The effect of glucagon-induced gastric relaxation on TLOSR frequency

This study aimed to determine the effect of glucagon-induced gastric relaxation on the frequency of transient lower oesophageal sphincter relaxations (TLOSRs). Eight normal subjects (four male, age 18-52 y) were studied after a 6-h fast using a combined manometric barostat assembly. The recording was divided into two 1-h sessions: (1) a baseline period with the barostat set at minimal distending pressure (MDP) + 2 mmHg and (2) a period with continuous glucagon or placebo infusion with barostat set at MDP + 2 mmHg. Patients were studied on two different days and randomly received glucagon (4.8 microg kg(-1) bolus followed by 9.6 microg kg(-1) h(-1) infusion) on 1 day and placebo (saline) on another. Lower oesophageal sphincter (LOS) pressure, frequency of TLOSRs, and barostat bag volumes were determined for both placebo and glucagon infusion. Glucagon induced significant fundal relaxation compared with placebo (P < 0.05) and significantly decreased baseline LEOS pressure (P < 0.05). The frequency of TLOSRs was not altered by glucagon infusion compared with placebo. Despite causing substantial proximal stomach relaxation, glucagon did not increase TLOSR frequency. This suggests that the relevant gastric mechanoreceptors responsible for triggering TLOSRs do not respond to passive elongation.

Distinct patterns of oesophageal shortening during primary peristalsis, secondary peristalsis and transient lower oesophageal sphincter relaxation

This study characterized oesophageal shortening during secondary peristalsis and transient lower oesophageal sphincter relaxation (TLOSR) in an attempt to determine its contribution to the opening mechanism. Eight healthy subjects (four males, 26 +/- 1 years) had metal clips affixed at 0, +3, and +8 cm relative to the squamocolumnar junction (SCJ), defining two distal oesophageal segments. Axial clip movement was assessed with concurrent videofluoroscopy and manometry during primary peristalsis, secondary peristalsis and TLOSR. Clip-defined oesophageal segment length change was measured at 0.5-s intervals. The magnitude of the most distal segment shortening was least with TLOSR, greatest with primary peristalsis and intermediate with secondary peristalsis. Conversely, maximal overall oesophageal shortening during TLOSR, evidenced by SCJ movement, was similar to that during primary peristalsis. In 3/12 TLOSRs, the moment of LOS opening and gas reflux was optimally imaged; SCJ excursion was 0.3 +/- 0.1 cm prior to LOS opening and 1.4 +/- 0.7 cm immediately after gas reflux. The segmental pattern of oesophageal shortening was distinct during primary peristalsis, secondary peristalsis and TLOSR. During TLOSR, significant elevation of the SCJ occurred only after LOS opening, suggesting that this was a consequence of oesophageal distension induced by gas reflux rather than a component of the opening mechanism.

The inherent cellular level of reactive oxygen species: one of the mechanisms determining apoptotic susceptibility of leukemic cells to arsenic trioxide

Though reactive oxygen species (ROS) has been noticed to be involved in arsenic trioxide (As(2)O(3))-induced apoptosis of tumor cells, its role in apoptosis signaling remained to be elucidated. The objective of this work was to explore the association of the inherent cellular ROS level with the susceptibility of the tumor cells to apoptosis induction by As(2)O(3). Low concentration of As(2)O(3) was administered to cultured leukemic cell lines NB4, U937, HL60 and K562. The difference in apoptotic sensitivity was displayed among four cell types. ROS probes were incubated with the cells in the absence of As(2)O(3), and ROS was thus quantified relatively by flow cytometry. We manifested, in four cell types, the inherently existed difference in whole ROS quantity, and a positive correlation between the inherent ROS level and their apoptotic sensitivity to As(2)O(3). Furthermore, by interference using a ROS producer, we demonstrated that an elevation of ROS level would sensitize the cells to As(2)O(3)-induced apoptosis. The results of the present work suggested that the inherent ROS level might be determinative in tumor cells for their apoptotic susceptibility to As(2)O(3).

Structure and dynamics of 6-hydroxymethyl-7,8-dihydropterin pyrophosphokinase

Folates are essential for life. Unlike mammals, most microorganisms must synthesize folates de novo. 6-Hydroxymethyl-7,8-dihydropterin pyrophosphokinase (HPPK) catalyzes pyrophosphoryl transfer from ATP to 6-hydroxymethyl-7,8-dihydropterin (HP), the first reaction in folate pathway, and therefore, is an ideal target for developing novel antimicrobial agents. Because of its small size and high thermal stability, E. coli HPPK is also an excellent model enzyme for studying the mechanisms of enzymatic pyrophosphoryl transfer. We have determined the crystal structures of HPPK in the unligated form and in complex with HP, two Mg2+ ions, and AMPCPP (an ATP analog that inhibits the enzymatic reaction). Comparison of the two crystal structures reveals dramatic conformational changes of three flexible loops and many side chains and possible roles of the active site residues.

[Weak signal detection in every heart cycle]

In this article, a new approach is introduced to lowering the myo-electronic noise in weak ECG signals. We use artificial neural network to make the noise be white, and then we adopt an adaptive filter of which the reference signal is achieved by extracting from other ECG cycle. The outcome is the reduction of both white noise and non-white noise in ECG signal. Satisfactory results have been achieved by using this method in the experiment of late potential detection.

Comparison of structural changes of cell surface carbohydrates in the eustachian tube epithelium of chinchillas infected with a Streptococcus pneumoniae neuraminidase-deficient mutant or its isogenic parent strain

Six different lectin probes were used to examine alterations of the cell surface carbohydrates in the chinchilla eustachian tube (ET) lumen subsequent to the intranasal (i.n.) challenge with the Streptococcus pneumoniae parent strain, D39, or its isogenic derivative, DeltaNA1, which is deficient in neuraminidase NanA. The labelling pattern revealed that the binding of wheat germ agglutinin (WGA), Erythrina cristagalli lectin (ECL), peanut agglutinin (PNA), Bandeiraea simplicifolia lectin II (BSL II) and succinylated wheat germ agglutinin (SWGA) were increased in the lumenal surface of the ET in the D39 inoculated cohort compared to the uninfected control, which indicated that N-acetylglucosamine (GlcNAc) and D-galactose residues were exposed. Concurrently, decreased labelling with Sambucus nigra agglutinin (SNA) indicated that there were few sialic acid residues remaining in the ET epithelium subsequent to i.n. inoculation with D39. The DeltaNA1 neuraminidase deficient mutant, however, did not induce any significant changes in the lectin labelling patterns, and was comparable to that of the control cohort. We propose that products of the nanA gene have a significant impact on the changes of the carbohydrate moieties in the ET epithelium and may be responsible for the previously reported increased ability of the D39 parent to colonize the nasopharynx and invade the middle ear.

A three-dimensional model of the human facilitative glucose transporter Glut1

The human facilitative transporter Glut1 is the major glucose transporter present in all human cells, has a central role in metabolism, and is an archetype of the superfamily of major protein facilitators. Here we describe a three-dimensional structure of Glut1 based on helical packing schemes proposed for lactose permease and Glut1 and predictions of secondary structure, and refined using energy minimization, molecular dynamics simulations, and quality and environmental scores. The Ramachandran scores and the stereochemical quality of the structure obtained were as good as those for the known structures of the KcsA K(+) channel and aquaporin 1. We found two channels in Glut1. One of them traverses the structure completely, and is lined by many residues known to be solvent-accessible. Since it is delimited by the QLS motif and by several well conserved residues, it may serve as the substrate transport pathway. To validate our structure, we determined the distance between these channels and all the residues for which mutations are known. From the locations of sugar transporter signatures, motifs, and residues important to the transport function, we find that this Glut1 structure is consistent with mutagenesis and biochemical studies. It also accounts for functional deficits in seven pathogenic mutants.

[Effects of calcium on biological characteristics of wheat seedlings under ultraviolet-B radiation stress]

Under simulated ultraviolet-B radiation (UV-B, 280-320 nm), effect of calcium on biological characteristics of wheat seedlings was studied with pot culture experiment. The results showed that the growth indexes of wheat seedlings on ground and underground in calcium concentration 2 mmol/L treated group were obviously reduced than that of wheat seedlings in control treated group (the descending range of 8.1%-36.1%) under UV-B stress (0.35 W/m2, 6 h per day, for 7 day). And the decreasing degree of growth indexes (3.2%-28.6%) for wheat seedlings in calcium concentration 6 mmol/L treated group were lower than in calcium concentration 2 mmol/L treated group. The experiment proved that calcium can mitigate the damage of ultraviolet-B radiation on wheat seedlings, and this effect was related to that calcium affected physiological and biochemical characteristics of wheat seedlings.

Unusual conformational changes in 6-hydroxymethyl-7,8-dihydropterin pyrophosphokinase as revealed by X-ray crystallography and NMR

The crystal structure of Escherichia coli 6-hydroxymethyl-7,8-dihydropterin pyrophosphokinase (HPPK) in complex with MgADP has been determined at 1.5-A resolution with a crystallographic R factor of 0.191. The solution structure of HPPK in complex with Mg(2+) and beta,gamma-methyleneadenosine 5'-triphosphate (MgAMPPCP) has been determined using a simulated annealing protocol with 3,523 experimental NMR restraints. The root mean square deviation of the ensemble of 20 refined conformers that represent the solution structure from the mean coordinate set derived from them is 0.74 +/- 0.26 A for all backbone atoms and 0.49 +/- 0.22 A when residues Pro(14), Pro(44)-Gln(50), and Arg(84)-Pro(91) are excluded. Binding of MgADP causes significant changes in the conformation and dynamical property of three loops of HPPK that are involved in catalysis. A dramatic, unusual conformational change is that loop 3 moves away from the active center significantly with some residues moving by >17 A. The binding of MgADP also stabilizes loop 1 and loop 3 but makes loop 2 more mobile. Very similar conformational and dynamical changes are observed in the NMR solution structure of HPPK.MgAMPPCP. The conformational and dynamical changes may play important roles in both substrate binding and product release in the catalytic cycle.

Identification of functional regions of Cbp3p, an enzyme-specific chaperone required for the assembly of ubiquinol-cytochrome c reductase in yeast mitochondria

The Cbp3 protein of Saccharomyces cerevisiae is an enzyme-specific chaperone required for the assembly of ubiquinol-cytochrome c reductase of the mitochondrial respiratory chain. To gain preliminary insight into the role of Cbp3p during assembly, 29 independently isolated mutants were examined to define functional regions of the protein. Mutants were analyzed with respect to respiratory growth, ubiquinol-cytochrome c reductase assembly, and steady state amounts of enzyme subunits and Cbp3p. Three regions essential for Cbp3p activity were identified: regions 1 and 3 were required for Cbp3p function, while region 2 was necessary for protein stability. Mutation of Glu134 in region 1 (Cys124 through Ala140) impaired the ability of the Rieske FeS protein to assemble with the enzyme complex. Mutations targeted to region 3 (Gly223 through Asp229) primarily affected the 14 kDa subunit and cytochrome c(1) assembly. Gly223 was found especially sensitive to mutation and the introduction of charged residues at this site compromised Cbp3p functional activity. Region 2 (Leu167 through Pro175) overlapped the single hydrophobic domain of Cbp3p. Mutations within this area altered the association of Cbp3p with the mitochondrial membrane resulting in enhanced protein turnover. The role of the amino-terminus in Cbp3p activity was investigated using cbp3 deletion strains Delta12-23, Delta24-54, Delta56-96 and Delta12-96. All mutants were respiratory competent, indicating that residues 12-96 were not essential for Cbp3p function, stability or mitochondrial import. Analysis of carboxy-terminal deletion mutants demonstrated that the final 44 residues were not necessary for Cbp3p function; however, alterations in the secondary structure of the extreme carboxy-terminal 17 residues affected assembly protein activity.

Study of an Au colloid self-assembled electrode and its application to the determination of carbon monoxide

A novel electrochemical sensor has been developed for the detection of carbon monoxide. The chemically modified electrode, prepared by reaction of cysteine and then an Au colloid of size approximately 15 nm with a platinum microelectrode, has excellent catalytic activity toward carbon monoxide, with an oxidation potential of +600 mV relative to the Ag/AgCl electrode. The CO gas sensor is based on an Au colloid self-assembled modified electrode as working electrode, an Ag/AgCl electrode as reference electrode, a Pt electrode as counter electrode, and a porous film which is in direct contact with the gas-containing atmosphere. The effects on the determination of CO of different internal electrolyte solutions of perchloric acid, hydrochloric acid, sulfuric acid, nitric acid, and phosphate buffer of different concentrations were also studied. The sensor is characterized by a short response time and highly reproducible detection of CO. This sensor can be used in the field of environmental monitoring and control.

Mercurial sensitivity of aquaporin 1 endofacial loop B residues

The water channel protein aquaporin-1 (AQP1) has two asparagine-proline-alanine (NPA) repeats on loops B and E. From recent structural information, these loops are on opposite sides of the membrane and meet to form a pore. We replaced the mercury-sensitive residue cysteine 189 in AQP1 by serine to obtain a mercury-insensitive template (C189S). Subsequently, we substituted three consecutive cysteines for residues 71-73 near the first NPA repeat (76-78) in intracellular loop B, and investigated whether they were accessible to extracellular mercurials. AQP1 and its mutants were expressed in Xenopus laevis oocytes, and the osmotic permeability (P(f)) of the oocytes was determined. C189S had wild-type P(f) but was not sensitive to HgCl(2). Expression of all three C189S cysteine mutants resulted in increased P(f), and all three mutants regained mercurial sensitivity. These results, especially the inhibitions by the large mercurial p-chloromercunbenzene-sulfonic acid (pCMBS) ( approximately 6A wide), suggest that residues 71-73 at the pore are accessible to extracellular mercurials. A 30-ps molecular dynamics simulation (at 300 K) starting with crystallographic coordinates of AQP1 showed that the width of the pore bottleneck (between Connolly surfaces) can vary (w(avg) = 3.9 A, sigma = 0.75; hydrated AQP1). Thus, although the pore width would be > or = 6 A only for 0.0026 of the time, this might suffice for pCMBS to reach residues 71-73. Alternative explanations such as passage of pCMBS across the AQP1 tetramer center or other unspecified transmembrane pathways cannot be excluded.

Manometric characteristics of the upper esophageal sphincter recorded with a microsleeve

OBJECTIVES

We compared manometric recordings of the upper esophageal sphincter (UES) recorded with a miniature sleeve to those obtained using standard manometry.

METHODS

The UES pressure of eight volunteer subjects was measured by station pull-through (SPT), by rapid pull-through (RPT), and with a microsleeve sensor for 30 min, followed by 15 min of esophageal acid infusion. Deglutitive UES relaxation recorded with a microsleeve and solid state sensor were compared.

RESULTS

The UES pressure recorded with the microsleeve (25+/-9 mm Hg) was significantly less than that by SPT (114+/-18 mm Hg) or RPT (152+/-19 mm Hg), and was unaffected by acid infusion. Periods of low UES pressure were observed during long interswallow intervals (11+/-4, range 6-18 mm Hg). Deglutitive relaxation duration and intrabolus pressure measured with the microsleeve were less than those recorded by the solid state transducer.

CONCLUSIONS

"Normal" UES pressure is heavily dependent on measurement technique; pressures obtained with a miniature sleeve are a fraction of those obtained by SPT or RPT. During periods of relative comfort with minimal swallowing, UES tone is approximately 10 mm Hg, similar to that during sleep. Volume modulation of deglutitive UES relaxation is demonstrable with a microsleeve, albeit with less precision than with a solid-state transducer.

Bisubstrate analogue inhibitors of 6-hydroxymethyl-7,8-dihydropterin pyrophosphokinase: synthesis and biochemical and crystallographic studies

6-Hydroxymethyl-7,8-dihydropterin pyrophosphokinase (HPPK) catalyzes the transfer of pyrophosphate from ATP to 6-hydroxymethyl-7,8-dihydropterin (HP), leading to the biosynthesis of folate cofactors. Like other enzymes in the folate pathway, HPPK is an ideal target for the development of antimicrobial agents because the enzyme is essential for microorganisms but is absent from human and animals. Three bisubstrate analogues have been synthesized for HPPK and characterized by biochemical and X-ray crystallographic analyses. All three bisubstrate analogues consist of a pterin, an adenosine moiety, and a link composed of 2-4 phosphoryl groups. P(1)-(6-Hydroxymethylpterin)-P(2)-(5'-adenosyl)diphosphate (HP(2)A, 5) shows little affinity and inhibitory activity for E. coli HPPK. P(1)-(6-Hydroxymethylpterin)-P(3)-(5'-adenosyl)triphosphate (HP(3)A, 6) shows moderate affinity and inhibitory activity with K(d) = 4.25 microM in the presence of Mg(2+) and IC(50) = 1.27 microM. P(1)-(6-Hydroxymethylpterin)-P(4)-(5'-adenosyl)tetraphosphate (HP(4)A, 7) shows the highest affinity and inhibitory activity with K(d) = 0.47 microM in the presence of Mg(2+) and IC(50) = 0.44 microM. The affinity of MgHP(4)A for HPPK is approximately 116 and 76 times higher than that of MgADP and 6-hydroxymethylpterin, respectively. The crystal structure of HPPK in complex with 7 (HPPK.MgHP(4)A) has been determined at 1.85 A resolution with a crystallographic R factor of 0.185. The crystal structure shows that 7 occupies both HP- and ATP-binding sites and induces significant conformational changes in HPPK. The biochemical and structural studies of the bisubstrate analogues indicate that the bisubstrate analogue approach can produce more potent inhibitors for HPPK and the minimum length of the link for a bisubstrate analogue is approximately 7 A.

[Expression of rasp21, C-myc, C-erbB-2, and AFP in 2-FAA induced experimental hepatocarcinogenesis]

OBJECTIVE

To investigate the distribution of oncogenes and their relationships in 2-FAA induced experimental hepatocarcinogenesis.

METHODS

Rasp21, C-myc, C-erbB-2, and AFP were detected and analyzed by the SP method of immunohistochemistry.

RESULTS

Some cells expressed rasp21, C-myc, and AFP in peripheral liver lobules and alternated hepatocyte foci in the early stage of the experiment. And with the formation and progression of hyperplastic hepatocytic nodules, expressed cells increased and often accompanied each other. Expression of C-erbB-2 appeared in the middle stage of the hepatocarcinogenesis.

CONCLUSIONS

Expression of rasp21, C-myc, and AFP in the experimental hepatocarcinogenesis is an early molecule change, which may relate to the initiation of hepatocarcinogenesis and be considered to be one of the molecular bases for the morphogenesis of hepatocarcinogenesis. During the development of lesion, C-erbB-2 may have promoting effects. It is also clear that malignant transformation of hepatocyte needs the cooperation of multiple oncogenes.

A novel procedure for pre-embedding double immunogold-silver labeling at the ultrastructural level

Pre-embedding double immunogold-silver labeling using two ultrasmall gold conjugates has not been attempted previously because a means of distinguishing labels by conjugates of identical sizes was lacking. This study investigated the feasibility of creating a particle size segregation between two ultrasmall gold conjugates through sequential immunogold incubations and silver enhancements. Two primary antibodies, mouse anti-synaptophysin and rabbit anti-glial fibrillary acidic protein (GFAP), were used in the model system. Differentiation of the double labeling was achieved by incubating with one ultrasmall gold conjugate, followed by silver enhancement, and then incubating with the second ultrasmall gold conjugate, followed by additional silver enhancement. This resulted in two groups of silver-enhanced particles: smaller particles enhanced once and larger particles enhanced twice. Electron microscopic examination revealed two readily distinguished populations of gold-silver particles within the appropriate structures, with very little size overlap. The quality of the ultrastructure permitted identification of most subcellular organelles. This procedure provides for the first time a pre-embedding immunogold-silver labeling protocol that allows the precise subcellular co-localization of multiple antigens.

Manometric heterogeneity in patients with idiopathic achalasia

BACKGROUND & AIMS

In certain cases of achalasia, particularly those in early stages with minimal endoscopic or radiographic abnormalities, the diagnosis may rely on manometry, which is the most sensitive test for the disease. The aim of this study was to critically evaluate the manometric criteria in a population of patients with idiopathic achalasia.

METHODS

Clinical histories and manometric recordings of 58 patients with idiopathic achalasia and 43 control subjects were analyzed with regard to esophageal body contraction amplitude, peristaltic effectiveness in terms of both completeness and propagation velocity, lower esophageal sphincter (LES) resting pressure, LES relaxation pressure, and intraesophageal-intragastric pressure gradient. Variants of achalasia were defined by finding manometric features that significantly differed from the remainder of achalasia patients, such that the diagnosis might be questioned.

RESULTS

Four manometrically distinct variants were identified. These variants were characterized by (1) the presence of high amplitude esophageal body contractions, (2) a short segment of esophageal body aperistalsis, (3) retained complete deglutitive LES relaxation, and (4) intact transient LES relaxation. In each instance, the most extreme variant is discussed and compared with the remainder of the achalasia population and with controls.

CONCLUSIONS

The significance in defining these variants of achalasia lies in the recognition that these sometimes confusing manometric findings are consistent with achalasia when combined with additional clinical data supportive of the diagnosis. Furthermore, such variants provide important clues into the pathophysiology of this rare disorder.

[Expression of the gene encoding human leukocyte differentiation antigen 5D4]

OBJECTIVE

To make sure that 5D4 cDNA is a full length cDNA and to prepare antigens to make monoclonal antibodies against different epitopes in 5D4 protein.

METHODS

Recombinant expression vectors pGEX-5X-3-5D4 (full length) and pGEX-5X-3-5D4 (5'fragment) were constructed. 5D4 polypeptides were expressed in Escherichia coli DH5 alpha. 5D4 mRNA expression was detected in various tissues and cell lines with Northern blot assay and RT-PCR.

RESULTS

Northern blot demonstrated five mRNA transcripts of 1.9, 2.4, 3.9, 4.5, and 10.0 kb in length existing and expressing of various extent in various tissues. The 1.9 kb mRNA transcript was observed only in the spleen and the small intestinal tissues. The expression of 5D4 mRNA was different in various cell lines. 5D4 polypeptides were expressed in Escherichia coli DH5 alpha.

CONCLUSION

The 1,846 bp 5D4 cDNA is a full length cDNA. A full length 5D4 protein and a 5D4 polypeptide which is the NH2 side to the transmembrane region fused with GST with a molecular weight of 66,000 and 60,000 expressing in Escherichia coli DH5 alpha.

[Effect of 6A8 alpha-mannosidase expression on the proliferative response of human B cell line 3D5]

OBJECTIVE

To study the effect of 6A8 alpha-mannosidase expression on the proliferative response of human B cell 3D5.

METHODS

Recombination of adeno-associated virus vector(rAAV) mediated delivery of sense 6A8 DNA or antisense 6A8 DNA into 3D5 cells, and monoclonal antibody 6A8 alpha staining and Con A binding assay for determination of the change of 6A8 alpha-mannosidase expression, MTT assay for proliferation detection of 3D5 cells driven by Staphylococcus aureus crude cell suspension formalin-fixed (SAC), lower molecular weight B cell growth factor (LMW-BCGF), or rIL-6.

RESULTS

The expression of 6A8 alpha-mannosidase was enhanced in sense 6A8-transduced cells and reduced in antisense 6A8-transduced cells. In comparison with the wild type and the mock-transduced cells, the proliferative response of the sense 6A8-transduced cells to SAC stimulation was enhanced (P < 0.05). However, transduction with antisense 6A8 did not affect the response. In addition, transduction with either sense or antisense 6A8 had no effect on proliferation of 3D5 cells induced by LMW-BCGF or IL-6.

CONCLUSION

The proliferative response to SAC stimulation was enhanced in the 3D5 cells with enhanced expression of 6A8 alpha-mannosidase. Either enhancement or reduction of 6A8 alpha-mannosidase expression had no effect on proliferation induced by LMW-BCGF or IL-6.

Catalytic center assembly of HPPK as revealed by the crystal structure of a ternary complex at 1.25 A resolution

BACKGROUND

Folates are essential for life. Unlike mammals, most microorganisms must synthesize folates de novo. 6-Hydroxymethyl-7, 8-dihydropterin pyrophosphokinase (HPPK) catalyzes pyrophosphoryl transfer from ATP to 6-hydroxymethyl-7,8-dihydropterin (HP), the first reaction in the folate pathway, and therefore is an ideal target for developing novel antimicrobial agents. HPPK from Escherichia coli is a 158-residue thermostable protein that provides a convenient model system for mechanistic studies. Crystal structures have been reported for HPPK without bound ligand, containing an HP analog, and complexed with an HP analog, two Mg(2+) ions, and ATP.

RESULTS

We present the 1.25 A crystal structure of HPPK in complex with HP, two Mg(2+) ions, and AMPCPP (an ATP analog that inhibits the enzymatic reaction). This structure demonstrates that the enzyme seals the active center where the reaction occurs. The comparison with unligated HPPK reveals dramatic conformational changes of three flexible loops and many sidechains. The coordination of Mg(2+) ions has been defined and the roles of 26 residues have been derived.

CONCLUSIONS

HPPK-HP-MgAMPCPP mimics most closely the natural ternary complex of HPPK and provides details of protein-substrate interactions. The coordination of the two Mg(2+) ions helps create the correct geometry for the one-step reaction of pyrophosphoryl transfer, for which we suggest an in-line single displacement mechanism with some associative character in the transition state. The rigidity of the adenine-binding pocket and hydrogen bonds are responsible for adenosine specificity. The nonconserved residues that interact with the substrate might be responsible for the species-dependent properties of an isozyme.

[Identification of high-lying odd energy levels of uranium by resonant ionization mass spectrometry]

Single-colour and two-colour multiphoton resonant ionization spectra of uranium atom were studied extensively with a Nd:YAG laser-pumped dye laser atomic beam apparatus time-of-flight mass spectrometer in our laboratory. The energy locations of high-lying odd-parity levels in the region 33,003-34,264 cm-1, measured by a two-colour three-step ionization technique, were reported here. The angular momentum quantum number J was uniquely assigned for these levels by using angular momentum selection rules.

Bolus transit assessed by an esophageal stress test in postfundoplication dysphagia

INTRODUCTION

Dysphagia is common after Nissen fundoplication but the relationship between dysphagia and bolus transit is poorly defined. This study compared bolus transit of fundoplication patients to normal individuals.

METHODS

Twelve fundoplication patients and 20 healthy volunteers rated their ability to swallow eight bolus consistencies from no difficulty (0) to extreme difficulty (3) to compute a dysphagia score (range = 0-24). A 16-lumen manometric assembly was positioned across the esophagogastric junction (EGJ) and subjects were imaged fluoroscopically in a supine posture while swallowing 5 cc liquid barium and a 5-cc marshmallow-like viscoelastic barium bolus. Videofluoroscopic images were analyzed for total esophageal transit time and the fraction of time required to cross the EGJ. Manometric tracings were analyzed for the intrabolus pressure proximal to the EGJ, intragastric pressure, and distal peristaltic amplitude for each bolus.

RESULTS

Dysphagia scores for fundoplication patients were significantly higher (7.3 +/- 5.1, range = 1-17) than for normals (0.5 +/- 0.6, range = 0-2). This correlated with longer total transit times for liquids and solids (r = 0.60, P < 0.01) and a greater percentage of transit time attributable to the EGJ transit. Retrograde flow at the EGJ (escape of bolus proximally up the esophagus) and peristaltic dysfunction were more frequent in fundoplication patients. However, no differences existed in manometric parameters between groups.

CONCLUSIONS

Fundoplication impairs both liquid and solid esophageal bolus transit. Dysphagia perceived by fundoplication patients correlated with increased transit time, particularly across the EGJ. Combined quantitative evaluation with manometry and fluoroscopy reveals functional defects in fundoplication subjects, which are not evident by either modality alone.

[Effect of 5,7-dihydroxytryptamine on the distribution pattern of calcitonin gene-related peptide in different motoneuron pools]

OBJECTIVE

The effect of 5,7-dihydroxytryptamine (5,7-DHT) on distribution pattern of calcitonin gene-related peptide (CGRP) in different motoneuron pools was studied in rats.

METHODS

Cholera toxin B subunit coupled with colloidal gold (CB-Au) retrograde labeling combined with CGRP immunocytochemistry technique was mainly used.

RESULTS

In control group, there was a different distribution pattern of CGRP-LI content in soleus motoneuron (SOL-Mn) and extensor digitorum longus motoneuron (EDL-Mn) pools. SOL-Mn pools had a higher ratio of neurons lacking CGRP-LI/weak CGRP-LI and a lower proportion of strongly CGRP-LI labeled ones. Comparing with control, there was a marked shift to increasing of CGRP-LI content in SOL-Mn pool and slight decrease in EDL-Mn pools 14 days after 5,7-DHT. All the SOL-Mns were CGRP-LI positive and the ratio of CGRP-LI strongly positive Mns significantly increased (P < 0.001) while 5,7-DHT did not increase the ratio of CGRP-LI strongly positive Mn in EDL-Mn pool.

CONCLUSIONS

Except muscular motor activity, the different distribution pattern of CGRP-LI content in SOL-Mn and EDL-Mn pools is related to different 5-HT inputs. SOL-Mns may receive more 5-HT inputs.

Dissecting the nucleotide binding properties of Escherichia coli 6-hydroxymethyl-7,8-dihydropterin pyrophosphokinase with fluorescent 3'(2)'-o-anthraniloyladenosine 5'-triphosphate

6-hydroxymethyl-7,8-dihydropterin pyrophosphokinase (HPPK) catalyzes the transfer of pyrophosphate from ATP to 6-hydroxymethyl-7, 8-dihydropterin, the first reaction in the folate biosynthetic pathway. Like other enzymes in the folate pathway, HPPK is an ideal target for development of antimicrobial agents because the enzyme is essential for microorganisms but is absent from humans and animals. Using 3'(2')-o-anthraniloyladenosine 5'-triphosphate as a fluorescent probe, a fluorometric competitive binding assay has been developed for measuring the dissociation constants of various compounds that bind to the ATP site of HPPK. The fluorometric assay has been used to determine the nucleotide specificity and dissect the energetics of the binding of MgATP. The order of affinity of various nucleoside triphosphates for HPPK is MgATP>MgGTP>MgITP>MgXTP approximately MgUTP approximately MgCTP. The affinity of MgATP for HPPK (K(d)=2.6+/-0.06 microM) is 260-fold higher than that of MgGTP and more than 1000-fold higher than those of the other nucleoside triphosphates, indicating that HPPK is highly specific with respect to the base moiety of the nucleotide. The affinity of ATP for HPPK in the presence of Mg(2+) is 15 times that in the absence of Mg(2+), indicating that the metal ion is important for the binding of the nucleotide. Removal of the gamma-phosphate from MgATP reduces its affinity for HPPK by a factor of approximately 21. The affinity of AMP for HPPK is about one third that of ADP and almost the same as that of adenosine. The result suggests that among the three phosphoryl groups of MgATP, the gamma-phosphoryl group is most critical for binding to HPPK and the alpha-phosphoryl group contributes little to the binding of the nucleotide. The affinity of MgATP is 18 times that of MgdATP, indicating that the 2'-hydroxyl group of MgATP is also important for binding. van't Hoff analysis suggests that binding of MgATP is mainly driven by enthalpy at 25 degrees C and the entropy of binding is also in favor of the formation of the HPPK.MgATP complex.

Does the route of feeding modify gastric emptying in rats?

BACKGROUND

It has been shown that the pattern of previous nutrient intake can influence gastric emptying. However, the effect of the absence of enteral stimulation in the setting of a normal energy supply on gastric emptying has not been examined. The aim of this study was to determine whether the absence of enteral stimulation during total parenteral nutrition (TPN) could modify gastric emptying in rats.

METHODS

Two experiments were performed. First, gastric emptying of a peptone meal was compared between rats receiving TPN, oral liquid diet (same solution as TPN), or regular diet (control group) for 10 days. In the second experiment, gastric emptying of two test meals (40% peptone and 25% glucose) was studied before and after rats received TPN or intragastric nutrition (same solution as TPN) for 10 to 12 days.

RESULTS

In experiment 1, gastric emptying of 40% peptone in the TPN and liquid diet groups was slower than that in the control group. This difference was significant between the TPN group and the control group (p < .01) but not between the liquid diet and control groups (p = .076). Gastric emptying of this meal in the TPN and liquid diet groups was similar. In experiment 2, no difference in gastric emptying of 40% peptone or 25% glucose was found between rats receiving TPN and those receiving intragastric nutrition for 10 to 12 days.

CONCLUSIONS

The composition of diet not the route of feeding is important in the modification of gastric emptying by the pattern of previous nutrient intake.

Increased frequency of transient lower esophageal sphincter relaxation induced by gastric distention in reflux patients with hiatal hernia

BACKGROUND & AIMS

This study aimed to determine if hiatal hernia influences vulnerability to reflux and transient lower esophageal sphincter relaxation (tLESR) during gastric distention in patients with gastroesophageal reflux disease (GERD).

METHODS

Eight normal subjects and 15 patients with GERD were studied. A metal clip attached to the squamocolumnar junction (SCJ) was beneath the hiatus in all control subjects. Eight GERD patients with >/=1-cm SCJ-hiatus separation were considered hernia patients, and 7 with <1-cm separation were considered nonhernia patients. Manometry and esophageal pH were recorded for 30 minutes, after which the stomach was loaded with acid dextrose and the recording continued for 2 hours with intragastric air infusion of 15 mL/min.

RESULTS

Baseline reflux was comparable among groups. Gastric distention increased the frequency of reflux by the tLESR mechanism in all groups. Controls and nonhernia patients had median increases of 4.0 and 4.5 in tLESR frequency, respectively, and hernia patients had a median increase of 9.5/h. tLESR frequency was highly correlated with the SCJ-hiatus separation (r = 0.76; P < 0.001).

CONCLUSIONS

Gastric air infusion was a potent stimulus for tLESR and reflux. The resultant tLESR frequency was directly proportional to the separation between the SCJ and hiatus, suggesting that the perturbed anatomy associated with hiatal hernia predisposed to eliciting tLESRs in patients with GERD.

[The multicolour three-photon resonant ionization spectrum studies in uranium atom]

The multicolour three-photon resonant ionization spectra of 238U were measured by using the pulsed dye lasers system synchronously pumped by a frequency doubled Nd:YAG-laser 532 nm output(operated at 10 Hz), a device for atomic beam of U, time-of-flight mass spectrometer and boxcar integrator. The dye laser pulses have a 6 ns duration. Beams from the dye lasers, which have the same polarization direction and are focused by lenses, entered an interaction chamber through opposite windows on a common axis and spatially overlapped the U atomic beam. The optical pulse from dye laser DL2 was delayed to arrive at the interaction region 8 ns after the pulse from dye laser DL1; in the same way, the pulse from DL3 was delayed 8 ns after from DL2. The atomic beam device was made from stainless steel. We generated the U vapor by heating solid U in a graphite crucible by e-type electron-field on first excited states were studied in uranium atom. The question how to determine single-colour, two-colour and three-colour three-photon resonant ionization peak in the three-colour three-photon resonant ionization spectra diagram were solved.

Esophagogastric junction pressure topography after fundoplication

OBJECTIVES

This study compared the pressure topography after laparoscopic Nissen fundoplication to that of normal subjects and patients with hiatal hernia and reflux disease.

METHODS

Seven patients with fundoplication, 7 normal subjects and 7 patients with hiatal hernia, were studied. The squamocolumnar junction and intragastric margin of the esophagogastric junction (EGJ) were marked with metal clips. Axial and radial characteristics of EGJ pressure were mapped relative to the hernia and clipped during concurrent fluoroscopy and manometry. Responses to inspiration and abdominal compression were also analyzed.

RESULTS

Fundoplication modifies the EGJ by restoration of the hiatal component of EGJ pressure and elongation of the subdiaphragmatic component. Maximal EGJ pressure after fundoplication is mainly dependent on the extrinsic effect of the hiatal canal that compresses the esophagus; the resultant length of the EGJ reflects the length of the fundic wrap. Integrity of the EGJ after fundoplication is independent of the intrinsic lower esophageal sphincter itself.

CONCLUSIONS

Fundoplication alters the pressure topography of the EGJ by reducing the hiatal hernia, tightening the hiatal orifice, and constructing a subdiaphragmatic wrap of variable length. Each effect depends on different technical aspects of the surgery with the potential of substantial variability in the resultant pressure topography.

[6A8 cDNA encodes A type of alpha-mannosidase]

OBJECTIVE

To find the nature of the protein encoded by 6A8 cDNA.

METHODS

In the light of that the ligand of Con A is mannoses and that the function of alpha-mannosidase is trimming of mannoses in the oligosaccharide chains of glycoproteins, COS-7 cells and CNE-2L2 cells, a cloned cell line of human nasopharyngeal carcinoma, were transfected with pRc/CMV-sense 6A8 cDNA or pRc/CMV-antisense 6A8 cDNA and the Con A binding to the cells was examined upon a lazer scan confocal microscope.

RESULTS

The data demonstrated that with transfection of pRc/CMV-sense 6A8 cDNA the binding of Con A to the cells was decreased, but the staining of the cells with mAb 6A8 was enhanced, and vise versa for the cells with transfection of pRc/CMV-antisense 6A8 cDNA.

CONCLUSIONS

The protein encoded by 6A8 cDNA might be a type of alpha-mannosidase recognized by mAb 6A8.

[A light and scanning electron microscopic study of primary teeth in hypophosphatasia]

OBJECTIVE

To investigate the features of primary tooth structure in hypophosphatasia.

METHODS

Three primary teeth from two patients at age of 3 yr-6 month and 4 yr-2 month, who were diagnosed hypophosphatasia. The structural changes of these teeth were examined by light microscopy, polarizing microscopy and scanning electron microscopy.

RESULTS

The complete absence of cementum was a prominent feature in all the teeth, three small island-shape cementun areas were found in scanning electron microscopy. A large number of resorptions were found on the root surfaces, particularly near apical portions of roots. The main findings included disturbances of dentin mineralization, hypoplasia or aplasia of root cementum and external resorption of root dentin.

CONCLUSION

The hypoplasia or aplasia of root cementum was thought to be the prime etiological factor in the early loss of primary teeth.

[Simultaneous determination of tungsten, molybdenum and titanium by k-factor dual-wavelength standard addition method]

In this paper, a new method for simultaneous spectropthotometric determination of tungsten, molybdenum and titanium is proposed. The method is based on the difference of absorption spectra of the three elements forming coloured complexes with PF in acidic medium and in the presence of nonionic surfactant Tween-80. The absorbance of sample was measured at wavelengths of 503, 530 and 560 nm, and the data were treated by the principle of the k coefficients and dual-wavelength standard addition method. The method has been applied to the determination of tungsten, molybdenum and titanium in steels, and satisfactory results were obtained.

Esophageal sensitivity and symptom perception in gastroesophageal reflux disease

Patients with gastroesophageal reflux disease (GERD) experience a wide spectrum of symptoms, varying both in quality and severity. This review summarizes clinical observations of esophageal sensitivity and symptom perception in GERD patients. The Bernstein test, although lacking standardization, remains a useful tool in determining esophageal sensitivity to acid stimuli. Ambulatory 24-hour pH monitoring with symptom event marking and subsequent symptom-reflux correlation between acid reflux events and esophageal symptomatology now provides an alternative method for establishing esophageal acid sensitivity. The intraesophageal balloon distention test (IEBD) was developed to assess esophageal sensitivity to mechanical stimuli. Variants of each of these tests have been applied to the evaluation of uncomplicated GERD patients and patients with esophagitis and Barrett's metaplasia, who generally demonstrate less esophageal sensitivity than the former group. Studies using these methods have demonstrated increased esophageal sensitivity in patients with esophageal chest pain and have also identified a subset of patients with esophageal symptoms yet normal esophageal acid exposure, a condition referred to as "hypersensitive esophagus." The Bernstein test, 24-hour pH monitoring with symptom assessment, and IEBD have each contributed to our understanding of esophageal pain syndromes; it is hoped that future work in this area will lead to improved and more specific therapy for these patients.

Esophageal solid bolus transit: studies using concurrent videofluoroscopy and manometry

OBJECTIVE

Our aim was to assess the efficacy and mechanism of solid bolus transit through the esophagus.

METHODS

Eight healthy volunteers were studied with concurrent manometry and videofluoroscopy while swallowing 5 ml liquid barium, a 5-6 mm diameter bread ball, and 4 g chewed bread in both a supine and upright posture. As many as four successive swallows were performed until clearance was achieved.

RESULTS

The esophageal clearance of liquid barium was 100% with the first swallow. Clearance of the unchewed bread ball occurred with the first swallow in only 6.7% of trials in the upright posture and 5.9% in the supine posture. After four swallows, clearance was 100% and 52.9% in the upright and supine postures, respectively. Chewed bread was more readily cleared than unchewed bread, with 100% clearance after two swallows in the upright posture and 91% clearance after four swallows in the supine posture. The most common locus of bread stasis was at the aortic arch and carina. The bread boluses were noted to move more effectively when localized in the head as opposed to the tail of the bolus composite. Nonocclusive contractions often occurred at the bolus tail despite the increased peristaltic amplitude seen with the chewed bread. Failed peristalsis, a frequent cause for solid clearance failure, was observed during 30% of all bread swallows. This usually occurred distal to the stopping point of the bolus, suggesting it to be the result rather than the cause of impaired transit.

CONCLUSIONS

Although infrequently perceived by these normal subjects and in contradistinction to liquid clearance, bread is rarely cleared from the esophagus with a single swallow. Mastication and an upright posture facilitate the esophageal transport of solids. Bolus composition and impaired bolus transit alter the amplitude and conductance of peristalsis. Manometric data pertaining to liquid clearance through the esophagus do not readily apply to bread.

Crystal structure of 6-hydroxymethyl-7,8-dihydropterin pyrophosphokinase, a potential target for the development of novel antimicrobial agents

BACKGROUND

Folate cofactors are essential for life. Mammals derive folates from their diet, whereas most microorganisms must synthesize folates de novo. Enzymes of the folate pathway therefore provide ideal targets for the development of antimicrobial agents. 6-Hydroxymethyl-7,8-dihydropterin pyrophosphokinase (HPPK) catalyzes the transfer of pyrophosphate from ATP to 6-hydroxymethyl-7,8-dihydropterin (HP), the first reaction in the folate biosynthetic pathway.

RESULTS

The crystal structure of HPPK from Escherichia coli has been determined at 1.5 A resolution with a crystallographic R factor of 0.182. The HPPK molecule has a novel three-layered alpha beta alpha fold that creates a valley approximately 26 A long, 10 A wide and 10 A deep. The active center of HPPK is located in the valley and the substrate-binding sites have been identified with the aid of NMR spectroscopy. The HP-binding site is located at one end of the valley, near Asn55, and is sandwiched between two aromatic sidechains. The ATP-binding site is located at the other end of the valley. The adenine base of ATP is positioned near Leu111 and the ribose and the triphosphate extend across and reach the vicinity of HP.

CONCLUSIONS

The HPPK structure provides a framework to elucidate structure/function relationships of the enzyme and to analyze mechanisms of pyrophosphoryl transfer. Furthermore, this work may prove useful in the structure-based design of new antimicrobial agents.

Differential asparagine-linked glycosylation of voltage-gated K+ channels in mammalian brain and in transfected cells

Glycosylation of ion channel proteins dramatically impacts channel function. Here we characterize the asparagine (N)-linked glycosylation of voltage-gated K+ channel alpha subunits in rat brain and transfected cells. We find that in brain Kv1.1, Kv1.2 and Kv1.4, which have a single consensus glycosylation site in the first extracellular interhelical domain, are N-glycosylated with sialic acid-rich oligosaccharide chains. Kv2.1, which has a consensus site in the second extracellular interhelical domain, is not N-glycosylated. This pattern of glycosylation is consistent between brain and transfected cells, providing compelling support for recent models relating oligosaccharide addition to the location of sites on polytopic membrane proteins. The extent of processing of N-linked chains on Kv1.1 and Kv1.2 but not Kv1.4 channels expressed in transfected cells differs from that seen for native brain channels, reflecting the different efficiencies of transport of K+ channel polypeptides from the endoplasmic reticulum to the Golgi apparatus. These data show that addition of sialic acid-rich N-linked oligosaccharide chains differs among highly related K+ channel alpha subunits, and given the established role of sialic acid in modulating channel function, provide evidence for differential glycosylation contributing to diversity of K+ channel function in mammalian brain.

Lower esophageal sphincter relaxation characteristics using a sleeve sensor in clinical manometry

OBJECTIVE

We undertook this study to determine the characteristics of swallow-induced lower esophageal sphincter (LES) relaxation in the setting of clinical manometry using a standardized methodology.

METHODS

We reviewed 170 manometric recordings performed using a perfused manometric assembly with a sleeve sensor and a computer polygraph. Patients were categorized as patient controls, gastroesophageal reflux disease (GERD), diffuse esophageal spasm (DES), or achalasia. Tracing were semiautomatically analyzed for basal LES pressure, LES pressure during deglutitive relaxation (relaxation LES pressure), duration of LES relaxation, timing of LES relaxation, and the success rate of primary peristalsis.

RESULTS

Forty-six patient controls, 93 with GERD, five with DES, and 26 with achalasia were identified. GERD and achalasia patients had lower or higher basal LES pressures than patient controls, respectively. Compared with patient controls, achalasia patients had higher relaxation LES pressures, lower percent LES relaxation, and shorter durations of LES relaxation. The best single measure for distinguishing achalasia was the relaxation LES pressure; using the 95th percentile value of patient controls (12 mm Hg) as the upper limit of normal, its sensitivity and positive predictive value for the diagnosis of achalasia were 92% and 88%, respectively. Coupled with the finding of aperistalsis, a relaxation LES pressure > or = 10 mm Hg achieved 100% sensitivity and positive predictive value among these patients.

CONCLUSIONS

Sleeve sensor recording is a practical method for clinical manometry that reliably records LES relaxation characteristics and is amenable to both a standardized manometry protocol and a semiautomated analysis routine. Relaxation LES pressure has a high diagnostic value for achalasia.

Neuroendocrine synaptic vesicles are formed in vitro by both clathrin-dependent and clathrin-independent pathways

In the neuroendocrine cell line, PC12, synaptic vesicles can be generated from endosomes by a sorting and vesiculation process that requires the heterotetrameric adaptor protein AP3 and a small molecular weight GTPase of the ADP ribosylation factor (ARF) family. We have now discovered a second pathway that sorts the synaptic vesicle-associated membrane protein (VAMP) into similarly sized vesicles. For this pathway the plasma membrane is the precursor rather than endosomes. Both pathways require cytosol and ATP and are inhibited by GTPgammaS. The second pathway, however, uses AP2 instead of AP3 and is brefeldin A insensitive. The AP2-dependent pathway is inhibited by depletion of clathrin or by inhibitors of clathrin binding, whereas the AP3 pathway is not. The VAMP-containing, plasma membrane-derived vesicles can be readily separated on sucrose gradients from transferrin (Tf)-containing vesicles generated by incubating Tf-labeled plasma membrane preparations at 37 degreesC. Dynamin- interacting proteins are required for the AP2-mediated vesiculation from the plasma membrane, but not from endosomes. Thus, VAMP is sorted into small vesicles by AP3 and ARF1 at endosomes and by AP2 and clathrin at the plasma membrane.

[Studies on the functional anatomy of Golgi-phobic dendrites of spinal motoneurons in rats--different dendroarchitectures of the motoneurons to slow muscle and fast one]

OBJECTIVE

The functional anatomy of Golgi-phobic dendrites (GBD) of spinal motoneurons (Mn) in rats was studied from their postnatal development.

METHODS

Cholera toxin B subunit conjugated with horseradish peroxidase (CB-HRP) retrograde labelling method was mainly used.

RESULTS

In the extensor digitorum longus Mn pool (EDL-Mn) GBD gradually decrease during development and are only a few in adults. The related value of the surface density of the white matter dendrites, most of them are GBD, of the soleus Mn pool (SOL-Mn) is nearly double than that of EDL-Mn.

CONCLUSIONS

GBD of motoneurons might be related to their action patterns, especially the tonic action of slow muscle, such as the soleus. The hypotheis of dual circuits in motor control, the paralateral circuit on GBD regulates control of tonic action and the core circuit on Golgi-philic dendrites (GLD) and somata regulates phasic action, such as on EDL-Mn, has been further enhanced.

[Value of pulmonary diffusion capacity in predicting the short-term prognosis after lung resection in lung cancer patients.]

BACKGROUND

To determine the relationship between pulmonary diffusion capacity (DLCO) and the short-term prognosis after lung resection in patients with lung cancer.

METHODS

A retrospective analysis of 413 consecutive patients with lung cancer who underwent lung resection was performed. Among them , 27 had low DLCO before operation (DLCO < 60 %predicted for total pneumonectomy or bilobectomy , < 50 %predicted for lobectomy) , as a low DLCO (LDLCO) group ,and other 386 patients as a control group.

RESULTS

There were more patients with chronic bronchitis , history of heavy smoking and underwent chemotherapy or radiotherapy preoperatively in LDLCO group than those in control group. The hospital mortality rates within 30 days after lung resection were no significant difference between the two groups ( P > 0. 05) ,whereas incidence of respiratory complications in LDLCO group was higher than that in control group ( P < 0. 05) .

CONCLUSIONS

A reduction in DLCO before operation can remarkably increase respiratory complications after pulmonary resection. DLCO is one of important predictors of risk for lung resection.

On-demand treatment of gastro-oesophageal reflux symptoms: a comparison of ranitidine 75 mg with cimetidine 200 mg or placebo

AIM

To compare the effects of ranitidine 75 mg with those of either cimetidine 200 mg or placebo given on demand for relief of typical symptoms of gastro-oesophageal reflux disease during a 15-day period.

METHODS

A total of 1336 patients (aged > or = 18 years) with heartburn episodes were recruited and randomly assigned to a ranitidine 75 mg, cimetidine 200 mg or placebo group. Depending on the occurrence or persistence of heartburn, treatment was administered as required up to three times daily, with at least 2 h between drug doses. Antacids were allowed as rescue medication if symptoms persisted for at least 2 h after the third medication on any given day. The primary end-point was defined as the proportion of patients with relief of at least 75% of heartburn episodes during the study period (i.e. relief occurring within 2 h after drug ingestion and lasting for at least 5 h).

RESULTS

Analysis was performed in an intention-to-treat population comprising 504 subjects in the ranitidine group, 515 in the cimetidine group and 270 in the placebo group. Primary end-point success rates were 41, 38 and 28%, respectively, for the three groups (P < 0.001 for ranitidine vs. placebo, P = 0.274 for ranitidine vs. cimetidine). Ranitidine 75 mg was significantly more effective than placebo in providing overall heartburn relief (P < 0.001). The differences between the ranitidine and cimetidine groups were not significant, except for a greater reduction in heartburn frequency in the ranitidine group at the end of the study period (P < 0.05). Drug dose was lower and less rescue medication was used in the ranitidine group than the placebo group. The three treatment groups did not differ in terms of tolerability.

CONCLUSION

On-demand ranitidine 75 mg or cimetidine 200 mg are safe and effective treatment for reflux-related symptoms.

Inhibition of prostaglandin-induced intestinal secretion by igmesine in healthy volunteers

BACKGROUND & AIMS

Igmesine, a final sigma ligand, has been shown to inhibit intestinal secretion and diarrhea in animal models. The purpose of this study was to measure the inhibitory effect of igmesine on basal and prostaglandin E2 (PGE2)-induced jejunal secretion in normal volunteers.

METHODS

Jejunal absorption of water and electrolytes was measured with a three-lumen open-segment perfusion method in 16 volunteers. A double-blind crossover study was performed involving intraluminal infusion of PGE2 after oral administration of placebo or igmesine at two doses.

RESULTS

PGE2 induced net secretion of water and electrolytes (P < 0.01 vs. basal conditions). The effect of PGE2 on water and electrolytes was not changed by 25 mg of igmesine but was suppressed by 200 mg of igmesine. This effect lasted at least 3 hours after a single oral dose. Igmesine at a dose of 200 mg also produced a significant decrease in basal rates of water and electrolyte absorption.

CONCLUSIONS

Igmesine, a final sigma ligand, inhibits PGE2-induced intestinal secretion in normal humans. Evaluating the drug in chronic diarrheas may be of interest.