impaired by both anal- and oral-side distension. The dominant power was significantly reduced from -2.96 +/- 0.90 dB at baseline to -6.00 +/- 0.64 dB during anal-side distension (P < 0.0005) and from -3.90 +/- 0.85 dB at baseline to -7.17 +/- 0.90 dB during oral-side distension (P < 0.001). The percentage of normal 17 to 22-cpm slow waves was significantly decreased from 97.39 +/- 0.88% to 83.48 +/- 3.12% during anal-side distension (P < 0.0005) and from 92.49 +/- 2.42% to 68.80 +/- 7.24% during oral-side distension (P < 0.002). The percentage of slow wave coupling was decreased from 95.08 +/- 2.27% to 52.48 +/- 7.73% during anal-side distension (P < 0.0005) and from 84.82 +/- 6.75% to 49.21 +/- 8.91% during oral-side distension (P < 0.001). The instability coefficient of the dominant frequency was significantly increased during anal-side distension. In conclusion, intraluminal distension of the jejunum severely impairs jejunal slow waves. The slow waves on both sides of distension become less coupled, less regular, and are of lower amplitude.

Post-partum acute exacerbation of chronic hepatitis in a hepatitis C-carrier mother

Hepatitis C virus infection is a global health problem; however, the interaction between pregnancy and chronic hepatitis C remains controversial. A Taiwanese woman with chronic hepatitis C had an uncomplicated pregnancy and gave birth to a female baby through spontaneous vaginal delivery. The serum levels of alanine aminotransferase and hepatitis C virus (HCV) RNA were measured before pregnancy, in the first and third trimesters, 1 and 3 months after delivery, respectively. During her pregnancy, the serum aminotransferase levels became normalized, while the serum HCV-RNA levels declined significantly and consecutively with the lowest viral load in the third trimester. One month after delivery, she had an abrupt elevation of serum HCV-RNA level, paralleling a hepatitis flare with serum aminotransferase level more than 20-fold the upper normal limit. The serum HCV-RNA levels declined thereafter, and serum aminotransferase levels became normalized 3 months postdelivery. She was infected with HCV genotype 1a throughout the entire follow-up period, and other causes of hepatitis flare were excluded. In conclusion, post-partum acute exacerbation of chronic hepatitis may occur in HCV-carrier mothers, and an abrupt elevation of serum HCV-RNA level may be associated with the acute exacerbation.

Blind separation of slow waves and spikes from gastrointestinal myoelectrical recordings

Myoelectrical recordings of the gut contains slow waves (slow rhythmicity) and spikes (fast rhythmicity). While the slow wave determines the frequency and propagation of gastrointestinal contractions, spike activities are directly associated with the contractions. Traditionally, spikes are extracted from the myoelectrical recording using high-pass/bandpass filters. Due to sharp rising edge (high-frequency component) of the slow wave, the conventional method is not accurate in the separation of the slow wave and spikes, although it has been used for years. In this paper, a novel and fast blind source separation algorithm was developed. Experimental results showed that the proposed method was able to accurately extract spike activities from the myoelectrical recordings obtained in dogs and that its performance was not affected by the high-frequency components of the slow wave.

Painting of fourth, a chromosome-specific protein in Drosophila

Chromosome-specific gene regulation is known thus far only as a mechanism to equalize the transcriptional activity of the single male X chromosome with that of the two female X chromosomes. In Drosophila melanogaster, a complex including the five Male-Specific Lethal (MSL) proteins, "paints" the male X chromosome, mediating its hypertranscription. Here, with the molecular cloning of Painting of fourth (Pof), we describe a previously uncharacterized gene encoding a chromosome-specific protein in Drosophila. Unlike the MSL proteins, POF paints an autosome, the fourth chromosome of Drosophila melanogaster. Chromosome translocation analysis shows that the binding depends on an initiation site in the proximal region of chromosome 4 and spreads in cis to involve the entire chromosome. The spreading depends on sequences or structures specific to chromosome 4 and cannot extend to parts of other chromosomes translocated to the fourth. Spreading can also occur in trans to a paired homologue that lacks the initiation region. In the related species Drosophila busckii, POF paints the entire X chromosome exclusively in males, suggesting relationships between the fourth chromosome and the X and between POF complexes and dosage-compensation complexes.

Abnormal glucose tolerance in transfusion-dependent beta-thalassemic patients

OBJECTIVE

To study the prevalence of and risk factors for abnormal glucose tolerance in transfusion-dependent beta-thalassemic patients.

RESEARCH DESIGN AND METHODS

A total of 89 transfusion-dependent beta-thalassemic patients were interviewed. Diabetes was previously diagnosed in 14 of them. In the remaining 75 patients, 68 participated in an oral glucose tolerance test. Potential risk factors were identified using the independent t test, chi2 test, and Fisher's exact test. Logistic regression analysis was used to select the independent risk factors that best predicted abnormal glucose tolerance A two-tailed P value of <0.05 was considered to be statistically significant.

RESULTS

The prevalence of impaired glucose tolerance was 8.5% (7 of 82) and that of diabetes was 19.5% (16 of 82). Presentation with diabetic ketoacidosis was 31.1% (5 of 16). The risk factors for abnormal glucose tolerance found in transfusion-dependent beta-thalassemic patients were serum ferritin concentration and hepatitis C infection.

CONCLUSIONS

The interaction of iron overload and hepatitis C infection worsened the prognosis of thalassemic patients. Aggressive iron-chelation therapy as well as prevention and treatment of hepatitis C infection should be mandatory in managing glucose homeostasis in transfusion-dependent beta-thalassemic patients in Taiwan.

Using CT to diagnose tracheal rupture

OBJECTIVE

A retrospective study was performed to assess CT sensitivity for diagnosing tracheal rupture. Intubated cadaver tracheas were examined to assess endotracheal tube balloon overdistention and deformity and to evaluate the relationship of balloon pressures to tracheal injury.

MATERIALS AND METHODS

Neck or chest CT scans of 14 patients with tracheal rupture and 41 control trauma patients with pneumomediastinum but without tracheal injury were reviewed and compared to assess the presence and location of extrapulmonary air, whether direct visualization of tracheal wall disruption was possible, the size and shape of endotracheal tube balloon, signs of transtracheal balloon herniation in intubated patients, and the location of the extratracheal endotracheal tube. Intact and experimentally injured cadaver tracheas were used to evaluate tube balloon pressure and configuration.

RESULTS

All 14 patients with tracheal rupture had deep cervical air and pneumomediastinum. Overdistention of the tube balloon occurred in 71% (5/7) of the intubated patients, and balloon herniation occurred in 29% (2/7). Direct tracheal injury was seen in 71% (10/14) of the patients as a wall defect (n = 8) or deformity (n = 2). Overall, CT was 85% sensitive for detecting tracheal injury. Patients with tracheal injury had a significantly lower incidence of pneumothorax (p = 0.01) than did the control group. The CT appearance of balloon herniation through defects in the cadaver tracheas closely mimicked those of patients with tracheal injury. The amount of balloon pressure required to rupture the intubated trachea was extremely high and rupture was difficult to obtain.

CONCLUSION

CT can reveal tracheal injury and can be used to select trauma patients with pneumomediastinum for bronchoscopy, leading to early confirmation and treatment.

Postprandial improvement of gastric dysrhythmias in patients with type II diabetes: identification of responders and nonresponders

Using the technique known as electrogastrography, we studied the postprandial response of gastric myoelectrial activity in subjects with type II diabetes. Seventy-one subjects with type II diabetes underwent 1 hr of fasting electrogastrography recording. HbA1c and fasting serum glucose levels were obtained. Subjects then underwent an additional 2 hr of electrogastrography recording in the post prandial state. Sixty of the 71 patients (85%) had gastric rhythm abnormalities in the fasting state. Forty-six of 71 subjects (65%) responded to the test meal by improving their electrogastrography tracings (responders) while 35% did not respond (nonresponders). The time spent in bradygastria during the fasting state by responders was 26.3+/-12.8% vs 10.9+/-8.5% for nonresponders (P < 0.0001). The percent tachygastria during the fasting state in responders was 19.8+/-13.0%, which was less than nonresponders (38.3+/-29.7%) (P < 0.001). Fasting plasma glucose and HbA1c could not be used to predict the gastric myoelectrical response to meal. In conclusion, gastric rhythm disturbances are common in type II diabetes; there was no correlation between HbA1c levels, age, duration of diabetes, or fasting serum glucose and gastric dysrhythmia in response to meal; two groups of subjects emerged: those who became less dysrhythmic in the post pradial state (responders) and those who did not (non-responders); and fasting bradygastria was associated with responders and fasting tachygastria was associated with nonresponders.

Prevalence of gastric myoelectrical abnormalities in patients with nonulcer dyspepsia and H. pylori infection: resolution after H. pylori eradication

The aims of this study were to investigate the effects of H. pylori eradication on gastric myoelectrical activity and dyspeptic symptoms. Sixty-two subjects with H. pylori infection and no active peptic ulcer participated in this study, which involved three sessions. Anti-H. pylori therapy consisting of clarithromycin and omeprazole was given for two weeks. Gastric myoelectrical activity was measured using surface electrogastrography and dyspeptic symptoms were scored at each session. A [14C] urea breath test was performed at baseline and one month after treatment. In comparison with baseline, the percentage of normal slow waves was significantly increased and the mean total symptom score was significantly reduced one and three months after therapy (P < 0.05). Approximately 40% of patients with nonulcer dyspepsia' symptoms and H. pylori infection have abnormal gastric myoelectrical activity, which may be normalized following the eradication of H. pylori infection. The normalization of gastric myoelectrical activity may be one explanation for the significant symptom improvement in this subset of the dyspepsia population after H. pylori eradication.

Clonidine inhibits postprandial response of antral myoelectrical activity

Clonidine, an alpha2-adrenergic agonist, is known to inhibit gastric motility and delay gastric emptying in both humans and animals, but its effect on gastric myoelectric activity is unclear. The aim of this study was to investigate the effect of clonidine on postprandial gastric myoelectric activity. The experiment was performed in eight hound dogs (14.5-22.6 kg) implanted with three pairs of bipolar serosal electrodes with an interval of 4 cm and the most distal pair 2 cm above the pylorus. Each dog was studied twice on two separate days after a complete recovery from surgery. Gastric myoelectrical activity was recorded for 30 min in the fasting state and 90 min after a solid test meal of 838 kcal. Two tablets of clonidine (0.4 mg) were given with the meal in one of the sessions. The dominant frequency and power of the slow waves from the most distal pair were calculated by computerized spectral analysis. All data were expressed as mean +/- SE. A significant postprandial increase in the dominant power of the slow wave and an increase in the percentages of gastric slow waves with spike bursts were observed in the control session, whereas the dominant frequency of gastric slow waves showed a significant postprandial decrease after the meal. The dominant power increased 8.24+/-0.5, 8.6+/-0.2, and 7.5+/-0.3 dB, respectively, in the first, and second, and third 30-min period after the meal (all P < 0.01 vs baseline). Clonidine completely abolished the postprandial increase in the dominant power of the gastric slow wave and significantly inhibited spike bursts. The dominant power only increased 2.4+/-1.1 dB (P > 0.05 vs baseline; P < 0.01 vs the first postprandial period in the control session), 0.6+/-1.5 dB (P > 0.05 vs baseline; P < 0.05 vs the second postprandial period in the control session) and -1.5+/-2.2 dB (P > 0.05 vs baseline; P < 0.05 vs the third postprandial period in the control session) respectively during the first, second, and third periods after the meal and clonidine. However, it did not affect the postprandial change of the dominant frequency of gastric slow waves. No significant changes in percentage of regular slow waves were noted with the meal or with clonidine (P > 0.05). In conclusion, the postprandial response of gastric myoelectrical activity in dogs to a solid meal is featured with an increase in amplitude and spike bursts, which is inhibited by clonidine.

Sonography of acute right side colonic diverticulitis

BACKGROUND

To describe the prevalence and sonographic findings and ultrasound diagnostic accuracy of the right side colonic diverticulitis in patients having right lower abdominal pain with indeterminate nature.

METHODS

A total of 934 patients with acute right lower abdominal pain of clinically indeterminate nature were referred for ultrasound examination (US). US studies were performed with 3.5 to 7.0 (or occasionally 10) MHz transducers using graded compression method. Twenty-three patients were finally diagnosed to have an uncomplicated acute diverticulitis of the right colon. The gray-scale sonographic images were reviewed. A retrospective study was undertaken to evaluate diagnostic contribution of US.

RESULTS

The prevalence of acute right side colonic diverticulitis was 2.5% in patients with clinically indeterminate acute right lower abdominal pain. Locations of the inflamed diverticula include cecum in 6 patients, proximal ascending colon in 15 patients, and distal ascending colon in only 2 patients. Sonography detected 21 inflamed diverticula with 1 false positive and 2 false negative results. The most typical sonographic feature of an inflamed diverticulum of right side colon was a rounded or oval-shaped hypoechoic or nearly anechoic structure (52%) protruding out from the segmentally thickened colonic wall. Some of them might contain strong echoes representing gas or feces (43%), or stone in the lumen (5%). Regional pericolic or peridiverticular fat thickening was noted in 57% of patients, and segmental colon wall thickening in 38%. US examination yielded a sensitivity of 91.3%, a specificity of 99.8%, an overall accuracy of 99.5%, a positive predictive value of 95.5%, and a negative predictive value of 99.7%. A positive sonogram made the likelihood of acute right side diverticulitis 456.5 times greater compared with the pretest clinical impression. US differentiated acute right side colonic diverticulitis from acute appendicitis with a 100% accuracy.

CONCLUSIONS

Ultrasound can be extremely useful in diagnosing acute right side colonic diverticulitis. Careful ultrasound evaluation of the right colon and the cecum may facilitate a correct diagnosis and help differentiate from acute appendicitis, and steer the surgeon to a more effective management.

Acinar cell carcinoma with hypervascularity

Acinar cell carcinoma is an uncommon malignancy with a reported incidence of 1% among exocrine tumors of the pancreas. The case of a 60-year-old Taiwanese man who presented with obstructive jaundice, abdominal pain, and body weight loss is described here. A mixed clinical picture of islet cell tumor and ductal carcinoma of the pancreas was shown to be a hypervascular tumor at the pancreatic head region with an irregular stricture at the common channel of the common bile and pancreatic ducts. The patient had normal levels of plasma carcinoembryonic antigen, carbohydrate antigen 19-9, alpha-fetoprotein, but an increase in plasma levels of insulin and C-peptide. Immunohistochemical stains and electron microscopic examination of the tumor was consistent with acinar cell carcinoma.

PML and the oncogenic nuclear domains in regulating transcriptional repression

Promyelocytic leukemia protein (PML) is a tumor suppressor involved in the t(15;17) translocation that causes acute promyelocytic leukemia (APL). PML is located at multiple nuclear domains known as PML oncogenic domains (PODs), whose structures are dynamically regulated and disrupted in t(15;17) APL cells. PML is involved in several important cellular processes; however, its exact function is unclear. Recently, a POD-associated protein was found to be transcriptional repressor, suggesting a new role for PODs in regulating transcriptional repression.

Impairment of gastric and jejunal myoelectrical activity during rectal distension in dogs

It is known that distension of the rectum induces gastric hypomotility and delays gastric emptying. Its effect on gastrointestinal myoelectrical activity has not been well studied, however. The aim of this study was to investigate the effects of rectal distension on gastrointestinal myoelectrical activity in dogs. Six hound dogs implanted with electrodes on the serosa of the stomach and proximal jejunum were studied. The protocol consisted of a 30-min baseline recording and another 30-min recording during rectal distension. Gastric myoelectrical activity was severely impaired by rectal distension. The dominant power was significantly decreased from -2.79 +/- 0.52 dB at baseline to -4.84 +/- 1.26 dB during distension (P < 0.05). The percentage of normal 4-6 cycles per minute gastric slow waves was reduced from 95.08 +/- 1.11% to 83.63 +/- 4.00% (P < 0.02), and the percentage of tachygastria was increased during distension (0.33 +/- 0.19% vs 6.03 +/- 1.27%, P < 0.02). The instability coefficient of the dominant frequency was significantly increased (0.134 +/- 0.012 vs 0.326 +/- 0.074, P < 0.05). The percentage of slow wave coupling was reduced from 93.99 +/- 0.76% to 73.43 +/- 2.07% (P < 0.00003). In the small bowel, only the instability coefficient of dominant frequency showed a significant increase during distension. Other parameters were not affected by rectal distension. We conclude that rectal distension severely impairs gastric myoelectrical activity. The induced gastric dysrhythmia and reduced slow wave amplitude and coupling may be the underlying pathophysiology of gastric hypomotility and delayed gastric emptying observed during rectal distension.

Cisapride provides symptomatic relief in functional dyspepsia associated with gastric myoelectrical abnormality

OBJECTIVE

We evaluated the effects of cisapride (10 mg t.d.s. and 20 mg b.d.) on gastrointestinal symptoms and gastric myoelectrical activity in patients with functional dyspepsia. Myoelectrical activity was measured by electrogastrography.

METHODS

Patients with functional dyspepsia, defined as discomfort in the epigastrium, a negative endoscopy, and clinical symptoms of dyspepsia, were enrolled. A total of 38 patients participated in the study (23 female; 15 male; 24-72 years of age). Screening electrogastrography identified those with a normal electrogastrogram (14 subjects) and those with an abnormal electrogastrogram (24 patients). Patients were randomly assigned to 2 weeks of placebo or 2 weeks of cisapride (10 mg t.d.s.); both groups then received 2 weeks of cisapride (20 mg b.d.). Electrogastrograms were repeated at the end of each 2-week treatment period.

RESULTS

Cisapride 10 mg t.d.s. significantly improved symptoms in all patients. An additional 2 weeks of treatment with cisapride 20 mg b.d. led to continued improvement in symptoms in all patients, with significant improvement in the group with abnormal baseline electrogastrograms. Cisapride significantly improved postprandial bloating and discomfort in patients with abnormal baseline electrogastrograms. Cisapride also significantly improved postprandial gastric myoelectrical activity as measured by electrogastrography in patients with abnormal baseline electrogastrograms.

CONCLUSION

Cisapride provides symptomatic relief and improves gastric myoelectrical abnormalities in patients with functional dyspepsia.

Human Slug is a repressor that localizes to sites of active transcription

Snail/Slug family proteins have been identified in diverse species of both vertebrates and invertebrates. The proteins contain four to six zinc fingers and function as DNA-binding transcriptional regulators. Various members of the family have been demonstrated to regulate cell movement, neural cell fate, left-right asymmetry, cell cycle, and apoptosis. However, the molecular mechanisms of how these regulators function and the target genes involved are largely unknown. In this report, we demonstrate that human Slug (hSlug) is a repressor and modulates both activator-dependent and basal transcription. The repression depends on the C-terminal DNA-binding zinc fingers and on a separable repression domain located in the N terminus. This domain may recruit histone deacetylases to modify the chromatin and effect repression. Protein localization study demonstrates that hSlug is present in discrete foci in the nucleus. This subnuclear pattern does not colocalize with the PML foci or the coiled bodies. Instead, the hSlug foci overlap extensively with areas of the SC-35 staining, some of which have been suggested to be sites of active splicing or transcription. These results lead us to postulate that hSlug localizes to target promoters, where activation occurs, to repress basal and activator-mediated transcription.

Spatio-temporal nonlinear modeling of gastric myoelectrical activity

The accomplishment of a complete digestive process of human stomach is regulated by a spatio-temporally-coordinated electric pattern called gastric myoelectrical activity (GMA). The normal patterns of GMA present temporal evolution from endogenous rhythmic oscillation to bursting of spikes associated with contractions, and also ordered spatial propagation of the oscillating waves. The abnormal patterns of GMA have been observed in temporal dysrhythmia, such as tachygastria, bradygastria and arrhythmia, and in spatial propagation failure, such as retrograde propagation and uncoupling. Different GMA patterns are associated with different gastric symptoms and there exist some nonlinear mechanisms to govern the formation and dynamic evolution of these patterns. However, these mechanisms are so complex that few of them are known by medical observations. The aim of this study is to explore these mechanisms by spatio-temporal modeling of GMA. The single-cell model simulating the formation process of slow waves and spikes, the multi-cell model simulating the propagation process of GMA and the extracellular model simulating the formation of bipolar recordings are presented.

Time-frequency analysis of heart rate variability using short-time fourier analysis

This study was done to introduce new parameters derived by time frequency analysis of heart rate variability data. Four simulation experiments were carried out to compare the short-time Fourier transform (STFT) analysis method to the traditional overall spectral analysis method. Sinusoidal signals were generated with identical total power in the high-frequency band, but varying time-frequency and time-amplitude information. The STFT method was also applied to heart rate variability data from the stages of normal human sleep. Data analysis included computation of the power in the high-frequency band by overall spectral analysis. The instability coefficients (ICs) of the frequency and power in the high-frequency band were derived by STFT analysis. The ICs derived by the STFT method were able to describe time-frequency and time-amplitude variations in sinusoidal signals which contained identical total power in a specified frequency range. The ICs of the frequency and power were able to differentiate variations in vagal activity between the stages of human sleep and waking. The ICs represent new parameters derived by the STFT method, and allow the detection and quantification of short-lasting time-frequency and time-amplitude variations that remain obscured by overall spectral analysis.

Entrainment of intestinal slow waves with electrical stimulation using intraluminal electrodes

The aim of this study was to investigate whether the intestinal stimulation would be feasible using a less invasive method: intraluminal electrodes. The study was performed in nine healthy hound dogs (15-26 kg). Four pairs of electrodes were implanted on the serosa of the jejunum at an interval of 5 cm with the most proximal pair 35 cm beyond the pylorus. An intestinal fistula was made 20 cm beyond the pylorus. Simultaneous recordings of intestinal myoelectrical activity were made for 2 h in the fasting state from both intraluminal and serosal electrodes. Various pacing parameters were tested. The frequency of the intestinal slow wave recorded from the intraluminal electrodes was identical to that from the serosal electrodes (18.78+/-0.3 cpm vs 18.75+/-0.3 cpm, r=0.99, p <0.001), and so was the percentage of normal 17-22 cycles/ min waves (95.83+/-3.9% vs 98.16+/-1.33%, r=0.96, p<0.01). A complete entrainment of the intestinal slow wave was achieved in every dog with electrical stimulation using intraluminal ring electrodes. The effective pacing parameters were pulse width of 70 ms, amplitude of 4 mA and frequency of 1.1 IF (intrinsic frequency). The time required for the entrainment of the intestinal slow wave with intraluminal pacing was 25.0+/-2.1 s. The maximum driven frequency was found to be 1.43+/-0.01 IF. The results reveal that intraluminal pacing is an effective and efficient method for the entrainment of intestinal slow waves. It may become a potential approach for the treatment of intestinal motor disorders associated with myoelectrical abnormalities.

The t(5;17) acute promyelocytic leukemia fusion protein NPM-RAR interacts with co-repressor and co-activator proteins and exhibits both positive and negative transcriptional properties

The t(5;17) variant of acute promyelocytic leukemia (APL) fuses the genes for nucleophosmin (NPM) and the retinoic acid receptor alpha (RARalpha). Two NPM-RAR molecules are expressed as a result of alternative RNA splicing. Both contain RARalpha sequences that encode the DNA binding, heterodimerization, and ligand activation domains of RARalpha. This study was designed to test the ability of these fusion proteins to act as transcriptional activators of retinoic acid responsive promoters. The NPM-RAR fusion proteins bind to retinoic acid response element sequences as either homodimers or as heterodimers with RXR. Transcription of retinoic acid-inducible promoters is activated by the fusion proteins in the presence of retinoic acid. The level of transactivation induced by the NPM-RAR fusions differs from the level of transactivation induced by wild-type RARalpha in both a promoter and cell specific fashion, and more closely parallels the pattern of activation of the PML-RAR fusion than wild-type RARalpha. In addition, NPM-RAR decreases basal transcription from some promoters and acts in a dominant-negative fashion when co-transfected with wild-type RARalpha. Both NPM-RAR and PML-RAR interact with the co-repressor protein SMRTe in a manner that is less sensitive than RARalpha to dissociation by retinoic acid. Retinoic acid induces binding of the co-activator protein RAC3. These data indicate that the NPM-RAR fusion proteins can modulate expression of retinoid-responsive genes in a positive or negative manner, depending on context of the promoter, and lend support to the hypothesis that aberrant transcriptional activation underlies the APL phenotype. (Blood. 2000;95:2683-2690)

Postprandial response of gastric slow waves: correlation of serosal recordings with the electrogastrogram

Controversial interpretations have been given to the postprandial increase in the dominant power (amplitude) of the electrogastrogram (EGG). The aim of this study was to find an appropriate interpretation of the postprandial EGG power changes. Simultaneous serosal and cutaneous recordings of gastric myoelectrical activity were made in 11 patients with gastroparesis in the fasting state and after the ingestion of 8 oz of water. The dominant frequency and corresponding power of the recording before and after water were computed using the power spectral analysis method. It was found that the dominant frequency of the EGG was the same as that of the serosal recording in 10 patients. One patient showed a substantial amount of dysrhythmia and no obvious dominant frequency was noted. A decrease in the dominant frequency was found in these 10 patients after the ingestion of water. Tachygastria of higher than 4 cycles/min was observed in one of 11 patients both in the prewater and postwater states. Consistent changes in amplitude after a drink of water were noted in both serosal recording and EGG. Statistical analysis demonstrated that the dominant power change after water computed from the EGG was correlated with that observed in the serosal recording (r = 0.757, P = 0.007). In conclusion, exogenous stimulation, such as ingestion of water, may change the amplitude of the gastric slow wave and this change is reflected in the EGG, suggesting that the change of the slow-wave amplitude is an important contributing factor to the postprandial change in the EGG dominant power.

Entrainment of segmental small intestinal slow waves with electrical stimulation in dogs

The aim of this study was to derive effective pacing parameters for the entrainment of segmental intestinal myoelectrical activity. The study was performed in 12 dogs. Four pairs of electrodes were implanted on the serosa of the jejunum. Electrical stimulation of the small intestine was performed via the most proximal pair. For the slow waves within a distance of 5 cm, a complete entrainment was achieved with a pacing frequency of 1.1 times the intrinsic frequency (IF), a pulse width of 140 msec, and an amplitude of 4 mA. The time required for the entrainment was 25.6 +/- 2.7 sec. The maximum driven frequency was 1.38 +/- 0.03 IF. The percentage of the entrainment at this frequency was 44.0 +/- 3.9%. The data indicate that pacing is able to completely entrain segmental intestinal myoelectrical activity, suggesting that normalization of intestinal myoelectrical dysrhythmia is feasible with pacing.

Effects of caffeine on gastrointestinal myoelectric activity and colonic spike activity in dogs

BACKGROUND

Caffeine is known to produce various effects on the gastrointestinal tract. Few studies have, however, investigated the effects of caffeine on gastrointestinal myoelectric activity under physiologic conditions. The aims of this study were to investigate the effects of caffeine on colonic motility (spike activity) and gastric and jejunal slow waves in conscious dogs.

METHODS

The study was performed in eight healthy female hound dogs (15-20 kg) in which one pair of electrodes was implanted on the serosa of the stomach, one pair on the proximal jejunum, and another pair on the ascending colon. The protocol consisted of a 60-min recording as base line and a 90-min recording after intravenous injection of saline, a low dose of caffeine (125 mg), or a high dose of caffeine (250 mg).

RESULTS

In the colon there was a significant increase in the number of spike bursts per minute after the injection of both the low (6.69+/-1.27 versus 8.22+/-1.31, P < 0.05) and the high dose (4.38+/-1.23 versus 6.92+/-0.98, P < 0.05) of caffeine. The increase in the total energy of spikes per minute after the injection of the high dose of caffeine was significantly higher than that after the low dose of caffeine (41.2+/-14.6 versus 133.4+/-39.2, P < 0.05). The characteristics of the gastric and jejunal slow waves were, however, not affected by caffeine.

CONCLUSION

Caffeine increases spike activity in the colon, and its effect may be dose-dependent. Gastric and jejunal slow waves are not affected by caffeine.

The SRC family of nuclear receptor coactivators

Nuclear hormone receptors are ligand-dependent transcription factors that regulate genes critical to such biological processes as development, reproduction, and homeostasis. Interestingly, these receptors can function as molecular switches, alternating between states of transcriptional repression and activation, depending on the absence or presence of cognate hormone, respectively. In the absence of hormone, several nuclear receptors actively repress transcription of target genes via interactions with the nuclear receptor corepressors SMRT and NCoR. Upon binding of hormone, these corepressors dissociate away from the DNA-bound receptor, which subsequently recruits a nuclear receptor coactivator (NCoA) complex. Prominent among these coactivators is the SRC (steroid receptor coactivator) family, which consists of SRC-1, TIF2/GRIP1, and RAC3/ACTR/pCIP/AIB-1. These cofactors interact with nuclear receptors in a ligand-dependent manner and enhance transcriptional activation by the receptor via histone acetylation/methylation and recruitment of additional cofactors such as CBP/p300. This review focuses on the mechanism of action of SRC coactivators in terms of interactions with receptors and activation of transcription. Specifically, the roles of the highly conserved LXXLL motifs in mediating SRC function will be detailed. Additionally, potential diversity among SRC family members, as well as several recently cloned SRC-associated cofactors, will be discussed.

Steroid/nuclear receptor coactivators

In higher eukaryotes, steroids/thyroid hormones and many lipophilic compounds regulate cellular physiology through binding to the steroid/nuclear receptor proteins. Steroid/nuclear receptors are ligand-dependent transcriptional activators that can stimulate gene expression. This transcriptional activation plays a pivotal role in hormone-regulated physiological and pharmacological responses. In recent years, several steroid/nuclear receptor cofactors have been identified and found to interact with the receptor and modulate its transcriptional activity. Among these cofactors, a family of three co-activators has been the focus of intense studies. Although gaps remain, progress has been made in understanding how a given co-activator interacts with the receptor and promotes transcriptional activation. We are beginning to understand co-activator action; for instance, several studies have established the molecular basis of antagonism by anti-hormones and the connection of co-activators with human cancers.