Clinical influence of vagotomy on postoperative acute phase response

BACKGROUND: Although there is increasing evidence suggesting that the vagus nerve functions as a connector between the nervous and immune systems in animals, little is known about the role of the vagus nerve in postoperative acute phase response in humans. MATERIALS AND METHODS: The extent of fever and acute phase protein response and the production of inflammatory cytokine during the early postoperative period were compared among the patients who had undergone total gastrectomy including truncal vagotomy (n = 13), those having distal gastrectomy with division of vagal branches (n = 14), and the patients with vagal nerve preserving gastrectomy (n = 12). RESULTS: There was no significant difference in serum levels of C-reactive protein, alpha-1-antirypsin, and interleukin-6 among the three groups. Also, postoperative maximum body temperature was similar. CONCLUSIONS: Vagotomy did not influence acute phase response after gastric cancer surgery. A multipathway mechanism for acute phase response including the induction of fever is suggested.     

桂附地黄丸对肺纤维化模型肺组织IL-10表达的影响

目的：探讨桂附地黄丸防治肺纤维化的作用及机理。方法：用平阳霉素诱导肺纤维化模型大鼠后，用药组每天灌胃桂附地黄丸，第28d后处死各组大鼠，观察、比较各组大鼠肺部病理组织学改变及肺组织中白细胞介素10（IL-10）的表达。结果：桂附地黄丸组、强的松对照组肺纤维化程度显著低于模型对照组（P〈0．05），而肺组织IL-10的表达显著高于模型对照组；且桂附地黄丸组IL-10的表达显著高于强的松对照组。结论：桂附地黄丸能明显减轻平阳霉素所致的大鼠肺纤维化程度，并能显著增强IL-10的表达。     

六味通脉胶囊对动脉硬化闭塞症患者T细胞亚群及白细胞介素-6、肿瘤坏死因子-α的影响

目的研究六味通脉胶囊对动脉硬化闭塞症(ASO)患者外周血白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)含量变化及T细胞亚群的影响,并进一步探讨该复方中药抗ASO的作用机制。方法将93例符合入选标准的ASO患者,采用双盲双模拟研究方法,随机分为治疗组和对照组,从T细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)I、L-6、TNF-α含量变化等方面进行前瞻性对比治疗研究。结果ASO患者存在免疫功能的低下,血液IL-6、TNF-α含量明显升高,与健康人比较有显著性差异(P<0.05或0.01)。经3个疗程的治疗后,2组患者的各观察指标均有不同程度的改善,与治疗前比较有显著性差异(P<0.05或0.01);治疗后治疗组与对照组比较,有显著性差异(P<0.05或0.01)。结论六味通脉胶囊能明显提高免疫功能,降低血液IL-6、TNF-α的含量。六味通脉胶囊对ASO患者的预后影响与提高免疫功能及降低血液IL-6、TNF-α的含量有关。     

干扰素-γ对小鼠哮喘模型气道炎症和肺T淋巴细胞及血浆IgE的影响

[目的]探讨干扰素-γ(IFN-γ)对支气管哮喘(哮喘)小鼠气道炎症及肺T淋巴细胞和血浆中IgE的影响。[方法]C57BL／6小鼠随机分为正常对照组(A组,10只)、哮喘模型组(B组,10只)、IFN-γ注射组(C组,10只)。采用卵蛋白(OVA)和氢氧化铝致敏、雾化建立哮喘模型,B组、C组分别在致敏同时第1、3、5、9、15、17、20 d,1次／d腹腔注射生理盐水(0.1 m1)和IFN-γ(1 500U)。第22 d收取肺泡灌洗液(BALF)并取其肺T淋巴细胞体外培养及血浆中IgE。分析小鼠BALF和肺部淋巴细胞产生的细胞因子IL-4、IL-5及血浆中IgE水平的变化。[结果]A组无症状,B组哮喘鼠症状重,C组哮喘鼠症状轻。在BALF中嗜酸性粒细胞百分比(EOS％)计数A组0,B组20.1±7.0,C组0.7±0.2。哮喘模型组肺T淋巴细胞中IL-4、IL-5,血浆中IgE显著高于正常对照组(P<0.01),治疗组肺T淋巴细胞中IL-4、IL-5,血浆中IgE显著低于哮喘模型组(P<0.01)。[结论]IFN-γ可以抑制哮喘小鼠气道炎症,其机制之一可能与是抑制肺T淋巴细胞产生的IL-4、IL-5,降低血清中总IgE水平有关。     

Rapid determination of trisomy 18 parental origin using fluorescent PCR and small tandem repeat markers: case reports

Trisomy 18 is the second most common genetic defect after trisomy 21, almost 90% of which are due to additional chromosome from the mother. The parental origin of the additional chromosome can, if required, be determined by two methods: karyotyping, which takes several weeks; or, more recently, by polymerase chain reaction (PCR) which is often problematic. Fluorescent PCR of small tandem repeats (STRs) can determine the parental origin in the majority of cases within 5 h. Although the incidence of paternal origin is known for both trisomy 21 and trisomy 18, this technique can rapidly determine the parental origin in cases where there is insufficient samples to perform conventional tests. Determining parental origin by these methods may also have clinical significance in the diagnosis of chromosomal translocations or in the diagnosis of genetic disease using linkage analysis.     

Influence of continuous infusion of interleukin-1 alpha on the core protein and the core protein fragments of the small proteoglycan decorin in cartilage.

Decorin, a collagen-binding small proteoglycan, is considered to have a specific function in the organization or stability of the collagen network. Therefore, alteration of its molecular properties may be of pathophysiological relevance during the development of cartilage damage. It is shown here that normal cartilage from rabbit knee-joint contains glycosaminoglycan chain-bearing core protein fragments of 39, 23, and 18 kDa, each one amounting to approximately 5-6% of the intact decorin core protein. Continuous infusion of human recombinant interleukin-1 alpha for 14 days (200 ng/day) into a knee-joint led in condylar cartilage to a reduction in the amount of intact core protein from 2 micrograms/mg wet tissue to about 1.1 micrograms/mg. The increase in its quantity found after infusion of heat-inactivated interleukin-1 was not statistically significant. The concentration of all three core protein fragments became reduced to a similar extent as the intact core protein under the influence of the cytokine, and additional fragments were not found. Surprisingly, there was a much smaller response to interleukin-1-treatment in patellar cartilage.     

Cardiac metabolism: A technical spectrum of modalities including positron emission tomography,single-photon emission computed tomography,and magnetic resonance spectroscopy

Noninvasive techniques for the assessment of cardiac metabolism are important for the detection of potentially salvageable tissue in jeopardized areas of the myocardium. The correct identification of hibernating and stunned myocardium in patients with severely depressed cardiac function can have vital therapeutic consequences for the patient. Changes in myocardial fatty acid and glucose metabolism during acute and prolonged ischemia can be traced by positron-emitting or gamma-emitting radiopharmaceuticals. Alternatively,³¹P-labeled magnetic resonance spectroscopy can be used for the assessment of high-energy phosphate metabolism. It is not yet clear which modality will emerge as the most useful in the clinical setting. Positron emission tomography (PET) that uses combinations of flow tracers and metabolic tracers offers unique opportunities for quantification and high-resolution static and rapid dynamic studies. Currently, assessment of glucose metabolism with¹⁸F-fluorodeoxyglucose is regarded as the gold standard for myocardial viability and prediction of improvement of impaired contractile function after revascularization. However, preserved oxidative metabolism may be required for potential functional improvement, and therefore assessment of residual oxidative metabolism by¹¹C-labeled acetate PET may prove to be more accurate than¹⁸F-fluorodeoxyglucose PET, which reflects both anaerobic and oxidative metabolism. Moreover, because fatty acids are metabolized only aerobically, they are excellent candidates for the clinical assessment of myocardial viability and prediction of functional improvement after revascularization. Especially derivatives of fatty acids that are not metabolized but accumulate in the myocyte are attractive for myocardial imaging. Examples are¹²³I-beta-methyl-p-iodophenyl pentadecanoic acid and 15-(o-¹²³I-phenyl)-pentadecanoic acid. These tracers can be detected by planar scintigraphy and single-photon emission computed tomography, which are more economical and widely available than PET. In addition, 511 keV collimators have been developed recently, making the detection of positron emitters by planar scintigraphy and single-photon emission computed tomography feasible. The experience with³¹P-labeled magnetic resonance spectroscopy in humans is still limited. With current magnetic resonance spectroscopic techniques, insufficient spatial resolution is achieved for clinical purposes, but the possibility of serial measurements to monitor rapid changes of phosphate-containing molecules in time makes magnetic resonance spectroscopy very valuable for the research of myocardial metabolism.     

Development and proliferation of lymphocytes in mice deficient for both interleukins-2 and -4

Interleukin (IL)-2 and IL-4 are considered as important regulators of growth and differentiation of lymphocytes. We report that in mice made deficient for both IL-2 and IL-4 by gene targeting all major T cell subsets and B cells were normal, indicating that IL-2 and IL-4 are not essential for development of the immune system. Paradoxically, proliferation of T cells was increased in both IL-2- and IL-4-deficient homozygous mice.     

Preliminary assessment of fluorine-18 fluorodeoxyglucose positron mission tomography in patients with bladder cancer

The purpose of this study was to assess the feasibility of imaging of bladder cancer with fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) scanning. We studied 12 patients with histologically proven bladder cancer who had undergone surgical procedures and/or radiotherapy. Retrograde irrigation of the urinary bladder with 1000–3710 ml saline was performed during nine of the studies. Dynamic and static PET images were obtained, and standardized uptake value images were reconstructed. FDG-PET scanning was true-positive in eight patients (66.7%), but false-negative in four (33.3%). Of 20 organs with tumor mass lesions confirmed pathologically or clinically, 16 (80%) were detected by FDG-PET scanning. FDG-PET scanning detected all of 17 distant metastatic lesions and two of three proven regional lymph node metastases. FDG-PET was also capable of differentiating viable recurrent bladder cancer from radiation-induced alterations in two patients. In conclusion, these preliminary data indicate the feasibility of FDG-PET imaging in patients with bladder cancer, although a major remaining pitfall is intense FDG accumulation in the urine. Present address: Department of Radiology, National Defense Medical College, 3-2 Namiki, Tokorozawa 359, Japan