Synthesis and in vitro cytotoxicity of 3- or 4-dialkylaminomethyl-1-azaanthraquinones

Six 3-dialkylaminomethyl-1-azaanthraquinones and five 4-dialkylaminomethyl-1-azaanthraquinones were synthesized and evaluated in vitro cytotoxicity against four human cancer cell lines. The compounds retained much of their cytotoxic activity against the multi-drug-resistant cell line (KB-V-1) as shown by resistance index.

Synthesis and in vitro cytotoxicity of 3-substituted-1,8-diazaanthraquinones produced by Lewis-acid catalyzed hetero Diels-Alder reaction

A hetero Diels-Alder reaction of quinoline-5,8-dione with 1-(N,N-dimethylamino)-3-methyl-1-aza-1,3-butadiene proceeded to give 3-methyl-1,8-diazaanthraquinone (100% regioselectivity) in the presence of Lewis-acid catalyst (ZnCl2 or ZnBr2). Subsequent functionalizations of the benzylic methyl group resulted in the 1,8-diazaanthraquinone analogues as potential antitumor agents. The most active compound, 8, exhibited in vitro cytotoxic activity comparable to that of doxorubicin.

Intestinal Behçet syndrome: CT features of patients with and patients without complications

PURPOSE

To analyze the computed tomographic (CT) features of intestinal Behçet syndrome and to determine the usefulness of CT in detecting complications.

MATERIALS AND METHODS

The CT scans of 28 patients with intestinal Behçet syndrome were retrospectively reviewed. Five patients had bowel perforation, and two had peritonitis. Patterns of bowel involvement, patterns of contrast enhancement, and ancillary findings were compared in patients with complications (n = 7) and patients without complications (n = 21).

RESULTS

Ten patients had polypoid lesions, nine had a thickened bowel wall, and nine had both findings. Lesion enhancement was mild in eight patients (29%) and marked in 20 (71%). Polypoid lesions were more commonly seen in patients without complications (P = .020); a thickened bowel wall was more commonly seen in patients with complications (P = .030). Seventeen of 18 patients (94%) with minimal perienteric infiltration did not have complications (P = .0003), whereas all five patients with severe perienteric infiltration did have complications.

CONCLUSION

In patients with known intestinal Behçet syndrome, CT can be useful in determining the extent of the lesions and in identifying cases in which complications are likely to occur.

Surgical resection of mucoepidermoid carcinoma at the carina in a 9-year-old boy

Mucoepidermoid carcinoma of trachea and bronchi is a rare tumor, especially in children. The authors report a case of 9-year-old boy with mucoepidermoid carcinoma at the carina. His presenting symptoms were hemoptysis of recent onset and intermittent cough of 2 years' duration. Preoperative assessment of the tumor was an intraluminal polypoid mass arising from the carina extending into the trachea and right main stem bronchus. A complete resection with reconstruction of carina was successful. The tumor was 12 mm in size, polypoid with a broad base. It had characteristic features of a low-grade mucoepidermoid tumor, namely, admixture of islands of intermediate cells and glandular components with invasion of submucosa. The patient is now 15 months postsurgery free of disease.

1998 ARRS Executive Council Award. Radiology in the emergency department: technique for quantitative description of use and results. American Roentgen Ray Society

OBJECTIVE

We sought to develop quantitative methods to describe the use and results of imaging studies in emergency department patients.

MATERIALS AND METHODS

A computerized nonrelational database containing records of 3.5 million diagnostic reports generated by our radiology department from 1988 to 1997 was queried using Boolean and natural language search tools. Each record contained data fields for patient demographics, examination description and billing code, names of interpreting radiologists and referring physicians, patient history, report body, and report impression.

RESULTS

Emergency department admissions and imaging studies were stable from 1991 to 1997, averaging 60,000 and 52,000 per year, respectively. Bone radiographs comprised 45.1% of examinations; chest radiographs, 44.6%; and abdominal radiographs, 10.4%. The percentages of radiographs interpreted as normal were 75.9% in 1992 and 75.3% in 1996, with cervical spine (88.7%), thoracic spine (86.3%), and knee (86.3%) yielding the highest proportion of studies with normal findings. The number of CT studies of the body increased from 1840 in 1993 to 3101 in 1997. Studies of the abdomen accounted for most of this increase (52.3% in 1993 to 66.0% in 1997). During evaluations for cervical spine injury, a mean of 6.5% of radiographic studies were followed by CT studies, and the findings of 89.0% of those CT studies were interpreted as normal.

CONCLUSION

Radiology report databases represent a resource from which broad descriptions of the use and results of imaging studies can be obtained. Such descriptions may be useful in departmental and hospital administration, technology assessment, cost-effectiveness studies, and health policy formulation.

Staurosporine-induced Ca2+ mobilization in rat mandibular salivary acini

The effect of the protein kinase C inhibitor, staurosporine, on intracellular Ca2+ homeostasis was investigated in rat mandibular salivary acinar cells loaded with fura-2. Fura-2 fluorescence was measured at 510 nm while the excitation wavelength was alternated between 340 nm and 380 nm. The ratio of fluorescence intensity (F(340/380)) was used as an index of [Ca2+]i. Stimulation of acinar cells with 10 microM carbachol (CCh) induced a rapid increase in F(340/380) followed by a slow decrease to a sustained elevated level. Addition of 1 microM staurosporine in the presence of CCh caused a further increase in F(340/380). In order to examine whether the staurosporine-induced increase in F(340/380) could be attributed either to the Ca2+ entry pathway or to the mobilization of Ca2+ from intracellular Ca2+ stores, 1 microM staurosporine was added in the presence of CCh after Ca2+ had been omitted from the perfusate. Even in the absence of extracellular Ca2+, F(340/380) still increased slowly from 0.75 +/- 0.05 to 1.57 +/- 0.24 after a delay ranging between 5 min and 10 min. However, the IP3-sensitive intracellular Ca2+ stores did not seem to play a major role in this phenomenon because staurosporine still increased F(340/380) by 0.6 +/- 0.10 after the complete depletion of IP3-sensitive Ca2+ stores by the exposure of cells to 1 microM thapsigargin, a microsomal Ca2+ ATPase inhibitor, in Ca2+-free conditions. These results suggest that staurosporine mobilizes Ca2+ from IP3-insensitive intracellular Ca2+ stores in rat mandibular salivary acinar cells.

Localization of hepatitis B virus DNA in hepatocellular carcinoma by polymerase chain reaction in situ hybridization

The polymerase chain reaction in situ hybridization (PCR-ISH) is a new technique that combines the sensitivity of PCR with the localizing ability of ISH. To investigate the expression pattern of hepatitis B virus (HBV) in the tissue of hepatocellular carcinoma (HCC), we detected HBV-DNA with PCR-ISH in paraffin-embedded tumor and corresponding non-tumor tissues from 11 HCC patients. HBV-DNA was detected in 4 of 11 tumor tissues and in 7 of 10 non-tumor tissues. In tumor tissues, positive signals were scattered in the tissue with occasional clustering, and were found mainly in the cytoplasm of HCC cells rather than in the nucleus. In non-tumor tissues, the number of positive signals was higher than in tumor tissues and they were found in regenerating nodules with differing patterns and intensities. When we compared the detection rate of PCR-ISH with nested PCR among 10 tissue samples, HBV-DNA was detected in 5 tissue samples by PCR-ISH, but the S gene was detected in 10, precore gene in 9 and X gene in 8 by nested PCR. The findings suggest that PCR-ISH is a sensitive technique for localizing HBV in tissue sections and that the low level of HBV replication persists in HCC cells.

Prevalence and disease experience rates in Korean physicians

This study aimed to find out the morbid status of Korean physicians living in Korea, as one part of a feasibility study on the Korean physician cohort. It was performed by mail survey using a self-administered questionnaire from Jan. 1, 1995 through Dec. 31, 1995. Study subjects were 21,552 including 17,877 (81.1%) males and 3,384 (15.5%) females. Person based prevalence rate of disease was 17.7% (18.3% for males and 13.8% for females) with the rate increasing with age. The disease group showing the highest prevalence rate was circulatory diseases (5.16%) for males, and respiratory disease (3.13%) for females. The individual disease showing the highest prevalence rates was hypertension (3.77%) for males and allergic rhinitis (2.25%) for females. The person based disease experience rate was 36.2% (36.9% for males, 32.7% for females) with the rate increasing with age. The disease group showing the highest disease experience rate was digestive disease for both sexes (10.05% for males, 7.42% for females). Individual disease showing the highest disease experience rate was hypertension (5.00%) for males and allergic rhinitis (4.08%) for females. There were different ranks of both prevalence and disease experience rate depending on age in both sexes.

Digital infrared thermographic imaging in patients with gastroesophageal reflux disease

We performed a thermographic study to observe any possible interaction between the esophageal acid perfusion and the temperature changes of skin surface in patients with gastroesophageal reflux disease (GERD). Twenty-seven patients with GERD were categorized as group I(globus symptoms with posterior laryngitis) and group II (heartburn and/or regurgitation symptoms). Patients and 6 healthy volunteers underwent Bernstein test (BT) and digital infrared thermographic imaging (DITI) simultaneously. The positive rate for BT in group I and group II was 22.2% and 55.6%, respectively, and the DITI positive rate was 55.6% for group I and 50.0% for group II. None of healthy control were positive in BT or DITI. All subjects with DITI positive were hypothermic. The overall accordance rate between DITI and BT was 69.7%. All group I patients showed a diffuse type, while in group 11, 4 patients showed diffuse type and 5 patients showed localized type (p<0.05). In patients with DITI (+)/BT (-), 83.3% showed diffuse type, whereas equal numbers of diffuse and localized type were noted in patients with DITI (+)/BT (+). In conclusion, add contact with a sensitive mucosa leads to an activation of the sympathetic nervous system in some patients with GERD, inducing skin surface hypothermia.

Iron repressibility of siderophore and transferrin-binding protein in Staphylococcus aureus

In order to investigate whether the iron acquisition mechanisms of Staphylococcus aureus are induced by iron restriction in vitro, we examined S. aureus ATCC 6538 for production of siderophore and expression of transferrin-binding protein (SA-tbp) in normal or deferrated brain heart infusion broth (BHI). Siderophore production was earlier and greater in the deferrated BHI. The SA-tbp, detected by ligand blot assay, was expressed only in the deferrated BHI. When human transferrin was added to the deferrated BHI, siderophore production was later and lower than when transferrin was not present. In conclusion, both iron acquisition mechanisms of S. aureus were found to be iron-repressible and via both of them, human transferrin-bound iron was utilized for growth under iron-restricted condition.

A new class II rice chitinase, Rcht2, whose induction by fungal elicitor is abolished by protein phosphatase 1 and 2A inhibitor

Among the four classes of chitinase, a class II chitinase had not yet been reported for rice. We have isolated and characterized a class II acidic chitinase, Rcht2, from rice (Oryza sativa L. cv. Cheongcheongbyeo). The protein consists of a single polypeptide chain of 261 amino acid residues and includes a putative signal sequence of 29 amino acids at its N-terminus. It has a calculated molecular mass of 27,642 Da and an isoelectric point of 5.56. The Rcht2 chitinase lacks the cysteine-rich and hinge domains in the N-terminal region of the protein, which is the criterion for its classification as a class II chitinase. Comparison of the genomic and the cDNA sequence revealed that the coding region of Rcht2 consist of three exons of 301, 112, and 370 bp separated by two introns of 89 and 984 bp. In suspension-cultured rice cells, the transcript level of Rcht2 was dramatically increased by treatment with both glycol chitin and fungal elicitor. The application of protein phosphatase 1 and 2A inhibitors, calyculin A and okadaic acid, effectively abolished the induction of Rcht2 in response to fungal elicitor. In contrast, the activation of Rcht2 transcript was not inhibited by both cycloheximide and protein kinase inhibitors. These results demonstrate that protein dephosphorylation events play a crucial role in the elicitor-mediated induction of Rcht2 in rice cells, while de novo protein synthesis is not required for induction.

Epidemic adenoviral lower respiratory tract infection in pediatric patients: radiographic and clinical characteristics

OBJECTIVE

This retrospective study was undertaken to evaluate the radiographic and clinical findings of adenoviral lower respiratory infection during an epidemic period.

CONCLUSION

Epidemic adenoviral pneumonia may mimic bacterial pneumonia on radiographs. Findings that include bilateral and multifocal involvement on chest radiographs, normal or decreased WBC associated with lymphocytosis, and progression of illness despite extensive antibiotic therapy, help to differentiate epidemic adenoviral from bacterial pneumonia.

Acute gastroparesis in Duchenne's muscular dystrophy

Duchenne's muscular dystrophy (DMD) is an X-linked recessive disease. Clinical descriptions of the disorder focus principally on skeletal muscle degeneration. Another manifestation, which involves the gastrointestinal tract, may be fatal. But its prevalence remains undefined. We report here a case of acute gastroparesis associated with Duchenne's muscular dystrophy. In our case, the patient's symptoms were improved by prokinetic agents and timely decompression in life-threatening acute gastric dilatation.

Alterations in frequency of interleukin-2 (IL-2)-, gamma interferon-, or IL-4-secreting splenocytes induced by Candida albicans mannan and/or monophosphoryl lipid A

We have shown previously that intravenous injection of Candida albicans mannan (MAN) into naive mice induced CD8+ effector downregulatory cells and that such cells were not produced if mice were deficient in CD4+ or I-A+ cells during the early interval (< or =30 h) following the introduction of MAN. Moreover, the nonspecific biological response modifier monophosphoryl lipid A (MPL), given in vivo or incubated with cells in vitro, can abrogate the MAN-specific immunomodulatory activity. The mechanism by which the abrogation is mediated is unknown, but it is hypothesized to involve cytokines. Therefore, we measured the number of cytokine-secreting cells for the Thl cytokine interleukin-2 (IL-2) and the Th2 cytokine IL-4, as well as for gamma interferon (IFN-gamma), in splenocyte populations from MAN and/or MPL-treated mice, using an enzyme-linked immunospot assay designed to detect individual cytokine-secreting cells (spot-forming cells [SFC]). Cytokine-secreting cells were demonstrated in cell suspensions enriched for CD4+ cells, but no SFC could be demonstrated in populations enriched for CD8+ cells. Both MAN and MPL, when administered to separate groups of animals, stimulated the production of increased numbers of cytokine-producing cells for each of the three cytokines tested. The response with respect to IL-4-secreting cells, however, was the most striking. Despite the fact that MAN and MPL independently caused increases in SFC to all three cytokines, when both MAN and MPL were administered to the same animal, all increases were reversed, and the numbers of SFC detected were at or below those detected in saline control animals. These data support the hypothesis that IL-4 is involved in MAN-specific immunoregulatory activities. The data also emphasize the fact that two immunomodulators, i.e., MAN and MPL, having similar effects when given in vivo independently, may be antagonistic when administered sequentially to the same animal.

Sleep deprivation activates epileptiform discharges independent of the activating effects of sleep

An electroencephalogram (EEG) recorded after sleep deprivation (SDEEG) in epilepsy patients often discloses epileptiform discharges (ED) when routine EEG (REEG) does not, but since sleep alone activates ED, activation during SDEEG may result merely from the induction of sleep. We retrospectively investigated whether SDEEG is useful when REEG containing wakefulness and sleep fails to show ED. Subjects were patients with definite or highly probable epilepsy whose REEG lacked ED and who later underwent SDEEG. All had wakefulness and at least stage II sleep during both REEG and SDEEG. Patients with ED on REEG were specifically excluded to avoid including patients with activation due merely to the occurrence of sleep. Patient and EEG characteristics were studied, including duration of wakefulness and each sleep stage and timing and characteristics of ED. Fifteen of 29 patients (52%) had activation on SDEEG; exclusively during wakefulness in 1, exclusively during sleep in 6 and in both wakefulness and sleep in 8. Activation rates were not significantly different between wakefulness (9, 60%), stage I (11, 74%) and stage II (11, 74%). EEG characteristics were similar for REEG and SDEEG, except that total EEG duration and stage II sleep were longer in SDEEG than in REEG, which did not influence activation by a logistic regression model (p > 0.05). We conclude that sleep deprivation activates ED independent of the activating effects of sleep and therefore is useful in evaluation of suspected epilepsy even when REEG contains sleep.

Effect of erythromycin on gastric emptying in healthy individuals assessed by radio-opaque markers and plasma acetaminophen levels

We simultaneously recorded gastric emptying of radio-opaque markers (ROMs) and monitored serial changes in plasma acetaminophen (AAP) levels to demonstrate the relationship between the ROM and the AAP methods, and we investigated the effect of a single intravenous dose of erythromycin (EM) on gastric emptying in healthy human subjects. After an overnight fast, subjects were randomized to receive either placebo or EM lactobionate (Abbott, North Chicago, IL, USA) 250 mg intravenously in a single dose, given immediately before a standard meal. Subjects ingested 1.5 g of AAP and ROMs with the test meal. A supine plain abdominal radiograph was taken 1, 2, 3, and 6 h after ingestion of the test meal. Peripheral blood samples were obtained 0, 0.5, 1, 1.5, 2, 3, and 6 h after ingestion of the test meal. EM significantly accelerated gastric emptying of ROMs. By 6 h, no markers remained in the stomach in any of the subjects in the placebo or EM groups. By 120 min, half of the ROMs had passed into the duodenum in 12.5% of subjects after placebo, whereas EM injection resulted in gastric emptying of half of the ROMs in all subjects. There was no difference in plasma AAP concentration between the placebo and EM groups. There were significant correlations between maximum plasma AAP concentration and gastric emptying of ROMs 120 min after ingestion (r = 0.546; P = 0.019), and between time of maximum plasma AAP concentration and gastric emptying of ROMs 120 min after ingestion (r = -0.568; P = 0.014). The time taken to reach the peak concentrations ranged from 30 to 90 min after ingestion, whereas most ROMs were emptied 120 min after ingestion. We conclude that the gastric emptying assessed by ROMs and by serial changes in plasma AAP level are good, non-invasive, clinically applicable tests, with a significant correlation between the two tests. A single intravenous dose of EM had a prokinetic effect on gastric emptying, assessed by ROMs, in healthy human subjects.

A case of bleeding from the Dieulafoy lesion of the jejunum

Dieulafoy lesion is an uncommon cause of gastrointestinal bleeding, reported to be only 2% of acute or chronic upper gastrointestinal bleeding episodes. Bleeding occurs from a small mucosal erosion involving an unusually large submucosal artery in an otherwise normal mucosa. It is associated with massive, life threatening hemorrhage and is difficult to diagnosis. In most cases the lesion is encountered in the proximal stomach, antrum, duodenum, colon and rectum. In particular, extragastric Dieulafoy lesion is an extremely rare source of intestinal bleeding. In Korea, no case of bleeding from a Dieulafoy lesion of the small intestine has been previously reported. We experienced one case of bleeding from a jejunal Dieulafoy lesion, which was confirmed by the pathologic examination of the resected specimen, and report here.

Congenital bronchoesophageal fistula associated with esophageal diverticulum in the adult

Congenital bronchoesophageal fistula is a rare clinical entity in adults. This anomaly may cause various symptoms such as respiratory infections, coughing bouts when eating or drinking, and even hemoptysis. The fistula can cause symptoms in childhood but may not appear until adulthood. We recently experienced a case of congenital bronchoesophageal fistula associated with esophageal diverticulum in an adult. A 63-year-old woman was admitted to our hospital due to chest discomfort, sore throat and coughing bouts when eating. An empyema with lung abscess had occurred eight years previously. Results of the physical examination were unremarkable. A Barium swallowing revealed a medium-sized diverticulum at the right anterior aspect of the esophagus, which had developed a fistulous connection with the right lower lobe bronchus. The patient was treated by fistulectomy and lobectomy of the right lower lobe. The postoperative course was smooth and uneventful.

A thickness map of iliac bone of Korean adults

The iliac bone is one of the most common donor sites for bone graft. Despite such potential and clinical usefulness, the anthropometric data on the iliac bone are lacking. The purpose of this study is to construct a thickness map that provides the mean iliac bone thickness of its various points and their differences. We studied 58 hip bones (from 23 males and 35 females) from Korean adults. We measured the iliac bone thickness at 26 points, which were positioned at regular intervals on each given iliac bone, using a Techlock GM 21 caliper gauge. The mean thickness of each measuring point of the male and the female, and of the right and the left, was compared with each other through paired t-test; the measurements did not differ significantly. From the anteriorposterior perspective, the region between anterior superior iliac spine (ASIS) and iliac tubercle was relatively thick. However, it became progressively thinner before it reached the sacroiliac articulation. It became thicker again toward the posterior superior iliac spine (PSIS), the thickest area. From the superoinferior perspective of superior iliac crest and inferior acetabulum, the thickness became inferiorly thinner in the anterior part between ASIS and iliac tuberosity. However, in the posterior part between the sacroiliac joint and PSIS, there was no significant difference of thickness. We hope that our thickness map can serve as a practical guide to the choice of an ideal site of the iliac bone for bone graft to obtain desired thickness.

Prevalence of childhood asthma based on questionnaires and methacholine bronchial provocation test in Korea

BACKGROUND

In most epidemiological survey studies, only subjective symptoms and past medical history of asthma have been used as diagnostic criteria. Even though a questionnaire survey can be performed in a large population study at low cost, limitations such as lack of objectivity and poor predictability in non-specific bronchial hyperresponsiveness cannot be avoided.

OBJECTIVES

The purpose of this study was to elucidate the prevalence of current asthma based on questionnaires and methacholine bronchial provocation test, and the prevalence of atopy in Korea.

METHODS

We performed modified ATS respiratory questionnaires and allergen skin-prick test with 10 common inhalant allergens among 3219 subjects aged 7-19 years in Seoul and a rural part of a small city, Chungju in Korea. Methacholine bronchial provocation tests were also performed among those who had asthma symptoms according to the questionnaire. The criteria of asthma was presence of both asthma symptoms and non-specific bronchial hyperresponsiveness. Atopy was defined as when an allergen induced weal size is same or larger than that caused by histamine.

RESULTS

The prevalence of asthma based on questionnaires and methacholine bronchial provocation tests was 4.6%, while the prevalence of wheeze was 8.2% and 19.3% of total population complained of one or more respiratory symptoms related to asthma on the questionnaires. There was no significant difference according to age, sex and living area. The mean prevalence of atopy was 35.0% and the most common allergens were Dermatophagoides farinae (30.9%), Dermatophagoides pteronyssinus (27.5%), cat fur (20.4%) and cockroach (11.8%). The atopy prevalence in Chungju area was higher than that in Seoul and males showed a higher prevalence than females. The asthma prevalence was higher among atopics (6.8%) than among non-atopics (2.7%). None of questionnaire items were enough to predict the presence of bronchial hyperresponsiveness in terms of sensitivity, specificity and positive predictive value.

CONCLUSION

The prevalence rate of current asthma in Korea was 4.6% and the prevalence rate of atopy in Korea was 35.0%. Questionnaire-based surveys are not enough to predict the actual prevalence of asthma.

Influence of pentobarbital-Na on stimulation-evoked catecholamine secretion in the perfused rat adrenal gland

OBJECTIVES

The present study was attempted to investigate the effects of pentobarbital-Na, one of the barbiturates which are known to depress excitatory synaptic transmission in the central nervous system at concentrations similar to those required for the induction and maintenance of anesthesia, on catecholamines (CA) secretion evoked by cholinergic stimulation and membrane-depolarization from the isolated perfused rat adrenal gland, and to clarify the mechanism of its action.

METHODS

Mature male Sprague-Dawley rats were anesthetized with thiopenal-Na (40 mg/kg, s.c.). The adrenal gland was isolated by the methods of Wakade. A cannula used for perfusion of the adrenal gland was inserted into the distal end of the renal vein. The adrenal gland was carefully removed from the animal and placed on a platform of a leucite chamber.

RESULTS

The perfusion of pentobarbital-Na(30-300 uM) into an adrenal vein for 20 min produced relatively dose-dependent inhibition in CA secretion evoked by ACh(5.32 mM), DMPP(100 uM for 1 min), McN-A-343(200 uM for 2 min), Bay-K-8644(10 uM) and high potassium(56 mM), while it did not affect the CA secretion of cyclopiazonic acid(10 uM). Also, in the presence of thiopental-Na (100 uM), CA secretory responses evoked by ACh, DMPP, McN-A-343 and high K+ were markedly depressed. Moreover, in adrenal glands preloaded with ketamine(100 uM for 20 min), which is known to be a dissociative anesthetic, CA secretion evoked by ACh, DMPP, McN-A-343 and high K+ were significantly attenuated.

CONCLUSION

Taken together, these experimental results suggest that pentobarbital-Na depresses CA release evoked by both cholinergic stimulation and membrane-depolarization from the isolated rat adrenal medulla and that this inhibitory activity may be due to the result of the direct inhibition of Ca++ influx into the chromaffin cells without any effect on the calcium mobilization from the intracellular store.

A preceding airway reaction to one allergen may lead to priming of the airway responses to another allergen

This study aimed to determine whether a preceding airway response to one allergen leads to priming of the airway responses to another allergen. Twelve asthmatic children who had positive prick tests to two allergens, Dermatophagoides pteronyssinus (D.p.) and German cockroach (CR), participated in a randomized, placebo-controlled crossover study. We performed two consecutive inhalation challenges, D.p. challenge being followed 48 h later by CR challenge. The effect of initial (D.p.) challenge on the early and late airway responses to the subsequent (CR) challenge (CR2) was examined by comparing the responses with those to CR challenge preceded by sham challenge (CR1). The geometric mean PD20 of CR allergen in the CR2 was 2.8 BU (breath unit) (range of 1 SD; 0.77-10.4), which was 12.0-fold less than that (33.7 BU, 10.8-105.2) in the CR1. The administration of a 6.1-fold less dose (8.9 BU, 2.7-28.8) in the CR2 than in the CR1 (54.5 BU, 44.1-69.3) provoked a similar degree of late-phase reactions (18.7 +/- 7.3% vs 15.8 +/- 9.6%). Our data indicated that the early- and late-phase reactions to CR challenge were augmented by the preceding reaction to D.p. This suggests that a preceding airway response to one allergen may lead to priming, with enhancement of the early and late airway responses to the subsequent challenge with another allergen.

Role of rebamipide on induction of heat-shock proteins and protection against reactive oxygen metabolite-mediated cell damage in cultured gastric mucosal cells

Reactive oxygen metabolites (ROM) have been reported to be important in the pathogenesis of ischemia/ reperfusion-, ethanol-, nonsteroidal antiinflammatory drug-, or Helicobacter pylori-induced gastric mucosal injury. Rebamipide, a novel antiulcer agent, has been reported either to prevent various acute experimental gastric mucosal lesions or to accelerate the healing of chronic gastric ulcers. The underlying mechanism by which rebamipide exerts its cytoprotective effect in the damaged stomach is not fully determined. We investigated the role of rebamipide in protecting against ROM-mediated cell damage in gastric mucosal cells and in inducing cytoprotective proteins. Cells were exposed to ROM enzymatically generated by hypoxanthine-xanthine oxidase. Cytotoxicity was quantified by measuring specific 51Cr release from prelabeled cells. ROM caused dose-dependent increase in cytotoxicity and amount of thiobarbituric acid-reactive substances (TBA-RS). ROM-induced cytotoxicity and TBA-RS were dose-dependently decreased by the addition of rebamipide and/or catalase, but not by superoxide dismutase alone. The effects of rebamipide on electric spin resonance signal were investigated. We found that the DMPO spin adduct ESR signal of hydroxyl radicals (DMPO-OH) was significantly attenuated by rebamipide. Western blot analysis showed that induction of heat-shock protein (HSP70) was significantly increased following rebamipide administration in a dose-dependent manner. Based on these results, it is concluded that rebamipide exerted a protective effect on HX-XO-induced gastric mucosal cell cytotoxicity through one or more of the following mechanism(s): (1) inhibition of lipid peroxidation of the cell membrane; (2) hydroxyl radical scavenging activity; and (3) induction of cellular cytoprotective protein such as HSP70.

Comparison of antiproliferative effects of 1-histamine-2 receptor antagonists, cimetidine, ranitidine, and famotidine, in gastric cancer cells

In the immune system, histamine is known to suppress cytotoxic T-lymphocytes and nitrogen induced lymphocyte thymidine uptake, down-regulate some cytokines, and activate suppressor T-lymphocytes, and in the gastrointestinal system, histamine was reported to have trophic effects on gastrointestinal epithelial cells. Enhanced rates of cell proliferation by histamine are implicated in the pathogenesis. This study was designed since there is a lack of comparative data about the cell proliferations of histamine-2 receptor antagonist (H2-RA), cimetidine, ranitidine, and famotidine, in gastric cancer. KATO-III and AGS cell lines were used in this experiment. The concentrations of the histamine and cimetidine were 10(-5)-10(-8) M, respectively and those of ranitidine and famotidine were 10(-6)-10(-9)M, respectively. Cell proliferation after drug treatment was evaluated by direct cell counting, [3H]thymidine incorporation, and MTT assay. Activities of ornithine decarboxylase (ODC), a rate limiting enzyme in polyamine synthesis, were measured after each drug treatment. Protein kinase A, a cAMP-dependent protein kinase system, was assayed using [alpha-32P]ATP. Histamine showed statistically significant cell proliferating effects in a dose-dependent manner (P < 0.001), the maximal effect in 10(-5) M concentration. ODC activities were increased in accordance with the increment of cell numbers after histamine treatment. Cimetidine reversed the histamine-stimulated cell proliferation significantly, the maximal effect in 10(-5) M concentration (P < 0.01). Although ranitidine showed the tendency to attenuate the cell proliferation dose-dependently, but without statistical significance, famotidine did not show such an effect at all. cAMP-dependent protein kinase activities were significantly increased following 10(-5) M histamine treatment, also reversed significantly by cimetidine co-administration (P < 0.01). Beneficial clinical outcomes could be anticipated from cimetidine treatment in patients with gastric cancer by anti-proliferating effects against gastric cancer cells. These effects of H2-RA are likely to be mediated by specific interactions at the H2-receptor.

Expressed sequence tags of Chinese cabbage flower bud cDNA

We randomly selected and partially sequenced cDNA clones from a library of Chinese cabbage (Brassica campestris L. ssp. pekinensis) flower bud cDNAs. Out of 1216 expressed sequence tags (ESTs), 904 cDNA clones were unique or nonredundant. Five hundred eighty-eight clones (48.4%) had sequence homology to functionally defined genes at the peptide level. Only 5 clones encoded known flower-specific proteins. Among the cDNAs with no similarity to known protein sequences (628), 184 clones had significant similarity to nucleotide sequences registered in the databases. Among these 184 clones, 142 exhibited similarities at the nucleotide level only with plant ESTs. Also, sequence similarities were evident between these 142 ESTs and their matching ESTs when compared using the deduced amino acid sequences. Therefore, it is possible that the anonymous ESTs encode plant-specific ubiquitous proteins. Our extensive EST analysis of genes expressed in floral organs not only contributes to the understanding of the dynamics of genome expression patterns in floral organs but also adds data to the repertoire of all genomic genes.

Increased serum interleukin-10 level in Kawasaki disease

Serum IL-10 level in Kawasaki disease(KD) was tested. In the KD patients' sera during the acute phase, the levels of IL-10 were markedly elevated (122.0 +/- 39.1 pg/ml) compared to 3.7 +/- 1.7 pg/ml in the control subjects (p < 0.001). The serum IL-10 levels remained elevated in the subacute phase (16. 7 +/- 9.7 pg/ml, p < 0.001) and were restored to the normal levels(7.9 +/- 3.9 pg/ml) during the convalescent phase. In the patients with acute febrile disease, the serum IL-10 level increased significantly (34.4 +/- 14.1 pg/ml, p < 0.001) compared to that of the age-matched control subjects, but were not as high as in acute phase of KD(p < 0.005). This increase in serum IL-10 levels in KD may contribute to the up-regulation of humoral immunity and to the down-regulation of acute inflammation due to an increase in proinflammatory cytokines.

Candida albicans mannan-specific, delayed hypersensitivity down-regulatory CD8+ cells are genetically restricted effectors and their production requires CD4 and I-A expression

There is considerable controversy over the induction and activity of down-regulatory cells active in various antigen-specific and antigen-nonspecific systems. We have been studying the nature of such cells in a Candida albicans mannan (MAN)-specific system for some time and report here the requirements for CD4+ and I-A+ cells during the inductive phase for the development of CD8+ effector cells, as well as the requirement for genetic compatibility for effector activity of CD8+ cells. Since we have shown previously that CD8+ down-regulatory cells were present in spleens of MAN-treated mice 4 days following the administration of MAN to naive mice, as determined by their ability to suppress delayed hypersensitivity (DH) when transferred to immunized recipients, we treated mice with monoclonal antibodies specific for CD4 and I-A at various times before, with or after the administration of MAN to assess the role of CD4+ and I-A+ cells in the development of the CD8+ effector cell. Both anti-CD4 and anti-I-A given before or up to 30 h after the administration of MAN abrogated the ability of splenocytes from MAN-treated mice to down-regulate MAN-specific DH in immunized recipients. Moreover, transfers of down-regulatory cells between H-2-incompatible strains of mice, specifically CBA/J and BALB/cByJ, provided evidence that the effector cell for the down-regulatory activity was also restricted genetically in its activity. Taken together, the data presented indicate that genetically compatible cells are required for both the inductive and effector stages of down-regulation of MAN-specific DH, suggesting that cell-cell cooperation is required for both stages and that CD4+ cells are required in a pathway leading to the development of the CD8+ effector cell.

Decreased CD5+ B cells during the acute phase of Kawasaki disease

We investigated the changes of CD5+ B cells in the peripheral blood of 20 Kawasaki disease (KD) patients. The percentage of CD5+ B cells in the total lymphocytes and in the total B cells significantly decreased during the acute phase of KD(p < 0.01), compared to that in the age-matched normal control subjects. After intravenous immunoglobulin(IVIG) treatment, the percentage of CD5+ B cells increased, but was still lower than that in the normal controls(p < 0.01). During the convalescent phase of the disease, the percentage of CD5+ B cells was restored to the normal levels. The levels of CD5+ B cell percentage in the total B cells of the patients with acute febrile disease showed similar levels to age-matched normal controls. The decreased CD5+ B cells in the patients with KD provides an additional abnormal immunological finding during the acute phase of the disease.

Characterization of a cDNA encoding cysteine proteinase inhibitor from Chinese cabbage (Brassica campestris L. ssp. pekinensis) flower buds

A cDNA encoding a new phytocystatin isotype named BCPI-1 was isolated from a cDNA library of Chinese cabbage flower buds. The BCPI-1 clone encodes 199 amino acids resulting in a protein much larger than other known phytocystatins. BCPI-1 has an unusually long C-terminus. A BCPI-1 fusion protein expressed in Escherichia coli strongly inhibits the enzymatic activity of papain, a cysteine proteinase. Genomic Southern blot analysis revealed that the BCPI gene is a member of a small multi-gene family in Chinese cabbage. Northern blot analysis showed that it is differentially expressed in the flower bud, leaf and root.

A genetic screen identifies cellular factors involved in retroviral -1 frameshifting

To identify cellular factors that function in -1 ribosomal frameshifting, we have developed assays in the yeast Saccharomyces cerevisiae to screen for host mutants in which frameshifting is specifically affected. Expression vectors have been constructed in which the mouse mammary tumor virus gag-pro frameshift region is placed upstream of the lacZ gene or the CUP1 gene so that the reporters are in the -1 frame relative to the initiation codon. These vectors have been used to demonstrate that -1 frameshifting is recapitulated in yeast in response to retroviral mRNA signals. Using these reporters, we have isolated spontaneous host mutants in two complementation groups, ifs1 and ifs2, in which frameshifting is increased 2-fold. These mutants are also hypersensitive to antibiotics that target the 40S ribosomal subunit. We have cloned the IFS1 gene and shown that it encodes a previously undescribed protein of 1091 aa with clusters of acidic residues in the carboxyl-terminal region. Haploid cells lacking 82% of the IFS1 open reading frame are viable and phenotypically identical to ifs1-1 mutants. This approach could help identify potential targets for antiretroviral agents.

Structural and functional studies of retroviral RNA pseudoknots involved in ribosomal frameshifting: nucleotides at the junction of the two stems are important for efficient ribosomal frameshifting

Ribosomal frameshifting, a translational mechanism used during retroviral replication, involves a directed change in reading frame at a specific site at a defined frequency. Such programmed frameshifting at the mouse mammary tumor virus (MMTV) gag-pro shift site requires two mRNA signals: a heptanucleotide shifty sequence and a pseudoknot structure positioned downstream. Using in vitro translation assays and enzymatic and chemical probes for RNA structure, we have defined features of the pseudoknot that promote efficient frameshifting. Heterologous RNA structures, e.g. a hairpin, a tRNA or a synthetic pseudoknot, substituted downstream of the shifty site fail to promote frameshifting, suggesting that specific features of the MMTV pseudoknot are important for function. Site-directed mutations of the MMTV pseudoknot indicate that the pseudoknot junction, including an unpaired adenine nucleotide between the two stems, provides a specific structural determinant for efficient frameshifting. Pseudoknots derived from other retroviruses (i.e. the feline immunodeficiency virus and the simian retrovirus type 1) also promote frameshifting at the MMTV gag-pro shift site, dependent on the same structure at the junction of the two stems.

Comparison of immunomodulative effects of the histamine-2 receptor antagonists cimetidine, ranitidine, and famotidine on peripheral blood mononuclear cells in gastric cancer patients

BACKGROUND

Histamine-2 receptor antagonist (H2-RA) have been shown to improve the function of various parts of the immune system. The proposed mechanism of the immunomodulative effects of H2-RA has been considered to be the inhibition of suppressor T-lymphocyte activity, an increase in interleukin-2 production, and an enhancement of natural killer cell activity. Most of these studies were done with cimetidine. Comparative data with other H2-RA are limited and conflict on immunomodulative effects. Comparison of the actions of H2-RA on the immune system is required.

METHODS

We compared the immunodulative effect of the H2-RAs cimetidine, ranitidine, and famotidine on peripheral blood mononuclear cells (PBMC) in normal controls and patients with gastric cancer. DNA synthesis, cytotoxicity against K562 cells, and the levels of soluble interleukin-2 receptor (sIL-2R) in supernatant were measured after addition of the various H2-RA to PBMC cultures.

RESULTS

Subjects with gastric cancer showed significantly higher levels of suppressor lymphocyte activity than normal controls. These levels were restored to levels of normal controls by the addition of cimetidine. Statistically significant lymphoblastogenesis and cytotoxicity against K562 cells were observed only in cimetidine-treated PBMC (p < 0.05); such effects were not observed in ranitidine- or famotidine-treated PBMC. Significantly increased levels of sIL-2R were found in supernatants obtained from culture flasks treated with cimetidine and phytohemagglutinin or ranitidine and phytohemagglutinin (p < 0.01).

CONCLUSIONS

Of the three H2-RAs tested, cimetidine had the strongest and famotidine the weakest immunomodulating effect. Only cimetidine augmented the cytotoxicity and proliferative response of lymphocyte to mitogen; neither ranitidine nor famotidine had such an effect. These results might be due to their structural differences. In addition, the immunologic effects of H2-RA are unlikely to be mediated via specific interaction at the H2 receptor.

Comparison of immunomodulative effects of histamine-2 receptor antagonists in gastric cancer patients: focus on the lymphoblastogenesis and cytotoxicity of peripheral blood mononuclear cells

A proposed mechanism of the immunomodulative effects of histamine-2 receptor antagonist (H2-RA) has been considered to be the inhibition of suppressor T-lymphocyte activity, an increase in interleukin-2 production of helper T-lymphocytes, and an enhancement of natural killer cell activity. Since there is a lack of comparative data about the immunomodulative effects of various H2-RAs, cimetidine, ranitidine and famotidine on peripheral blood mononuclear cells (PBMC), study of the comparison of the actions of H2-RA will be required. We compared the immunomodulative effect of each H2-RA on PBMC in patients with gastric cancer. DNA synthesis, cytotoxicity of PBMC against K562 cells and gastric cancer cell lines, and the levels of supernatant soluble interleukin-2 receptor (sIL-2R) were measured after the addition of each H2-RA, respectively. Increased suppressor cell activities were attenuated and restored to the levels of normal controls by the addition of cimetidine to H2-RA. Statistically significant lymphoblastogenesis and cytotoxicity against K562 cells were observed only in cimetidine-treated PBMC (P < 0.05). Such effects were not observed in ranitidine- or famotidine-treated PBMC. Neither cimetidine- nor ranitidine-activated activated PBMC showed any significant cytotoxicity against gastric cancer cells. Significantly increased levels of sIL-2R were found in supernatants obtained from culture flasks treated with cimetidine or ranitidine and phytohemagglutinin (P < 0.01). A significant correlation was found between the cytotoxicity of cimetidine- or ranitidine-treated PBMC and supernatant sIL-2R (P < 0.05). In conclusion, the most strongly modulative substance among H2-RAs was cimetidine and the least modulative drug was famotidine.(ABSTRACT TRUNCATED AT 250 WORDS)

Duodenal ectopic pancreas complicated by chronic pancreatitis and pseudocyst formation--a case report

Ectopic pancreas is no longer a rare clinical condition, but its unusual clinical manifestations, locations or complications are of clinical interest. We experienced a case (a 48 year-old male patient) of duodenal ectopic pancreas complicated by chronic pancreatitis and pseudocyst formation of which preoperative imaging findings mimicked a large duodenal submucosal tumor with cystic degeneration such as a leiomyosarcoma. Simultaneous chronic pancreatitis was also demonstrated in the isotopic pancreas of the patient postoperatively. Herein we report a rare clinical condition occurring in an ectopic pancreas with a brief review of the literature.

Obstructive jaundice due to compression of the common hepatic duct by right hepatic artery--a case associated with the absence of the lateral segment of the left hepatic lobe

Various benign and malignant conditions can cause biliary obstruction. We present a rare case of obstructive jaundice due to the compression of the common hepatic duct by the anteriorly overriding right hepatic artery. This case was also associated with the absence of the lateral segment of the left hepatic lobe. The patient was a 39 year-old housewife with a 4-day history of jaundice and occasional febrile sensation. An abdominal computed tomography showed absence of the lateral segment of the left hepatic lobe and a percutaneous transhepatic cholangiography showed a band-like filling defect of 2 mm width at the level of the upper common hepatic duct. The anteriorly overriding right hepatic artery compressing the common hepatic duct and the absence of the lateral segment of the left hepatic lobe were confirmed by operation.

Solitary rectal ulcer syndrome

We report three cases of solitary rectal ulcer syndrome (SRUS). The diagnosis was established according to histopathologic criteria. But, the initial clinical diagnosis was carcinoma, non-specific ulcer and localized proctitis respectively. SRUS is considered as one of functional disorder in pelvic floor which might go underdiagnosed due to unfamiliar concept in Korea. So we should consider SRUS to be one of the differential diagnosis in cases of complaining anorectal symptoms.

Effect of sex hormones on lipid peroxidation in rat liver

The role of sex hormones in hepatic lipid peroxidation, and in hepatic aldehyde oxidase and xanthine oxidase activities were investigated using rat liver homogenates. It was observed that male rat had a significantly greater content of malondialdehyde in liver than female. Among the sex hormones tested, estradiol, one of female hormones, markedly inhibited the formation of lipid peroxides in liver tissues in vitro. Especially, the inhibitory effect of estradiol appeared more remarkably in Fe+2-induced lipid peroxidation. The hepatic xanthine oxidase activity was decreased about 15% by 10(-6) M estradiol, whereas, the aldehyde oxidase activity was almost completely disappeared at the same concentration of estradiol. It implies that sex differences in lipid peroxidation is attributed to the suppression of free radical generating system by estradiol.

A double-blind, randomized, parallel group study of omeprazole and ranitidine in Korean patients with gastric ulcer

The efficacy of the proton pump inhibitor omeprazole, 20 mg every morning, was compared with that of the H2-receptor antagonist ranitidine, 150 mg every morning and at bedtime, in a double-blind randomized parallel group study in 250 patients with gastric or prepyloric ulcers. At both 4 and 8 weeks, significantly more patients had healed ulcers in the omeprazole group than the ranitidine group, whether the results were analysed on a per-protocol or an intention-to-treat basis. At 4 weeks, 74% of patients in the omeprazole group were healed compared with 51% in the ranitidine group (P = 0.001), and at 8 weeks the corresponding values were 99 and 82% (P = 0.001, per-protocol cohort). Omeprazole treatment and small ulcer size significantly increased the probability of healing, but smoking had no significant effect. Patients in the omeprazole group had significantly fewer occurrences of daytime epigastric pain during the first 4 weeks than the ranitidine group (P = 0.0037), as shown by their diary cards. Both treatments were well tolerated.