CLINICAL EVALUATION OF PERORAL CHOLANGIOSCOPY FOR BILIARY DISEASE USING NARROW BAND IMAGING

Regarding peroral cholangioscopy (POCS) for biliary disease, due to the recent appearance of a video cholangioscope that can obtain high‐quality images, it is possible to observe subtle changes of the biliary mucosa. In addition to the conventional observation method using POCS, the biliary mucosa with also observed with narrow band imaging (NBI) in one case of chronic cholangitis and four cases of extra hepatic bile duct tumor (three surgical cases). In the conventional observation method, the vessels in the surface layer of the biliary mucosa could be observed more clearly using NBI. In one case in which a tumor was observed, the irregularity of the biliary mucosa became clear on NBI, and the vessels inside a papillary tumor could also be easily observed. In another case of bile duct tumor, the conventional observation method showed a region in the proximity of the tumor where the vessels could not be seen clearly, but they could be seen clearly on NBI. In all of the cases, the bile juice was seen as red on NBI, which disturbed the observation. With POCS using NBI, it was possible to observe the vessels and irregularities in the surface layer of the biliary mucosa more clearly than with conventional observation methods.     

Effect of Inflammation on Costimulation Blockade-Resistant Allograft Rejection

Previously, we reported that allogeneic skin grafts were rapidly rejected by CD28 and CD40 ligand double deficient mice mediated by CD8⁺ T cells. These results indicated that some elements in addition to CD28- and CD40-mediated costimulation provide stimulatory signals for the activation of donor-specific CD8⁺ T cells. In this report, we investigated the role of inflammation associated with transplantation on costimulation-independent priming of CD8⁺ T cell during graft rejection. B6 RAG1 KO mice were transplanted with BALB/c-skin and adoptively transferred with syngeneic CD8⁺ T cells the same day or 50 days after transplantation. When blockade of CD28- and CD40-mediated costimulation failed to prevent acute rejection of freshly transplanted skin grafts, it efficiently delayed rejection of well-healed skin grafts. These results showed that factors associated with transplantation have essential roles in inducing costimulation blockade-resistant allograft rejection. Costimulation blockade failed to prevent acute graft-infiltration of NK cells and increasing expression of intragraft IL-12 and IL-15. These factors may trigger the graft-infiltration and priming of CD8⁺ T cells to induce costimulation blockade-resistant allograft rejection.     

Enhancement of bradykinin-induced prostacyclin synthesis in porcine aortic endothelial cells by pertussis toxin Possible implication of lipocortin I

Bradykinin-stimulated prostacyclin synthesis in porcine aortic endothelial cells was enhanced by pretreatment of the cells with pertussis toxin or islet-activating protein (IAP) for 5 hr or longer. Although ADP-ribosylation of a protein with a molecular weight of 41–42 kD in the cell membranes was completed by 3 hr after the addition of IAP into the incubation medium, there was good correlation between enhancement of bradykinin-induced prostacyclin synthesis and ADP-ribosylation of the IAP substrate over a wide range of IAP concentrations. Furthermore, even if IAP was removed from the incubation medium at 3 hr, bradykinin-induced prostaglandin synthesis at 24 hr was still potentiated. Cycloheximide and actinomycin D enhanced bradykinin-induced prostacyclin synthesis and apparently blocked the effect of IAP. Since this result suggested the involvement of an inhibitor protein(s) of prostacyclin synthesis in the IAP effect, we studied the effect of IAP on the level of lipocortin I which is known to inhibit phospholipase A₂. Western and Northern blot analyses revealed that IAP decreased the amounts of protein and mRNA of lipocortin I. These results suggest that the enhancement of bradykinin-induced prostacyclin synthesis by IAP is associated with a decrease in the level of lipocortin I.     

Observation on the distribution of ganglia in the ganglionated plexus of guinea-pig gallbladder

In order to investigate how the ganglia in ganglionated plexus were distributed throughout the overall region of the gallbladder, the gallbladder was dissected from guinea-pig and washed with Krebs solution via the cystic duct. This gallbladder was distended with 2 ml of the mixed solution of OsO4 and ZnI2 injected with a syringe via the cystic duct and the cystic duct was immediately tied with a thread. The gallbladder was placed in excess of the mixed solution for 7-10 hours. The gallbladder was longitudinally divided into two approximately equal parts and each was prepared for microscopic investigation. The one preparation was the ventral side of the gallbladder and the other preparation was its dorsal side. These preparations were viewed through a photomicroscope. The obtained results were as follows: 1. Ganglia which involved several nerve cells were observed. Ganglia and nerve bundles connecting the fellow ganglia formed an irregular network, that is, the so-called ganglionated plexus. These nerve bundles were connected with the perivascular nerves which ran parallel to and around blood vessels in several places of the wall of the gallbladder. 2. Ganglia were full of variety in size and shape. That is to say, the shape of ganglia is arranged in various patterns such as oval, spherical, triangular, square and so on. When the size of ganglia were shown by surface area of ganglia which were viewed within the sweep of photomicroscope, the size of ganglia were divided into three large groups, the small ganglia in the range of 1,400 microns2-3,500 microns 2, the large ganglia in the range of 3,500 microns2-10,000 microns2 and the extra-large ganglia in the range of 10,000 microns2-38,000 microns2. Per one gallbladder, 240 +/- 41 (n = 3) small ganglia, 263 +/- 28 (n = 3) large ganglia and 8 +/- 1 (n = 3) extra-large ganglia were found. And these ganglia were irregularly scattered all over the wall of gallbladder. Small ganglia were found more numerous than large ganglia in the cervical portion of the gallbladder. On the other hand, small ones were slightly fewer than large ganglia in the remainder portion of the gallbladder. 3. The ganglionated plexus contained 511 +/- 69 (n = 3) ganglia.(ABSTRACT TRUNCATED AT 400 WORDS)