胰岛素样生长因子-Ⅰ对重症急性胰腺炎大鼠小肠黏膜上皮细胞bax和bcl-2 mRNA表达的影响

目的:研究外源性胰岛素样生长因子-Ⅰ(insulin-like growth factor-Ⅰ,IGF-Ⅰ)对重症急性胰腺炎(severe acute pancreatitis,SAP)大鼠小肠黏膜上皮细胞凋亡及凋亡相关基因bax、bcl-2 mRNA表达的影响,探讨其对肠道屏障保护作用的机制.方法:72只♂Wistar大鼠按照随机数字表法分为假手术组(SO组,n=24)、重症急性胰腺炎组(SAP组,n=24)、IGF-Ⅰ治疗组(IGF-Ⅰ组,n=24).各组动物分别于术后6、12、24 h各处死8只,检测血浆淀粉酶,观察小肠组织病理学变化,TUNEL法检测小肠黏膜上皮细胞凋亡,RT-PCR检测小肠上皮细胞中bax和bcl-2mRNA的表达.结果:与SAP组各时相点相比,IGF-Ⅰ治疗组大鼠小肠黏膜上皮细胞凋亡指数显著降低(6h:13.88±1.73 vs 19.00±2.78;12 h:10.13±1.55 vs 17.63±1.60;24 h:9.50±1.07 vs 17.25±2.76;均P<0.05),小肠组织病理变化明显改善:小肠组织中bax mRNA的表达在IGF-Ⅰ组的各时相点较SAP组明显减弱(6 h:1.10±0.02vs 1.19±0.04;12 h:0.97±0.04 vs 1.16±0.02;24 h:0.87±0.03 vs 1.14±0.03,均P<0.05);bcl-2 mRNA的表达在IGF-Ⅰ组各时相点与SAP组相比明显增强(6 h:0.65±0.02 vs 0.57±0.02;12 h:0.69±0.04 vs 0.57±0.01;24 h:0.72±0.02 vs 0.58±0.01,均P<0.05).结论:外源性IGF-Ⅰ可以减轻SAP时肠黏膜的损伤.     

丹红注射液对重症急性胰腺炎大鼠胰腺组织ET-1、eNOS和iNOS基因表达的影响

目的:探讨重症急性胰腺炎(SAP)大鼠胰腺组织中内皮素-1(ET-1)、内皮型-氧化氮合酶(eNOS))及诱生型-氧化氮合酶(iNOS)基因的表达与胰腺组织损伤的关系以及中药丹红注射液对其基因表达的影响.方法:96只SD雄性大鼠分为对照组(A组)、SAP模型组(B组)及丹红治疗组(C组);用RT.PCR分别检测不同时间点各组大鼠胰腺组织中ET-1、eNos及iNos基因的表达:分别用放射免疫法、硝酸还原酶法测不同时间点各组大鼠测血液中ET-1、NO浓度:观察各组不同时间点的胰腺组织病理变化,并对胰腺组织损伤进行评分.结果:与B组比较,C组可明显降低胰腺组织各时间点ET-1、iNOS基因的表达(ET-1:4 h:0.31±0.15 vs 0.58±0.17.8 h:0.45±0.16 vs 0.72±0.31,12 h:0.73±0.19 vs 1.19±O.28.24h:0.64±0.26 vs 0.92±0.36:iNOS:4 h:0.32±0.10 vs 0.65±0.11,8h:0.36±0.14 vs 0.73±0.08,12 h:0.43±0.07 vs 0.87±0.15,24 h:0.32±0.06 vs 0.82±0.16,均p<0.05),上调eNOS基因的表达(4 h:0.55±0.12 vs 0.25±0.11,8 h:0.53±0.10 vs 0.27±0.12.12 h:0.60±0.12 vs 0.24±0.10.24 h:0.56±0.13 vs 0.28±0.16,均P<0.05).且可明显降低C组大鼠12、24 h时间点胰腺病理评分(12 h:4.73±1.29 vs 7.19±1.28,24 h:5.64±1.26 vs 8.92±2.16,均P<0.051.结论:丹红注射液可下调重症急性胰腺炎大鼠胰腺组织中ET-1与iNOs基因的表达,上调eNOs基因的表达,改善胰腺组织病理损伤.     

塞来昔布对大鼠重症急性胰腺炎的治疗作用

目的:探讨塞来昔布对大鼠重症急性胰腺炎(severe acute pancreatitis,SAP)治疗效果及机制.方法:SD大鼠共135只,其中75只随机平均分为SAP组,低剂量及高剂量塞来昔布组,观察其生存率;60只SD大鼠随机平均分为对照组(假手术组),SAP组,低剂量及高剂量塞来昔布组.胆胰管内注射牛磺胆酸钠溶液造模,ELISA法检测大鼠血清TNF-α、IL-1β及IL-6的表达;RT-PCR检测胰腺组织COX-2 mRNA的表达;HE染色、胰腺组织半定量积分评价胰腺病理学改变.结果:塞来昔布可降低大鼠SAP的病理损害积分,高剂量组在造模后的24 h可显著减低组织水肿(2.28±0.30 vs 2.73±0.22,P<0.05);在12和24 h均可显著降低腺泡坏死(2.03±0.15vs 2.48±0.24,2.09±0.10 vs 2.65±0.25,均p<0.05)及炎性细胞浸润(1.80±0.22 vs 2.51±0.17,1.57±0.26 vs 2.20±0.22,均p<0.05).造模后COX-2 mRNA表达及TNF-α、IL-1β及IL-6产生增加.塞来昔布治疗组上述检测指标明显低于SAP组(均P<0.05),且随塞来昔布剂量的增加其抑制作用逐渐增强.塞来昔布高剂量治疗组可显著提高大鼠SAP的生存率(16%vs 52%,P<0.05).结论:塞来昔布可能通过抑制TNF-α、IL-1β及IL-6的表达,改善胰腺局部病理改变及预后.     

罗格列酮对大鼠重症急性胰腺炎的干预作用

目的:观察过氧化物酶体增殖物活化受体γ(PPARγ)激动剂罗格列酮(ROSI)预处理后重症急性胰腺类(SAP)大鼠胰腺组织中PPARγ与诱导型一氧化氮合酶(iNOS)的表达,探讨ROSI对大鼠SAP的干预作用.方法:将72只6 SD大鼠随机分为假手术(SO)组、SAP组及ROSI组.每组24只.逆行胰胆管注射5%牛磺胆酸钠(1 mL/kg)制备SAP模型.ROSI组在制模前1 h腹腔注射1%罗格列酮(1mL/kg),然后制备SAP模型.术后3、6、12 h经腹主动脉取血处死大鼠(每个时间点8只),胰腺组织病理切片HE染色后评分,留取胰腺组织检测髓过氧化物酶(MPO)、iNOS、NO含量,逆转录聚合酶链反应(RT-PCR)检测胰腺组织中PPARγ和iNOS mRNA的表达水平.结果:与SAP组比较,ROSI组12 h点胰腺组织中MPO活性下降(2.09±0.36 U/g vs 2.67±0.58U/g,P<0.01),胰腺病理学评分改善(10.50±1.67 vs 12.50±1.77,P<0.05);ROSI组6、12 h点iNOS、NO活性低于同时间点SAP组(6 h点:4.39±1.20 U/mgprot vs 6.44±1.73 U/mgprot;22.58±5.49 μmol/gprot vs 36.90±7.28μmol/gprot;12 h点:9.87±2.69 U/mgprot vs 15.68±1.74 U/mgprot;17.06±5.40μmol/gprot vs24.47±4.98 gmol/gprot,均P<0.0 1);ROSI组胰腺组织中PPARV mRNA表达在3 h点明显增加,6 h点达最高峰,单次剂量(10 mg/kg)至12 h点仍持续表达,其表达水平分别为0.229±0.091,0.394±0.081,0.364±0.064.与SAP组比较.而6 h点与12 h点iNOS mRNA表达较同时段sAP组均有下降,差异有统计学意义(0.197±0.049 vs 0.269±0.068;0.266±0.067 vs 0.415±0.076,P<0.05或<0.01).结论:罗格列酮通过活化PPARγ途径,抑制胰腺组织中iNOS mRNA表达,减少iNOS和NO生成,减轻中性粒细胞浸润,从而减轻SAP时胰腺病理损害.     

核因子-κB在急性胰腺炎中的激活及NBD多肽的干预作用

目的:探讨核因子-κB(nuclear factor-kappaB.NF-KB),及活性氧簇(reactive oxygen species,ROS)在大鼠SAP发病过程中的作用:并观察NF-κB必需调节蛋白结合域(NF-κB essential modifier binding domain,NBD)多肽对大鼠SAP的干预作用.方法:逆行胰胆管内注射50 g/L牛磺胆酸钠(1mL/kg)制备大鼠SAP模型.大鼠64R,随机分成4组:假手术组,SAP组,TAT-NBD(WT)多肽组和TAT-NBD(MT)多肽组.术后6,12 h处死大鼠,观察胰腺组织病理、血清淀粉酶和胰腺组织NF-κB P65蛋白的变化.检测胰腺组织MDA含量及T-SOD活力.结果:与假手术组比较,SAP模型组6,12 h大鼠NF-κB P65蛋白表达显著升高(49.3±2.2vs 4.3±1.4,65.8±1.8 vs 5.0±1.3,均P<0.05);MDA生成增加(212.7±12.5 vs 87.7±7.5,296.8±13.3 vs 96.2±8.3,均P<0.05),T-SOD活力下降(88±10 vs 183±10,65±7 vs 194±10,均P<0.05);与SAP模型组比较,TAT-NBD(WT)多肽预处理6,12 h后,NF-κB P65蛋白表达(25.9±2.3,38.9±2.6)显著降低(P<0.05),MDA生成(102.5±10.4,164.5±12.2)降低(P<0.05);T-SOD活力(153±11,168±12)增加(P<0.05),胰腺病理学评分下降(5.04±0.41 vs 8.71±0.45,5.45±0.34 vs 10.31±1.23,均P<0.05),淀粉酶无明显变化.TAT-NBD(MT)多肽组上述指标均无明显变化.结论:SAP时大鼠胰腺组织的NF-κB过度激活,活性氧簇生成增加;NBD多肽预处理可以抑制NF-κB过度活化,减少活性氧簇生成,减轻胰腺局部炎症损伤.     

丹红对大鼠重症急性胰腺炎相关性心肌损害的防治作用

目的: 研究重症急性胰腺炎(SAP)时大鼠心肌损害和心肌组织凋亡基因表达的变化及意义,探讨中药制剂丹红注射液对SAP相关性心肌损害的防治作用.方法: SD大鼠72只随机分为正常对照组(A组,n = 24)、SAP模型对照组(B组, n = 24)和丹红治疗组(C组, n = 24). 采用腹腔注射L-Arg的方法制造SAP模型. 检测血清CTnI、CK-MB含量, 光镜、电镜下观察心肌组织的病理变化,免疫组化法检测术后6、12、18 h各时点心肌bcl-2、bax基因的表达产物.结果: 与A组相比, B组血清CTnI、CK-MB明显升高[CTnI(μg/L): 6 h: 2.18±0.07 vs 0.19±0.02, 12 h: 3.32±0.31 vs 0.21±0.05, 18 h:3.81±0.48 vs 0.20±0.08, 均P<0.05; CK-MB(U/L): 6 h: 3028.8±542.2 vs 178.0±42.2, 12 h:3511.7±1172.2 vs 176.4±39.8, 18 h:4921.2±1822.3 vs 185.2±41.6, 均P<0.05]. 与B组相比, C组血清CTnI、CK-MB也明显降低(均P<0.05). 与A组相比, B组bax表达(PU)产物明显升高(6 h: 4.58±1.07 vs 1.10±0.08, 12 h:8.02±0.31 vs 1.15±0.09, 18 h: 8.81±0.68 vs1.20±0.06, 均P<0.05); bcl-2/ bax比值明显降低(6 h: 0.55±0.11 vs 1.17±0.07, 12 h: 0.33±0.08vs 1.23±0.13, 18 h: 0.43±0.15 vs 0.98±0.19,均P<0.05). 与B组相比, C组bax表达产物明显降低; bcl-2表达产物明显升高(6 h: 3.15±0.92vs 1.25±0.16, 12 h: 4.93±0.52 vs 1.87±0.20,18 h: 4.63±0.82 vs 3.41±0.83, 均P<0.05);bcl-2/ bax比值明显升高(均P<0.05). 光镜、镜下可见SAP大鼠的心肌组织存在明显的变性、坏死等病理变化, C组心肌组织病理损伤明显减轻.结论: SAP可诱发心肌损害, 与心肌组织bcl-2基因表达降低、bax基因表达上调有关. 丹红注射液对SAP合并心脏损害的具有保护作用,其作用机制与下调bax基因在心肌组织中的表达, 上调心肌组织bcl-2基因的表达有关.     

西维来司钠对大鼠重症急性胰腺炎炎症反应的治疗作用

目的:检测重症急性胰腺炎(severe acute pancreatitis,SAP)大鼠血清中中性粒细胞弹性蛋白酶(neutrophil elastase,NE)、白介素-6(interfilon-6,IL-6)的含量及胰腺病理学改变,探讨西维来司钠对大鼠SAP的治疗作用.方法:采用经十二指肠乳头逆行胆胰管注射5%牛磺胆酸钠的方法制备大鼠SAP模型;药物治疗组静脉输入西维来司钠,切取胰腺组织行病理学评分,测定血清中NE、IL-6及淀粉酶的含量.结果:牛黄胆酸钠胰胆管注射可以制作典型的急性胰腺炎模型,其血清淀粉酶升高、胰腺病理损伤符合急性胰腺炎表现.西维来司钠治疗组血清淀粉酶值及NE、IL-6含量较模型组降低,有显著性差异(3h:5636.22±713.57 vs 5835.75±681.52,16.99±3.28 vs 22.93±4.74,181.86±36.56 vs 281.82±30.79;6h:5743.44±624.93 vs 6253.66±533.99,23.63±4.47 vs 31.81±4.69,184.15±28.56 vs 319.39±21.73;12h:7098.93±698....     

金黄益胆颗粒对重症急性胰腺炎大鼠胰腺组织中ICAM-1、TGF-β1表达的影响

目的:探讨金黄益胆颗粒对重症急性胰腺炎(SAP)大鼠胰腺组织中细胞间黏附分子1(ICAM-1)、转化生长因子β1(TGF-β1)表达的影响.方法:清洁级SD♂大鼠54只,随机分为对照组、模型组、治疗组,每组18只,各组又分为2h组、6h组及12h组3个时间段组,每个时间段组6只大鼠.5%牛磺胆酸钠逆行注射建立SAP大鼠动物模型.行胰腺组织镜下病理评分,免疫组织化学SP两步法检测胰腺组织中ICAM-1、TGF-β1蛋白的表达.结果:Schmidt胰腺组织镜下评分显示,与模型组比较,造模后6h、12h,治疗组大鼠胰腺组织的病理损害程度明显减轻(10.33±0.82vs14.00±0.63,P=0.000;9.67±0.82vs15.33±0.52,P=0.000).治疗组12h后ICAM-1阳性细胞表达明显减少(3.67±0.76vs6.40±0.72,P=0.000).治疗组6h和12h后TGF-β1表达明显增强(3.77±0.78vs0.60±1.00;5.17±1.42vs2.23±1.01,均P=0.000).结论:金黄益胆颗粒能够降低ICAM-1的表达,升高TGF-β1的表达,显著改善早期SAP大鼠胰腺...     

依达拉奉对大鼠重症急性胰腺炎的保护作用

目的:探讨依达拉奉对L-精氨酸诱导的重症急性胰腺炎(SAP)大鼠的治疗作用及机制.方法:将60只大鼠随机分为三组( n = 20). 采用大鼠腹腔内分次注射大剂量L-精氨酸(2.5g/k g×2, 间隔1 h)的方法制备SAP大鼠模型, 治疗组大鼠腹腔内注射依达拉奉注射液3 mg/kg, bid×3 d. 72 h后比较三组大鼠胰腺组织病理变化、腹水性状及量、血清淀粉酶(AMY)、TNF-α、IL-6水平和胰腺组织丙二醛(MDA)、超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)含量及预后.结果:72 h后, 与对照组相比, SAP组出现典型的SAP病理形态改变, 腹水量较多(5.16±1.52vs 0.50±0.10, P<0.01), 且大鼠血清AMY、TNF-α、I L-6及胰腺组织M DA均显著升高(8967.5±298.4 vs 720.1±119.7; 103.98±10.56 vs 41.59±3.79; 548.57±10.45 vs 198.34±2.10; 35.6±3.8 vs 7.9±2.2, 均P<0.01), 胰腺组织抗氧化物质GSH、SOD明显降低(7.2±0.6 vs 17.1±2.1; 7300±1800 vs 28400±2700,均P<0.01); 与SAP组相比, 治疗组胰腺组织病理损害减轻, 腹水量减少(4.05±1.22 vs 5.16±1.52, P<0.05), 且组织病理评分较低( P<0.05),血清AMY、TNF-α、IL-6及胰腺组织MDA明显降低(7809.5±158.3 vs 8967.5±298.4; 79.80±14.23 vs 103.98±10.56; 467±6.64 vs 548.57±10.45; 29.1±2.6 vs 35.6±3.8, 均P<0.05), 胰腺组织GSH、SOD升高(8.7±1.3 vs 7.2±0.6;114 000±27 000 vs 7300±1800, 均P<0.05).结论:依达拉奉能清除氧自由基、提高胰腺组织抗氧化物质SOD和GSH含量, 降低促炎细胞因子水平, 可减轻胰腺组织的病理损害,并且有可能降低死亡率.     

高迁移率族蛋白B1在重症急性胰腺炎肠屏障损害中的作用

目的:探讨高迁移率族蛋白B1在重症急性胰腺炎(SAP)肠屏障损害中的作用及其机制.方法:采用逆行胆胰管注射50 g/L牛磺胆酸钠制备SAP大鼠模型.将56只Wistar大鼠随机分为正常对照组(Control组),SAP 3h,6h,12h,24h,48h 5个亚组,二硫代氨基甲酸吡咯烷处理组(PDTC组),每组8只.PDTC组于建模后24h取材.测定血浆内毒素(LPs)、二胺氧化酶(DAO)水平,用逆转录-聚合酶链反应(RT-PCR)方法检测肠组织高迁移率族蛋白B1(HMGB1)mRNA表达,用Western blot法检测肠组织HMGB1水平.结果:与对照组比较,SAP 6h组大鼠肠组织HMGB 1 mRNA表达显著增高(0.41±0.06 vs 0.26±0.03,P<0.01),12h呈现进一步升高趋势,24h达峰值(0.62±0.06),并持续至48h.PDTC干预可显著降低肠组织HMGB1 mRNA表达(0.35±0.06 vs 0.62±0.06,P<0.01).PDTC组较SAP 24h组肠组织HMGB1 mRNA表达,血浆LPS和DAO显著下降(HMGB1 mRNA表达:0.35±0.06 vs 0.62±0.06,P<0.01;LPS:0.433±0.120 KEU/L vs 0.852±0.232 KEU/L,P<0.01;DAO:0.65±0.12 kU/L vs 1.36±0.22 kU/L,P<0.01).结论:SAP时,肠组织内HMGB1表达上调;PDTC可以明显抑制SAP时肠组织内HMGB1表达.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.