Pharmacological characterization of the voltage-dependent calcium channel of pancreatic B-cell.

Pharmacological characteristics of the voltage-dependent calcium channel (VDCC) of the pancreatic B-cell were studied using omega-conotoxin (omega CgTX) and dihydropyridine (DHP) calcium channel blockers. High glucose and potassium (K+) depolarization were employed as the stimulant of insulin release. omega CgTX (greater than 50 nM), a blocker of neural, but not muscular, Ca2+ channels, partially blocked (27%) the second, but not the first, phase of glucose-induced insulin release without a significant effect on K+ depolarization-induced insulin release. The DHP Ca2+ channel blocker nifedipine inhibited both phases of glucose-induced insulin release (ED50 = 200 nM) and completely abolished both phases of response at 10 microM. In contrast, the DHP Ca2+ channel blocker only partially suppressed (75% at 10 microM) K+ depolarization-induced insulin release with an ED50 of 100 nM. We conclude that pancreatic B-cell possesses at least two classes of VDCCs; one is DHP sensitive, and the other DHP insensitive. Partial suppression of the second phase of glucose-induced insulin release by a high concentration of omega CgTX may be due to its toxic effect on the secretory machinery other than VDCC.

Mastoparan-induced hormone release from rat pancreatic islets.

Mastoparan, a tetradecapeptide purified from wasp venom, stimulates insulin and glucagon release by rat pancreatic islets in a dose-related manner. In perifusion experiments, mastoparan produces monophasic hormone release, which ceases within 10 min of removal of the peptide. After exposure of the isles to mastoparan, glucose-induced insulin release is clearly retained. In incubation experiments, mastoparan-induced insulin release is greatly blocked by pretreatment of the islets with pertussis toxin or neomycin (inhibitor of phosphoinositide turnover) or by lowering the ambient temperature to 17 C. Pretreatment of the islets with nifedipine (calcium channel blocker), H-7 (inhibitor of A- and C-kinase), somatostatin, or divalent cation-free medium does not affect the response to mastoparan. Pretreatment with parabromophenacylbromide (phospholipase-A2 inhibitor) does not block the response induced by a high concentration of (58 microM) mastoparan. The peptide does not stimulate insulin synthesis during 30 min of incubation. Mastoparan raises the cytosolic free Ca2+ concentration, measured by fura-2, in isolated islet cells at normal (1.9 mM) and very low (6.5 microM) extracellular Ca2+ concentrations. Intravenous administration of mastoparan in rats causes a significant elevation of both insulin and glucagon. Together with the previous data, we conclude that mastoparan stimulates islet hormone release through a temperature-dependent process mediated by pertussis toxin-sensitive GTP-binding protein(s). Activation of phospholipase-C and liberation of intracellular Ca2+ are likely to be coupled to exocytosis. Ca2+ influx through the Ca2+ channel and protein kinase-A and -C appear not to be involved in mastoparan's hormone-releasing action. Phospholipase-A2 may be involved in the hormone release induced by low, but not high, concentrations of the peptide.

Antipituitary antibodies in patients with the primary empty sella syndrome.

The frequency of detection of serum antibodies against pituitary cells was determined in 32 patients with the primary empty sella syndrome. Antibodies reacting with corticotropin-secreting mouse AtT20 and PRL-secreting rat GH3 cells were found in 24 (75%) and 15 (47%), respectively, of the 32 patients; 14 patients (44%) had antibodies reacting with both cell lines. In patients with pituitary adenomas, the prevalence of antipituitary antibodies was significantly lower than in those with the empty sella syndrome; 1 of 9 acromegalic patients had antibodies reacting with GH3 cells, and 2 of 9 prolactinoma patients and 1 of 7 patients with nonfunctioning adenomas had antibodies reacting with both AtT20 and GH3 cells. Among 6 patients with idiopathic diabetes insipidus, 1 patient had antibodies reacting with AtT20 and GH3 cells, and 2 patients had antibodies reacting with either AtT20 or GH3 cells. None of 5 patients with established autoimmune diseases (3 with systemic lupus erythematosus and 2 with autoimmune adrenal failure) had antipituitary antibodies in their serum. These results suggest that pituitary antibodies may be related to the development of pituitary atrophy and the primary empty sella syndrome, and that the test may be clinically useful as a screening test for the empty sella syndrome.

Presence of anti-DNA antibody in diabetes mellitus: its relation to the duration of diabetes and diabetic complications.

In seven patients with insulin-dependent diabetes mellitus (IDDM) and 86 patients with non-insulin-dependent diabetes mellitus (NIDDM), serum anti-DNA antibody was measured by a semiquantitative radioimmunoassay (RIA) method. Prevalence of positive anti-DNA antibody (more than 20 U/mL) was five of seven in IDDM patients, 15 of 36 in NIDDM patients with insulin therapy, and seven of 50 in NIDDM patients without insulin therapy. None of normal subjects or patients with impaired glucose tolerance (IGT) showed positive anti-DNA antibody. The titer of anti-DNA antibody was higher in IDDM patients than in age-matched normal subjects (mean +/- SD; 22.1 +/- 15.3 v 6.5 +/- 2.2 U/mL, P less than .05). In patients with NIDDM, the antibody titer regardless of insulin treatment, was higher than in age-matched subjects with IGT (18.5 +/- 13.1 U/mL in NIDDM patients receiving insulin, 14.8 +/- 8.1 U/mL in NIDDM patients not receiving insulin, and 8.8 +/- 3.9 U/mL in IGT patients [P less than .001] for either of NIDDM groups v IGT). The titer of anti-DNA antibody was positively correlated with the duration of diabetes (r = .413, P less than .001) and with the postprandial blood glucose level (r = .311, P less than .01) in NIDDM patients when all of them were combined and analyzed as a group.(ABSTRACT TRUNCATED AT 250 WORDS)

Breathing pattern of anesthetized humans during pancuronium-induced partial paralysis.

We investigated the breathing patterns of 17 subjects anesthetized with enflurane before and after partial muscle paralysis produced by pancuronium bromide. In the face of significant muscle weakness produced by pancuronium, breathing patterns are characterized by decreases in both tidal volume and respiratory frequency. The decreased tidal volume corresponded to the decrease in occlusion pressure, indicating that the decreased tidal volume results solely from a decreased contractile force of the respiratory muscles. The decreased respiratory frequency was due to prolongation of both inspiratory and expiratory time without changing the ratio of the inspiratory time to the total breath time. Withdrawal of phasic vagal influence by airway occlusion before partial muscle paralysis revealed that an active Breuer-Hering inflation reflex was operative in only 8 of all 17 subjects. Since the contribution of the Breuer-Hering inflation reflex alone does not seem to account for the consistent decrease in respiratory frequency, some other mechanisms modulating respiratory frequency might be involved in the characteristic breathing patterns during partial muscle paralysis under enflurane anesthesia.

Abnormal molecular weight profile of urinary protein in rats with streptozotocin-induced diabetes.

A quantitative analysis of the molecular weight (MW) profile of urinary protein by SDS-PAGE was performed in streptozotocin (STZ)-injected, non-ketotic diabetic rats (DM group), diabetic rats receiving dipyridamole (DM-DIP group), normal rats (C group) and STZ-injected rats with near-normal glycemia due to insulin treatment (DM-INSULIN group). In the DM group, decrease of a small MW protein (SMWP) (MW 19.5 k) was found at 2.5 weeks, and an increase of larger MW proteins (LMWP) (MW 68 [albumin], 55 and 29 k) together with a decrease of SMWPs (MW 19.5 and 15 k) was found at 15 weeks, as compared to the C group: the MW profile of urinary protein in the DM-INSULIN and C groups was indistinguishable. At 15 weeks, creatinine clearance (Ccr) was significantly depressed and an increase in the mesangial matrix with electron dense deposits was evident in the DM group. The urinary protein abnormalities were partially corrected and the reduction of Ccr was absent in the DM-DIP group with no effect on glomerular morphology. STZ-induced diabetes in rats is accompanied by a reduction of urinary SMWP, and a subsequent increase of LMWP and depression of Ccr: dipyridamole ameliorates urinary protein abnormalities and prevents the reduction of Ccr.

[Evaluation of absorbed dose-distribution in the X-ray or gamma-irradiator for blood products].

Irradiation of blood products abrogates the proliferation of lymphocytes present in cellular component, which is currently the only accepted methodology to prevent transfusion-associated graft versus host disease (TA-GVHD). A range of irradiation dose levels between 15 Gy and 50 Gy is being used, but the majority of facilities are employing 15 Gy. It should, however, be recognized that the delivered dose in the instrument canister might differ from the actual dose absorbed by the blood bag. This study have evaluated the actual dose distribution under practical conditions where a container was loaded with blood products or water bags, or filled with distilled water. This approach provides data that the maximum attenuation occurred when the container was completely filled with a blood-compatible material. Thus, an error of approximately 20 percent should be considered in the dose measured in the in-air condition. A dose calibration in an in-air condition may lead to substantial underexposure of the blood products. A dose distribution study using adequately prearranged exposure period verified that the absorbed dose of 15 Gy was attained at any point in the container for both linear accelerator and gamma-irradiator. The maximal difference in the absorbed dose between measured points was 1.5- and 1.6-fold for linear accelerator and gamma-irradiator, respectively. In conclusion, using blood-compatible materials, a careful dose calibration study should be employed in which the absorbed dose of 15 Gy is obtained at the point where the lowest dose could be expected.

[Effect of gargling the throat with Panaxylocaine as a lubricant for the laryngeal mask airway].

We used Panaxylocaine as a suitable lubricant with gargling before insertion of laryngeal mask for twenty preoperative breast cancer patients. Patients were divided into two groups; Control group (N = 10) received water-based lidocaine gel just before insertion of laryngeal mask, and Panaxylocaine group (N = 10) received Panaxylocaine as a premedication for breast cancer operation. Compared to water-based lidocaine gel, Panaxylocaine was more effective for oral discomfort after insertion of laryngeal mask. But there was no difference between two groups about oral paresthesia. We conclude that Panaxylocaine is a good premedication before insertion of laryngeal mask preventing oral and pharyngeal complications.

Laryngeal and respiratory responses to tracheal irritation at different depths of enflurane anesthesia in humans.

The effect of three different depths of enflurane anesthesia (1.0, 1.4, and 1.8 MAC) upon laryngeal and respiratory responses to tracheal instillation of distilled water in nine female patients in whom a double-cuffed endotracheal tube had been inserted was investigated. The laryngeal responses were monitored by measuring the pressure in the saline-filled cuff positioned within the larynx, and the respiratory responses were monitored by measuring ventilatory flow and tracheal airway pressure. Increases in laryngeal cuff pressure in response to tracheal irritation were 19.7 +/- 4.5 cmH2O (mean +/- SD) at 1.0 MAC, 13.9 +/- 3.6 cmH2O at 1.4 MAC, and 7.6 +/- 1.8 cmH2O at 1.8 MAC, respectively (P less than 0.01 for anesthetic dose). At 1.0 MAC of enflurane anesthesia, tracheal instillation of saline caused immediate laryngeal constriction and all components of the tracheal response, such as apnea, expiration reflex, cough reflex, and spasmodic panting. At 1.4 and 1.8 MAC, the same stimulation caused only apnea and constriction of the larynx in the majority of patients. These results indicate that changes in depth of anesthesia can modify the laryngeal and respiratory responses to tracheal irritation. The close association of laryngeal and respiratory responses may be an integral part of the defensive reflex synergism.

Relationship between plasma concentration of morphine and analgesic effectiveness.

Morphine is a key drug for cancer pain management. In this study, we analyzed plasma morphine concentration in cancer patients who received continuous morphine drip and/or oral administrations of morphine: (1) The plasma concentration of morphine varied widely in patients whose pain was satisfactorily controlled at a constant dosage of morphine. The absolute value of the plasma concentration of morphine necessary for effective pain control could not be estimated; (2) When MS Contin was given at the doses 20 mg, 30 mg, 40 mg, the plasma concentration of morphine increased with increasing dose. Thus, when the dose was increased according to the severity of pain, the plasma concentration of morphine increased and in turn an analgesic effect was obtained; (3) In those patients who had difficulty in taking oral preparations and/or blocked intestines, plasma concentration of morphine following oral administration was relatively low causing an unsatisfactory analgesic effect. However, by changing from oral administration to continuous drip infusion, the plasma concentration of morphine became higher and pain relief was obtained; (4) Continuous drip infusion of morphine progressively increased plasma concentration of morphine in parallel with the increase in the dose of morphine if the patients had no pleural effusion, ascites, and/or oedema. In contrast, plasma morphine concentration in patients with pleural effusion, ascites, and/or oedema was about half of that observed in patients who have normal distribution area. The rapid development of pleural effusion and ascites lowers the blood level of morphine; (5) To use the plasma concentration of morphine as an index for the analgesic effect, it is essential to develop a method to measure the plasma concentration of morphine rapidly.

Gradual delay in glucose-induced first phase insulin secretion by the pancreatic islets of 7 week-, 6 month-, and 1 year-old rats.

The temporal profiles of insulin secretion by isolated pancreatic islets of male Wistar rats with various ages up to 1-year-old were studied using high glucose, potassium (K+) depolarization, and arginine as secretagogues. In the islets of 6-month-old rats, the onset and peak of glucose-induced first phase of insulin release were delayed for 1 min compared to those of 7--week-old rats. The onset and peak were further delayed for 1 min in the islets of 1-year-old rats. The onset of glucose-induced second phase of insulin secretion, and the onset and peak of K+ depolarization- and arginine-induced insulin release were not delayed in the islets of 6-month and 1-year-old rats. Glucose-stimulated increase in cytosolic free calcium ([Ca2+]i) seemed not delayed in the islets of 1-year-old rats. We conclude that the first phase of glucose-induced insulin release by the islets is selectively delayed as rat ages. It was suggested that the defect lies distal to the elevation of [Ca2+]i.

Mastoparan, a wasp venom, stimulates insulin release by pancreatic islets through pertussis toxin sensitive GTP-binding protein.

A wasp venom, mastoparan, rapidly stimulated insulin release by rat pancreatic islets in a dose-related manner. The amount of insulin released in response to 58 microM mastoparan far exceeded that induced by 27.8 mM glucose. Mastoparan stimulated insulin release to similar degrees at ambient glucose concentrations of 1.7 mM and 5.6 mM. The islets obtained from pertussis toxin-treated rats showed unequivocally less response to mastoparan. Pretreatment of islets with bromophenacyl bromide, a phospholipase A2 inhibitor, abolished their responsiveness to mastoparan. Pretreatment of islets with nifedipine, a Ca2+ channel blocker, was without effect. Mastoparan is a unique stimulator of insulin release by the pancreatic islets, which acts through GTP-binding protein(s) and phospholipase A2.

Somatostatin analogue (SMS 201-995) decreases plasma levels of corticotropin (ACTH) and corticotropin-releasing hormone in a patient with ectopic ACTH-producing tumors.

Effects of long-acting somatostain analogue (SMS 201-995) on plasma corticotropin (ACTH) and corticotropin-releasing hormone (CRH) levels were studied in a patient (63-year-old woman) with ectopic ACTH-producing tumors associated with type I multiple endocrine neoplasia (MEN-I). The patient had undergone bilateral adrenalectomy. Plasma CRH, as well as plasma ACTH, beta-endorphin and alpha-MSH, increased. The hormone levels were dramatically decreased by acute administration of SMS 201-995. Moderately higher doses of dexamethasone (0.05 or 0.1 mg/kg a day) did not decrease plasma CRH or ACTH. An extremely high dose of dexamethasone (0.2 mg/kg a day), however, decreased plasma ACTH, but failed to decrease plasma CRH. Acute administration of SMS 201-995 further lowered the level of plasma ACTH even in this condition. In addition to the decrease in ACTH, SMS 201-995 decreased plasma CRH. Chronic administration of SMS 201-995 continuously decreased plasma CRH, ACTH and beta-endorphin. The decrease in these hormone concentrations accompanied the disappearance of hyperpigmentation. These results suggested that SMS 201-995 inhibits hypersecretion not only of ACTH but also of CRH, and that the agent is therapeutically useful in normalizing the hypersecretion of these hormones.

Improved sensitivity in the measurement of residual leukocytes in platelet products using an automated leukocyte counter.

BACKGROUND AND OBJECTIVES: Leukocytes remaining in platelet concentrates may be responsible for side effects caused by platelet transfusion. A simple method of high sensitivity for determining trace numbers of leukocytes is currently needed. MATERIALS AND METHODS: An automated leukocyte counter, the LD-1000, the principle of which is a combination of spinning down on the observation field of stained nuclei derived from a 100 microl neat sample and image digitization with a charge coupled device camera, was newly developed and tested for sensitivity and reproducibility. RESULTS: While the theoretical lower limit of detection was 0.01 cells/microl, the limit of detection of the LD-1000 was verified to be 0.2 cells/microl. A good correlation (r = 0.86) was observed between the results obtained using the Nageotte method and the LD-1000. Repeated measurements also confirmed satisfactory reproducibility. CONCLUSIONS: The instrument provides a new method of enumerating residual leukocytes in platelet products with better sensitivity and easier procedure compared to the Nageotte method and will be useful for quality assurance purposes at blood centers.