Factors associated with elevated serum alanine aminotransferase in patients with type 1 diabetes mellitus.

AIM: Metabolic syndrome and type 2 diabetes are associated with insulin resistance and hepatic steatosis, which are common causes of alanine aminotransferase (ALT) elevation. This study aims to identify variables associated with altered ALT in type 1 diabetic (DM1) subjects. METHODS: A cross-sectional study conducted in the outpatient endocrinology clinic of a university hospital. Patients with DM1 were seen between December 2012 and September 2013; clinical variables were collected from medical records. RESULTS: Fifty-six patients were included aged 27 ± 10.1 years; 60.7% were men. The study subjects exhibited an average ALT of 36.7 ± 10.3 U/L (median = 35 U/L) and their average Body Mass Index (BMI) was 23.8 ± 3.8 kg/m2. When comparing individuals with elevated ALT > 35 U/L (N. = 27) with those ALT ≤ 35 U/L (N. = 29), we found that individuals with ALT values > 35 U/L showed a higher proportion of men (77.8% vs. 44.8%, P = 0.012) and a higher mean age (30.2 ± 12.3 vs. 24.6 ± 6.9 years, P = 0.046). When new ALT reference values were applied (19 U/L for women and 30 U/L for men), five individuals had normal ALT values. Individuals with elevated ALT had higher BMI (24.3 vs. 20.9; P = 0.036), fasting glucose (194.8 ± 101.2 vs. 123.6 ± 42.0 mg/dL; P = 0.013) and higher HbA1c (9.9 ± 2.8 vs. 7.8 ± 0.7%; P < 0.001) levels. In Pearson correlation analysis, ALT values ​correlated with HbA1c (r = 0.285; P = 0.033). CONCLUSION: In patients with DM1, elevated ALT values ​​are associated with BMI, fasting glucose and HbA1c.

Dependence of sonoluminescence intensity on the geometrical configuration of a reactor cell.

Dependence of sonoluminescence (SL) intensity on the geometrical configuration of a reactor cell is studied theoretically and experimentally. The model is a rectangular glass cell set in a water-cooling bath. Ultrasound is irradiated from the bottom of bath into the cell. Theoretical analysis of transmitted acoustic energy assuming a plane acoustic wave clarified the influences of distance between the transducer and the cell bottom, thickness of the cell bottom, and water depth in the cell. The theory is examined through intensity measurement of SL emitted in the cell using a photomultiplier tube. Dependence of SL intensity on the above parameters agreed with the theory very well. Distributions of SL are also observed using a high sensitive CCD camera and are compared with optically visualized sound fields to show the relationship between the sound field and the SL.

Clinical bitterness masking test for phantogeusia.

It is difficult to determine the reason why a patient complains of a bitter taste when their mouth is empty. We examined a new diagnostic test using a bitterness masking substance. The bitterness masking substance, 'Benecoat BMI-60' (hereafter BMI-60), is a masking substance specific to the taste cells' bitterness receptors. After patients gargled with BMI-60 solutions, the phantom sensation of bitterness was masked in some patients, but was not masked in others. Bitter substances in saliva seemed to be masked by BMI-60, but bitterness did not seem to be masked when the locus of the phantom sensation was within the peripheral nerve and/or the brain. The bitterness masking test is useful for diagnosis of the phantom sensation of bitter taste.

Massive hemorrhage after biopsy of an esophageal polyp.

Esophageal vascular malformations are very rare. Herein, we describe a rare polyp formed by an abnormally large vessel that bled profusely after biopsy. Despite endoscopic procedures, the patient continued to bleed and underwent emergency surgery. Histopathological examination revealed an abnormally large blood vessel with a thick wall in the upper part of the lamina propria mucosae and covered by squamous cell epithelium. The elevated lesion, which was endoscopically diagnosed a small polyp, was in fact an abnormally large artery covered by squamous cell epithelium. Massive bleeding after biopsy of an esophageal polyp is apparently so rare that it has not, as yet, been described.

Growth, pigmentation, and expression of the puf and puc operons in a light-responding-repressor (SPB)-disrupted Rhodobacter sphaeroides.

We previously cloned a trans-repressor, SPB, for the puf operon of Rhodobacter sphaeroides (Shimada et al. 1996) and revealed that SPB was a putative genetic counterpart to HvrA in Rhodobacter capsulatus, a trans-activator for the puf and puh operons (Mizoguchi et al. 1997). In this study we constructed a spb-disrupted R. sphaeroides, strain L-7, to elucidate the function of SPB. This disruption of the spb gene increased the photosynthetic growth rate and the cellular levels of photopigments under low-intensity light conditions. The disruption also derepressed the expression of the puf and puc operons under high-intensity light conditions. In strain L-7, however, strong illumination still reduced the cellular levels of photopigments as it did in the wild strain, suggesting that SPB did not directly affect the formation of photopigments. These results support our previous suggestion that SPB functions as a high-light repressor for puf operon in R. sphaeroides in striking contrast to HvrA, which is a low-light activator for puf and puh operons in R. capsulatus, even though SPB and HvrA are highly homologous. Disruption of spb gene had no effect on the oxygen-mediated regulation of the pigmentation or the expression of puf and puc operons.

Possible mechanisms underlying the suppression of gastric vagal afferents due to ecabapide (DQ-2511), a gastroprokinetic agent, in rats.

We examined the implication of a nitric oxide (NO)-guanosine 3',5'-cyclic monophosphate (cGMP) cascade in the suppression of gastric vagal afferents due to ecabapide in anesthetized rats using a standard extracellular method of multi-unit recording. Sodium nitroprusside (SNP, 0.5 mg/kg), an NO donor, depressed the afferent discharge rate of the vagus nerve, like ecabapide (60 micrograms/kg). On the other hand, NG-nitro-L-arginine (L-NNA, 5 mg/kg), an NO biosynthesis inhibitor, significantly elevated its discharge rate. Pretreatment with L-NNA completely blocked the action of ecabapide. Atropine (0.05 mg/kg), a competitive antagonist of muscarinic cholinoceptors, showed no effect on the afferent firing. These results suggest that ecabapide may suppress the activation of vagal afferents in gastric inhibitory vago-vagal reflex pathways through the NO-cGMP cascade.

The characteristics of specific IgG to phthalic anhydride (PA)-albumin conjugate.

Phthalic anhydride (PA), used in the chemical industry, binds to proteins and causes allergic reactions. It is important to study the characteristics of antibody to PA-protein. We produced specific IgG against PA-rabbit serum albumin (RSA) by administering subcutaneous injections of PA-RSA conjugate to two rabbits. Both rabbits' sera had high titers of IgG not only to PA-RSA but also to PA-human serum albumin (HSA) and HSA. In enzyme-linked immunosorbent assay (ELISA) and ELISA HSA inhibition, specific IgG to PA-HSA revealed cross-reactivity to three other phthalyl anhydride conjugates, hexahydrophthalic anhydride (HHPA)-HSA, methylhexahydrophthalic anhydride (MHHPA)-HSA, and methyltetrahydrophthalic anhydride (MTHPA)-HSA, in both sera. Titers of IgG to HHPA-HSA, MHHPA-HSA, and MTHPA-HSA were not significantly different. On affinity chromatography, highly specific IgG to PA hapten alone was purified. In the serum not binding to PA column, specific IgG to PA-HSA was significantly less than in original serum, but levels of specific IgG to other phthalyl anhydride-HSA were unchanged. Rabbits immunized with PA-RSA produced at least two types of IgG: one is to PA hapten alone and the other may be against new antigenic determinants (NADs) on HSA.

Comparative evaluation of DQ-2511, a novel gastroprokinetic agent, with cisapride in ameliorative action on experimentally induced delayed gastric emptying.

We compared the main pharmacological effect of DQ-2511 (3-[[[2-(3,4-dimethoxyphenyl)- ethyl]carbamoyl]methyl]amino-N-methylbenzamide), a novel gastroprokinetic agent, with that of cisapride. Single oral administration of DQ-2511 (3-10 mg kg-1) caused similar significant improvements to delays in gastric emptying of semi-solid meals evoked by cholecystokinin-octapeptide (CCK8: 5 micrograms kg-1, i.v.) in monkeys, to that with cisapride (3 mg kg-1). A 2-week oral treatment of unilaterally vagotomized rats with DQ-2511 (1-10 mg kg-1) lessened delays in gastric emptying, whereas cisapride (0.3-10 mg kg-1) had no effect under the same experimental protocols. In anesthetized rats, bolus intravenous injection of either compound (60 micrograms kg-1) enhanced gastric motility determined by means of strain gauge force transducers. Electrophysiological investigations revealed that bolus injection of DQ-2511 (6-60 micrograms kg-1) depressed the afferent discharge rate of the ventral gastric branch of the vagus nerve, while cisapride showed no effect. These results suggest that the mechanism of ameliorative action of DQ-2511 on delayed gastric emptying may differ from that of cisapride.

Effects of DQ-2511 on neutral activity in afferent and efferent loops of gastric vago-vagal reflex pathways in the rat.

1. DQ-2511 is a new substituted benzamide compound that has gastric prokinetic properties. Actions of the drug on neural discharge in the innervation of the stomach of anaesthetized rats were studied. Standard extracellular methods of multi-unit recording were used to study rates of firing in afferent and efferent filaments teased from gastric branches of the vague nerve. 2. Decreased firing in gastric vagal efferents was associated with increased rates of discharge in the gastric afferents. 3. Intravenous application of DQ-2511 resulted in increased frequency of firing in the efferents in association with decreased rate of discharge in afferent fibres. 4. Application of cholecystokinin octapeptide (CCK8) suppressed activity in the gastric efferents which occurred coincident with the elevated discharge in the afferents. Pretreatment with DQ-2511 blocked the actions of CCK8. 5. The results suggest that the gastric prokinetic action of DQ-2511 may involve suppression of activation of afferents in the sensory component of gastric inhibitory vago-vagal reflex pathways.

Pharmacological characteristics of DQ-2511 as a prokinetic agent.

The pharmacological characteristics of DQ-2511, a substituted benzamide (3-[[[2-(3,4-dimethoxyphenyl)ethyl]carbamoyl]methyl] amino-N-methylbenzamide), as a prokinetic agent were studied. Cholecystokinin-octapeptide, dopamine, and alpha-calcitonin gene-related peptide, all suppressed gastric emptying in mice. Reversal of the depressed emptying occurred when DQ-2511 was administered by the oral or intraperitoneal route. When the action of eight proposed metabolites of DQ-2511 on the mouse cholecystokinin-octapeptide model was investigated, the main metabolite in plasma, MA-2, showed no effect, although two minor metabolites ameliorated or aggravated the delayed gastric emptying. This finding implies that DQ-2511, as the parent compound itself, exerts the ameliorative action. In dogs treated with cisplatin or copper sulfate, DQ-2511 had no antiemetic activity, as assessed by the number of vomiting episodes. The concern that the mechanism of action of DQ-2511 was blockade of receptors for cholecystokinin-octapeptide, dopamine, serotonin, alpha-calcitonin gene-related peptide, nicotine or muscarine, was resolved by results of radioligand binding studies showing the absence of a DQ-2511 binding to any of these receptor types. Evidence is accumulating that the mechanism of the prokinetic action of DQ-2511 involves the intrinsic and extrinsic autonomic innervation.

DQ-2511, having an antiulcer action, elicits vasodilation through an increase in cyclic GMP contents in rat arteries.

It has been reported that 3-(([2-(3,4-dimethoxyphenyl)ethyl]carbamoyl)methyl)amino-N-methylbenz amide (DQ-2511: ecabapide) effectively increases gastric mucosal blood flow in rats, suggesting that this property may contribute to the antiulcer activity. To clarify the mechanisms underlying the increase in gastric mucosal blood flow, we investigated the dilator response of rat isolated thoracic aorta, mesenteric artery and celiac artery smooth muscle preparations to DQ-2511. This compound prevented noradrenaline-induced contraction in both the presence and absence of endothelium in the arterial specimen, and it (0.01-1 mM) inhibited these contractions induced by noradrenaline in all tissues in a concentration-dependent manner. This inhibitory effect of DQ-2511 was most evident in the celiac artery. The dilator response to DQ-2511 (0.1 mM) was abolished after pretreatment with methylene blue (3 microM), a guanylate cyclase inhibitor. Under the same conditions, methylene blue inhibited the dilator response to acetylcholine (1 microM), but not that to papaverine (10 microM). Furthermore, when DQ-2511 (0.01-1 mM) was incubated with the arterial preparations, this compound increased cyclic GMP content in segments in a concentration-dependent manner. These findings demonstrate that the vasodilation induced by DQ-2511 is independent of the endothelium and is related to the augmentation of intracellular cyclic GMP content, which may consequently contribute to the increased gastric mucosal blood flow.

Enhancing effect of DQ-2511 on gastric emptying of spontaneously hypertensive rats.

The present study was designed to clarify the potential of DQ-2511 (3-[[[2-(3,4-dimethoxyphenyl)ethyl]carbamoyl]carbamoyl]methyl] amino-N-methylbenzamide: ecabapide) as a gastroprokinetic agent in spontaneously hypertensive rats (SHR). The gastric emptying of SHR was clearly retarded relative to that of weight-matched normotensive Wistar-Kyoto (WKY) rats when evaluated by the acetaminophen (APAP) method with the semi-solid test meal. There was, however, no significant difference between both strains in gastric mucosal blood flow (GMBF) determined by means of a laser doppler flowmetry. A 2-week treatment of SHR with DQ-2511 (1 mg/kg, oral) stimulated gastric emptying without affecting body weight gain or indirect systolic blood pressure (SBP), whereas cisapride (3 and 10 mg/kg, oral) had no effect under the same conditions. The pharmacological characteristics of DQ-2511 as a gastroprokinetic agent are discussed on the basis of these results.

The measurement of gastric emptying in conscious rats by monitoring serial changes in serum acetaminophen level.

A method for evaluation of gastric emptying via monitoring serial serum levels of acetaminophen (APAP) as an indicator, without involving animal sacrifice, has been developed in conscious rats. We administered orally suspended test meals of 0.5, 1, 2, or 4 mL/rat each, containing 20 mg APAP. The animals were repeatedly bleed at 15, 30, 45, 60, or 90 min after APAP treatment. Serum APAP level was determined by a high-performance liquid chromatography. As a result, a 2-mL meal was found optimal to attain continuous levels of APAP in serum. The APAP method showed a close correlation (r = 0.77) with the phenol red method, a standard procedure for quantitative detection of gastric emptying entailing rat sacrifice. The blood loss (approximately 2 mL) resulting from the APAP method did not significantly modify the rate of gastric emptying. In addition, data was presented to substantiate the validity of the APAP method in demonstrating enhancement and inhibition of gastric emptying using cisapride and cholecystokinin-octapeptide (CCK), respectively. These results suggest that the APAP method is easy, versatile, and reliable, and requires only a minimal number of animals for the evaluation of sequential changes in gastric emptying.

Chronic toxicity and tumorigenicity study of aluminum potassium sulfate in B6C3F1 mice.

The tumorigenic potential of aluminum potassium sulfate [A1K (SO4)2 12H2O, APS], a compound which exists widely in the environment, was investigated in B6C3F1 mice. APS was administered in the diet for 20 months at dose levels of 1.0, 2.5, 5.0 and 10.0% (w/w). One group receiving the basal diet served as the control. Body weight gain in both sexes was decreased in the 10.0% APS treated group, and increased in the 1.0 and 2.5% APS treated groups. The survival rates at the end of the dosing period were 73.3% (male) and 78.3% (female) in the control group, and 86.7-95.0% (male) and 86.7-91.7% (female) in the APS treated groups. The survival rate showed a tendency to increase in both sexes in all the APS treated groups. In the tumor pathology, the incidence of hepatocellular carcinoma was significantly decreased in the males in the 10% APS treated group. The incidence of hepatocellular carcinoma was significantly decreased in females in all groups including the control group. As regards the nontumorous pathology, the incidence of myocardial eosinophilic cytoplasm showed a significant dose-dependent decrease in males in the APS treated groups. A comparison between the sexes revealed a significant decrease in the incidence of hepatocytic anisonucleosis, myocardial eosinophilic cytoplasm and acinar cell vacuolation of the submandibular gland in the females; and lymphocyte infiltration in renal cortex and pelvis, and vacuolation of cerebellar white matter were noted in the males. The results of the present study indicate that long-term administration of APS does not exert tumorigenic or any other toxic actions in B6C3F1 mice.

Induction of malignant fibrous histiocytoma in female Fisher rats by implantation of cyanoacrylate, zirconia, polyvinyl chloride or silicone.

Five kinds of foreign bodies (silicone, cellulose, polyvinyl chloride, zirconia and alkyl-alpha cyanoacrylate) were implanted into subcutaneous tissue of female Fisher rats. Subcutaneous tumors were induced in 27.3, 54.5, 100, 63.6% of rats by silicone rubber, polyvinyl chloride, zirconia and alkyl-alpha-cyanoacrylate, respectively, but not by cellulose. Almost all tumors were composed of a mixture of cells that resembled fibroblasts characterized by the presence of numerous rough-surfaced endoplasmic reticulum and Golgi apparatus, histiocytes characterized by developed endoplasmic reticulum and abundant lysosome, myofibroblasts characterized by the presence of both myofibrils and fibroblast-like structures, and immature mesenchymal cells. In some tumors, the cells exhibited a storiform pattern. Some tumor cells were positively stained by ED2 or anti-muscle actin antibody. The features of induced tumors in rats were consistent with those of human malignant fibrous histiocytoma. A rat malignant fibrous histiocytoma transplanted into the subcutaneous tissue of the syngeneic female Fisher rats grew and metastasized to the lungs.

Signet ring cells in breast carcinoma. An immunohistochemical and ultrastructural study.

Two cases of breast carcinoma composed predominantly of neoplastic cells with a signet ring appearance, one a case of invasive lobular carcinoma (ILC) and the other a case of invasive ductal carcinoma (IDC), were examined electron microscopically and immunohistochemically. In signet ring cells in the ILC, mucin was demonstrated ultrastructurally in the intracytoplasmic lumina and also to a small degree in the cytoplasmic mucous granules, whereas in signet ring cells in the IDC, mucin was found only in the cytoplasmic mucous granules. Immunohistochemically, signet ring cells in the ILC were intensely positive for gross cystic disease fluid protein (GCDFP-15), but those in the IDC showed no immunoreaction for GCDFP-15. Thus ultrastructural features and GCDFP-15 immunoreactivity appear to be useful for distinguishing between the two different types of signet ring cells.

Effects of nefiracetam, DM-9384 on amnesia and decrease in choline acetyltransferase activity induced by cycloheximide.

The effects of nefiracetam, [N-(2,6-dimethyl-phenyl)-2-(2-oxo-pyrrolidinyl)acetamide, DM-9384], a cyclic derivative of GABA, were investigated in the cycloheximide (CXM)-induced amnesia animal model using the passive avoidance task. Pre-training administration of DM-9384 attenuated the CXM-induced amnesia as indicated by prolongation of step-down latency. It protected against CXM-induced inhibition of choline acetyltransferase activity in the cerebral cortex. These results suggest that DM-9384 attenuates CXM-induced amnesia by interacting with AChergic neuronal system and enhancing protein synthesis in the brain.

Apocrine adenocarcinoma of the bilateral axillae.

A case of apocrine adenocarcinoma arising in the bilateral axillae is reported. The patient was an 88-year-old Japanese male who complained of a mass lesion and pus-like discharge in the right axilla. Another mass was also noticed in the left axilla. No other neoplastic lesion was found in other sites of the body. The histologic appearances of the bilateral axillary tumors were almost identical. Both were adenocarcinoma with varying degrees of differentiation, composed of glands and nests of atypical epithelial cells with abundant eosinophilic cytoplasm. Some neoplastic cells exhibited cytoplasmic projections on their apical surface. Foci of in situ carcinoma were observed within the neoplastic tissue in the bilateral axillae. The neoplastic cells were immunohistochemically positive for epithelial membrane antigen (EMA) and gross cystic disease fluid protein (GCDFP-15), but negative for carcinoembryonic antigen (CEA). On the basis of their histologic and immunohistochemical features and distinctive location, the tumors were diagnosed as apocrine adenocarcinoma.