Local recurrence after complete resection for non-small-cell carcinoma of the lung. Significance of local control by radiation treatment

Of 471 patients undergoing a complete resection for non-small-cell carcinoma of the lung between 1972 and 1989, 40 patients (8.5%) had local recurrences without extrathoracic distant metastasis. Excluding 8 patients who had malignant pleural effusion, we selected 32 patients (24 with hilar-mediastinal lymph node, 6 with bronchial stump, and 2 with chest wall recurrence) from the 40 patients and assessed the significance of local control by radiotherapy. The median length of survival after disease recurrence for these 32 patients was 19 months. Of 29 patients given radiation treatment, 16 who responded to the treatment survived significantly longer than nonresponders (median survival time 27 months versus 6 months, p < 0.01). Univariate analyses of survival after recurrences in relation to various factors revealed that sex and disease-free intervals were significant prognostic factors (p < 0.05) other than the effect of radiotherapy. A multivariate analysis showed that the effect of radiotherapy was the predominant prognostic factor. From these results, we conclude that local control with radiation is beneficial in patients with solely locally recurrent tumors in terms of improved survival.

Tauro alpha-muricholate has a biliary transport maximum (Tm) value equivalent to that for tauroursodeoxycholate and tauro beta-muricholate in the rat

Our previous studies have shown that Tm values for tauroursodeoxycholate (TUDC) and tauro beta-muricholate (T beta-MC) are more than two-fold higher than that for taurocholate (TC) in the rat. The present study attempted to clarify whether tauro alpha-muricholate (T alpha-MC) also has such an unusually large Tm value in the rat. Under nembutal anesthesia, male Wistar derived rats (body weight 280-300 g, 13 wks in age) were continuously infused with T alpha-MC solution. The infusion rate was raised stepwise every 20 min, until the bile flow began to decline. Bile was collected every 10 min and bile salt excretion rate was determined. The average of the highest three excretion values was assumed to be the Tm in each animal. The Tm value of T alpha-MC was found to be 2.86 +/- 0.36 mumol/min/100 g (mean +/- SD, n = 4), which was even greater than Tm values for TUDC (2.59 +/- 0.39 mumol/min/100 g, n = 4) and T beta-MC (1.93 +/- 0.31 mumol/min/100 g, n = 4) as we reported previously. The relationship between the bile flow rate (microliter/min/100 g, Y axis) and bile salt excretion rate (mumol/min/100 g, X axis) was highly linear [Y = (6.00 +/- 0.29) x +(6.60 +/- 1.88), P < 0.001, r = 0.95, n = 54]. The slope value for T alpha-MC (6.00 +/- 0.29 microliters/mumol) was significantly higher than that for TUDC (4.76 +/- 0.71 microliters/mumol) and was comparable to that for T beta-MC as we previously found for these bile salts in this rat strain. The results suggest that T alpha-MC has a very efficient transport system in this species as was observed for the other two bile salts that have a 7 beta-hydroxy group (TUDC and T beta-MC). This efficient transport system thus appears to be shared not only by bile salts specifically having a 7 beta-hydroxy group, but also by other bile salts such as T alpha-MC that have a 6 beta-hydroxy group but not a 7 beta-hydroxy group.

The pulmonary vascular response to acute hypoxia in chronic pulmonary disease: morphological assessment with magnified pulmonary wedge angiography

To detect hypoxic pulmonary vasoconstriction (HPV) morphologically, we investigated the pulmonary vascular response to acute hypoxia in 27 patients with chronic pulmonary disease (CPD) and 8 healthy subjects. Pulmonary hemodynamic measurements and magnified pulmonary wedge angiography (MPWA) were carried out before and after inhalation of 13% oxygen in nitrogen for 15 min. The diameters of central arteries (A) and muscular arteries (B) were measured using a densitometric method. Vasoconstriction was detected in the muscular arteries than in the central arteries by MPWA. There was a significant correlation between delta P (changes of mean PA pressure) and delta B/A (changes in diameters of B/A) in the CPD group. A significant correlation was found between delta SvO2 and delta B/A in the control group. We conclude that MPWA was a very useful method for the simple detection of HPV in patients with CPDs and we detected one site of HPV on the ninth generation of the pulmonary arterial tree by MPWA.

A complete culture system for avian transgenesis, supporting quail embryos from the single-cell stage to hatching

We report here a method to produce quail hatchlings by culture in vitro from the single-cell stage. The culture is composed of three steps. In the first step, the fertilized ovum surrounded by thick albumen obtained from the magnum is cultured for 24 hr at 41.5 degrees C in a tightly sealed 20-ml plastic cup with chicken thin albumen added to the equator level of the ovum (System Q1). In the second step, a quail egg shell, cut horizontally and emptied, is used as a bed shell. After the thick albumen is removed, the embryo with egg yolk is transferred to the bed shell and thin albumen from chicken eggs is added to fill the shell. Then, the embryo is cultured for an additional 52 hr at 37.5 degrees C while being rocked at an angle of 90 degrees at 30-min intervals (System Q2). The embryo is transferred again to a chicken bed shell and cultured at 37.5 degrees C with rocking at a 30-degree angle (System Q3). Just before hatching, the rocking of embryos is stopped. The procedure yielded a hatchability of 25%. For transgenesis, a plasmid construct containing a beta-actin-lacZ hybrid gene (pMiwZ) is microinjected into the ovum at the single-cell stage, which is cultured in vitro for 85-90 hr using Systems Q1 and Q2 consecutively. Seven out of 17 surviving embryos exhibited lacZ gene expression in embryonic tissues as detected by histochemistry. The procedure described here should be highly applicable for the production of transgenic birds.

Molecular characterization of an enterobacterial metallo beta-lactamase found in a clinical isolate of Serratia marcescens that shows imipenem resistance

A clinical isolate of Serratia marcescens (TN9106) produced a metallo beta-lactamase (IMP-1) which conferred resistance to imipenem and broad-spectrum beta-lactams. The blaIMP gene providing imipenem resistance was cloned and expressed in Escherichia coli HB101. The IMP-1 was purified from E. coli HB101 that harbors pSMBNU24 carrying blaIMP, and its apparent molecular mass was calculated to be about 30 kDa by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Kinetic studies of IMP-1 against various beta-lactams revealed that this enzyme hydrolyzes not only various broad-spectrum beta-lactams but also carbapenems. However, aztreonam was relatively stable against IMP-1. Although clavulanate or cloxacillin failed to inhibit IMP-1, Hg2+, Fe2+, or Cu2+ blocked the enzyme's activity. Moreover, the presence of EDTA in the reaction buffer resulted in a decrease in the enzyme's activity. Carbapenem resistance was not transferred from S. marcescens TN9106 to E. coli CSH2 by conjugation. A hybridization study confirmed that blaIMP was encoded on the chromosome of S. marcescens TN9106. By nucleotide sequencing analysis, blaIMP was found to encode a protein of 246 amino acid residues and was shown to have considerable homology to the metallo beta-lactamase genes of Bacillus cereus, Bacteroides fragilis, and Aeromonas hydrophila. The G+C content of blaIMP was 39.4%. Four consensus amino acid residues, His-95, His-97, Cys-176, and His-215, which form putative zinc ligands, were conserved in the deduced amino acid sequence of IMP-1. By determination of the amino acid sequence at the N terminus of purified mature IMP-1, 18 amino acid residues were found to be processed from the N terminus of the premature enzyme as a signal peptide. These results clearly show that IMP-1 is an enterobacterial metallo beta-lactamase, of which the primary structure has been completely determined, that confers resistance to carbapenems and other broad-spectrum beta-lactams.

[A case of obstructive sleep apnea syndrome with increased lung water during sleep]

A 22-year-old man was admitted to the department of plastic surgery in our university with diagnosis of ankylosis and microgeniea. His complaints were snoring and somnolence in the daytime, so we performed a Respigraph (Chest) that showed obstructive apnea during sleep. We diagnosed obstructive sleep apnea syndrome. So we observed pulmonary circulation and measured lung water using the double indicator dilution method (Nihon Koden, MTV-1100) during sleep. During the period of apnea, arterial oxygen pressure and mixed venous saturation decreased, reversely, mean pulmonary arterial pressure rose, lung water (ETV) and central blood volume increased. We considered that the increase of lung water during sleep apnea is caused by hemodynamic change due to hypoxia and increase of venous return. After operation, the value of blood gas assay and apnea index were improved.

An intrathoracic vagus nerve schwannoma invading the trachea

A patient with a schwannoma of the intrathoracic vagus nerve is presented. The tumor invaded the trachea and caused dyspnea. It was successfully excised by a segmental resection of the trachea with end-to-end anastomosis. This instance of an intrathoracic vagus tumor invading the trachea is, as far as we know, the first reported in the world.

Effects of acute hypotensive hemorrhage on arginine vasopressin gene transcription in the rat brain

To determine whether hypotensive hemorrhage has an effect on arginine vasopressin (AVP) gene expression, 16 ml/kg of arterial blood was drawn over 10 min in conscious unrestrained rats. Mean arterial blood pressure (MABP) and heart rate (HR) were measured, and the rats were decapitated before and 10 min, 1, 3, 6, 9, 12, and 24 h after the initiation of hemorrhage. The hypothalamic or cerebro-hypothalamic tissue was used to measure AVP mRNA by Northern blot analysis, and the trunk blood to measure plasma AVP, osmolality and hematocrit. Hemorrhage brought about rapid and transient decreases in MABP and HR accompanied by transient increases in plasma osmolality and AVP. Hematocrit decreased after the bleeding and reached a stable level 6 h after hemorrhage and thereafter. AVP mRNA was detected in the hypothalamus and not in the extrahypothalamic cerebral brain tissue under basal and posthemorrhage conditions. AVP mRNA in the cerebro-hypothalamic tissue increased by 1.8-fold at 6 h and 2.1-fold at 9 h after hemorrhage. These results indicate that AVP mRNA in the brain increases 6 h after increased AVP release in response to hypotensive hemorrhage.

C fiber generates a slow Na+ spike in the frog sciatic nerve

The present study was carried out to examine the properties of A and C fibers in the bullfrog sciatic nerves by applying several agents through perfusing solutions between stimulating and recording electrodes. The compound action potentials (CAPs) of A beta and A delta fibers were tetrodotoxin (TTX)-sensitive and were abolished in Na(+)-free solution. However, C fiber CAP was TTX-insensitive although CAP disappeared in Na(+)-free solution. Moreover, C fiber CAP was not blocked by Ca2+ channel blockers and its chronaxy (2 ms) and conduction velocity (0.70 m/s) indicate that the time constant of C fiber CAP is relatively large (2.88 ms). These suggest that a slow Na+ channel, which is TTX-resistant, contributes to C fiber action potentials.

Vascular anatomy of duodenal varices: angiographic and histopathological assessments

Duodenal varices are a rare occurrence, and the diagnosis and control of related bleeding is problematic. The vascular anatomy of duodenal varices in four patients was examined angiographically. The incidence of these varices was 0.4% in the patients with portal hypertension seen in our clinics from 1982 to 1991. The transparent specimen obtained at autopsy and treated with methyl salicylate and portographies in the remaining three patients revealed that the duodenal varix consisted of a single vessel with afferent and efferent vessels, forming a portasystemic shunt in the retroperitoneum. The varix transversed the duodenum and was present in the submucosal layer of the posterior wall. The afferent vessel was the superior or inferior pancreaticoduodenal vein originating in the portal vein trunk or superior mesenteric vein. The efferent vein drained into the inferior vena cava. In view of these observations, devascularization or percutaneous transhepatic obliteration of the varix would be our first choice of treatment for patients with duodenal varices.

Results of pulmonary resection of metastatic colorectal cancer and its application

A resection of pulmonary metastases from colorectal cancer was performed in 27 patients. The cumulative 5-year survival after thoracotomy was 41.1%. Patients with either one or two metastases had a significantly better survival, with a 5-year survival of 54.3%, than did those with a greater degree of metastases (p < 0.01). Other factors including the disease-free interval, size of metastases, type of pulmonary resection, and stage of primary cancer had no apparent influence on post-thoracotomy survival. Furthermore, the presence of controlled hepatic metastases had no adverse effect on survival and did not seem to contraindicate pulmonary resection. The lung and primary colorectal region were the major sites of recurrence. Therefore, the primary colorectal site should be explored thoroughly and the number of metastases should be carefully considered when pulmonary resection is considered for metastatic colorectal cancer.

Research note: effect of tu-chung leaf (Eucommia ulmoides) on egg production performance, egg quality, and fat metabolism in laying hens at a late production stage

The effects of tu-chung leaf (Eucommia ulmoides) supplementation on egg production performance, egg quality, and fat metabolism were investigated in laying hens at a late production stage. White Leghorn laying hens at 20 mo of age were provided ad libitum access to a practical diet with or without tu-chung leaf supplement for 3 mo. During the experimental period, egg production rate, egg weight, and feed intake were recorded every day. Egg samples from the last 3 days were collected to measure Haugh units and cholesterol concentration in the egg yolk. Plasma cholesterol concentration and abdominal fat weight were also determined. The results showed that no significant improvement in egg production was observed with tu-chung leaf addition. No significant effect of tu-chung was observed on Haugh units, plasma cholesterol, or egg yolk cholesterol, whereas abdominal fat weight was greater in hens fed the tu-chung diet than in those given the unsupplemented control diet. It was concluded that the beneficial effects of tu-chung leaf supplementation on egg production performance and egg quality were ambiguous and of little practical significance.

Treatment of invasive thymoma with pleural dissemination

The outcome of eight patients with invasive thymoma accompanying pleural dissemination was investigated. Only two patients had mediastinal tumor resection and pleural disseminated tumor excision. Seven patients underwent radiotherapy to the mediastinum and/or disseminated tumors. A clinical response to radiotherapy was achieved in the six patients with evaluable lesions (complete response in five patients and partial response in one). The estimated 5-year survival rate was 87.5%. Four patients were alive more than 10 years. So far, the mediastinal tumors of seven patients have been controlled for periods ranging from 42 to 154 months. Recurrence in six patients appeared as pleural tumors. Four out of the six patients had five courses of radiotherapy to the recurrent pleural tumors, four of which achieved complete response. No distant metastases were observed at any time. These observations suggest that radiotherapy should be the primary mode of treatment in cases of invasive thymoma with pleural dissemination.

Immunohistochemical distribution of amyloid precursor protein during normal rat development

This study focused on the immunohistochemical identification of the beta/A4 amyloid precursor protein (APP) in various developmental stages of both the rat central nervous system (CNS) and the peripheral nervous system (PNS). A comparative study with myelin basic protein (MBP) and synaptophysin (SYP) facilitated the understanding of neuronal maturation and synaptogenesis on both prenatal and postnatal development. Our immunohistochemical study revealed APP to be widely distributed through the nervous system while existing mainly in the cytoplasm, dendrites and axons of the neurons. However, immunoreactivity was also observed in either the ependymal cells or the choroid plexus epithelial cells. Our immunostaining was carried out by the hydrated autoclaving method and revealed the expression of APP at embryonic day 15 in the neuron of the mesencephalic nucleus of the trigeminal nerve and the anterior horn of the spinal cord, trigeminal and spinal ganglion, ependymal cells and the choroid plexus. We thus observed dramatic changes of APP expression in the cerebellum from the embryonic stage. The maturation of synaptogenesis in the cerebellar molecular layer was parallel to the extension of the dendrites of Purkinje cells, which revealed immunoreactivity for APP. These findings suggested that APP played an important role in neuronal maturation and synaptogenesis. Thus, APP is considered to be a useful marker for neuronal development.

Establishment of lung cancer cell line producing parathyroid hormone-related protein

Parathyroid hormone-related protein (PTHrP) producing cell line (KCC-C1) was established from malignant pleural effusion of a patient with squamous cell lung carcinoma. Hypercalcemia and granulocytosis were noted in the patient. The serum level of PTHrP, measured by N-terminal specific radioimmunoassay, was 110 pg/ml (normal < 20 pg/ml). The established KCC-C1 tumor cells proved to have PTHrP RNA transcripts and produce a large amount of PTHrP. Besides the production of PTHrP, the culture medium contained a significant level of interleukin 1 (IL-1). However, tumor necrosis factor or colony stimulating factor was not defected. Transplantation of KCC-C1 tumor cells into nude mice resulted in tumor formation with hypercalcemia. As IL-1 is also known to have bone-resorbing activity, KCC-C1 which may prove valuable in the study of the interaction between PTHrP and IL-1 for induction of hypercalcemia.

The effect of caloric restriction on the lateral diffusion constant of hepatocyte membrane proteins in C57BL/6 male mice of different ages: FRAP studies on liver smears

The lateral mobility of proteins in hepatocyte plasma membranes was compared in calorically restricted and ad libitum (AL)-fed C57BL/6 male mice in age groups from 7 to 28 months. Caloric restriction was achieved by means of the every-other-day (EOD) feeding regimen, maintained for various periods from 1 to 15 months. Protein lateral diffusion constant (D) in hepatocyte membranes was measured by means of fluorescence recovery after photobleaching (FRAP) in liver smears. The peroxide-induced autofluorescence (PIAF) was utilized as a fluorescent label. A mild (1 mM for 10 min) H2O2 treatment of liver smears produces oxidation of riboflavin that is bound to all proteins of the cell membrane. Using this technique, the average lateral diffusion constant (D) and the fractional recovery (FR) of these proteins can be measured. EOD feeding resulted in a significant decrease in body weights and also a significant increase in the values of D in all age groups after 1 month of EOD feeding. After 3.5 months of EOD feeding a further increase of D was observed (up to about 15%). Nevertheless no further change in D occurred if the EOD feeding was maintained for 6.5 or even 15 months. The negative linear age correlation of D observed in the AL-fed animals was present also under the EOD feeding; however, the whole regression equation shifted towards higher values. These experiments indicate that caloric restriction influences the lateral diffusion constant of membrane proteins in hepatocytes. The results are interpreted as a result of an increased protein turnover caused by the caloric restriction.

Expression of highly polysialylated neural cell adhesion molecule in calcitonin-producing cells

Calcitonin-producing cells are endocrine derivatives of the neural crest and have several neuron-like properties. Expression of the neural cell adhesion molecule in calcitonin-producing cells was examined using two types of antibodies to neural cell adhesion molecule: monoclonal antibody 12E3 recognizes the polysialic acid portion of highly polysialylated neural cell adhesion molecule, and monoclonal antibody AF11 and polyclonal antiserum react with the polypeptide portion common to three major isoforms of neural cell adhesion molecule. An immunohistochemical study revealed that highly polysialylated neural cell adhesion molecule was expressed both in fetal rat thyroidal calcitonin-producing cells and in a calcitonin-producing cell line, rMTC 6-23, established from explantable neoplasm of rat calcitonin-producing cells. The neural cell adhesion molecule in the rMTC 6-23 cells was further characterized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblot analysis. Two anti-neural cell adhesion molecule monoclonal antibodies, 12E3 and AF11, revealed a broad positive band around 200,000-250,000 mol. wt in solubilized proteins. When the polysialic acids were eliminated by neuraminidase treatment, the immunoreactivity to monoclonal antibody 12E3 was completely abolished, and core polypeptide corresponding to neural cell adhesion molecule with a molecular weight of 120,000 was detected by monoclonal antibody AF11. These results suggest that cells of the calcitonin-producing cell line express on their surfaces highly polysialylated 120,000 mol. wt form of neural cell adhesion molecule polypeptide.

Detection and characterization of blocking-type anti-acetylcholine receptor antibodies in sera from patients with myasthenia gravis

We developed a highly sensitive, convenient assay for measuring blocking-type anti-acetylcholine receptor antibodies, which inhibit the binding of 125I-labeled alpha-bungarotoxin (alpha-BuTx) to the acetylcholine receptor (AChR). This procedure detected inhibitory activities in sera from 76% of patients with myasthenia gravis. Results of an experiment done with synthetic peptide corresponding to the alpha-BuTx binding region in the alpha-subunit of Torpedo AChR suggested that this inhibition is due to nonspecific steric hindrance caused by the binding of antibodies to a region other than the alpha-BuTx site, rather than by direct binding to the latter site. The inhibitory activities of the blocking-type antibodies and the titers of non-blocking-type antibodies were correlated. Moreover, the blocking-type antibodies could dissociate 125I-labeled alpha-BuTx from 125I-labeled alpha-BuTx-human AChR complex, and their dissociation activities showed good correlation with the inhibitory activities.

Detection and characterization of blocking-type anti-acetylcholine receptor antibodies in sera from patients with myasthenia gravis

We developed a highly sensitive, convenient assay for measuring blocking-type anti-acetylcholine receptor antibodies, which inhibit the binding of 125I-labeled alpha-bungarotoxin (alpha-BuTx) to the acetylcholine receptor (AChR). This procedure detected inhibitory activities in sera from 76% of patients with myasthenia gravis. Results of an experiment done with synthetic peptide corresponding to the alpha-BuTx binding region in the alpha-subunit of Torpedo AChR suggested that this inhibition is due to nonspecific steric hindrance caused by the binding of antibodies to a region other than the alpha-BuTx site, rather than by direct binding to the latter site. The inhibitory activities of the blocking-type antibodies and the titers of non-blocking-type antibodies were correlated. Moreover, the blocking-type antibodies could dissociate 125I-labeled alpha-BuTx from 125I-labeled alpha-BuTx-human AChR complex, and their dissociation activities showed good correlation with the inhibitory activities.

Adaptive changes in zonation for gluconeogenic capacity in liver lobules of cold-exposed rats

The rate of gluconeogenesis from lactate increased in perfused livers after exposure of rats to cold for 5 days, and it returned to the control rate after 20 days [M. Shiota, T. Tanaka, and T. Sugano. Am. J. Physiol. 249 (Endocrinol. Metab. 12): E281-E286, 1985.]. The relationship between the increased gluconeogenic activity and its zonal distribution in liver lobules was studied in cold-exposed rats that had been starved for 24 h by examination of preparations enriched for periportal hepatocytes (PP-H) and for perivenous hepatocytes (PV-H), which had been isolated by the digitonin-collagenase perfusion technique. In the control group, the rate of gluconeogenesis from lactate or alanine was three times higher in PP-H than in PV-H. The rate of gluconeogenesis from these substrates in PP-H was not changed by exposure of rats to cold. The rates of PV-H increased to the level in PP-H after 5 days of exposure of rats to cold and then returned to the control rates after 20 days. The rate of gluconeogenesis from fructose was not altered in either preparation of cells by cold treatment of rats. The change in gluconeogenic capacity in PV-H caused by exposure of rats to cold was unrelated to changes in the activity of the malate-aspartate shuttle and of pyruvate kinase. The increased capacity in mitochondrial respiration was observed in both preparations of cells by cold treatment of rats for 5 days. The activity of phosphoenolpyruvate carboxykinase was higher in PP-H than in PV-H in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adjuvant chemotherapy for completely resected stage III non-small-cell lung cancer. Results of a randomized prospective study. The Japan Clinical Oncology Group

Two hundred nine patients with completely resected stage III non-small-cell lung cancer were randomized to receive postoperative cisplatin and vindesine chemotherapy or no further treatment. Before randomization, patients were stratified by the histologic characteristics of their tumors (squamous versus nonsquamous cell carcinoma). Prognostic variables such as histology, performance status, extent of operation, and tumor and nodal status of the eligible patients in chemotherapy (n = 90) and control groups (n = 91) were equally distributed. There was no statistically significant difference in disease-free and overall survival between the two groups. The 3-year disease-free survivals of the chemotherapy and control groups were 37% and 42%, respectively. The median survival times (5-year survival) were 31 months (35%) in the chemotherapy group and 37 months (41%) in the control group. These was no different pattern in the first site of recurrence (local versus systemic) between the two groups. This study failed to demonstrate the therapeutic benefits of postoperative cisplatin and vindesine chemotherapy.

Taurine conjugate of ursodeoxycholate plays a major role in the hepatoprotective effect against cholestasis induced by taurochenodeoxycholate in rats

Rats which were taurine-deprived through beta-alanine administration and untreated rats were used to elucidate the mechanism of hepatoprotective effects of ursodeoxycholate (UDC). Animals were infused with taurochenodeoxycholate (TCDC, 0.4 mumol.min-1.100 g-1) alone or in combination with tauroursodeoxycholate (TUDC), or with UDC (both 0.6 mumol.min-1.100 g-1) for 2 h. Ursodeoxycholate as well as TUDC prevented severe cholestasis and liver damage induced by TCDC infusion in both untreated and taurine-deprived rat groups. In untreated rats, however, UDC was less effective in hepatoprotection than TUDC as indicated by sequential changes in biliary LDH output during the period of 30 to 120 min (P < 0.05). In rats receiving UDC and TCDC, total biliary output of LDH for 2 h was significantly higher in taurine-deprived rats than that in the control (73.40 +/- 10.10 vs 41.14 +/- 12.56: P < 0.05), suggesting that the difference became greater upon taurine deprivation. In contrast, in rats receiving TUDC and TCDC, the protective effect was comparable for the taurine-deprived and untreated rats. When the animals were infused with UDC and TCDC, taurine-deprived rats exhibited a biliary excretion rate for TUDC half that of control rats (P < 0.05). Furthermore, a highly significant correlation was observed between the biliary excretion rate of TUDC and biliary output of LDH (r = -0.886, P < 0.0001). These results suggest that UDC conjugates, especially TUDC, and not UDC may play a major role in the prevention of cholestasis and liver cell damage caused by TCDC infusion.

Laparoscopic oversewing of a bleeding Mallory-Weiss tear under endoscopic guidance

Continuous bleeding from a Mallory-Weiss tear required laparoscopic surgery to halt the bleeding. The oversewing of the laceration at the esophagogastric junction was readily performed under video control with endoscopic guidance and the bleeding ceased. To stop bleeding from such a tear, we prefer to use this modern approach.

Two truncated forms of rat insulin receptor-related receptor

The insulin receptor-related receptor (IRR) (1271 amino acids) is expected to have unique functions as a novel member of the insulin receptor family. In this paper, we report two alternatively spliced variants of rat IRR mRNA, which are predicted to encode two truncated forms of IRR, sIRR-1 (410 amino acids) and sIRR-2 (469 amino acids). The amino acid sequence of sIRR-1 is identical to the N-terminal 410-amino acid sequence of IRR. sIRR-2 has an additional 59-amino acid insertion in the C-terminal region. Both truncated forms retain the N-terminal and cysteine-rich domains but lack the transmembrane and intracellular tyrosine kinase domains, indicating that the truncated forms are the secreted forms. The translation products of the truncated form mRNAs were detected in the stomach and kidney by Western analysis. However, the physiological significance of the secreted forms remains to be elucidated.