Expression and utilization of chymotrypsin-like but not trypsin-like serine protease enzymes by nonspecific T killer cells activated by anti-CD3 monoclonal antibody

Coculture of purified murine T cells with anti-CD3 monoclonal antibody (145-2C11) results in the induction of nonspecific cytotoxic T lymphocytes (CTL) with MHC-unrestricted cytolytic activity against a range of tumor targets. Serine proteases associated with effector cell granules are among the molecules postulated to play a role in cell-mediated cytolysis. The present study examines the ability of exogenous serine protease substrates to inhibit anti-CD3-activated cytotoxic T (ACT) cell-mediated killing of P815 mastocytoma and YAC1.2 lymphoma target cells. The chymotrypsin substrate N-acetyl-L-tyrosine ethyl ester (ATEE) was found to significantly inhibit ACT cell-mediated cytolysis. In contrast, the trypsin substrate N-benzoyl-L-arginine ethyl ester (BAEE) had little, if any, effect on ACT cell-mediated cytolysis. These effects were observed with both target cell populations. Conjugate inhibition studies performed with ATEE indicated that a chymotrypsin-like serine protease is involved in a postbinding event during cytolysis. Pretreatment of either target or effector cells with ATEE prior to cytolytic assay revealed that the chymotrypsin-like serine protease involved in cytotoxicity is of effector cell origin. Northern blot analysis of total RNA extracted from ACT cells revealed the presence of transcripts coding for CCP1 and CCP2 serine proteases known to be involved in antigen-specific CTL function, but little or no expression of the HF serine protease which has also been implicated in antigen-specific CTL killing. CCP2 exhibits chymotrypsin-like activity while HF displays trypsin-like activity. On the other hand, the CCP1 gene product has protease activity which resembles neither chymase nor tryptase activities. Thus, the level of mRNA expression for these serine proteases is consistent with our earlier observations, using the serine protease substrates, that a chymotrypsin-like serine protease but not a trypsin-like serine protease is involved in ACT cell-mediated cytolysis. "Lymphocyte panning" of ACT cells revealed abundant CCP1 and moderate CCP2 mRNA expression in CD4- and CD8+ anti-CD3-activated T cells with strong tumoricidal activity. CD8- anti-CD3-activated T cells with moderate cytolytic activity also expressed substantial levels of CCP1 and CCP2 mRNA, suggesting that both CD4- CD8- and CD4- CD8+ ACT cells participate in killing tumor targets. In contrast, CD4+ anti-CD3-activated T cells lacked both cytolytic activity and significant CCP1 and CCP2 mRNA expression. These findings are consistent with the involvement of chymotrypsin-like, as well as other, serine proteases in CTL-mediated lysis.

Reactivity of monoclonal antibody 1E5.B5 with a novel phenotypic marker expressed on a murine natural suppressor cell subset

Natural suppressor (NS) cells are antigen-nonspecific, MHC-independent immunoregulatory cells that are typically found in murine bone marrow (BM), newborn (NB) mouse spleen, and in splenic tissue of adult mice during pregnancy and following cyclophosphamide (CY) treatment. There has been a pressing need for the development of NS cell-specific monoclonal antibodies (mAb) since NS cells are generally described as null cells which lack the usual phenotypic markers of mature T cells, B cells, and macrophages. Here we present evidence that mAb 1E5.B5, which was raised in rats against murine splenic pregnancy-associated NS (SPANS) cells, recognizes a unique antigenic marker expressed by some, but not all, murine NS cells. In the presence of complement, mAb 1E5.B5 effectively eliminates SPANS activity, and diminishes NS activity of CY-treated spleen cells in mixed lymphocyte reactions (MLR). However, cytotoxic pretreatment with mAb 1E5.B5 had minimal effects on NS activity of BM and NB spleen cells. We also show that pregnancy spleen cells and CY-spleen cells with moderate NS activity in MLR can be positively selected for by "panning" with mAb 1E5.B5. In contrast, only weakly inhibitory cells are isolated from BM and NB spleen by this procedure. Cellular ELISA and flow cytometry confirm that mAb 1E5.B5 has specificity for pregnancy spleen cells and CY-spleen cells, as well as for NB spleen and BM cell preparations. Western blot analysis reveals that mAb 1E5.B5 reacts with a novel 50 kDa NS cell-associated antigen which we have termed NS-1. The NS-1 antigen is not present on other null cells such as natural killer (NK) cells and natural cytotoxic (NC) cells since cytotoxic pretreatment of pregnancy spleen cells with mAb 1E5.B5 does not affect antibody-dependent cell-mediated cytotoxicity, NK or NC activity.

Colour coded duplex sonography in suspected deep vein thrombosis of the leg

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[The meniscus suture. Results of a clinical and sonographic follow-up study]

The goal of our clinical and ultrasonographic study was to evaluate the results of the patients who underwent meniscal suture between June 1983 and December 1987 in our clinic. 41 patients (82%) were examined by the author, the mean follow-up time was 40 months. The mean Lysholm score rate was 93.4 points. 72.9% were able to return to their former sports level. 3 patients were suggested to have recurrence, but this could not be proven by arthroscopic and ultrasonographic means. High grade congruency of clinical and sonographic examination was obvious as it was in the literature. The meniscal suture healed in 92.5% so we recommend the procedure if ever possible.

The rat follistatin gene is highly expressed in decidual tissue

Follistatin was originally described as an ovarian polypeptide hormone able to suppress pituitary follicle-stimulating hormone (FSH) secretion in in vitro systems. We have isolated rat ovarian follistatin cDNA clones and used these to investigate the possibility that decidual tissue expresses the follistatin gene. We found that the follistatin gene is highly expressed during early pregnancy in tissue derived from the site of blastocyst implantation. Follistatin mRNA was observed in tissue obtained from the implantation site at days 6, 8 and 10 of gestation, but was not found in the placenta at later stages of gestation. This same pattern of follistatin expression was observed in pseudopregnant animals in which decidualization had been artificially induced, indicating that decidual tissue is the primary source of follistatin mRNA. In situ hybridization was used to examine follistatin gene expression in decidua in greater detail. The mRNA is preferentially found in antimesometrial tissue, and is strictly confined to the endometrial-derived decidual cells. These results suggest that follistatin might function as an important endocrine hormone during implantation of the fetus, perhaps by acting to appropriately modulate maternal FSH secretion during early pregnancy.

Demonstration that the enzyme that converts precursor of apolipoprotein A-I to apolipoprotein A-I is secreted by the hepatocarcinoma cell line Hep G2

The conversion of the precursor of apolipoprotein A-I (proapoA-I) to apolipoprotein A-I (apoA-I) is known to occur extracellularly by an enzyme that has been shown to be present in plasma. The hepatocarcinoma-derived cell line Hep G2, when grown in culture, secretes proapoA-I. We now show that this cell line also secretes the converting enzyme that correctly processes proapoA-I to mature apoA-I as determined by radio-sequence analyses. The secreted enzyme is inhibited by EDTA and 1,10-phenanthroline, is activated by Ca2+ and is unaffected by both phenylmethylsulfonyl fluoride and diisoprophylfluorophosphate in the same way as the converting enzyme previously described in the plasma. The conversion of proapoA-I to apoA-I effected by this enzyme obeys first-order kinetics and is linear over the first 4 h with a calculated initial velocity of 3.3% conversion per hour. The converting activity is secreted in a time-dependent fashion and parallels the mass of total secreted protein.

Acute acid load in recurrent oxalate stone formers

An acute acid load was used to evaluate potential chemical differences of urinary composition in recurrent oxalate stone formers and healthy controls. After intake of ammonium chloride, total calcium, ionized calcium and magnesium increased and citrate decreased significantly in both groups. Differences between stone formers and controls could be demonstrated from the excretion of total calcium, citrate, oxalate and uric acid only after acute acid load, whereas ionized calcium did not improve discrimination. These findings support the stone-promoting role of high acid food as well as the possibility of discriminating recurrent oxalate stone formers from controls by an acute acid-loading test.

[Aortic valve replacement with a bioprosthesis--which type of prosthesis?]

308 patients after aortic valve replacement by bio-prostheses were evaluated by questionnaire. The aim of the study was to estimate factors of risk for morbidity, which could be referred to the different xenogenic valve materials. After an average period of 41 months there was no statistical difference in postoperative status, such as exercise capacity, rate of survival and of freedom from thromboembolic events or repeat surgery. Although results of the early and intermediate postoperative period are satisfying with both types of valve prostheses a longer period of observation is required to draw distinct conclusions for xenogenic material related complications.

Primary-group support systems of the aged

This article examines whether the instrumental and affectual support provided the elderly differs among informal social support groups. Cantor's hierarchical-compensatory model postulates an order of preference in the choice of support group regardless of the type of aid sought. Litwak's task-specific model predicts that older people turn to different support groups depending on the type of assistance needed. Our test of these two models indicates that certain network members are more likely to be selected regardless of whether the assistance needed is instrumental or affective. The elderly turn primarily to the spouse followed by adult children, friends, siblings, and "other relatives" in that order. When lacking one of these categories of intimates, no compensatory principle operates.

Anomalous insertion of the inferior vena cava in the portal vein

The ultrasonographic findings of anomalous insertion of the inferior vena cava in the portal venous system were evaluated and correlated with angiographic features. The ontogenic development of the relevant venous system is revisited, and the most important anomalies of the inferior vena cava are presented. An attempt is made to integrate our findings into the relevant classifications following the literature available. Possible developmental mechanisms of the malformation are discussed.

From pulsating to tubular flow membrane-oxygenator

The Capiox 54, Interpulse and TMO oxygenators were compared under clinical conditions. None of the devices is ideal, however all are reliable in regard to gas exchange and laboratory data. Evacuation of air (CO2) seems a problem in Capiox, high pressure amplitudes are suspicious for creation of extreme shearing in Interpulse and TMO may reveal low (dead) flow areas within the blood path's.

Cranial nerve injury during carotid arterial reconstruction

In a series of 109 carotid arterial reconstructions cranial nerve injury was observed in 14 of 102 patients. Ipsilateral peripheral hypoglossal nerve injury occurred in nine patients with carotid occlusive disease. The marginal mandibular nerve was injured in three patients and recurrent laryngeal nerve dysfunction was noted in four patients. Two cranial nerves were injured in two patients. Full recovery of hypoglossal dysfunction was seen within 2-52 weeks (average 20 weeks). The nerves are injured by retraction to clear the operative field or by postoperative haematoma. Risk factors include crossing of the hypoglossal nerve close to the carotid bifurcation or procedures requiring long arteriotomy or skeletonization of the internal carotid artery. Unilateral cranial nerve injury is usually mild but will require delay of controlateral carotid reconstruction to avoid severe bilateral cranial nerve palsy.

The value of three-dimensional CT-scanning in head pathology

The A. A. present five patients with intracerebral pathology in which three-dimensional CT-scanning has been performed. The coordinates and the range of volume of the processes can be given by this technique allowing for accurate surgical and/or radiotherapy management. Sagittal reconstructions add to completeness of spatial imaging of the relationship of the tumours to topographic landmarks. Holographic imaging can be derived from both axial and coronal cuts as well as from reconstruction modes. The A. A. indicate the fields of application of three-dimensional modes and maintain that three-dimensional isoattenuation coefficient curves could be very helpful for optimal radiotherapy treatment planning. Further, CT-scanning is a non-invasive way of assessment of the patients during treatment, after treatment and longterm follow-up.

Localization of scanning level in computed tomography of the spine

A simple method for identifying the scanning level in computed tomography (CT) of the spine is described. The method involves exposing a lead lattice grid on a conventional X-ray film and taking a conventional spine film with aluminum markers on the patient's back. The film showing the grid and the markers on the patient's spine is used to localize the CT scans taken with the aluminum markers still on the patient's back.

CT scanning in two cases of lipoma of the spinal cord

Two cases of lipoma of the spinal cord are presented. CT gives a specific diagnosis in this condition without any contrast being given. It is important to make a preoperative diagnosis, as in lipoma of the spinal cord biopsy is dangerous and frequently makes the patient worse. CT is also valuable as the length of the required decompression laminectomy can be assessed.

Preliminary report of a new method of whole body CT-scanning

The authors suggest a new approach to CT-body examination derived from their experience in spinal investigations. They introduce a method of gantry tilt in association with inclination of the patient, and call the new mode "longitudino-axial sectioning". This method makes possible the simultaneous display of several vertebral levels, which is not possible with conventional CT-scanning. They suggest that by extrapolation, the method may be applied to thoracic and abdominal investigations, as well as to the study of joints. In addition, this technique could be the method of choice whenever urinary and biliary tracts have to be investigated for diagnostic and/or interventional purposes.

[Prevention of thromboembolism with heparin in gynecological and obstetric surgery]

During a period of 28 months 983 gynaecological patients had major abdominal or vaginal operations under Heparin prophylaxis. In no case thrombosis or pulmonary embolism occurred. 5 hemorrhages required surgical revision and temporary reduction of Heparin dose. Global tests for preoperative diagnosis of hemostasis and for postoperative control of Heparin effect are discussed. Possible reactive fibrinolysis under Heparin administration, its complications and control are mentioned. Peri- and postoperative prophylaxis of thrombo-embolism with Heparin in daily dosages up to 20,00 I.U. seems well suitable.

Physiologic significance of glucocorticoids and insulin in the regulation of hepatic gluconeogenesis during starvation in rats

The physiologic significance of glucocorticoids and insulin in the regulation of hepatic gluconeogenesis was investigated during a 48-hr starvation period by studying the factors presumed to control the rate of glucose synthesis in the final gluconeogenetic pathway. Rats were used, in which glucorticoids were removed by adrenalectomy before starvation, and in which serum insulin was kept constant before and after food withdrawal by pre-feeding with a proteinfree diet. It was found that adrenalectomized rats at constantly low serum insulin levels responded to starvation as rapidly, and to the same degree, as intact control subjects (1) by a significant increase in plasma glucagon and, consequently, in hepatic cAMP concentration; (2) by a coordinate elevation of the activities of hepatic pyruvate carboxylase, P-enolpyruvate carboxykinase, and fructose-1,6-diphosphatase; (3) by systematic alterations in the concentration of effectors of gluconeogenetic key enzymes; (4) by a shifting of the cytoplasmic NAD system towards the reduced state; (5) by a decrease in the intrahepatic concentration of glycogenic precursor substrates. These results suggest that the hepatic gluconeogenic response to starvation with respect to the regulatory factors 1-5 occurs independently from changes in the concentration of plasma glucocorticoids and insulin. The crossing over of the gluconeogenetic intermediates between pyruvate and P-enolpyruvate (PEP), which was observed in intact but not in adrenalectomized rats, supports the assumption that during starvation, glucocorticoids enhance the rate of glucose production by the liver predominantly by permitting hepatic cAMP to stimulate the yet undefined mechanism, which has been demonstrated in the isolated perfused rat liver to control the substrate flow between pyruvate and PEP.