Effect of famotidine on recurrent bleeding after successful endoscopic treatment of bleeding peptic ulcer.

AIM: We investigated the effect of acid suppression therapy on recurrent bleeding after successful endoscopic treatment of bleeding peptic ulcer. METHODS: A total of 400 patients with bleeding peptic ulcer received either intravenous infusion of famotidine (40 mg/day) (n = 207, 163 males, 44 females, mean age 61.5 years) or drip infusion of omeprazole (40 mg/day; n = 193, 134 males, 59 females, mean age 59.8 years) after successful endoscopic treatment. The fasting duration, hospital stay, volume of transfused blood, incidence of rebleeding and mortality were compared between the two groups. RESULTS: The incidence of rebleeding did not differ significantly between the famotidine group (9%) and the omeprazole group (8%). The mean hospital stay was significantly shorter in the omeprazole group (18.4 days) than in the famotidine group (21.5 days, P = 0.009). However, there was no statistically significant difference in fasting duration, volume of transfused blood or mortality. CONCLUSION: Our findings indicate that intravenous infusion of famotidine after successful endoscopic treatment is equivalent to drip infusion of omeprazole for prevention of recurrent bleeding.

Solvent effect on helicity induction of zinc bilinone bearing a chiral auxiliary at the helix terminal.

Solvent effects on helicity induction in zinc bilinone (ZnBL) derivatives bearing chiral auxiliaries at their 19-positions were investigated by using circular dichroic spectroscopy and (1)H NMR experiments. In ZnBLs 1 and 2, which possess (R)-2-methyl-1-phenylpropyloxy and (R)-1-phenylethyloxy groups at their 19-positions, respectively, the efficiency of helicity induction was significantly affected by employed solvents (78-95% de in 1 and 33-89% de in 2). The free energy changes of the P-M interconversion of 1 and 2 were linearly in proportion to reduction in polarizability of solvents: lower polarizability of solvents led to better efficiency of helicity induction in 1 and 2. With the support of the (1)H NMR study in addition to the molecular modeling previously reported, it was indicated that the solvophobic van der Waals interaction between the alkyl group in the chiral auxiliary and the A-ring of the bilinone skeleton in the preferred conformer plays a crucial role in determining the efficiency of helicity induction in 1 and 2.

Novel approaches to molecular recognition using porphyrins.

Studies of molecular recognition using designed and synthesised molecules provide valuable information on the principle and possible applications of artificial functional molecules. Porphyrin-based receptors have been used to elucidate haem-protein interactions and the basic mechanism of multi-point recognition.

Drug oxidation activities of horseradish peroxidase, myoglobin and cytochrome P-450cam reconstituted with synthetic hemes.

Drug oxidations by horseradish peroxidase (HRP), myoglobin (Mb) and cytochrome P-450cam (P-450cam) reconstituted with synthetic hemes were studied in comparison with a form of cytochrome P-450 purified from liver microsomes of polychlorinated biphenyl (PCB)-treated rats. N,N-Dimethylaniline (DMA) and 7-isopropoxycoumarin were hardly dealkylated by the heme-substituted proteins in the presence of NADPH-cytochrome c (P-450) reductase and NADPH, while substantial activity of this kind was observed in the presence of hydrogen peroxide or cumene hydroperoxide as oxygen donors. Specific activity varied, depending on the substrates, oxygen donors, heme derivatives and apoproteins employed. Very high levels of activity were observed in hydrogen peroxide-dependent DMA N-demethylation with HRP substituted with certain hemes. The highest level of activity was about two hundred times as high as that of rat liver cytochrome P-450. The relationship between such activity and the chemical structure of heme derivatives was discussed.

Crystal structures of modified myoglobins. II. Relation between oxygen affinity properties and structural changes around heme in myoglobins reconstituted with 2,4-diisopropyldeuteroheme, 2-isopropyl-4-vinyldeuteroheme, and 2-vinyl-4-isopropyldeuteroheme.

The crystal structures of sperm whale metmyoglobins reconstituted with three kinds of modified hemes, 2,4-diisopropyldeuteroheme, 2-isopropyl-4-vinyldeuteroheme, and 2-vinyl-4-isopropyldeuteroheme, have been determined and refined at 2.2 A resolution to R = 0.216, 0.219, and 0.195, respectively. All the crystals of these myoglobins are isomorphous with that of native metmyoglobin. The 2-vinyl-4-isopropyldeuteroheme was found to be in a reverse orientation, in which the heme plane is rotated by 180 degrees about an axis through the alpha-gamma-meso carbons, whereas the orientations of the other two hemes were the same as that of protoheme in native myoglobin. In the myoglobins with 2,4-diisopropyldeuteroheme and 2-vinyl-4-isopropyldeuteroheme, both of which have lower oxygen affinities than native myoglobin, the bulky isopropyl side chain pushes Phe 43 0.7 A toward His 64 (the distal histidine) in the former, and the whole E helix at most 1.5 A, including a 0.7 A shift of the His 64 imidazole ring, in the latter. The changes of the structures prevent His 64 from forming a hydrogen bond with the liganded oxygen molecule, so that these two modified myoglobins show low oxygen affinities. On the other hand, there is no such drastic displacement in myoglobin with 2-isopropyl-4-vinyldeuteroheme, which has a slightly higher oxygen affinity than native myoglobin.

[Endoscopic administration of OK-432 in gastric cancer].

This paper describes the morphological and histological changes of gastric cancer following OK-432 injection into and around the lesion under endoscopic observation. Of 10 cases of unresectable gastric cancer, 7 revealed morphological changes and 3 a significant reduction of tumor size. In one of these cases, all the tumor cells disappeared. In 7 cases of resected gastric cancer preceded preoperatively by OK-432 administration, no obvious morphological changes were observed. However, histologically, marked infiltration of inflammatory cells was observed at the site of injection, especially in the submucosal layer. In regional lymph nodes, a lymphocyte predominance pattern which may have resulted from augmentation of T-cell activity was observed in many cases. The results suggested that local OK-432 injection therapy does not have such a marked direct effect on tumor cells, but may be useful as a means of prevention against invasion into the submucosal layer and regional lymph nodes.

[Glucagon-producing carcinoid of the rectum--report of a case].

A 22-year-old male who had been receiving insulin therapy to treat uncontrollable hyperglycemia, was diagnosed to have a carcinoid in the lower rectum. The excised tumor was 1.5 cm in diameter, and showed a yellowish-white cut surface. It did not invade into the proper muscle. Numerous glucagon immunoreactive cells were found. The tumor cells contained many rounded neurosecretory granules. After tumor excision, the patient's hyperglycemia did not return in the absence of insulin administration. We suggest that the tumor may have secreted glucagon which may have acted as an antagonist against insulin in the circulation.

Studies on reconstituted myoglobins and hemoglobins. I. Role of the heme side chains in the oxygenation of myoglobin.

To clarify the functional role of the 2- and 4-side chains of heme in myoglobin oxygenation, we synthesized several new hemins carrying nonnatural side chains at positions 2 and 4, reconstituted myoglobins with them, and investigated their optical, ionization, and oxygen-binding properties. The absorption maxima for most of the reconstituted myoglobins except those reconstituted with hemins having carbonyl groups, no matter whether they are oxy-, deoxy-, or carbon monoxy-form, shifted by at most 20 nm toward shorter wavelengths than protoheme-myoglobin. The absorption spectrum is more affected by resonance effects than by inductive effects of the peripheral side chains of heme. Differences in optical and oxygenation properties between isomeric myoglobins carrying hemes with different side chains at positions 2 and 4 indicate that the 2- and 4-side chains of heme are functionally nonequivalent, as previously shown by Sono and Asakura [(1975) J. Biol. Chem. 250, 5227-5232] for monoformyl-monovinylheme myoglobins. Modification of the 4-side chain exerts greater influence on the oxygen affinity than that of the 2-side chain. The extrapolation method proposed by Sono and Asakura to correct for the protein factor seems to be applicable only as a special case and does not apply to the isomeric myoglobins studied by us. There was not correlation between pKa of the met-form and the oxygen pressure at half saturation, implying that the electronic effect of the side chains is not decisive for the oxygen affinity of myoglobin. The bulkiness of the 2- and 4-side chains, on the other hand, appear to have a certain relation to the affinity but is not a dominant factor. In addition to these factors, specific stereochemical considerations are required to explain all the oxygenation data for the various reconstituted myoglobins. We have proposed a stereochemical mechanism based on the movement of the heme group upon ligation of native myoglobin.

1H-NMR and rosonance Raman spectra of octaethylporphyrinatoiron(III) perchlorate and its mono imidazole adduct.

The 1H-NMR spectra and the resonance Raman spectra of intermediate spin complex, octaethylporphyrinatoiron (III) perchlorate (OEP-Fe(III)ClO4) and its mono imidazole adduct have been recorded and analyzed. The perchlorate complex was determined to be an intermediate-spin state (S = 3/2) in dichloromethane. The mono imidazole and 2-methylimidazole adducts of OEP-Fe(III)ClO4 were of the high-spin state in dichloromethane, which is a good model for the ferrihemoproteins such as metmyoglobins. The spin state of OEP-Fe(III)ClO4 varies the polarity of solvent from typical high-spin (S = 5/2) to typical low-spin (S = 1/2) state including intermediate-spin state (S = 3/2). The resonance Raman studies of the intermediate-spin complex in various solvents indicate that the complex is a plausible model to reproduce anomalous physico-chemical properties of the ferricytochrome c' at physiological condition.

Influence of steric factors on oxygen binding. I. Studies on 2,4-diisopropyldeuteroheme-myoglobin.

Sperm whale apomyoglobin was recombined with 2,4-diisopropyldeuterohemin to form 2,4-diisopropyldeuteroheme-myoglobin and its various physico-chemical properties were investigated to get an insight into the structural and functional role of the peripheral vinyl groups. 2,4-Diisopropyldeuteroheme-myoglobin showed a four times lower oxygen affinity at 25 degrees C and larger enthalpy and entropy changes of oxygenation than the corresponding values of native myoglobin. 2,4-Diisopropyldeuteroheme-metmyoglobin shows a pKa value of 9.68 which is higher than those of native metmyoglobin and mesoheme-metmyoglobin. The rate of autooxidation of oxy-form was about seven times larger in 2,4-diisopropyldeuteroheme-myoglobin than in native myoglobin. The electron-donating effect of isopropyl groups does not give straightforward explanation for these anomalous properties of 2,4-diisopropyldeuteroheme-myoglobin. It is proposed that site and stereospecific van der Waals' interaction between the polypeptide side chains and the peripheral 2,4-diisopropyl groups may weaken the interaction between the bound oxygen molecule and the distal His, resulting in the decrease in the stability of oxyform.