Trypsin activity

A normal serum amylase level is found in up to 32% of patients with acute alcoholic pancreatitis. This underlines the need for more sensitive diagnostic tests in this frequent cause of pancreatitis. Animal and human studies have shown that chronic alcohol consumption leads to important modifications in trypsinogen metabolism. The present work has prospectively analyzed admission serum trypsin activity with a new biochemical test and usual markers such as amylase, lipase, and immunoreactive trypsin in 32 attacks of acute pancreatitis. Seventeen were due to alcohol and 15 to other causes, including 11 with gallstone pancreatitis. High trypsin activity (median: 235 units/liter; range: 165–853) was found in all patients with acute alcoholic pancreatitis even when the amylase level was normal on admission (3/17: 18%). Trypsin activity did not differ between nonalcoholic pancreatitis (N=15): 84 units/liter (42–98), alcoholic controls (N=15): 77 units/liter (40–122), and healthy controls (N=62): 81 units/liter (15–143). The difference was not related to the severity of disease or circulating α₂-macroglobulin, α₁-protease inhibitor, or immunoreactive trypsinogen levels. Lipase/amylase ratio was less discriminant than trypsin activity between alcoholic and nonalcoholic diseases. We conclude that serum trypsin activity seems specific to acute alcoholic pancreatitis and should be included in new prospective studies assessing biochemical testing of alcohol-related pancreatic diseases.     

Physical activity

There are a total of 30 publications regarding the role physical exercise in primary prevention of coronary artery disease, nearly a quarter of a million patients have participated in these studies. The average observation time reaches 10 years. According to the guidelines of the ACC/AHA Task Force this is the basis for the evidence/recommendation class I. The benefit derived from this treatment considerably exceeds the risk; thus, there is no need for additional studies. A great number of population-based risk factors were evaluated; in several randomized studies and meta-analyses concordant results were achieved with respect to direction and degree of the therapeutic effect (Level B).     

Neuropeptidergic mediators of spontaneous physical activity and non-exercise activity thermogenesis

Lean individuals have high levels of spontaneous physical activity (SPA) and the energy expenditure derived from that activity, termed non-exercise activity thermogenesis or NEAT, appears to protect them from obesity. Conversely, obesity in different human populations is characterized by low levels of SPA and NEAT. Like in humans, elevated SPA in rats appears to protect against obesity: obesity-resistant rats have significantly greater SPA and NEAT than obesity-prone rats. We review the literature on brain mechanisms important in mediating SPA and NEAT. The focus is on neuropeptides, including cholecystokinin, corticotropin-releasing hormone (also known as corticotropin-releasing factor), neuromedin U, neuropeptide Y, leptin, agouti-related protein, orexin-A (also known as hypocretin-1), and ghrelin. We also review information regarding interactions between these neuropeptides and dopamine, a neurotransmitter important in mediating motor function. Finally, we present evidence that elevated signaling of pathways mediating SPA and NEAT may protect against weight gain and obesity.     

Lifestyle physical activity

Conclusion The concept of lifestyle physical activity arose from reassessment of epidemiologic evidence on physical activity and health and the development of new public health recommendations for physical activity. The research base on lifestyle physical activity remains limited, but studies to date have been consistent and of     

DNA-relaxing activity and endonuclease activity in Xenopus laevis oocytes.

Complex simian virus 40 DNA produced by a soluble cell-free extract derived from stage 6 oocytes of Xenopus laevis consists of fully relaxed circles (i.e., with no superhelical turns). An endonuclease and a DNA-relaxing protein, either or both of which could be responsible for the relaxation of the complex DNA, have been purified from the extract. The endonuclease(s) produces nicked circles (having a single-strand scission) and linear full-size molecules. The DNA-relaxing protein is in the nucleus, has a molecular weight of apporximately 70,000, and is able to remove both negative and positive superhelical turns.     

Glucagon degrading activity

To evaluate the effect of glucagon degrading activity (GDA) on radioimmunoassay (RIA) of glucagon, I measured GDAs in plasma, serum, lysed red blood cells (RBC), and suspension of mononuclear cells and granulocytes. Serum levels of GDA in patients with various diseases were also examined. 1. Serum GDA values in normal subjects (control) measured by TCA precipitation method were 4.6 +/- 2.2% (mean +/- S.D.). GDA values in plasma treated with citrate and those in serum treated with aprotinin were not different from those in nontreated serum. GDAs in plasma treated either with EDTA and aprotinin or with EDTA alone were significantly lower than those in control serum, but the values in plasma treated with heparin were markedly higher than those in control serum. 2. GDAs in RBC lysate and suspension of mononuclear cells and granulocytes remained low up to the concentration of 23 X 10(4) RBC/microliters and 5000 mononuclear cells or granulocytes/microliters, respectively. GDAs in RBC lysate and mononuclear cells were markedly suppressed by the treatment with EDTA, whereas GDAs in granulocytes were inhibited by the treatment with aprotinin. 3. Markedly high values of GDA were obtained in serum of patients with pancreas diseases, liver diseases, renal diseases and hyperthyroidism. However, in four patients these elevated levels were restored to normal value after recovery from these disorders. The elevated GDA values in serum were suppressed to normal value by the addition of EDTA and aprotinin. 4. On Bio-Gel P-6 column chromatography, 125I-glucagon incubated with patient serum containing high GDA values revealed several peaks eluted after 125I-glucagon. 5. In healthy subjects, immunoreactive glucagon (IRG) levels in nontreated serum were not different from those in plasma treated either with EDTA and aprotinin or with heparin. 6. In patients showing high serum GDA levels, serum GDA levels were not significantly related to IRG levels in plasma treated with EDTA and aprotinin. These results indicate that a series of treatment of blood samples before assay: addition of EDTA and aprotinin to the blood samples, immediate separation of plasma from blood cells, and storage at 4 degrees C is recommended to avoid breakdown of glucagon by GDAs.     

Placental CSF-like activity

We have examined amniotic fluid and cultured supernatants of a variety of placental cells for the presence of colony-stimulating factor (CSF) activity. The supernatants of cultured human choriocarcinoma cell lines, Jeg and Jar, contained CSF activity that induced the formation of granulocyte-macrophage colony-forming unit (CFU-GM) and multipotential colony-forming unit (CFU-GEMM) colonies. Cultured supernatants of nontransformed rat placental cells, chorionic villous cells, and amniotic fluid also induced CFU-GM colonies.     

冠心病介入治疗后血小板、纤溶动态变化及其临床意义

通过对36例经皮腔内冠状动脉成形术（PTCA）成功的冠心病患者进行6个月随访，发现心绞痛复发组（B组，10例）血小板α颗粒膜蛋白-140水平手术后1、3、6个月时比无心绞痛复发组（A组，26例）高（分别P＜0．05、P＜0．01和P＜0．01）。血浆组织型纤溶酶原激活剂活性B组在术后呈下降趋势，其组织型纤溶酶原激活剂抑制剂活性则明显升高。血浆vWF抗原两组在术后1h均显著上升，以后A纷呈下降趋势，而B组仍保持较高水平。提示：PTCA术后临床症状复发、再狭窄发生与血小板持续高活性有关，同时内皮损伤、纤溶活性降低也起一定作用。     

Assessing disease activity and disease activity indices for inflammatory bowel disease

A crucial step in the development of clinical trials to determine the efficacy of various therapies for inflammatory bowel disease (IBD) has been the creation of activity indices. This article reviews the major components and operating characteristics of clinical activity indices commonly used in randomized, controlled trials of IBD therapy. In addition, the paper provides a brief overview of the developmental requirements for any new index.     

射频导管消融术对血小板活性和纤溶活性的影响

射频导管消融术 (ＲＦＣＡ)是根治某些快速心律失常安全有效的方法 ,但术中、术后发生血栓栓塞并发症时有报道 ,对ＲＦＣＡ的安全性带来负面影响。本组观察了ＲＦＣＡ前后不同时间内血小板活性和纤溶系统活性的变化 ,探讨ＲＦＣＡ并发血栓栓塞的可能机制。资料和方法　 36例阵发性室上性心动过速在我院行ＲＦＣＡ治疗的患者 ,男性 2 0例 ,女性 16例 ,平均年龄(38 6± 12 3)岁。术前检查均无血栓栓塞性疾病和出血性疾病病史。所有患者在ＲＦＣＡ插管前、插入电极导管完成心内电生理检查放电前 (放电前 )、放电消融成功后即刻、消融成功后 30…     

临床疾病活动指数和简化疾病活动指数在类风湿关节炎疾病活动性评估中的比较研究

目的 评价临床疾病活动指数( CDAI)、简化疾病活动指数(SDAI)同疾病活动指数28( DAS28),对类风湿关节炎(RA)疾病活动性的评估价值.方法 连续纳入200例RA患者,评估每例RA患者的关节肿胀数(SJC)、关节压痛数(TJC)、患者对病情的总体评估(PGA)、医生对病情的总体评估( PhGA)、健康评估问卷(HAQ),检测红细胞沉降率(ESR)、C反应蛋白(CRP),计算DAS28、CDAI、SDAI.用Pearson相关分别分析DAS28、CDAI、SDAI与上述任意指标的相关性.按DAS28、CDAI、SDAI各活动分期截止点将200例RA患者分类,记录各活动期患者例数,用Kappa值描述CDAI与SDAI的内部一致性,并用Kappa值分别描述CDAI、SDAI与DAS28的内部一致性.以DAS28为参照标准,用ROC曲线描述CDAI和SDAI划分RA的缓解/低度和中/重度的区分效能.结果 200例RA患者的CDAI (17.2±11.1)、SDAI (19.1±11.6)与DAS28(4.3±1.5)均呈正相关(r=0.876,0.861,P＜0.05).二者及DAS28与HAQ(0.6±0.7)亦均呈正相关(r=0.522,0.523,0.482,P＜0.05).比较CDAI与SDAI,二者Kappa值为0.777,进一步比较CDAI、SDAI与DAS28的Kappa值分别为0.482,0.394.以DAS28作为参照标准,CDAI、SDAI的ROC曲线下面积分别为0.906、0.888.结论 CDAI、SDAI同目前国际公认的DAS28一样,亦可以很好地评估RA疾病活动性,且二者与HAQ的相关性高于DAS28.相比于SDAI,CDAI缺少炎性指标,但二者一致性极好,且CDAI与DAS28的内部一致性优于SDAI与DAS28.此外,CDAI划分RA的缓解/低度和中/重度的效能稍高于SDAI.CDAI更简便、快捷、准确,适用于RA的日常评估.     

Is colonic electrical activity a similar phenomena to small-bowel electrical activity?

PURPOSE: This study was designed to investigate colonic spike bursts regarding 1) their migration behavior, 2) their pressure correlates, and 3) comparing colonic short spike bursts with spike bursts from migrating myoelectric complex from the small bowel. METHODS: Rectosigmoid electromyography and manometry were recorded simultaneously in seven normal volunteers and electromyography alone in five others during two hours of fasting and for two hours after one 2,100-kJ meal. One patient with an ileostomy was also studied by the same method to record the migrating myoelectric complex from the terminal ileum during fasting. RESULTS: Three kinds of spike bursts were observed in the pelvic colon: rhythmic short spike bursts, migrating long spike bursts, and nonmigrating long spike bursts. The meal significantly increased the number of migrating and nonmigrating long spike bursts (from 25 to 38.7 percent of the recording time; P <0.01). These bursts of potentials showed a peak 15 minutes after the meal, which may be caused by the gastrocolic reflex. Migrating long spike bursts started anywhere along the rectosigmoid and migrated from there aborad 82 percent of the time and orad or in both directions in 10 or 7 percent of the time, respectively. They originated pressure waves 99 percent of the time. Short spike bursts were more frequent before the meal (15.1 percent before and 9.6 percent after the meal), but the difference was not significant; they neither propagated nor initiated pressure waves detected by the miniballoon. CONCLUSIONS: Migrating long spike bursts were the only potentials that migrated, sometimes for short distances. Short spike bursts are a different phenomenon from the small-bowel migrating myoelectric complex because they do not migrate; they can occur during the postprandial period and never originated intraluminal pressure waves.Supported by a grant from the Instituto Nacional de Investigação Científica, Proc. DBI-22086.Presented at the meeting of the Portuguese Congress of Gastrenterology, Vila Moura, Portugal, June 2 to 5, 1993.     

Using step activity monitoring to characterize ambulatory activity in community-dwelling older adults

OBJECTIVES: To explore the potential of using step activity monitoring to detect differences in ambulatory activity associated with advancing age and declining function in community-dwelling seniors. DESIGN: Cross-sectional pilot study. SETTING: General communities of Seattle, Washington; Catonsville, Maryland; and Durham, North Carolina. PARTICIPANTS: Thirty healthy younger adults, 28 healthy older adults, and 12 older adults reporting functional limitations. MEASUREMENTS: Ambulatory activity data were collected over 6 days with the StepWatch 3. Average daily values were calculated for number of steps, number of minutes of activity, number of activity bouts, variability of minute-to-minute activity, and randomness of minute-to-minute activity fluctuations. RESULTS: Healthy older adults engaged in fewer bouts of activity (P=.03) and displayed less-variable activity (P=.02) than younger adults. Older adults reporting functional limitations not only engaged in fewer bouts of activity (P=.009) and less variable activity (P<.001) than younger adults, but also accumulated fewer total steps (P=.003) and minutes of activity (P=.008) and had less-random minute-to-minute activity fluctuations (P=.02). CONCLUSION: Step activity monitoring data were useful for detecting differences in ambulatory activity according to age and functional limitation. Monitor-based measures reflecting patterns of ambulatory activity show promise for use in studies of physical functioning.     

Coagulation-associated enhancement of fibrinolytic activity via a neutralization of PAI-1 activity

Total fibrinolytic activity in the vasculature is finely tuned by the balance between tissue plasminogen activator and plasminogen activator inhibitor type 1 (PAI-1). Although PAI-1 targets plasminogen activators, it also reacts with other serine proteases such as thrombin and factor Xa. The latter was shown to interact with PAI-1 only when a physiological concentration of calcium ions (Ca++) is present. Through such interaction, thrombin and Ca++-bound factor Xa shortened fibrin clot lysis times in a purified system by neutralizing PAI-1 activity. Both unfractionated heparin and vitronectin were shown to enhance the clot lysis further. Together with the cleavage and inactivation of PAI-1 by human neutrophil elastase, which was reported previously from our laboratory, such neutralization of PAI-1 activity by these serine proteases was shown to be strongly involved in the coagulation-associated enhancement of fibrinolytic activity.