Late preconditioning against myocardial stunning. An endogenous protective mechanism that confers resistance to postischemic dysfunction 24 h after brief ischemia in conscious pigs

Conscious pigs underwent a sequence of 10 2-min coronary occlusions, each separated by 2 min of reperfusion, for three consecutive days (days 1, 2, and 3 of stage I). The recovery of systolic wall thickening (WTh) after the 10th reperfusion was markedly improved on days 2 and 3 compared with day 1, indicating that the myocardium had become preconditioned against "stunning." 10 d after stage I, pigs underwent again a sequence of 10 2-min coronary occlusions for two consecutive days (days 1 and 2 of stage II). On day 1 of stage II, the recovery of WTh after the 10th reperfusion was similar to that noted on day 1 of stage I; on day 2 of stage II, however, the recovery of WTh was again markedly improved compared with day 1. Blockade of adenosine receptors with 8-p-sulfophenyl theophylline failed to prevent the development of preconditioning against stunning. Northern blot analysis demonstrated an increase in heat stress protein (HSP) 70 mRNA 2 h after the preconditioning ischemia; at this same time point, immunohistochemical analysis revealed a concentration of HSP70 in the nucleus and an overall increase in staining for HSP70. 24 h after the preconditioning ischemia, Western dot blot analysis demonstrated an increase in HSP70. This study indicates the existence of a new, previously unrecognized cardioprotective phenomenon. The results demonstrate that a brief ischemic stress induces a powerful, long-lasting (at least 48 h) adaptive response that renders the myocardium relatively resistant to stunning 24 h later (late preconditioning against stunning). This adaptive response disappears within 10 d after the last ischemic stress but can be reinduced by another ischemic stress. Unlike early and late preconditioning against infarction, late preconditioning against stunning is not blocked by adenosine receptor antagonists, and therefore appears to involve a mechanism different from that of other forms of preconditioning currently known. The increase in myocardial HSP70 is compatible with, but does not prove, a role of HSPs in the pathogenesis of this phenomenon.

Values of intravenous ergonovine test with two-dimensional echocardiography for diagnosis of coronary artery spasm

The purpose of this study was to evaluate the clinical validity of the bedside ergonovine test with digital echocardiography and the side-by-side continuous cineloop display method (ergonovine echocardiography) as a noninvasive diagnostic tool for coronary artery spasm. Bedside ergonovine test was performed in 66 patients who showed coronary vasospasm during coronary angiography including provocation testing (group with variant angina) and 39 patients with normal angiograms and no evidence of coronary artery spasm (group with nonanginal pain). A bolus of ergonovine maleate (0.025 or 0.05 mg) was injected at 5-minute intervals up to total cumulative dosage of 0.35 mg, and 12-lead electrocardiography and two-dimensional echocardiography were recorded every 3 minutes after each injection. Left ventricular wall motion was analyzed with a commercially available quad system. The positive criteria of bedside ergonovine test included reversible ST segment elevation or depression on electrocardiograms (ECG criteria) and reversible regional wall motion abnormalities by echocardiography (Echo criteria). The overall sensitivity and specificity of ECG criteria were 53% (35/66; 95% confidence interval 41% to 65%) and 100%, respectively. By Echo criteria the sensitivity increased to 89% (59/66; 95% confidence interval 81% to 97%), with a specificity of 95% (37/39).(ABSTRACT TRUNCATED AT 250 WORDS)

Organization of the 5' region of the rat ATP citrate lyase gene

A genomic clone, encompassing the 5' flanking region and the first seven exons of rat ATP citrate lyase gene, was isolated from a rat genomic library and sequenced. Primer-extension analysis showed that mRNA is transcribed at 4407 nucleotides upstream from the translation start site. Primer-extension analysis and sequencing of ATP citrate lyase cDNA amplified by PCR showed that the promoter used for transcription is identical in mammary gland, lung, liver, brain and kidney. Southern-blot analysis showed that the ATP citrate lyase gene exists as a single copy. The 5' flanking region contains several consensus sequences defined as promoter elements. These include a CAAT box and Sp1-binding sites. However, a TATA box lacks this promoter. The expression of the chloramphenicol acetyltransferase gene was induced by the 5' flanking region (-2370 to -1) in the CHO cell line. The 5' flanking region also contains several sequence elements that may be involved in the transcriptional regulation of the gene.

Induction of hepatic ATP-citrate lyase by insulin in diabetic rat--effects of insulin on the contents of enzyme and its mRNA in cytosol, and the transcriptional activity in nuclei

The effects of insulin on ATP-citrate lyase, its mRNA in cytosol, and the transcriptional activity in nuclei of diabetic rat liver were studied. Experimental diabetes was induced by an intraperitoneal injection of streptozotocin, and livers were removed from rats at 0, 1, 3, 6, 16, and 72 hours after the administration of insulin. ATP-citrate lyase began to increase at 16 hours, and continuously increased until 72 hours. The amount of mRNA encoding ATP-citrate lyase increased abruptly at 16 hours, then decreased to near basal level in 72 hours. No change in the transcription rate was observed until 3 hours after insulin administration. However, the activity increased 4-fold at 6 hours and 7-fold at 16 hours, 16-fold at 6 hours and 28-fold at 16 hours when pGACL1 and pGACL2 were used as probes, respectively, preceding the increase in the amounts of mRNA and the enzyme. It is suggested that the increase in the amount of ATP-citrate lyase by insulin is primarily due to the increase in the transcriptional activity of the gene in nuclei, which results in the subsequent increase in the amount of mRNA for the biosynthesis of ATP-citrate lyase in cytosol.

Tendocutaneous free flap transfer from the dorsum of the foot

Tendocutaneous free flap transfer has been used to treat troublesome wounds involving skin and tendons, with the dorsum of the foot being the most frequent donor site. Free flaps consist of the dorsalis pedis artery, saphenous vein, branch of the superficial peroneal nerve, long extensor tendons, and overlying skin. We analyzed 13 cases of skin and tendon loss from the dorsum of the hand and wrist that were treated with tendocutaneous free flap from the dorsum of the foot. The size of the flap was from 6 x 5 cm to 11.5 x 7.1 cm (average, 9.2 x 5.9 cm), and the transferred tendons ranged from 1 to 5 in number (average, 2.9), and 5 to 17 cm in length (average, 9.2 cm). The transferred flaps survived in all cases, and the transferred tendons were functioning well except in two cases of electrical burn. The complications included two cases of tendon adhesion, one case of marginal necrosis of the flap, and three cases of donor-site wound problem.

Occlusive and reperfused myocardial infarction: detection by using MR imaging with gadolinium polylysine enhancement

PURPOSE

To assess the capability of gadolinium polylysine-enhanced cardiac magnetic resonance (MR) imaging in depicting normal and ischemic myocardium during occlusion and reperfusion of the left anterior descending artery.

MATERIALS AND METHODS

Contrast-enhanced MR images were obtained in 18 cats during 90 minutes each of occlusion and reperfusion. The change in signal intensity (SI) was compared among normal myocardium and central and peripheral ischemic zones. Results were compared with those of 2,3,5-triphenyltetrazolium chloride staining.

RESULTS

During occlusion, the ischemic zone lacked enhancement while normal myocardium had gradual enhancement. During reperfusion, the ischemic zone had strong enhancement. In cats with large infarction, the central and peripheral ischemic zones had intermediate and high SI, respectively; in cats with focal or no infarction, the entire ischemic zone had high SI.

CONCLUSION

Occlusive and reperfused myocardial infarction can be detected at gadolinium polylysine-enhanced MR imaging by means of differential SI changes in normal myocardium and central and peripheral ischemic zones.

Relation of pulmonary venous flow to mean left atrial pressure in mitral stenosis with sinus rhythm

To determine whether pulmonary venous flow measured by transesophageal Doppler echocardiography can be used to estimate mean left atrial pressure (LAP), we prospectively studied 12 consecutive patients with sinus rhythm undergoing percutaneous mitral balloon commissurotomy for their severe mitral stenosis (mitral valve area < 1.5 cm2). We correlated Doppler variables of pulmonary venous flow and the mean LAP measured by left atrial catheterization. Among the variables of the pulmonary venous flow, the systolic fraction (i.e., the systolic velocity-time integral expressed as a fraction of the sum of systolic and early diastolic velocity-time integral) correlated significantly with mean LAP (r = -0.71, p < 0.05) and mitral valve area (r = 0.64, p < 0.05). Peak velocity and velocity-time integral in systole also significantly correlated with mean LAP (r = -0.66, r = -0.67 respectively, p < 0.05). We conclude that the more severe the degree of mitral stenosis in patients with sinus rhythm, the less systolic pulmonary venous flow in severe mitral stenosis.

Immediate and one-year results of percutaneous mitral balloon valvuloplasty using Inoue and double-balloon techniques

Many investigators have reported the results of percutaneous mitral valvuloplasty (PMV) using the Inoue or double-balloon technique, but to date, the immediate and long-term follow-up results of the 2 different procedures have not been compared in a prospective study. Therefore, a prospective, randomized trial was performed in 120 consecutive patients who underwent PMV using Inoue (n = 59; group I) or double (n = 61; group D) balloons. The success rate was 83% in group I, and 89% in group D. The magnitude of changes in mitral valve area and hemodynamic variables was the same in both groups. Immediately after dilation, the long diameter changes of the mitral orifice was greater in group D, and the increase in ejection fraction slope was significantly greater in group D. The duration of the total procedure, and the fluoroscopic time was significantly shorter in group I. The incidence of left-to-right shunt at the atrial level (Qp/Qs > 1.5) was 3.4% in group I and 4.9% in group D. Severe mitral regurgitation (grade > or = 3) occurred in 2 patients in each group. At follow-up, the mitral valve area had significantly decreased at 6 months, but no further changes occurred at 1-year follow-up in both groups. The long diameter of the mitral orifice was greater in group D until 6 months after PMV, but the difference was not apparent at 1-year follow-up. In conclusion, the Inoue and double-balloon techniques obtained equivalent results in the success rate and frequency of complications.(ABSTRACT TRUNCATED AT 250 WORDS)

Regulation of ATP-citrate lyase at transcriptional and post-transcriptional levels in rat liver

The amounts of ATP-citrate lyase in liver cytosol began to increase at 12 hours after refeeding a high-carbohydrate diet and further increased until 48 hours. The amounts of the ATP-citrate lyase mRNA began to increase at 6 hours and reached to a maximum level at 12 hours, followed by decrease to a very low level until 48 hours. The elevated amount of the ATP-citrate lyase mRNA reflected on the increase of ATP-citrate lyase content in the first 24 hours, but these two parameters were not paralleled thereafter. The transcriptional activity of ATP-citrate lyase gene in nuclei of rat liver began to increase at 4 hours and further increased to reach a maximum level of 24 fold at 12 hours, maintaining a high level of 17 fold until 48 hours. The elevation of transcriptional activity of ATP-citrate lyase gene preceded the increase of ATP-citrate lyase mRNA content in the liver cytosol by 2 hours, and its increasing pattern was similar to changes of mRNA content until 12 hours. However, while the transcriptional activity remained at a high level until 48 hours, the ATP-citrate lyase mRNA concentration in the cytosol decreased after 12 hours.

Isolation of vindoline from Catharanthus roseus by supercritical fluid extraction

Vindoline was extracted from the leaves of Catharanthus roseus over the ranges of 35-70 degrees C and 100-300 bar using supercritical carbon dioxide with and without the addition of 3 wt % ethanol as a cosolvent. The vindoline contents in the extracts were determined by HPLC and identified by LC/MS. The remarkable highest vindoline concentration, 58 wt %, was obtained at the lowest temperature, 35 degrees C, and the highest pressure, 300 bar, of this study. The use of a cosolvent only slightly improved the extraction yields or selectivities at some experimental conditions.

Regulation of fatty acid synthase at transcriptional and post-transcriptional levels in rat liver

The regulation of fatty acid synthase in rat liver was investigated at transcriptional and post-transcriptional levels. When rats were fasted for 3 days and refed on a high-carbohydrate diet, the amounts of FAS in liver cytosol began to increase at 12 hours and further increased until 48 hours. The amount of mRNA for FAS began to increase at 6 hours and reached to a maximum level at 12 hours, indicating that the expression of mRNA for FAS precedes the increase of FAS protein pool. After 12 hours the amounts of mRNA gradually decreased and remained at a much lowered level between 24 and 48 hours. The elevated amount of FAS mRNA reflected on the amount of FAS protein in the first 24 hours, but these two parameters were not paralleled thereafter, probably due to the changes in the translational efficiencies. The run-on transcriptional activity of FAS gene began to increase at 4 hours after refeeding a high-carbohydrate diet and further increased to reach a maximum level 25 fold of the initial level at 12 hours, followed by a 16 fold level between 24 and 48 hours. The elevation of run-on transcriptional activity of FAS gene preceded the increase of FAS mRNA in the liver cytosol by 2 hours, and a similar increasing pattern was observed until 12 hours. However, FAS mRNA concentration decreased gradually after 12 hours, while the transcriptional activity remained at a high level until 48 hours. The changes in FAS mRNA content in the cytosol of rat liver were closely related to the transcriptional activity of FAS gene in the early phase of induction, but another regulatory mechanism seems to operate in the decrease of mRNA after 12 hours.

Borna disease: association with a maturation defect in the cellular immune response

Borna disease virus (BDV) is a negative-strand RNA virus which produces persistent infection in a variety of experimental animals. In the rat, the presence or absence of clinical signs of Borna disease, a characteristic, biphasic neurobehavioral illness, depends on host-related factors. A window of opportunity exists after birth wherein inoculation with BDV produces a persistently infected rat without signs of Borna disease or encephalitis (persistent, tolerant infection-newborn [PTI-NB] rat). Although immunopathological destruction of the nervous system does not occur in the PTI-NB rat, significant alterations in the development of the nervous system were noted, including site-specific lysis of neurons. Unlike the case with other pharmacologically produced, persistent, tolerant BDV infections, adoptive transfer of spleen cells from BDV-infected rats did not produce disease in the PTI-NB rats. PTI-NB rats developed Borna disease after being connected by parabiosis to rats with Borna disease. Bone marrow transplantation experiments revealed that bone marrow cells from PTI-NB rats produced Borna disease in lethally irradiated, BDV-infected recipient rats. Bone marrow from PTI-NB rats contained a complement of inflammatory cells capable of inducing Borna disease. Thus, the loss of BDV-specific cellular immunity appeared to occur after the release of cells from the bone marrow.

A case of intestinal hemorrhage due to small intestinal metastases from primary lung cancer

Although intestinal metastases from lung cancer are not rare at postmortem studies, the development of clinically significant symptoms from the gastrointestinal metastases is very unusual. We report a case of small intestinal hemorrhage leading to intestinal perforation secondary to metastases from a large cell carcinoma of the lung in a 31-year-old man along with a review of the literature.

Studies on immunopotentiating activities of antitumor polysaccharide from aerial parts of Taraxacum platycarpum

The polysaccharide fraction from Taraxii Herba showed potent immunopotentiating activities with antitumor activities. The fraction having small amount of protein inhibited the growth of solid tumor and increased peritoneal exudate cells and immunoorgan weights in normal mice, and also increased hypersensitivities in tumor bearing mice.

Quantification of Cholesterol Oxidation Products in a Variety of Foods

Cholesterol oxidation products (COPS) were estimated in a variety of foods by gas chromatography. Substantial quantities of α- and β-epoxide (2 to 46 and 0 to 111 ppm, respectively) and lesser quantities of 7β-hydroxy- and 7-ketocholesterol were found in powdered egg products. Other foods found to contain COPS included dehydrated chicken, turkey and beef (0 to 43 ppm); and Cheddar, Blue, Romano and Parmesan cheese powders (0 to 17 ppm). Powdered infant formulas and dehydrated baby foods displayed several peaks coinciding to COPS but none were confirmed by mass spectroscopy. COPS were either not detected or noted at < 15 ppm in fresh dairy products.

RFLP analysis of HLA-DR beta and -DQ beta genes in the Korean patients with insulin-dependent diabetes mellitus

Human genomic DNA samples from 19 Korean patients and 31 controls of known serological DR antigen specificity were studied for insulin-dependent diabetes mellitus (IDDM)-associated variation in HLA-DR beta and -DQ beta restriction fragment length polymorphisms (RFLPs). Genotyping allowed for accurate assignment of HLA-DR types. For HLA-DRw6, a 12kb/DR beta/Taq I fragment was decreased in Korean IDDM (p less than 0.05). However, we could not find an increased frequency of a 12kb/DQ beta/Bam HI fragment or decreased frequency of a 3.7kb/DQ beta/Bam HI fragment in Korean IDDM. These results suggest a possible protective role of the HLA-DRw6 specificity in IDDM, irrespective of ethnic background, the absence of a specific DQ beta RFLP pattern associated with IDDM in Koreans, and the difference of the Korean population in the genetic of IDDM, compared to the Caucasoid population.

Tryptophan degradation in transplanted tumor cells undergoing rejection

The depletion of an essential amino acid, tryptophan, caused by indoleamine 2,3-dioxygenase induction in vitro, has been shown to be due to a mechanism that is used in self-defense against inhaled microorganisms and tumor growth. In this communication, we report the results of measuring dioxygenase activity in the peritoneal exudate cells and tumor cytotoxicity at the transplantation loci after in vivo transplantation of tumor cells into the peritoneal cavity of syngeneic or allogeneic strains of mice. The enzyme was induced only when the tumor cells were being rejected from allogeneic animals and no change was observed when the cells continued to grow in syngeneic animals. Furthermore, when the syngeneic tumor cells in a diffusion chamber were i.p. transplanted simultaneously with i.p. injection of allogeneic tumor cells, the enzyme was induced not only in allografted tumor cells but also in the syngeneic tumor cells. Under these conditions, the tumor cells in the diffusion chamber ceased to grow and 50% of the cells were rejected. To determine the type of cells containing the induced enzyme, the peritoneal exudate cells (tumor cells and host cells--mostly small lymphocytes) were separated into six fractions by sedimentation under gravity and by differential centrifugation. Approximately 80% of total enzyme activity was localized in a tumor-rich fraction (98.9% purity), whereas only 0.2% of the activity was found in a lymphocyte-rich fraction (99.5% purity). The localization of indoleamine 2,3-dioxygenase in the tumor cells was confirmed by complement-dependent lysis with specific antibodies against tumor and host cells.

Tryptophan degradation in transplanted tumor cells undergoing rejection

The depletion of an essential amino acid, tryptophan, caused by indoleamine 2,3-dioxygenase induction in vitro, has been shown to be due to a mechanism that is used in self-defense against inhaled microorganisms and tumor growth. In this communication, we report the results of measuring dioxygenase activity in the peritoneal exudate cells and tumor cytotoxicity at the transplantation loci after in vivo transplantation of tumor cells into the peritoneal cavity of syngeneic or allogeneic strains of mice. The enzyme was induced only when the tumor cells were being rejected from allogeneic animals and no change was observed when the cells continued to grow in syngeneic animals. Furthermore, when the syngeneic tumor cells in a diffusion chamber were i.p. transplanted simultaneously with i.p. injection of allogeneic tumor cells, the enzyme was induced not only in allografted tumor cells but also in the syngeneic tumor cells. Under these conditions, the tumor cells in the diffusion chamber ceased to grow and 50% of the cells were rejected. To determine the type of cells containing the induced enzyme, the peritoneal exudate cells (tumor cells and host cells--mostly small lymphocytes) were separated into six fractions by sedimentation under gravity and by differential centrifugation. Approximately 80% of total enzyme activity was localized in a tumor-rich fraction (98.9% purity), whereas only 0.2% of the activity was found in a lymphocyte-rich fraction (99.5% purity). The localization of indoleamine 2,3-dioxygenase in the tumor cells was confirmed by complement-dependent lysis with specific antibodies against tumor and host cells.

HLA and insulin-dependent diabetes mellitus in Koreans

Specific allelic associations vary among ethnic groups. We studied the distribution of HLA-A, -B, -C and -DR antigens in 41 patients with insulin-dependent diabetes mellitus (IDDM) and 280 unaffected persons in Korea. HLA typing was performed by the standard microlymphocytotoxicity test using antisera supplied by the Third Asia-Oceania Histocompatibility Workshop Conference (3rd AOHWC, 1986). There was no association between HLA-A, -B, or -C and IDDM. However, the frequencies of HLA-DR3 and HLA-DR4 were increased in the patients as compared with the controls (19.5% vs 4.3%, RR 5.4, corrected p < 0.005 for DR3 and 61.0% vs 36.4%, RR 2.7, corrected p < 0.05 for DR4). Also a decreased frequency of HLA-DR2 was found in the patients with IDDM (9.8% vs 32.1%, RR 0.3, corrected p < 0.05). These results emphasize the differences in HLA-IDDM associations among different ethnic groups.

Prostaglandin synthesizing enzyme activities of hepatocytes and non-hepatocytes in rat liver as a function of age

The developmental profile of prostaglandin (PG)-synthesizing enzymes in liver was investigated in rats from the fetus to 2 years old. In the neonatal period, the activities of PGD2-(2.7 nmol/min/mg protein) and PGE2-(2.2 nmol/min/mg protein) synthesizing enzymes were predominant, whereas PGE2-synthesizing enzyme alone further increased in activity during adult to old ages (5.2-6.1 nmol/min/mg protein). In order to determine the sites of PGs production in rat liver, we prepared hepatocytes and non-hepatocytes by a collagenase digestion method. Regardless of the ages we examined, the major PG produced in the hepatocytes was proved to be PGE2, on the other hand, PGD2 was almost exclusively produced in the non-hepatocytes. These results suggest that each PG may have individual roles in the development of rat liver.

Capillary column gas-liquid chromatographic resolution of oxidized cholesterol derivatives

Fused-silica capillary columns were evaluated for the resolution of oxidized cholesterol derivatives. Thermal instability of diol derivatives, epimeric 7 alpha- and 7 beta-hydroxy, 4 beta-hydroxy, and 25-hydroxycholesterol, was observed during gas chromatography. After derivatization as trimethylsilyl ethers the foregoing diols, alpha-epoxide, cholestane-triol, 7-ketocholesterol, and cholesta-3,5-dien-7-one were completely resolved on a DB-1 column. Each oxidized sterol revealed excellent response linearity as the trimethylsilylated sterol, enabling reliable quantification. The identity of each derivatized sterol was confirmed by mass spectrometry.

Developmental changes in the activities of prostaglandin synthesizing enzymes in the digestive and immune systems of rat

The developmental changes of prostaglandin (PG) synthesizing enzymes in the digestive system (stomach and small intestine) and the immune system (spleen and thymus) of rats were investigated. In all the digestive organs, the predominant PG produced from PGH2 changed at around 2 weeks after birth to another PG. Further, the predominant activities of PG synthesizing enzymes were different organ by organ in the digestive system. In the case of the immune system, only the activity of PGD2 synthesizing enzyme displayed a significant increase during development and the activities of other PG synthesizing enzymes remained insignificant throughout the development. These results suggest that PGs may play important roles during the development of each organ.