Leukocytapheresis therapy with leukocyte removal filter for inflammatory bowel disease

Leukocytapheresis (LCAP) with a leukocyte removal filter was administered to 44 patients with inflammatory bowel disease (IBD), diagnosed as ulcerative colitis (UC) in 25 and Crohn's disease (CD) in 19. Clinical and blood examinations showed no side effects in any of the patients. During intensive therapy, clinical improvement was recognized in 21 of the 25 UC patients (84%), 8 of whom had an excellent response, and in 16 of the 19 CD patients (84.2%), 4 of whom had an excellent response. The clinical improvement continued throughout the maintenance therapy in 19 of the UC patients (76%) and in 12 of the CD patients (63.2%). In both the UC and the CD patients, flow cytometry study showed that those who had improved generally had high values for the percentages of HLADR+, HLADR+CD3+, HLADR+CD8+, and CD11a+CD8+ cells before the first LCAP, and that these values decreased to near the normal range after both intensive and maintenance therapy. In the patients who showed poor response, in contrast, the values had been at or near normal before the initial LCAP administration. The clinical improvement and the findings on flow cytometry suggest that LCAP exerts an immuno-modulatory effect and is an effective therapy for patients with IBD in whom conventional drug treatments have failed.

Sweet's syndrome associated with undifferentiated connective tissue syndrome

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Changing pattern of mental health utilization in Hachijojima

We have reviewed retrospectively 229 patients interviewed by the mental health team in the Hachijojima since the establishment of our services in 1987. The 6 year observation period was classified into three chronological stages for the purposes of identifying any change in the utilization pattern of the mental health services of the island. The rate of schizophrenia was observed to have decreased from 48% in the first 2 years of the study period to 28% in the last 2 years; while that of other mental disorders increased yearly. Interestingly, an increasing number of patients were referred to our services by professionals in areas other than mental health (from 42 to 77%), and patients without any history of psychiatric treatment were more frequently seen (from 36 to 75%) in the later part of the study period. These changes suggest the importance of access to mental health services.

[Trial of combined cytosine arabinoside with granulocyte colony-stimulating factor therapy or refractory acute myeloid leukemia]

Thirteen cases, including 10 relapse cases, of refractory acute myeloid leukemia (AML) (aged 17-70, median 46) by cytosine arabinoside (Ara-C) combined with granulocyte colony-stimulating factor (G-CSF) simultaneously to enhance the sensitivity to Ara-C. Low dose Ara-C (10-40 mg/day) combined with G-CSF was administered in most of them. Complete (CR) and partial remission (PR) were achieved in 5 and 4 patients, respectively, and response (CR + PR) rate was 69.2%. We obtained 5 CRs and 3 PRs in 10 patients with relapsed AML. However, CR and PR duration was short in all cases. None of the 3 patients with MO, AML transformed from myelodysplastic syndrome (MDS), and de novo AML with trilineage myelodysplasia (TMDS) had any response. There was no leukemic colony formation in the culture medium containing G-CSF in the nonresponding patients. The combination therapy caused severe myelosuppression, and most patients experienced prolonged neutropenia, and suffered from infections. In some patients enhanced chemosensitivity of leukemic cells induced by G-CSF was indicated but, the effect of this approach must be determined by large scale controlled studies.

Leukocytapheresis therapy, performed with leukocyte removal filter, for inflammatory bowel disease

Leukocytapheresis (LCAP), performed with a leukocyte removal filter, was administered five times, at 1-week intervals, for 5 weeks of intensive therapy and five times, at approximately 1-month intervals, for approximately 5 months of maintenance therapy, to 13 patients with inflammatory bowel disease (IBD) diagnosed as ulcerative colitis (UC) in 8 and Crohn's disease (CD) in 5. Clinical and blood examinations showed no side effects in any of the patients. During the intensive therapy, excellent or moderate clinical response was recognized in 11 of the 13 patients (84.6%), of whom 6 had a dramatic response; the excellent or moderate clinical response continued throughout the maintenance therapy in 8 of the patients (61.5%). Flow cytometry showed that the patients who had improved generally had high values for percentages of HLADR+, HLADR+CD3+, and HLADR+CD8+ cells before the first LCAP, and that these values and the C-reactive protein levels and erythrocyte sedimentation rates had decreased to the normal range by the end of both intensive and maintenance therapy. In the patients who showed poor response, in contrast, all the above values had been at or near normal before the initial LCAP administration. The clinical improvement in the absence of any additional medical treatment suggests that LCAP has the capacity to influence the causal mechanism(s) of IBD and that IBD is strongly associated with the cell-mediated immune response.

Changes in striatal dopamine metabolism after microsphere embolism in rats

BACKGROUND AND PURPOSE

Dopamine plays an important role in striatal function. The present study was undertaken to elucidate the pathophysiological changes in striatal dopamine metabolism after microsphere embolism.

METHODS

Microspheres (48 microns) were injected into the right internal carotid artery of rats. Extracellular levels of dopamine and its metabolites were measured by in vivo microdialysis with the aid of high-performance liquid chromatography. In vivo striatal tyrosine hydroxylation and turnover (catabolism) rate of dopamine were estimated on the first and third days after the embolism. These were estimated by measuring tissue dopa or dopamine content in the presence of either an aromatic L-amino acid decarboxylase inhibitor or a tyrosine hydroxylase inhibitor, respectively.

RESULTS

In the microdialysis study, a 190-fold increase in the release of dopamine from the right striatum was observed 40 minutes after microsphere embolism, whereas the striatal dopamine metabolites decreased during the first 180 minutes after the embolism. Microsphere embolism decreased the striatal dopamine content throughout the experiment (28 days), whereas it increased tissue dopamine metabolites on the first day, followed by a decline in the metabolites on the third day or later. The in vivo turnover rate of dopamine decreased both on the first and third days, whereas the in vivo tyrosine hydroxylation decreased only on the third day after the embolism.

CONCLUSIONS

The results suggest that microsphere embolism induces severe damage to striatal dopaminergic metabolism 3 to 28 days after the embolism. Dopamine synthesis may be more resistant to the embolism-induced ischemic insults than its catabolism.

Stimulation by epigallocatechin gallate of interleukin-1 production by human peripheral blood mononuclear cells

(-) Epigallocatechin gallate (EGCg) potently stimulated the production of interleukin-1 (IL-1) and tumor necrosis factor by human peripheral blood mononuclear cells. The intracellular amounts of IL-1 beta and especially IL-1 alpha induced by EGCg, were significantly higher than their extracellular counterparts. ECCg stimulated the production of adherent cells, with IL-1 producing capacity (per cell basis) that was significantly higher than nonadherent cells. Although IL-1 alpha mRNA synthesis (assessed by Reverse Transcriptase-Polymerase Chain Reaction) was slightly enhanced, IL-1 beta mRNA synthesis was not significantly enhanced by EGCg treatment. Lipopolysaccharide (LPS) also stimulated the production of IL-1 alpha and IL-1 beta production, but failed to induce the adherent cells. These data suggest that EGCg and LPS stimulate mononuclear cells by different mechanisms.

Ameliorating effect of clentiazem (TA-3090), a new Ca antagonist, on the impaired learning ability of poststroke SHRSP

We investigated the influence of clentiazem (8-chloro-diltiazem, (+)(2S,3S)-3-acetoxy-8-chloro-5-[2-(dimethyl-amino)ethyl]-2,3-dihydro-2- (4-methoxyphenyl)-1,5-benzothiazepin-4(5H)-one maleate, TA-3090) and other Ca antagonists on the impaired learning ability in poststroke spontaneous hypertensive rats stroke prone (SHRSP) using a shuttle box. SHRSP were given 1% NaCl solution as drinking water until the development of stroke (poststroke SHRSP). Active avoidance task was started from the fourth day after the onset of stroke. Over a period of 20 sessions (15 trials/session/day), the mean avoidance rate of the poststroke SHRSP was significantly lower than that of the nonstroke control group that was not given the salt solution. Clentiazem (1, 3, and 10 mg/kg/day) administered orally for 23 days after the development of stroke increased the avoidance rate in a dose-dependent manner. Nimodipine (1 and 10 mg/kg/day) also increased the avoidance rate, but its effect was not dose dependent. We also investigated the influence of clentiazem and other Ca antagonists on the passive avoidance performance by mice using a light-dark box. Clentiazem (3, 10, and 30 mg/kg) and other Ca antagonists, nimodipine (1 mg/kg) and nicardipine (10 mg/kg), all failed to protect either CO2- or electroconvulsive shock (ECS)-induced avoidance deficit when administered orally 1 h before the acquisition or retention trial. These results may be explained by the possibility that the Ca antagonists may ameliorate the impaired learning ability in poststroke SHRSP through their improving effect on the cerebral circulation disturbance.

IL-7 in the cell-mediated immune response to a human pathogen

The goal of the present study was to investigate the role of IL-7 in regulating immune responses to infection. Leprosy provides a model for understanding human immune responses to infection; the disease presents as a spectrum in which the clinical manifestations correlate with the levels of cell-mediated immunity to the pathogen, Mycobacterium leprae. To determine whether IL-7 is produced at the site of infection in leprosy, we used the PCR to measure IL-7 and IL-7R mRNA in skin lesions. IL-7 mRNA was more strongly expressed in the tuberculoid form of the disease, in which the infection is limited (mean cpm = 48 +/- 8; n = 11), as compared with the progressive lepromatous form (17 +/- 2; n = 11). IL-7R mRNA, both membrane-bound and soluble forms, were also more strongly expressed in tuberculoid lesions, although these differences were not as striking as those for IL-7. The cellular source of IL-7 included Ag-stimulated monocytes and IFN-gamma-induced keratinocytes. M. leprae-induced PBMC responses in tuberculoid patients involved up-regulation of IL-7 and IL-7R mRNA and was IL-7 dependent. In contrast, M. leprae did not induce IL-7 mRNA in lepromatous patients, and their T cell responses were weakly augmented by rIL-7. These data suggest that IL-7, produced at the site of disease, contributes to the cell-mediated immune response to human pathogens.

IL-7 in the cell-mediated immune response to a human pathogen

The goal of the present study was to investigate the role of IL-7 in regulating immune responses to infection. Leprosy provides a model for understanding human immune responses to infection; the disease presents as a spectrum in which the clinical manifestations correlate with the levels of cell-mediated immunity to the pathogen, Mycobacterium leprae. To determine whether IL-7 is produced at the site of infection in leprosy, we used the PCR to measure IL-7 and IL-7R mRNA in skin lesions. IL-7 mRNA was more strongly expressed in the tuberculoid form of the disease, in which the infection is limited (mean cpm = 48 +/- 8; n = 11), as compared with the progressive lepromatous form (17 +/- 2; n = 11). IL-7R mRNA, both membrane-bound and soluble forms, were also more strongly expressed in tuberculoid lesions, although these differences were not as striking as those for IL-7. The cellular source of IL-7 included Ag-stimulated monocytes and IFN-gamma-induced keratinocytes. M. leprae-induced PBMC responses in tuberculoid patients involved up-regulation of IL-7 and IL-7R mRNA and was IL-7 dependent. In contrast, M. leprae did not induce IL-7 mRNA in lepromatous patients, and their T cell responses were weakly augmented by rIL-7. These data suggest that IL-7, produced at the site of disease, contributes to the cell-mediated immune response to human pathogens.

Quantitative determination of diol metabolites of CS-670, a new antiinflammatory agent, by capillary column gas chromatography-mass spectrometry

CS-670(I), being developed as a non-steroidal anti-inflammatory agent, is a racemic prodrug. It has been found to be readily metabolized to active metabolites: trans and unsaturated mono-ols (trans-OH, unsaturated-OH). We report here a method for the quantitative determination of the eight diol stereoisomers excreted in urine after administration I. The diols were well separated and quantitated using capillary column GC-MS after a rather simple derivatization with diazomethane-trifluoroacetic anhydride. Sex differences in rats and species differences between rats and mice were observed in the metabolism of I: the trans-diols originating from trans-OH were predominantly excreted in male and female rat urine but the excretion rate was greater in the male rats; the cis-diols originating from cis mono-ol (cis-OH) were the major urinary metabolites in mice. The hydroxy groups were mainly introduced at the respective equatorial hydrogen atoms at the 4'-carbon of trans-OH and the 5'-carbon of cis-OH. The 4'- and 5'-hydroxy groups in the diols were in the cis conformation with respect to the original 2'-hydroxy group. As approximately 9% of the trans-diols were excreted in urine after administration of cis-OH to rats, the chiral inversion from cis-OH to trans-OH was suggested to occur through the saturated ketone intermediate.

Effects of TA-0910, a novel orally active thyrotropin-releasing hormone analog, on the gait of ataxic animals

The effects of TA-0910 (1-methyl-(S)-4,5-dihydroorotyl-L-histidyl-L- prolinamide), a new thyrotropin-releasing hormone (TRH: L-pyroglutamyl-L-histidyl-L-prolinamide) analog, on ataxia were compared with those of TRH given by oral administration. The ataxic models used were the Rolling mouse Nagoya (RMN) showing genetic dysfunction of the cerebellum and striatum, rats with chemical degeneration of the inferior olive induced by 3-acetylpyridine (3-AP, 40 mg/kg, i.p.) and rats with a lesion of the thoracic spinal cord induced by mechanical compression. TA-0910 (1, 3, 10 mg/kg per day) clearly showed ameliorating effects on all these ataxic models. The dose-dependent effect of TA-0910 (10 mg/kg per day) on the gait of RMN was sustained until 2 weeks after the end of its 2-week administration. TRH (100, 300 mg/kg per day) also showed ameliorating effects on ataxia in RMN and 3-AP-treated rats. The ameliorating action of TA-0910 on ataxia was 100-300 times more potent than that of TRH.

Regulation of heat production of brown adipocytes via typical and atypical beta-adrenoceptors in the rat

Previous studies in our laboratory demonstrated that microcalorimetry is an appropriate method for estimating the physiological function of isolated rat brown adipocytes. In the present study, to elucidate the mode of action of typical and atypical beta-adrenoceptors on heat production of this cell, the effect of novel adrenergic beta 3-agonists was compared with that of other typical adrenergic reagents by direct microcalorimetry. Isoproterenol and beta 3-agonists, BRL37344, ICI215001, and CGP12177, increased heat production in a dose-dependent manner, however, phenylephrine had no effect. Propranolol and pindolol did not increase the heat production but attenuated the effect of isoproterenol and BRL37344 in a dose-dependent manner. Molar IC50 values of propranolol and pindolol for BRL37344 were about 10(-5) and 3 x 10(-6) M, respectively, whereas those of the two antagonists for isoproterenol were about 3 x 10(-7)M. The pA2 values by Schild analysis of propranolol vs. isoproterenol and BRL37344 were 7.91 and 6.13, respectively. These results suggest that heat production may be regulated via both beta 3- and typical beta-adrenoceptors in brown adipocytes.

Effects of cytotoxic factors of Helicobacter pylori on superoxide generation in situ in the rabbit stomach

OBJECTIVE

To evaluate the effect of certain cytotoxic products of Helicobacter pylori on superoxide generation in situ and on the infiltration by polymorphonuclear cells into the gastric mucosa. The agents studied were ammonia, a culture supernatant of H. pylori, and N-formyl-methionyl-leucyl-phenylalanine (FMLP), a chemotactic factor.

METHODS

One or two of these agents were dripped onto rabbit gastric epithelium. The number of polymorphonuclear cells in gastric mucosa were counted histologically. Superoxide generation was measured by a chemiluminescence method, using a Cypridina luciferin analog, 2-methyl-6-phenyl-3,7-dihydroimidazo[1,2-alpha]pyrazin-3-one , a chemiluminescence probe that responds to the generation of superoxides and singlet oxygen radicals. Bovine erythrocyte copper zinc superoxide dismutase was dripped to confirm that the increase in photon counts was a direct consequence of the generation of superoxides.

RESULTS

The greatest infiltration of polymorphonuclear cells into the gastric mucosa was observed with the administration of 1 mmol/l FMLP followed by 5.9 mmol/l ammonia, and 10 mmol/l FMLP followed by 59 mmol/l ammonia. There was no increase in the number of polymorphonuclear cells in the other experiments. Increased chemiluminescence was observed in conjunction with the infiltration of polymorphonuclear cells and was inhibited by superoxide dismutase.

CONCLUSIONS

Acute gastritis and superoxide generation in situ were induced by ammonia after pretreatment with FMLP.

Simultaneous occurrence of adenomas in stomach, duodenal bulb, and colon: disappearance of gastric and duodenal adenomas during oral administration of 5'-deoxy-5-fluorouridine

The present report concerns a patient who was first diagnosed as having adenoma in the duodenal bulb and subsequently was discovered to have adenomas in the stomach and colon. Surgical procedures including endoscopic resection could not be carried out because the patient had advanced liver cirrhosis. Follow-up colonoscopy no longer detected any polyp in the colon. Ultrasonography demonstrated a slowly growing hypoechoic mass in the liver, which was indicative of hepatocellular carcinoma. Then, single chemotherapy with oral administration of 5'-deoxy-5-fluorouridine was initiated. Surprisingly, repeated esophagogastroduodenoscopy revealed gradual regression of the gastric and duodenal tumors. Findings from the endoscopy and biopsy materials 10 months after the start of therapy showed disappearance of the gastric and duodenal adenomas. Despite enlargement of the hepatic mass, no recurrence of gastric and duodenal tumors has been noted during the past 1 1/2 yr.

Role of nuclear histone-H1 kinase in regeneration of rat liver

The activities of nuclear histone-H1 kinase and C-kinase as well as the amount of phosphate bound to histone-H1 following partial hepatectomy were studied in rat. It was found that the nuclear histone-H1 kinase activity increased twice within 80 h, first 20 to 30 h, and second at 50 to 70 h after partial hepatectomy. The timing of increase of the enzyme activity correlated with increased amount of bound phosphate. On the other hand, the increase of the C-kinase activities occurred between 5 and 15 h after partial hepatectomy. Antibodies raised against human cdk2, human cyclin-A and mouse cdc2 kinase showed no detectable effect on the nuclear histone H1 kinase activity. These results suggest that phosphorylation of histone-H1 in liver regeneration may be catalysed by a putative kinase(s).

[Clinical experience and early results of aortic valve replacements with Medtronic Hall 20 A]

We experienced aortic valve replacement for 18 patients (4 male and 14 female, ranging from 40 to 81 years old, mean 64 years old) with small aortic annulus with new small prosthesis. Medtronic Hall 20 A (MH 20 A). The average body surface area was 1.47 m2 (range 1.28 to 1.81 m2). One patient was died of lung cancer at 3 months postoperatively. One nonstructural dysfunction and one low cardiac output syndrome was noted during operation. Sixteen survivors with MH 20 A, showed satisfactory clinical results, except for minor thromboembolism, in 2 patients. The MH 20 A had the same function as that of MH 21 A, already reported. We concluded that aortic valve replacement by Medtronic Hall 20 A prosthesis was usefull for the patient with small aortic annulus.