Air trapping on expiratory high-resolution CT scans in the absence of inspiratory scan abnormalities: correlation with pulmonary function tests and differential diagnosis

OBJECTIVE

We wish to describe the differential diagnosis and pulmonary function correlates of patients with normal findings on inspiratory high-resolution CT (HRCT) scans who showed air trapping on expiratory scans.

MATERIALS AND METHODS

HRCT scans in 273 consecutive patients with suspected diffuse lung disease were reviewed. HRCT consisted of inspiratory scans at 1- to 2-cm intervals and expiratory scans at three levels. Studies considered to show expiratory air trapping were divided into two groups, one having normal findings on inspiratory scans and one having abnormal findings on inspiratory scans. Pulmonary function test results in these groups were compared with a group of patients who had normal findings on inspiratory and expiratory HRCT scans.

RESULTS

Forty-five patients showed air trapping on expiratory HRCT scans. Of these 45 patients, inspiratory high-resolution CT scans showed abnormal findings in 36 (bronchiectasis, bronchiolitis obliterans, asthma, chronic bronchitis, and cystic fibrosis). In the remaining nine patients, inspiratory HRCT had normal findings; conditions in these nine patients included bronchiolitis obliterans (n = 5), asthma (n = 3), and chronic bronchitis (n = 1). Results of pulmonary function tests in patients with air trapping and normal findings on inspiratory scans were intermediate, falling between those of patients with normal findings on inspiratory and expiratory HRCT scans and those of patients with air trapping and abnormal findings on inspiratory scans.

CONCLUSION

Air trapping on expiratory HRCT scans in patients with normal findings on inspiratory scans is most often associated with bronchiolitis obliterans and asthma. Obtaining expiratory scans in patients who may have one of these diseases is recommended.

Distal pancreatectomy--does it have a role for pancreatic body and tail cancer

BACKGROUND/AIMS

Pancreatic resection is the only hope for clinical improvement for patients with carcinoma of the body and tail of the pancreas. However, it is unclear whether palliative pancreatic resection is effective or not for patients with carcinoma of the body and tail of the pancreas.

METHODOLOGY

To determine the appropriate treatment for patients with pancreatic body and tail cancer, we analyzed the records of 74 patients with ductal carcinoma of the body or tail of the pancreas who were treated at Kanazawa University Hospital between 1970 and 1995.

RESULTS

Using a multivariate Cox proportional-hazard model (factors: age, sex, chemotherapy, radiotherapy, hepatic metastasis, peritoneal dissemination, operative procedure), the presence of hepatic metastasis, peritoneal dissemination, and the type of operative procedures (resection or not) were found to be significant prognostic factors. Surgical resection was the most important prognostic factor. The patients with surgical resection had a significantly higher survival rate than those without resection (p < 0.0001). The survival rate of the patients with palliative resections was also significantly higher than that of the patients without resection, except for the patients with advanced liver metastasis (H3). The survival rate of the patients with palliative resections was also higher than that of the patients without resection, even in patients with peritoneal dissemination.

CONCLUSIONS

Surgical resection prolongs the average survival for patients with carcinoma of the body and tail of the pancreas, except for the patients with multiple liver metastasis. These data support the role of palliative pancreatectomy in patients with carcinoma of the body and tail pancreas.

A new system for the measurement of electrogenicity produced by ion pumps using a thin polymer film: examination of wild type bacteriorhodopsin and the D96N mutant over a wide pH range

We developed a new assay system for the measurement of capacitive electric currents generated by ion pumps using the thin polymer film 'Lumirror' (Toray Co., Japan). This system enables us to examine the electrogenicity of ion pumps over a wide range of experimental conditions with high reproducibility due to the mechanical and chemical stability, the high electric resistance and the high electric capacitance of the thin polymer film. Using this method, we examined the photoelectric response of wild type bacteriorhodopsin and its D96N mutant over a wide pH range (2.8-10.0). The results were explained in terms of the affinities of the proton binding sites for translocated protons. A possibility that the direction of the proton transfer from the Schiff base was influenced by the protonation/deprotonation state of the surrounding proton binding sites was suggested. We also found that this film can be used as a substrate for atomic force microscopy (AFM) samples and hence the active purple membrane was observed with AFM.

Inhaled procaterol inhibits histamine-induced airflow obstruction and microvascular leakage in guinea-pig airways with allergic inflammation

BACKGROUND

Beta2-adrenoceptor agonists (beta2-agonists) are shown to inhibit airway microvascular leakage in experimental animals. This effect may change in animals with chronic airway inflammation.

OBJECTIVE

We examined whether inhaled beta2-agonists inhibit microvascular leakage in guinea-pig airways with chronic allergic inflammation.

METHODS

Three weeks after the sensitization with ovalbumin (OA; 6 mg/mL), each guinea pig was challenged with inhaled OA once a day for 1 or 3 weeks. Control animals without sensitization with OA also inhaled vehicle for OA (saline) for 3 weeks. One day after the last challenge, different doses of inhaled procaterol (1, 3 or 10 microg/mL) or vehicle was given to animals for 10 min after an anaesthesia. Fifteen minutes after the end of inhalation, the animals were given i.v. Evans blue dye (EB dye; 20 mg/kg), a marker of microvascular leakage, and then i.v. histamine (3 or 30 microg/kg) or vehicle. Lung resistance, a parameter of airflow obstruction, was measured for 6 min and the lungs were removed to calculate the amount of extravasated EB dye into the airways.

RESULTS

A significant increase in eosinophil infiltration into the airways was seen in sensitized and challenged animals compared with control animals without sensitization. Among animals receiving antigenic exposure for either 0 (control), 1 or 3 weeks, 10 microg/mL procaterol significantly inhibited 30 microg/kg histamine-induced increase in EB dye extravasation to a similar degree (ranged from 28.7 to 69.8% inhibition) as well as that in lung resistance (more than 90% inhibition in all groups). The minimal dose of procaterol to inhibit 3 microg/kg histamine-induced microvascular leakage was not different between nonsensitized control animals and those sensitized and challenged for 3 weeks at all airway levels.

CONCLUSION

Inhaled beta2-adrenoceptor agonists may be also potent in attenuating microvascular leakage even in the airways with chronic allergic inflammation.

Role of hydrogen peroxide for cell death induction by sodium 5,6-benzylidene-L-ascorbate

The role of hydrogen peroxide in the induction of cell death in human promyelocytic leukemic HL-60 cells by sodium 5,6-benzylidene-L-ascorbate (SBA) and its degradation product, ascorbic acid, was investigated. Millimolar concentrations of these compounds induced cell death, characterized by cell shrinkage, nuclear and internucleosomal DNA fragmentation, disappearance of microvilli and condensation of chromatin near the nuclear membrane. Catalase significantly reduced the cytotoxic activity of these compounds, whereas superoxide dismutase, nitric oxide (NO) generator, NO scavenger and NO synthase inhibitor were inactive, suggesting the possible role of H2O2. Determination of H2O2 with the peroxyoxalate chemiluminescence demonstrated that sodium ascorbate and SBA produced H2O2 in amounts necessary for cell death induction.

Identification and characterization of the ARP1 gene, a target for the human acute leukemia ALL1 gene

ALL1, the human homologue of Drosophila trithorax, is directly involved in human acute leukemias associated with abnormalities at 11q23. Using the differential display method, we isolated a gene that is down-regulated in All1 double-knockout mouse embryonic stem (ES) cells. The gene, designated ARP1 (also termed RIEG, Ptx2, or Otlx2), is a member of a family of homeotic genes containing a short motif shared with several homeobox genes. Using a bacterially synthesized All1 polypeptide encompassing the AT-hook motifs, we identified a 0.5-kb ARP1 DNA fragment that preferentially bound to the polypeptide. Within this DNA, a region of approximately 100 bp was protected by the polypeptide from digestion with ExoIII and DNase I. Whole-mount in situ hybridization to early mouse embryos of 9.5-10.5 days indicated a complex pattern of Arp1 expression spatially overlapping with the expression of All1. Although the ARP1 gene is expressed strongly in bone marrow cells, no transcripts were detected in six leukemia cell lines with 11q23 translocations. These results suggest that ARP1 is up-regulated by the All1 protein, possibly through direct interaction with an upstream DNA sequence of the former. The results are also consistent with the suggestion that ALL1 chimeric proteins resulting from 11q23 abnormalities act in a dominant negative fashion.

Variable gene segment-specific N-insertions at the signal joint of T-cell receptor Vbeta-Dbeta recombinations

The V(D)J recombination of immunoglobulin and a T-cell receptor generates two species of DNA junctions, a coding joint and a signal joint. Non-templated nucleotides (N-nucleotides) are inserted in these DNA junctions. We analyzed the N-insertion at signal joints generated by the Vbeta-Dbeta recombinations. N-insertions were detected at signal joints of Vbeta2, Vbeta3, Vbeta10, Vbeta18 and Vbeta14 but not in Vbeta8 and Vbeta7. These data show that the N-insertion at signal joints is dependent on the Vbeta locus used for the recombination. We suggest that the regional chromosomal configuration may differ in recombinase accessibility.

Induction of torsades de pointes by dobutamine infusion in a patient with idiopathic long QT syndrome

We used a provocative test with dobutamine infusion to diagnose long QT syndrome (LQTS) in a girl with a history of syncope. When dobutamine was infused at a rate of 10 microg/kg/min, the QT interval corrected for heart rate (QTc) was prolonged from 460 ms to 620 ms with abnormal TU complexes and torsades de pointes developed. In 5 control subjects the QTc did not change significantly during low-dose dobutamine infusion. Low-dose dobutamine, in addition to isoproterenol, may be useful for evaluation of prolongation of the QT interval and abnormal TU complexes in patients in whom LQTS is suspected.

[HRCT findings of pulmonary Mycobacterium avium complex: a comparison with tuberculosis]

Computed tomographic (CT) findings of 70 patients with Mycobacterium avium complex (MAC) disease were analyzed by two chest radiologists and compared with those of 37 patients with Mycobacterium tuberculosis infection. Common CT findings in patients with MAC, included bronchiectasis (97%), small nodules (89%), parenchymal distortion (60%), bronchial wall thickening (56%), consolidation (50%) and cavity formation (49%) and small nodules (86%), bronchiectasis (70%), consolidation (57%) and bronchial wall thickening (51%) in patients with Mycobacterium tuberculosis. Bronchiectasis and parenchymal distortion were significant in patients with MAC compared with Mycobacterium tuberculosis patients. Bronchiectasis involving the RUL, RML, lingula and LLL and small nodules involving the RML were often seen in patients with MAC. Both bronchiectasis and small nodules were commonly observed in multiple lobes in both types of patients. Cavities in MAC infection tended to be thin and smooth walled, and less commonly associated with consolidation. We conclude that CT findings of MAC infection were characterized by widely distributed bronchiectasis and small nodules and/or cavities with thin, smooth walls. These CT findings are one of the keys in differentiating MAC from Mycobacterium tuberculosis.

Expiratory high-resolution CT scan

Although high-resolution CT scan has proved most useful in the diagnosis of infiltrative lung disease, its use in the diagnosis of airway and obstructive lung diseases has recently been emphasized. In particular, the use of dynamic expiratory or postexpiratory CT scans, usually in combination with an inspiratory high-resolution CT scan study, has proved useful in the diagnosis and assessment of obstructive lung diseases. This article reviews the use of expiratory CT scan in the diagnosis of lung disease, including the various CT scan techniques that can be used, normal and abnormal expiratory CT scan findings, and the use of expiratory CT scan in a variety of obstructive diseases.

Atomic force microscopy of histological sections using a new electron beam etching method

In order to examine histological sections of the rat vomeronasal epithelium with the atomic force microscope (AFM), we developed an electron beam etching method that improves the resolution of AFM images. This method results in AFM images comparable to those obtained with the transmission electron microscope (TEM). Ultrathin tissue sections embedded in epoxy resin were observed before and after the treatment with electron beam radiation. Before electron beam treatment, epithelial structures such as the microvilli surface, dendritic processes, the supporting cell layers and the neuronal cell layers were all visible using the AFM. However, only a few subcellular structures could also be resolved. The AFM images were not as clear as those obtained with the TEM. After electron beam treatment, however, the resolution of AFM images was greatly improved. Most of the subcellular structures observed in TEM images, including the inner membrane of mitochondria, ciliary-structure precursor body, junctional complexes between the neurons and supporting cells, and individual microvilli were now visible in the AFM images. The electron beam treatment appeared to melt the embedding resin, bringing subcellular structures into high relief. The result of this study suggests that electron beam etching of histological samples may provide a new method for the study of subcellular structure using the AFM.

Relationship between IgG1 levels and airway responses in guinea pigs actively and passively sensitized to hexahydrophthalic anhydride

Organic acid anhydrides (OAAs) are industrial chemicals that may cause induction of specific IgE and airway symptoms in exposed workers. They are a good model for studies of relationships between chemical structure and the sensitizing potential of reactive low-molecular-weight compounds. Hexahydrophthalic anhydride (HHPA) is such a compound. This study aimed to evaluate the relationship between specific IgG1 levels and airway responses in a model to predict the sensitizing potential of OAAs. Guinea pigs were either actively or passively sensitized to HHPA. For active sensitization, guinea pigs were injected i.d. with 0.1 ml of olive oil (vehicle) or 0.05, 0.5, or 5% HHPA in olive oil. Passive sensitization was performed by i.p. injection of different volumes of antisera (0.75-6 ml, either unheated to keep IgE or heated to destroy IgE) taken from HHPA-sensitized guinea pigs. Specific antibody levels were evaluated with ELISA and passive cutaneous anaphylaxis. Animals were challenged 16-18 days after active sensitization, or 2 days after passive sensitization, by intratracheal instillation with HHPA conjugated to guinea pig serum albumin (HHPA-GPSA; 0.05% in saline), and the immediate effects on lung resistance (RL), and plasma extravasation, measured as Evans blue dye extravasation, for up to 6 min were recorded. Active sensitization caused production of specific IgG1. Provocation with HHPA-GPSA caused an increase of both RL and Evans blue dye extravasation, which was dependent upon the active sensitization dose. Challenge with HHPA-GPSA in passively sensitized guinea pigs also produced an increase in both RL and Evans blue dye extravasation which was related to the IgG1 level. In the guinea pig model of HHPA-induced airway allergy, the airway responses are closely related to the serum levels of specific IgG1. Thus, the IgG1 levels induced by the immunization may reflect the sensitizing potential of HHPA.

Characterization of stress-induced sudden death in cardiomyopathic hamsters

Stress is known clinically and experimentally to contribute to the development or exacerbation of cardiovascular dysfunction. In an attempt to construct an animal model of stress-induced cardiovascular dysfunction and to understand its mechanisms, the effects of cold-immobilization stress and its cardiovascular consequences were investigated in cardiomyopathic Syrian hamsters (BIO 14.6) and age-matched healthy control hamsters. Repeated exposure (5 days) to cold-immobilization in the supine position induced no detectable ill effects in the healthy control hamsters but had a lethal effect in the cardiomyopathic hamsters: more than half of the animals died suddenly during or after the stress sessions. Autopsy study of these animals showed significant increases in the weights of the heart, adrenal, liver and kidney and in the serum levels of alkaline phosphatase, urea nitrogen, creatinine and glucose in the cardiomyopathic hamsters subjected to the stress. Propranolol (0.1-10 mg/kg i.p.) administered just before each cold-immobilization for 5 consecutive days dose-dependently and significantly prevented the lethal effects of the stress. Furthermore, it was demonstrated that the drug significantly reduced the increase in the weights of the heart, adrenal, liver and kidney observed in the stressed cardiomyopathic hamsters, whereas phentolamine (0.1-10 mg/kg) and atropine (0.1-10 mg/kg) did not prevent the stress-induced sudden death. The series of acute experiments using single exposure of this stress revealed that the stress evoked severe arrhythmia in some of the cardiomyopathic hamsters and increased the levels of circulating catecholamines in both healthy and cardiomyopathic hamsters. These results taken together suggest that stress accelerates the cardiovascular dysfunction in cardiomyopathic hamsters and provide the first evidence that excitation of the sympathetic nerves, in which beta-adrenoceptors appear to be involved, but not the parasympathetic nerves, has an important role in the etiology of stress-induced cardiac sudden death of cardiomyopathic hamsters.

Inhomogeneous lung attenuation at thin-section CT: diagnostic value of expiratory scans

PURPOSE

To determine the utility of expiratory scans for diagnosis of inhomogeneous attenuation on thin-section computed tomographic (CT) scans.

MATERIALS AND METHODS

On the basis of clinical information and pulmonary function test results, disease in 53 patients with inhomogeneous attenuation on inspiratory scans was classified into four groups--infiltrative, airway, vascular, or mixed. Without knowledge of the diagnosis, inhomogeneous attenuation was classified as (a) ground-glass opacity due to infiltrative disease, (b) mosaic perfusion due to airway disease, or (c) mosaic perfusion due to vascular disease, and the degree of confidence was indicated. Each case was reclassified if necessary on the basis of expiratory scan findings.

RESULTS

A correct diagnosis was made more often on the basis of both inspiratory and expiratory scans than on the basis of inspiratory scans alone (92% [49 of 53 patients] vs 79% [42 of 53], respectively [P < .05]). Accuracy increased from 81% (21 of 26) to 89% (23 of 26) in cases of infiltrative disease and from 84% (16 of 19) to 100% (19 of 19) in cases of airway disease. A correct interpretation with high confidence level was reached more often with expiratory scans than on the basis of inspiratory scans alone (92% [49 of 53] vs 45% [24 of 53], respectively [P < .0001]). The extent of air trapping correlated significantly with pulmonary function test results. With expiratory scans, the classification of inhomogeneous attenuation was changed in 15% (eight of 53) of cases and the confidence level was improved in 51% (27 of 53) (P < .0001).

CONCLUSION

Expiratory scans significantly improved diagnostic accuracy in patients with inhomogeneous attenuation on inspiratory scans, and they helped in the diagnosis of diffuse lung disease.

Analysis of single-strand conformation polymorphisms by capillary electrophoresis with laser induced fluorescence detection

Detection of point mutations in genomic DNA is important for diagnosis of inherited characteristics and genetic diseases. A point mutation in a specific region of DNA amplified by polymerase chain reaction (PCR) can be detected with single-strand conformation polymorphism (SSCP) analysis. Analysis of SSCP by laser-induced fluorescence capillary electrophoresis in entangled polymer solution (CE-LIF) has been developed in the present paper. K-ras genes including seven mutations were amplified with primer labeled with Texas Red at its 5' end. The labeled PCR products were dissociated to single strands by heating and separated with capillary gel electrophoresis and He-Ne laser-excited fluorescence detection. Our results suggest that all fragments having normal (Gly) and mutated (Ala, Arg, Cys, Ser, Val, Asp) sequences at codon 12 can be distinguished. Analysis of SSCPs with CE-LIF is well suited for clinical analysis of SSCPs because of its high sensitivity, resolution, reproducibility and speed.

Stress increases plasma enzyme activity in rats: differential effects of adrenergic and cholinergic blockades

Plasma creatine phosphokinase, lactic dehydrogenase, glutamic-oxaloacetic transaminase and glutamic-pyruvic transaminase activities significantly increased in rats immersed in 23 degrees C water for 6 hr after restraint (water immersion stress). The stress-induced rises in the four enzymes were significantly prevented by the intraperitoneal injection of 6-hydroxydopamine (80 mg/kg), propranolol (1 and 10 mg/kg) or timolol (1 and 10 mg/kg) but not by phentolamine (0.1-10 mg/kg) and atropine (0.1-10 mg/kg). The stress also significantly increased plasma urea nitrogen and glucose levels; however, neither propranolol (0.1-10 mg/kg) nor timolol (0.1-10 mg/kg) did affect these levels. On the other hand, 6-hydroxydopamine (80 mg/kg) and phentolamine (10 mg/kg) slightly but significantly prevented the increase in plasma urea nitrogen level, and the stress-induced hyperglycemia was significantly prevented by either phentolamine (10 mg/kg) or atropine (1 and 10 mg/kg). Plasma norepinephrine and epinephrine levels were also increased significantly by the stress, and the norepinephrine response was suppressed significantly by 6-hydroxydopamine. In conclusion, excessive peripheral sympathetic activity possibly plays an important role in the water immersion stress-induced increases in the plasma enzymes activity primarily via beta-adrenoceptors, whereas alpha-adrenoceptors and the cholinergic nerves might be involved in the stress-induced increases in plasma urea nitrogen and glucose levels.

Haemophagocytic lymphohistiocytosis in association with granular lymphocyte proliferative disorders in early childhood: characteristic bone marrow morphology

Five paediatric cases of haemophagocytic lymphohistiocytosis (HLH) which showed proliferation of granular atypical lymphocytoid cells in bone marrow are reported. All cases were girls aged 8 months to 4 years who had marked hepatosplenomegaly. Marker analysis on peripheral blood mononuclear cells revealed an increase in the CD3+HLADR+ subset in three cases and the CD3- CD56+ subset in one case. An Epstein-Barr virus genome was detected in three cases, and monoclonality was confirmed in two cases. A characteristic morphology of large granular lymphocytes (LGL) was identified, with elongated bizarre features that resembled horsetail-, tadpole-, cucumber- or shooting star-type configurations on the bone marrow smear. Serum concentrations of soluble interleukin-2 receptor and interferon-gamma were elevated in all cases. All five cases required multi-agent chemotherapy which resulted in two complete remission, two partial remissions and one no response. Refinement of treatment is required for these paediatric GLPD cases which probably comprise a specific high-risk subgroup among secondary HLH patients which had previously escaped notice.

Effect of maturation on allergen-induced airflow obstruction and airway plasma exudation in sensitized guinea pigs

Airway reactivity to bronchoconstrictor mediators changes with age. We studied the effects of maturation on airway responses provoked by allergen challenge [ovalbumin (OA) 0.05, 0.15 and 0.5 mg/kg i.v] in passively sensitized immature (190 +/- 2 g: 2 weeks old) and adult guinea pigs (566 +/- 16 g: 13 weeks old). In both groups of animals, we measured both lung resistance (RL) to monitor airflow obstruction and extravasation of Evans blue dye, to quantify airway plasma exudation. Immature guinea pigs required a larger dose of OA at the challenge to induce a significant increase in RL and extravasation of Evans blue dye compared with adult guinea pigs. In addition, immature animals responded less to the lower doses of OA than adults. Pretreatment with pyrilamine, an antihistamine, suppressed the increase in RL in immature animals, whereas the remaining component of the increase in RL was seen in adult animals. Intravenous allergen challenge causes less airflow obstruction and airway plasma exudation in immature than in adult guinea pigs. Allergen-induced airflow obstruction is mediated mainly via histamine in immature animals, whereas this may not be the case in adult animals.

Molecular characterization of extrachromosomal circular DNAs from differentiating embryonic stem cells

Embryonic E14 stem cells were differentiated to parietal yolksac-like flat cells in vitro in the absence of added feeders and LIF (Leukemia Inhibitory Factor). We cloned circular DNAs from the differentiating E14 cells. Out of 9 DNA inserts with the unique sequence, one clone showed a chromosomal rearrangement which could have occurred between a pair of short inverted repeats. Recombination mechanism is discussed in view of two other circularization events of the flanking sequences between short inverted repeats shown in differentiated P19 embryonal carcinoma cells.

Relation between theophylline and circulating vitamin levels in children with asthma

We investigated the effect of theophylline administration on circulating vitamin levels in children with asthma. Twenty-three asthmatic children, ranging in age from 7 to 15 with a mean of 10.8 years and including 16 patients who were treated with slow-release theophylline and 7 patients not receiving any type of theophylline preparation, were enrolled in this study. They all were inpatients who had been hospitalized for the control of asthma. Steady-state serum theophylline and vitamin A, B1, B2, B6, B12 and C levels were evaluated in these patients. Circulating vitamin B1 and B6 levels were depressed in asthmatic children treated with theophylline compared to those not receiving the agent (38.4 +/- 1.6 (mean +/- SEM) vs. 46.4 +/- 3.5 ng/ml and 7.1 +/- 0.5 vs. 11.8 +/- 2.1 ng/ml, respectively, p < 0.05). A significant negative correlation between theophylline and circulating levels of vitamin B6 was demonstrated in the subjects of this study (rs = -0.657, p < 0.001). In contrast, no relationship was noted between theophylline and circulating vitamin B1 levels. Theophylline did not affect circulating vitamin A, B2, B12 or C levels. We conclude that theophylline induces depression of circulating vitamin B1 and B6 levels in asthmatic children, although a dose-dependent interaction between theophylline and vitamin B1 would be unlikely.

[A new strategy for the therapy of pancreatic cancer by proton pump inhibitor]

Bafilomycin A1 is a specific inhibitor of vacuolar type proton pump (V-ATPase). This study was designed to examine the effect of bafilomycin A1 on the growth of Capan-1 human pancreatic cells which overexpress V-ATPase. Nude mice bearing a xenografted tumor of Capan-1 cell line were treated for 4 weeks with bafilomycin A1 (1.0 mg/kg/day). This treatment inhibited tumor growth, which was significantly reduced as compared with controls after 21 days (p < 0.05). However, there were no significant differences in body weights between groups. Microscopically, a large number of tumor cells in the treated group showed signs of apoptosis. These findings suggest that apoptosis induced by bafilomycin A1 was the event involved in suppression of tumor growth in vivo.

[Inhibitory effect of FOY-305 on liver metastasis of the pancreatic cancer]

The potential for hepatic metastasis in nude mice was studied by the intrasplenic implantation method with five human pancreatic cancer cell lines, Capan-1, BxPC-3, AsPC-1, Panc-1, and MIAPaCa-2, especially in relation to serine protease expression, including urokinase-type plasminogen activator and pancreatic trypsinogen 1 (cationic form). The inhibitory effect of a serine protease inhibitor agent, FOY-305, on hepatic metastasis was also a assessed. As a result, the potential for hepatic metastasis was well correlated with expression of pancreatic trypsinogen 1 in these cell lines, and the incidence of metastasis was significantly decreased by FOY-305. These findings suggest that pharmacologic inhibition of serine protease activity may be a new strategy for the therapy of pancreatic cancer metastasis.

MHC class II molecules are not required for survival of newly generated CD4+ T cells, but affect their long-term life span

We grafted fetal thymi from wild-type mice into immunodeficient RAG-2-/- or class II-/-RAG-2-/- (class II MHC-) recipients and followed the fate of naive CD4+ T cells derived from the grafts. In both types of recipients, newly generated CD4+ T cells proliferated to the same extent in the periphery and rapidly filled the empty T cell compartment. However, CD4+ T cells in class II- recipients gradually decreased in number over 6 months. These results show that interactions between the TCR and class II molecules are not required for newly generated CD4+ T cells to survive and proliferate, but are necessary to maintain the size of the peripheral T cell pool for extended periods.

Chicken immunoglobulin mu-chain gene: germline organization and tandem repeats characteristic of class switch recombination

We have isolated the phage clones covering the region spanning from the heavy (H)-chain joining (J) region to the end of the mu-chain gene of the chicken immunoglobulin (Ig). The distance from JH to the first exon of the mu-chain constant (C) region is approximately 13 kb, and introns between the C region exons measure more than 3 kb. These distances are significantly larger than those of known mu-chain genes. We found a region cross-hybridizing to the switch regions of the mouse C mu and C alpha genes just in front of the first exon of C mu. Partial nucleotide sequencing of this region revealed that this region consists of tandem repeats of pentamers (C/T)(C/A)CAG complementary to the mammalian switch repetitive region. These findings suggest that this region is a good candidate for a class switch region of the mu-chain gene of chicken Ig.

Inflammatory responses in skin and airways after allergen challenge in brown Norway rats sensitized to trimellitic anhydride

Trimellitic anhydride (TMA) is a low-molecular-weight compound which causes occupational allergy. Brown Norway rats were sensitized to TMA injected intradermally (0.3% TMA suspended in oil). Three weeks later, we examined responses to either free TMA injected intradermally, or TMA conjugated to rat serum albumin (TMA-RSA) given by inhalation (0.5%, nebulized for 15 min). Twenty-one days after the sensitization, Evans blue dye was given i.v. (20 mg/kg), and extravasation of dye in skin was measured 30 min after oil or TMA injections (0.03-10% in oil). In a separate series of experiments, we evaluated the accumulation of eosinophils in the skin after single and repeated injections of TMA (0.03-0.3%). The injection sites were removed and fixed in formalin 18-24 h after the last injection. In a third series of experiments, we evaluated the effects of airway exposure to TMA-RSA (0.5% in 0.9% saline) on the accumulation of eosinophils in the bronchial wall counted with quantitative light microscopy. Intradermal injections of free TMA caused a dose-dependent increase of Evans blue dye extravasation which was significantly higher in sensitized animals than in controls. Skin histology revealed a significant and dose-dependent increase in eosinophils after repeated TMA injections in sensitized animals. Exposure to aerosolized TMA-RSA caused a significant increase of eosinophils in the bronchial wall of sensitized rats compared with nonsensitized rats. Sensitized animals showed significantly higher levels of specific IgG and IgE. We conclude that brown Norway rats can be used as a model of TMA-induced allergic inflammation, mimicking occupational asthma.

Early expression of Ig mu chain from a transgene significantly reduces the duration of the pro-B stage but does not affect the small pre-B stage

During B cell development, V-J rearrangements at the Ig heavy mu chain (IgH mu chain) locus occur in early cycling precursors (pro-B stage). Subsequently, rearrangements at the Ig light (IgL) chain locus occur in late resting precursors (small pre-B stage). To study the effects of mu chain expression on the rate of B cell development, purified hematopoietic stem cells (HSC) bearing a mu chain transgene or wild-type HSC were transferred into immunodeficient RAG-2-/- mice and B cell development was followed over time. In addition, cycling B cell precursors were pulse-labeled by the injection of BrdU into transgenic and wild-type mice, and the production of BrdU-labeled kappa + and lambda + B cells was followed over time. These experiments suggested that early expression of the mu chain from the transgene significantly shortened the duration of the pro-B stage and immediately drove the precursors to differentiate into small pre-B cells. By contrast, the presence of the transgene did not affect the small pre-B stage, where IgL rearrangements occur. Thus, kappa and lambda rearrangements occurred only after the arrest of cell cycling as previously shown in wild-type mice, even when the mu chain is artificially expressed earlier in B cell development.

CT-guided transthoracic needle biopsy: a comparison between automated biopsy gun and fine needle aspiration

AIMS

We retrospectively investigated the diagnostic accuracy and complication rate of transthoracic core biopsy using an automated biopsy gun and compared the findings with those of aspiration needle biopsy.

PATIENTS AND METHODS

Seventy-three patients underwent 74 core biopsy procedures and 50 patients underwent 52 aspiration biopsy procedures. Of these, a final diagnosis was obtained in 107 lesions with surgery or clinical course. Fifteen patients in which a final diagnosis was not obtained were excluded from the study on diagnostic accuracy. Thus, in the study of diagnostic accuracy, 63 core biopsy procedures for 62 lesions are included. Core biopsy was performed with an 18 G cutting needle using an automated biopsy gun. Aspiration biopsy was performed with a 20 G aspiration needle.

RESULTS

Core biopsy yielded sufficient material in 57/63 procedures (90.5%). A correct diagnosis was obtained in 36 procedures (85.7%) for malignant leisons and a specific benign diagnosis was obtained in 11 procedures (52.4%). Aspiration biopsy yielded a correct diagnosis in 26 procedures (81.3%) for malignant leisons and in seven (46.7%) for benign lesions. The overall correct diagnosis were 75.8% and 71.7% with core biopsy and aspiration biopsy, respectively. Core biopsy gave a higher predictive rate than that of aspiration biopsy for both benign and malignant lessons (P < 0.02). Pneumothorax occurred in 18/74 (24.3%) patients with core biopsy and in 18/45 (40.0%) patients with aspiration biopsy. Of these, three with core biopsy and two with aspiration biopsy needed tube drainage. The other complication was haemoptysis, which occurred in six patients following core biopsy and in three after aspiration biopsy. All nine cases subsided spontaneously. There were no fatal complications.

CONCLUSIONS

Core biopsy with a biopsy gun increase the diagnostic accuracy with a higher histologic predictive rate and no obvious additional risk of complications.

Effect of age, height, and prechallenge respiratory resistance on bronchial hyperresponsiveness in childhood asthma using the forced oscillation technique

To evaluate the effects of age, height and prechallenge respiratory system resistance (Rrs) on bronchial responsiveness to methacholine inhalation (BRm) as measured by the oscillation technique in children with mild asthma, we studied BRm in 92 atopic children aged from 8 to 13 years (mean +/- SD, 10.5 +/- 1.7 years). Inhalation challenge was performed by administering progressively doubling doses of methacholine, until a twofold increase in Rrs from baseline had been reached. The minimum cumulative dose of methacholine (Dmin) at which Rrs deviated from baseline was identified by the point of deflection of the continuously recorded Rrs tracing. The Dmin represented the amount of methacholine which elicited BRm. By using single-regression analysis, height was negatively correlated with Rrs (p < 0.001). Height was positively and Rrs was negatively correlated with age (p < 0.001 and p < 0.001, respectively). Furthermore, height and age were correlated with Dmin (p < 0.001 and p < 0.001, respectively), but prechallenge Rrs was not correlated with Dmin (p > 0.1). To minimize the effect of height and prechallenge Rrs on BRm, the relationships between Dmin and age was studied in a subgroup with a narrow range of heights (135-155 cm, n = 32), and a narrow range of prechallenge Rrs (5.0-6.9 cmH2 O/L/s, n = 42); there remained a statistically significant correlation between Dmin and age in the groups with comparable heights (p = 0.026) and Rrs (p = 0.003). These data suggest that the BHR in childhood asthma may be affected by height and age when measured by the oscillation technique. Considering the many advantages of the oscillation method, this technique may be very suitable for measuring BHR in childhood asthma.

U46619 (a thromboxane A2 mimetic) induces airflow obstruction and airway plasma extravasation in the guinea pig: the role of histamine, cyclooxygenase metabolites, leukotrienes and PAF

The aim of the present study was to characterize the airway effects of U46619, a stable thromboxane A2 mimetic, instilled into the trachea of guinea pigs in vivo, and to investigate the role of different mediators in these effects. The airflow obstruction was evaluated by measurement of airway insufflation pressure (P1) and plasma extravasation by quantification of Evans Blue dye (EBD) in airways. U46619, given as a single dose to each animal (1 pmol-10 nmol), caused a dose-dependent increase in P1 and extravasation of EBD. The threshold dose required to induce an increase in P1 was 30 times lower than the threshold dose necessary to evoke EBD extravasation. The role of inflammatory mediators was studied when 10 pmol (inducing only the increase in P1) or 10 nmol (inducing the increase in both P1 and EBD extravasation) of U46619 was administered. The effects of both doses of U46619 were abolished by ICI192,605, an antagonist of prostanoid receptor for thromboxane A2 (0.5 mg/kg i.v.). The airflow obstruction induced by 10 nmol of U46619 was potentiated by indomethacin, a cyclo-oxygenase inhibitor (10 mg/kg i.v.). EBD extravasation induced by 10 nmol U46619 was attenuated by BW70C (6 mg/kg i.v.), a selective 5-lipoxygenase inhibitor, by ICI198,615 (0.5 microgram/kg i.v.), a leukotriene D4/E4 receptor antagonist and by WEB2086 (1 mg/kg i.v.) a platelet-activating factor receptor antagonist. Pyrilamine (2 mg/kg i.v.), a histamine H1 receptor antagonist, did not have any influence on U46619-induced airway effects. We conclude that U46619 possesses a higher potency in the induction of airflow obstruction than in the induction of plasma extravasation and that U46619-induced plasma extravasation may be partly mediated via leukotrienes and platelet-activating factor.

Immunoglobulin gene hyperconversion ongoing in chicken splenic germinal centers

It has been believed that the peripheral lymphocytes in chickens proliferate by self-renewing amplification of the preimmune repertoire generated in bursa. We amplified rearranged immunoglobulin variable (V) region genes from the single germinal centers induced by immunization. The sequence analysis of these genes revealed that most were derived from distinct B-cell clones which expanded locally, generating somatic antibody mutants at a high rate. Somatic hypermutations included unlinked base changes and the linked base modifications interpreted as unidirectional transfer of sequences from V region pseudogenes. This finding demonstrates the ongoing post-bursal diversification of B-cells in splenic germinal centers by templated gene conversion as well as untemplated point mutations.

Antimetastatic effect of a novel indolocarbazole (NB-506) on IMC-HM murine tumor cells metastasized to the liver

IMC-HM cells were isolated from spontaneously induced ascitic IMC carcinoma cells that had been maintained intraperitoneally in CDF1 mice. Metastasis to the liver of subcutaneously implanted IMC-HM cells was detected 10 days after implantation into the flanks of mice (day 10), but metastasis to other organs was limited. Thereafter, however, tumor cells spread rapidly to lymph nodes, lung, spleen, ovary and other organs, and the mice died on day 13 to 18. We report here, together with the properties of IMC-HM cells, the effects of adriamycin, cisplatin, etoposide and a new indolocarbazole antitumor compound (NB-506) on this model of metastasis. Although these anticancer agents all inhibited the growth of the subcutaneous tumors, their effects on the life span of the tumor-bearing mice varied. Treatment with NB-506, started on day 1, more than doubled the survival period at doses 30 mg/m2 to 900 mg/m2. Further, treatment with NB-506, started on day 4 after resection of the primary tumor, inhibited growth of the metastasized tumor in the liver and other organs. Etoposide also increased the life span at a limited range of doses. However, the life-prolonging effects of adriamycin and cisplatin were marginal. These results demonstrate that IMC-HM carcinoma is a good model for spontaneous metastasis to the liver followed by lethal spread to many organs. Moreover, NB-506 was found to be highly effective against the growth not only of subcutaneous tumors, but also of tumors metastasized to the liver.

Potent antitumor activity of quinolone compounds with an unsaturated aminoazabicyclo group at the C-7 position of the quinolone ring

Relationships between the substituents on the quinolone nucleus of 2 and related compounds and their biological activities were studied. 2, 3 and 1 carrying a (1R, 2R, 6R)-2-amino-8-azabicyclo[4.3.0.]non-3-en-8-yl group at the C-7 position increased the rate of formation of DNA-protein complexes in cells, and inhibited the growth of tumor cells more strongly than the compounds with other substituents. The introduction of a fluorine atom or a methoxy group at the 8-position and an amino group at the 5-position increased the activity still further. The three compounds listed were all effective against P388 leukemia in mice. Subcutaneous injection of 2 at 2 mg/kg strongly suppressed the growth of human MX-1 breast cancer cells in nude mice. 1 has various functional groups that increase the cytotoxic potential of quinolone derivatives: a (1R, 2R, 6R)-2-amino-8-azabicyclo[4.3.0.]non-3-en-8-yl moiety at C-7, a cyclopropyl group at the 1-position, fluorine atoms at the 6- and 8-positions, and an amino group at the 5-position of the quinoline carboxylic acid. These data suggest that this series of compounds provide good models for the further design of potent antitumor quinolones.

Analysis of single-strand DNA conformation polymorphism by capillary electrophoresis

Analysis of single-strand conformation polymorphism (SSCP) by capillary electrophoresis (CE) was developed. The conformational change of single-strand DNA is caused by a mutation in a DNA fragment. The change is detected as mobility shift in CE. The effects of acrylamide gel concentration, running temperature and fragment size amplified by the polymerase chain reaction (PCR) were studied to develop the separation of SSCP. The model DNA used was the divE 42 gene carrying wild- and mutant-type (G-->A point mutation at the 141 site). The results show that two single-strand DNA fragments that differ in one nucleotide can be separated by CE within minutes. This method was also applied to the separation of SSCP for N-ras gene including four kinds of mutations. All mutations tested in this study could be distinguished. CE is well suited for clinical analysis of SSCP because it is rapid and reproducible, allows on-line detection and is easy.

Re-evaluation of the probabilities for productive arrangements on the kappa and lambda loci

V-J arrangements at Ig light chain (IgL) genes occur in resting small pre-B cells. In the absence of cell division, the probability of production kappa and lambda rearrangements is proportional to the output of kappa+ B and lambda+ B cells in bone marrow. The kinetics and probability of productive kappa or lambda rearrangements was assessed in three groups of mice carrying two (wild-type), one or no intact Igkappa gene, and the following conclusion are drawn. Kappa and lambda rearrangements occur independently at different kinetics, and rearrangements are initiated at a time when kappa rearrangements are stopping. The probability of productive kappa and lambda rearrangements per chromosome is calculated to be approximately 60 and approximately 20% respectively. Thus, a kappa gene can attempt rearrangements up to three times per chromosome during B cell development. These findings explain that the observed ratio of kappa+ B/lambda+ B cell production in wild-type mice is 95/5.

[A case of RSD with complete disappearance of symptoms following intravenous ketamine infusion combined with stellate ganglion block and continuous epidural block]

A 74 year-old woman with a 6-month history of RSD following herpes zoster on her right arm was treated with stellate ganglion blocks (SGB), continuous epidural block (CEB) and continuous intravenous infusion of ketamine known as one of the NMDA receptor blockers. Of the symptoms of RSD, burning pain and hyperperspiration but allodynia disappeared after the treatment with SGB 8 times and CEB for 4 days. Allodynia disappeared completely after ketamine treatment, where ketamine was infused once using a subanesthetic dose for 2 hours. It is considered that ketamine is one of the useful drugs for the treatment of neuropathic pain with allodynia.

Bilateral intralobar pulmonary sequestration

A 34-year-old male presented with an infected intralobar pulmonary sequestration of the left lower lobe. Aortography revealed bilateral anomalous systemic arteries, originating in the lower level of the descending thoracic aorta, to the lower lobe on each side. The portion of the right lower lobe, which was perfused by the anomalous systemic artery was seen otherwise normal in anatomy without any recognizable sequestered lung tissue. The patient underwent a left postero-lateral thoracotomy on June 22, 1994. Each aberrant artery was recognized to take off from a common branch of the descending aorta at the level of the diaphragm. A left lower lobectomy with division of the left aberrant artery as well as ligation of the right anomalous artery were done. A postoperative pulmonary perfusion scan depicted normal uptake of radioactivity in the right lower lobe, suggesting normal pulmonary arterial perfusion to the area receiving previously the anomalous systemic arterial flow. An anomalous systemic artery perfusing an otherwise normal lung can be classified as one of the forms of intralobar pulmonary sequestration and could be ligated without resection of the involved area of the lung.

Airway responses following intradermal sensitization to different types of allergens: ovalbumin, trimellitic anhydride and Dermatophagoides farinae

Sensitization of guinea pigs by intradermal injections of the occupational allergen trimellitic anhydride (TMA) in oily vehicle has been shown to be very reproducible. We studied the effect of intradermal sensitization with ovalbumin (OA) in oily vehicle on immune and airway responses in guinea pigs. We also compared airway responses to trimellitic anhydride or Dermatophagoides farinae (DF; mite) with those to OA in guinea pigs intradermally sensitized to respective allergens. Three to four weeks after sensitization, the animals were challenged with intratracheal instillation of these allergens. Intradermal injections with OA developed dose-dependently specific IgG1 antibodies to OA demonstrated by ELISA. In animals sensitized with different doses of OA in corn oil vehicle, a challenge with OA induced a reversely dose-dependent airflow obstruction and airway plasma exudation. In contrast, animals sensitized with OA in saline vehicle had dose-dependent airway responses to OA. Challenge with OA caused an immediate peak and subsequently persistent airflow obstruction, whereas this response to either TMA guinea pig serum albumin or Df was slowly progressive in animals sensitized to respective allergens. The animals sensitized to TMA or Df may show a different profile of airway responses following the challenge compared to OA. Intradermal sensitization may be a valuable method of sensitization for the development of an animal model of airway allergy to different types of allergens, including chemicals or mites.

Effect of procaterol, a beta 2-adrenoceptor agonist, on skin whealing response caused by inflammatory mediators in asthmatic children

BACKGROUND

Beta 2-adrenoceptor agonists have been shown to reduce allergen-induced skin whealing responses via inhibition of mediator release.

OBJECTIVE

To study whether beta 2-adrenoceptor agonists have a direct action against inflammatory mediator-induced skin whealing responses.

METHODS

We examined the effect of procaterol, a beta 2-adrenoceptor agonist, on skin whealing responses to histamine, platelet-activating factor (PAF), substance P, or bradykinin in eight asthmatic children in a double-blind, randomized, cross-over study. Two hours after taking procaterol (50 micrograms) or placebo orally, the subjects were given these mediators intradermally at a concentration of 10(-5) M.

RESULTS

Procaterol has a small but significant inhibitory effect on wheal formation following the intradermal injection of histamine and PAF by an average of 15% (P < .05) and 18% (P < .05) respectively but not against substance P or bradykinin.

CONCLUSIONS

Our results suggest that although beta 2-adrenoceptor agonists may have an inhibitory effect against plasma exudation from microvasculature in the human skin, bronchodilatory effects are more prominent.

Bradykinin-induced release of thromboxane B2 into bronchoalveolar lavage fluid of guinea pigs: relationship to airflow obstruction

The aim of this study was to evaluate the role of thromboxane A2 in bradykinin-induced airflow obstruction in guinea pig in vivo. Airway insufflation pressure (Pi) was measured to assess airflow obstruction and the thromboxane B2 (a stable metabolite of thromboxane A2) concentration in bronchoalveolar lavage fluid was determined by radioimmunoassay. The animals were pretreated with propranolol (1 mg/kg i.v.) and suxamethonium (5 mg i.v.) prior to bradykinin administration. Bradykinin instillation into the trachea (300 nmol) induced a Pi increase (47.5 +/- 8.3 cm H2O versus 23.8 +/- 1.5 in sham) and significant thromboxane B2 release into bronchoalveolar lavage fluid (79 +/- 19 pg/ml versus 19 +/- 6 in sham). A thromboxane synthase inhibitor (OKY-046, 30 mg/kg i.v.; ((E-E)-3-[p(1H-imidazole-1-yl-methyl) phenyl]-2-propenoic acid hydrochloride mono-hydrate)) or a thromboxane A2 receptor antagonist (ICI192,605, 0.5 mg/kg i.v.; (4-(Z)-6-(2-o-chloro-phenyl-4-o-hydroxyphenyl-1,3-dioxan-cis-5-yl) hexenoic acid)) reduced the Pi increase evoked by bradykinin (38.7 +/- 3.8 and 40.6 +/- 3.8 cm H2O, respectively). OKY-046 abolished the thromboxane B2 release. A platelet-activating factor receptor antagonist, WEB2086 (1 mg/kg i.v.; (3-[4-(chlorophenyl)-9-methyl-6H-thienol [3,2-f][1,2,4]trizolo-[4,3-a][1,4] diazepin-2-yl]1-4-(4-morpholinyl)-1-propanon) did not significantly affect any measured parameter. We conclude that, in guinea pigs, bradykinin-induced airway effects are associated with a local thromboxane A2 release.

Development of a novel luminol-related compound, 3-propyl-7,8-dihydropyridazino-[4,5-g]quinoxaline-2,6,9(1H)- trione, and its application to hydrogen peroxide and serum glucose assays

Manual and flow injection methods with chemiluminescence detection were developed for the determination of hydrogen peroxide (H2O2) using a novel luminol-related compound, 3-propyl-7,8-dihydropyridazino[4,5-g]quinoxaline-2,6,9(1H)-trione (PDIQ), having a higher efficiency than luminol. The methods are based on the chemiluminescence produced by the reaction of H2O2 with PDIQ in the presence of microperoxidase in alkaline media. Detection limits for manual and flow injection methods are 13 pmol per 100 microliter of test solution and 1.3 pmol per 100 microliter injection volume, respectively, at a ratio of chemiluminescence intensities (or peak heights) of test to blank of 2. The manual method was applied to the determination of glucose in human serum. The method correlated well with the conventional spectrophotometric method (4 = 0.998).