Tripterygium glycosides suppress production of interleukin‐4 by splenocytes in oxazolone‐induced murine colitis

OBJECTIVE: To investigate the in vitro effect of Tripterygium glycosides (TG) on cytokine production by splenocytes in oxazolone (OXZ)‐induced colitis in mice. METHODS: Oxazolone (6 mg in 50% ethanol) was administered to male SJL/J mice intrarectally to induce colitis and the mice were killed 3 days later. Isolated splenocytes were cultured for 24 h in the presence of phorbol myristate acetate and ionomycin. A preparation of Tripterygium glycosides at a concentration of either 0.1 mg/mL or 0.01 mg/mL was added to the culture medium of splenocytes. Production of interferon gamma (IFN‐γ) and interleukin‐4 (IL‐4) in the supernatant were measured by ELISA. RESULTS: Production of IFN‐γ in the normal control group was suppressed by TG at both concentrations (0.01 and 0.1 mg/mL; 1.24 ± 0.13 pg/mL (samples without TG) → 0.97 ± 0.26 pg/mL (0.01 mg/mL TG) → 0.87 ± 0.18 pg/mL (0.1 mg/mL TG); P < 0.02) in a dose dependent manner. In the OXZ‐induced colitis group, the basic level of IFN‐γ was significantly lower than that of the normal control group (1.24 ± 0.13 pg/mL vs 0.65 ± 0.08 pg/mL; P < 0.01); but IL‐4 production was significantly increased in the OXZ‐induced colitis without TG group (7.83 ± 0.69 pg/mL vs 5.65 ± 0.48 pg/mL, P < 0.01). In both groups, TG suppressed IL‐4 production in a dose‐dependent manner (normal control group: 5.65 ± 0.48 pg/mL (samples without TG) → 4.97 ± 0.38 pg/mL (0.01 mg/mL TG) → 3.98 ± 0.32 pg/mL (0.1 mg/mL TG), P < 0.01; OXZ group: 7.83 ± 0.69 pg/mL (samples without TG) → 7.07 ± 0.47 pg/mL (0.01 mg/mL TG) → 6.35 ± 0.48 pg/mL (0.1 mg/mL TG), P < 0.01). CONCLUSION: Oxazalone‐induced IL‐4 overproduction by splenocytes was significantly suppressed by TG in a dose dependent manner and the beneficial effects of TG on ulcerative colitis might be related to the suppression of the Th2 type (e.g. IL‐4) mediated immunological response of splenocytes.     

Crohn's Disease Initially Suggested by Minute Esophageal Erosions—Report of a Case

A 19–year-old woman visited our hospital complaining of fever and epigastral-gia. Upper gastrointestinal endoscopy showed minute discrete erosions surrounded by elevated mucosa about one millimeter in diameter in the esophagus and aphthoid erosions in the stomach. Biopsy samples obtained from the esophagus showed non-caseating epitheloid granulomas, suggesting Crohn's disease. Colonoscopy showed a small erosion in the cecum adjacent to the vermiform appendix and biopsy showed non-caseating epitheloid granulomas and Crohn's disease was diagnosed. In hospital, she was treated with elemental diet and 5–aminosalicyclic acid. Clinical symptoms disappeared rapidly and laboratory data became normal. We thus report a rare case of early-stage Crohn's disease initially indicated by biopsy of minute esophageal erosions. (Dig Endosc 1999; 11: 255–258)     

Pulmonary dysanapsis, methacholine airway responsiveness and sensitization to airborne antigen

Abstract Whether the disproportional growth of airways relative to lung parenchyma (dysanapsis) has any relationship to the development of non-specific bronchial hyperresponsiveness and atopy was investigated in 45 family members of the patients with atopic asthma. As indices of pulmonary dysanapsis, forced expiratory flow_25-75/forced vital capacity (FEF_25-75/FVC) and the tracheal cross sectional area divided by the forced expiratory volume (X-SA/FVC) were examined. As an index of non-specific airway responsiveness, the cumulative dose of inhaled methacholine needed to induce 35% reduction of respiratory conductance (PD₃₅) was determined by continuous respiratory resistance measurement. For examination of atopy, skin prick tests were conducted, and total serum IgE and IgE specific to common inhaled antigens were measured. FEF_25-75/FVC showed no significant correlation to FVC but showed a significant correlation to log (PD₃₅). When the analysis was done in the subjects whose FEVI/FVC was more than 0.8, FEF_25-75/FVC showed a significant negative correlation to FVC but lost its correlation to log(PD35). X-SA/FVC showed a significant negative correlation to FVC but had no significant correlation to log(PD₃₅). These relations were conserved when the analysis was done in subjects without airway obstruction. In addition, FEV₁/FVC had a significant correlation to log(PD₃₅) and FEF_25-75/FVC. However, subjects who had a positive IgE(MAST) had a significantly smaller X-SA/FVC than those with a negative IgE(MAST) (0.60 ± 0.14[SD] and 0.72 ± 0.18, respectively, P<0.02). These results suggest that although pulmonary dysanapsis does not have a significant relation to airway responsiveness to inhaled methacholine, it may be associated with sensitization to airborne antigens.     

Genetic factors in lung disease Part II: Lung cancer and angiotensin converting enzyme gene

The recent progress in molecular biology has led to the elucidation of pathogenesis of lung cancer. The development of a lung cancer requires multiple genetic changes, consisting of the activation of oncogenes, including the K-ras and myc genes, and of inactivation of tumour suppressor genes, including the Rb, p53 and CDKN2 genes. Knowing the specific genes undergoing such changes should be useful as biomarkers for the early detection of cells destined to become malignant. Moreover, such genetic changes could be targets of newly designed drugs and gene-based therapy. Although the angiotensin I-converting enzyme was originally discovered in equine plasma, it has been recognized in various organs and cells other than vascular endothelial cells. This enzyme is also known to have wide substrate specificity to many peptides. The definite roles of angiotensin converting enzyme (ACE) in the respiratory system are largely unknown. Recent progress in molecular biology of the ACE, however, gives us a good chance to look over the significance of ACE in respiratory diseases as well as cardiovascular disorders. In this review, we show the recent advances in the basic studies of the ACE and refer to its clinical application.     

Difficulty in estimating localized bowel contraction by colonic manometry: a simultaneous recording of intraluminal pressure and luminal calibre

To examine whether or not intraluminal pressure changes at a site in the human colon reflect with fidelity the local bowel wall contractions or relaxation, endoscopic recording of the changes in colonic calibre as a parameter of the motor events with simultaneous manometry was performed at a fixed site in a prepared sigmoid colon during the interdigestive state. In four of the 12 subjects, a total of 20 phasic pressure waves with an amplitude of 13–22 mmHg and a duration of 13–18 sec were obtained in a 20 min recording session. Eighteen of the 20 phasic pressure waves (90%) were associated not with a decrease (contraction) but with an increase in the calibre (relaxation). The pressure change began 0.2–8.4 sec (mean: 4.5 sec) behind and ended ? 1.8 to 8 sec (mean: 3.5 sec) ahead of the calibre change. In the other eight subjects, no phasic pressure change was recorded in the presence of an overt calibre change. We conclude that manometric phasic pressure change recorded at a site in the empty human colon is not necessarily correlated with the localized contractile activity. Extrapolation of pressure profiles in the colon to motor events at the manometric site should be cautious.     

Histoclinical Long-standing Follow-up Study of Hyperplastic Polyps of the Stomach

In a series of 2,013 gastric polyps in 1,201 patients, morphological and histopathological studies have been performed. Ninety-three hyperplastic polyps in 56 patients have been followed-up endoscopically and histopathologically for five to 12 years. The incidence of detection of gastric polyps has increased: 1.4% in 1967 to 8.7% in 1979 year by year. Thirty patients (54%) among the 56 showed changes in number, size or shape of polyps during follow-up. Twenty patients (37%) revealed numerical changes (increase in 16 patients, reversion in three patients and vanishing in two patients).
Twenty-eight polyps (30%) showed morphological changes, six of them showed continuous enlargement, 18 lesions repeated enlargement, stationary or reduction stages, three lesions were reversed and two polyps disappeared.
Histopathologically, three lesions showed transformation from the hyperplastic type to adenoma while demonstrating morphological enlargement. Two of these showed increase in cellular atypia, from the hyperplastic type through adenoma with severe atypia and finally to carcinoma in the polypectomy specimens. From this study, it was concluded that although hyperplastic polyps show changes in size, shape or number with passage of time, malignant changes occur in only a few cases.     

Spontaneous rupture of adrenal pheochromocytoma with capsular invasion

A 67-year-old Japanese man developed a sudden onset of severe right-side upper abdominal pain, nausea and vomiting. On hospitalization, physical examination revealed sweating, tachycardia, hypertension and the appearance of peripheral vasoconstriction. An urgent computed tomography scan with contrast demonstrated a large hematoma in the right retroperitoneal space. A phentolamine test and an 131iodine metaiodobenzylguanidine scan suggested pheochromocytoma. An elective right adrenalectomy was successfully performed after pretreatment for sufficient volume replacement with continuous administration of alpha- and beta-adrenergic blocking agents. Pathological diagnosis was an adrenal pheochromocytoma 9.0 x 6.5 cm in diameter with evidence of capsular invasion, which could be associated with a tear in the capsule.     

Occlusal force pattern during rhythmic human tapping movement

The dynamic occlusal force patterns associated with the performance of rhythmic tapping movement were analysed in normal subjects, who were instructed to make tapping movements at four frequencies, 2, 2.5, 3.3 and 5 Hz, with as constant a magnitude of force as possible. The occlusal force recorded by an intra-oral customized device showed a triphasic pattern which could be divided into two components, and this pattern was more clearly defined during slower tapping movements. Of the two components, the first was relatively stable, regardless of changes in tapping frequency, while the second was highly dependent on the tapping cycle duration, and its duration was shortened with increases in tapping frequency. Furthermore, there was a significant correlation between the changes in the occlusal power phase and those in the burst duration of the masseter EMG simultaneously recorded by a pair of surface electrodes. On the basis of these findings, it is suggested that the tapping rhythm is modulated by the duration of the occlusal power phase and the associated jaw elevator muscle activity.     

A New Method for Measurement of Gastric and Colonic Lesions with an Electronic Endoscope and Image Processor

In order to measure the sizes of gastric and colonic lesions endoscopically, we established a system composed of an electronic endoscope, image processor, and personal computer. The long and short diameter of the lesion were calculated by a program which corrected the curvature radius of the lens of the endoscope and variables. 1) To evaluate its accuracy, we measured a 10 mm scale spherical model at different distances from the lens of the endoscope. The mean value was 9.7 mm, ranging from 9.0 to 10.9 mm. The rate of error was –0.38±4.4 % (mean±SE). 2) Using this system, we measured the sizes of 34 gastric and colonic lesions in 34 patients (3 with gastric cancers, 20 with gastric polyps, and 11 with colonic polyps), and compared them with the real sizes of the resected or polypectomized specimens. The rate of error was–1.1±1.3% (mean±SE). The results showed that our system was useful to evaluate the accurate sizes of gastric and colonic lesions endoscopically.