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Biomedical subjects

E Cho

Publications and source records attributed to E Cho.

At least 73 records · Page 4Linked to original sources
PubMed1992

Liver and spleen phagocytic depression after peripheral ischemia and reperfusion.

Liver and spleen phagocytic clearance of blood-borne microparticulate tissue debris and products of intravascular coagulation after trauma and surgical injury is an important mechanism to limit the deposition of debris in the pulmonary vascular bed. Plasma fibronectin (pFn) modulates this clearance process. We evaluated the effect of a localized peripheral ischemia and reperfusion injury on liver and spleen phagocytic function. Male rats (250 to 350 g) underwent 4 hours of tourniquet-induced bilateral hindlimb ischemia, followed by 18 hours of reperfusion after release of the tourniquet. Rats subjected to ether anesthesia alone or anesthesia followed by groin incision without ischemia were the control and sham groups, respectively. Reticuloendothelial (RE) phagocytic function was assessed at 15 minutes and 18 hours after the start of reperfusion by the in vivo liver and spleen removal of blood-borne iodine 125 (125I)-test microparticles, which were coated with gelatin (denatured collagen) to enhance their interaction with pFn. Liver and spleen particle uptake in control and sham rats was similar. In contrast, after 4 hours of ischemic injury with 15 minutes of reperfusion, we observed a 30% to 40% decrease (p less than 0.05) in liver and spleen particle uptake as compared with sham controls with partial restoration of this removal mechanism by 18 hours. This depression in liver and spleen phagocytic function was associated with a significant (p less than 0.05) increase in the deposition of the 125I-test particles in the lung. RE depression was not due to a deficiency of pFn; indeed, a marked elevation (588 +/- 12 micrograms/mL versus 1,083 +/- 40 micrograms/mL) of pFn was observed by immunoassay over the 18-hour reperfusion interval. Comparative bioassay of humoral (opsonic) versus cellular (Kupffer's cell) activity revealed that Kupffer's cells in livers from controls or ischemia-reperfusion rats exhibited normal phagocytic function when incubated in plasma harvested from either control or 4-hour ischemic rats. The opsonic activity of plasma harvested after ischemia and reperfusion was also more than adequate, consistent with the immunoassay analysis. Thus, the impaired liver and spleen clearance mechanism after peripheral ischemia and reperfusion injury did not appear to be due to either a macrophage cellular deficit or a lack of pFn. This clearance depression may be mediated by splanchnic malperfusion, which is known to develop after peripheral ischemia and reperfusion and associated soft tissue injury.

Animals↗
PubMed1992

Anaesthesia in a parturient with osteogenesis imperfecta.

A 20-yr-old primigravida at 38 weeks gestation with premature rupture of membranes and evidence of fetal distress required urgent Caesarean section. The diagnosis of osteogenesis imperfecta had been made 4 days earlier. The patient refused a regional anaesthetic. Difficulties in the administration of general anaesthesia to patients with osteogenesis imperfecta were recognized and managed accordingly. These problems are discussed and the importance of early antenatal assessment of such patients by the department of anaesthesia is emphasized.

Adult↗
PubMed1992

Rebound elevation of fibronectin after tissue injury and ischemia: role of fibronectin synthesis.

Plasma fibronectin (pFn) stimulates macrophage phagocytosis of tissue debris; pFn deposition in tissues may influence vascular integrity. Although the acute depletion of pFn after surgery and/or injury has been described, less attention has been given to the rebound hyperfibronectinemia presumably "triggered" by the early pFn depletion. Using a model that compartmentalized the site of tissue injury and thus attenuated the initial pFn depletion, we studied this rebound elevation of pFn in anesthetized rats (250-350 g) after the surgical trauma of groin dissection alone (sham group) or surgery coupled with 4 h of hindlimb ischemia (experimental group). Nonoperated control rats were also anesthetized. Shams had baseline (preoperative) 6-, 8-, and 22-h postoperative pFn levels of 573 +/- 61, 598 +/- 62, 695 +/- 57, and 929 +/- 87 micrograms/ml, respectively. In the surgery-ischemia group, pFn also elevated to 1,117 +/- 40 micrograms/ml at 22 h postsurgery. Nonoperated control rats (only anesthetized) had no elevation of pFn. Intravenous infusion of gelatin-coated lipid particles (50 mg/100 g) depleted pFn by 89.3% but was unable to prevent the rebound elevation of pFn. The blood clearance of 125I-labeled pFn was very similar in control, sham, and experimental rats. In contrast, pFn synthesis over the 22-h period was dramatically altered and equal to 2.12 +/- 0.16, 3.40 +/- 0.56, and 4.49 +/- 0.17 mg pFn synthesized/100 g body wt, in control, sham, and experimental rats respectively. Thus a rapid increase in pFn synthesis contributes to the rebound hyperfibronectinemia after sublethal surgical injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Proteolysis of gelatin-bound fibronectin by activated leukocytes: a role for leukocyte elastase.

Fragmentation of subendothelial matrix-bound fibronectin by proteases released from stimulated leukocytes has been implicated in lung vascular injury. We studied the degradation of fibronectin bound to denatured collagen by inflammatory polymorphonuclear leukocytes (PMNL). Tissue culture wells coated with denatured collagen (gelatin) were pretreated with 125I rat plasma fibronectin to allow for fibronectin binding prior to the addition of rat inflammatory PMNL. The release of both intact and fragmented fibronectin from the 125I-labelled artificial matrix was quantified following the addition of PMNL stimulated by the phagocytosis of opsonized zymosan as well as leukocyte elastase. Stimulated PMNL released three times more radiolabelled fibronectin from the denatured collagen surface during a 4 h incubation as compared with unstimulated PMNL. This pattern of 125I-fibronectin release could also be elicited by the addition of purified leukocyte elastase alone, in the absence of PMNL. The release of radiolabelled fibronectin by stimulated PMNL was blocked in a dose-dependent manner by the addition of both methoxysuccinyl-alanine-alanine-valine chloromethyl ketone (AAPVCK), a leukocyte elastase specific inhibitor as well as phenylmethylsulfonylfluoride (PMSF), a non-specific serine protease inhibitor. Western blot analysis coupled with autoradiography confirmed the presence of fibronectin fragments in the medium after addition of PMNL or leukocyte elastase. The large molecular weight fragments (60-200 kD) were not labelled, but the smaller molecular weight fragments (less than 45 kD), derived from the artificial matrix, were labelled. Thus, fibronectin complexed with denatured collagen is susceptible to proteolytic degradation by stimulated inflammatory PMNL. Such a process may have a role in the pathogenesis of acute vascular injury following microvascular margination of activated blood leukocytes.

Amino Acid Chloromethyl Ketones↗
PubMed1991

Leukocyte elastase-independent proteolysis of gelatin-bound fibronectin by inflammatory macrophages.

Fragmentation of lung matrix fibronectin by proteases released from activated phagocytic cells has been implicated in lung vascular injury. We examined whether denatured collagen (gelatin)-bound fibronectin can be degraded by peritoneal exudate mononuclear phagocytes harvested from rats 96 h after intraperitoneal casein injection. Microtiter plates were pretreated with gelatin and then supplemented with purified 125I rat plasma fibronectin, which readily bound to the gelatin. Stimulated inflammatory exudate cells were added and proteolysis of the bound fibronectin was studied by the release of [125I]fibronectin fragments into the media. Following 2 h of incubation, peritoneal exudate mononuclear macrophages stimulated with opsonized zymosan released three times more radiolabeled fibronectin into the medium as compared to background controls, and 1.5 times more radiolabeled fibronectin as compared to cells not stimulated with zymosan. Western blot analysis and autoradiography confirmed the presence of fragments of fibronectin in the culture medium. Some of these fragments were clearly derived from the radiolabeled matrix, but others that were not labeled were potentially released directly from the added stimulated macrophages. The release of radiolabeled fibronectin was inhibited by N-p-tosyl-L-lysine chloromethyl ketone (TLCK), a trypsin specific inhibitor, but not by methoxysuccinyl-alanine-alanine-proline-valine-chloromethyl-ketone (AAPVCK), a leukocyte elastase-specific inhibitor. These results suggest that fibronectin bound to denatured collagen is susceptible to leukocyte elastase-independent enzymatic degradation by stimulated inflammatory exudate mononuclear phagocytic cells. Such proteolysis may mimic a pathological process associated with lung vascular injury during the sequestration of activated macrophages in the lung microcirculation and interstitium.

Animals↗
PubMed1991

[Evaluation of percutaneous transhepatic gallbladder drainage (PTGBD) for acute cholecystitis].

We performed percutaneous transhepatic gallbladder drainage (PTGBD) in 71 of 129 patients with acute cholecystitis. In 70 of 71 patients, clinical symptoms and laboratory data were rapidly improved by PTGBD. In order to evaluate the degree of acute cholecystitis, the clinical symptoms, laboratory data and ultrasonographic findings of these patients were analyzed by the quantification theory of Hayashi. As a result, irregular thickening of the gallbladder wall and gallbladder swelling presented by US and physical findings with Blumberg's sing or defence in the abdomen were most important findings to assess the severity of acute cholecystitis. Based on these data, we originally introduced the Severity Score of this disease and used it a criterion of PTGBD indication. The patients with the score above 0.5 were considered to be indicative for emergent PTGBD. In high risk patients (e.g., the aged or of diabetes mellitus) with the score above 0, this procedure should be indicated. In 24 of 71 patients, Percutaneous Transhepatic Gallbladder Scope (PTGBS) were attempted to retrieve stones, and it was completely successful in 16 patients.

Acute Disease↗
PubMed1991

[Preoperative diagnosis and staging of pancreatic cancer by endoscopic ultrasonography (EUS)--a comparative study with other diagnostic tools].

Endoscopic ultrasonography (EUS), ultrasonography (US), computed tomography (CT), and angiography (Angio) were performed in 26 patients with pancreatic cancer which were all resected. Preoperative findings of each diagnostic tools were compared with histological findings. In order to discuss the effectiveness of each body imagings, the preoperative staging of pancreatic cancer was evaluated in direct invasion to the anterior pancreatic capsule and stomach (S), direct invasion to the duodenum (D), direct invasion to the retroperitoneal adjacent vessels (Rp), and regional lymph node metastasis (N). The overall accuracy rate was 77% with EUS (50% with US, 38% with CT, 56% with Angio) in S, 81% with EUS (44% with US, 38% with CT, 63% with Angio) in D, 77% with EUS (58% with US, 42% with CT, 73% with Angio) in Rp, and 65% with EUS (58% with US, 38% with CT) in N. EUS revealed high accuracy rates because EUS images of the whole pancreas, surrounding organs and major vessels were clearly visualized through the gastroduodenal walls. Also, the accuracy rates of Angio in Rp and US in N were almost the same as those of EUS in Rp and N. However, it was difficult for every procedure to diagnose the retroperitoneal perineural invasion. From these results, EUS is one of the most beneficial procedures for detecting of the extent of cancer. EUS is expected to be popularized in the diagnosis and staging of the pancreatic cancer.

Adult↗
PubMed1991

[Prevalence of K-ras gene mutations in human colorectal cancers].

It has been reported that mutations in the human ras gene family convert these genes into active oncogenes. In the present study using in vitro gene amplification by the polymerase chain reaction (PCR) and mutation detection by the oligonucleotide hybridization assay, a total of 86 colorectal cancers were analyzed for the point mutations at codon 12 and 13 of K-ras genes. Mutations were present in 33 of the 86 colorectal cancers examined; 32 of the 33 mutations were at codon 12 of this gene and one of them was at codon 13. There was no apparent correlation between the presence of a ras gene mutation in a carcinoma and its anatomical location, level of differentiation, depth of invasion, degree of lymphnode metastasis or stage of progression, however, the high incidence of K-ras mutations was observed in early stage carcinomas (depth m and sm). This results support the concept that the point mutation of K-ras gene is early event in tumorigenesis of colorectal cancer.

Base Sequence↗
PubMed1990

Plasma fibronectin levels during cardiopulmonary bypass.

Plasma fibronectin, also called cold-insoluble globulin, is a cryoprecipitable glycoprotein with both opsonic and adhesive activities. It binds to collagen, actin, and heparin and can form soluble as well as cryoprecipitable complexes in the cold. Fibronectin augments particulate phagocytosis by the reticuloendothelial system and can influence lung vascular permeability. Plasma fibronectin deficiency is temporally associated with respiratory failure in septic surgical, trauma, and burn patients. We measured plasma fibronectin and albumin levels in nine adults undergoing elective cardiopulmonary bypass to determine whether dilution alone could account for the changes in plasma fibronectin. Plasma fibronectin concentration decreased 17% with the surgical trauma of opening of the chest and placement of the vascular cannulas. On heparinization and initiation of cardiopulmonary bypass, plasma fibronectin fell an additional 48% (P less than 0.001), whereas albumin concentration (corrected for albumin in the pump prime) fell only 25% (P less than 0.001), emphasizing that dilution was not the only mechanism contributing to the decline in plasma fibronectin. Fibronectin levels began to increase after discontinuation of cardiopulmonary bypass and in association with diuresis, but unexpectedly they remained subnormal until 4 days postoperation. Thus the decline in fibronectin concentration with cardiopulmonary bypass may be due to dilution as well as opsonic consumption and possible complexing with heparin in the cold.

Adult↗
PubMed1989

Effect of repetitive low-dose endotoxin on liver parenchymal and Kupffer cell fibronectin release.

Repetitive low-dose endotoxin, at a dose which will result in endotoxin tolerance, produces a marked but transient 2- to 3-day increase in plasma fibronectin. This elevation of fibronectin appears to contribute to increased hepatic Kupffer cell phagocytic function observed with repetitive low-dose endotoxin administration. Although numerous cell types synthesize fibronectin, hepatocytes are believed to be the major cell source of fibronectin in the plasma. Since Kupffer cells also synthesize fibronectin, we sought to determine the relative contribution of hepatic Kupffer cells, as compared to parenchymal cells, to the elevation of plasma fibronectin following repetitive low-dose endotoxin administration. Kupffer cells isolated from rats previously treated for 3 consecutive days with 100 micrograms Salmonella enteritidis endotoxin released greater (p less than 0.01) amounts of fibronectin over time in culture (3, 6, 12 and 24 hr) as compared to Kupffer cells isolated from normal rats. Experiments in which fibronectin was normalized to DNA content of the cells in culture also showed similar results for fibronectin release by Kupffer cells (normal: 2.9 +/- 0.5 ng per microgram DNA per 24 hr; endotoxin-treated: 53.3 +/- 1.3 ng per microgram DNA per 24 hr). Hepatocytes from endotoxin-treated rats released less (p less than 0.01) fibronectin over time than hepatocytes isolated from normal animals. As with Kupffer cells, results for fibronectin release by hepatocytes were similar when normalized to the DNA content (normal: 190.0 +/- 9.4 ng per microgram DNA per 24 hr; endotoxin-treated: 83.3 +/- 4.2 ng per microgram DNA per 24 hr).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Comparison of peroral and percutaneous cholangioscopy.

The clinical applications of peroral and percutaneous cholangioscopies are discussed, and the indications, advantages, disadvantages and therapeutic results compared. Peroral cholangioscopy (PCS) performed between January 1986 and April 1989 with the most advanced mother and baby 'scope system was compared with percutaneous cholangioscopic procedures such as PTCS, POCS and PTCCS done in the same period. PCS was done to remove common bile duct stones using electrohydraulic lithotripsy and to diagnose bile duct tumors with effective biopsy studies. Removal of intrahepatic bile duct stones was successfully performed with percutaneous cholangioscopy compared with the PCS procedure. For direct visualization of common bile duct tumors, PCS was the preferred approach for tumors located in the middle CBD to the liver hilus. On the other hand, percutaneous approaches had a good indication for the lesions in the distal CBD. Thus, the best approach for each lesion should be selected for effective diagnosis and treatment.

Bile Duct Diseases↗
PubMed1989

Contribution of hepatic fibronectin synthesis to regulation of plasma fibronectin.

Intravenous injection of gelatinized particles, which are phagocytized by the reticuloendothelial system, elicits an acute depletion of plasma fibronectin followed by restoration to normal concentrations in 6-8 h and a rebound elevation at 24 h. We determined the contribution of hepatic fibronectin synthesis to the restoration of plasma fibronectin in rats after particle infusion by measuring the net incorporation of 75selenomethionine into plasma fibronectin during the recovery period. Rats injected intravenously with gelatinized particles had a greater (P less than 0.01) incorporation of labeled 75selenomethionine into fibronectin but less (P less than 0.05) incorporation of 75selenomethionine into total plasma protein than control rats. Inhibition (86%) of hepatic fibronectin synthesis by pretreatment with cycloheximide limited the recovery of fibronectin levels by only 60%, suggesting a source(s) other than hepatic synthesis may contribute to the restoration of plasma fibronectin. Using purified human plasma fibronectin as a tracer in the plasma pool, we found that 26% of the soluble fibronectin consumed from the plasma during particle clearance was subsequently released back into the plasma over a 4-h interval. Tissue analysis indicated that 125I-labeled fibronectin, which was previously incorporated into the tissues, was not released from the tissue pool after the injection of gelatinized particles. Thus the normalization and regulation of plasma fibronectin levels after its acute depletion due to blood-borne particles is a result of 1) an increase in hepatic synthesis of fibronectin, 2) the release of fibronectin previously consumed as an opsonin during particle clearance, and 3) the release of soluble intact fibronectin from a preformed storage pool.

Animals↗
PubMed1989

[Basic studies on cutting of composite resin cores].

Filler contents, Knoop hardness, characteristics of cutting and surface texture of eight commercial composite resin cores were investigated. Two posterior composite resins and two silver alloys were used as controls. No differences were found in filler contents and Knoop hardness between the composite resin cores and posterior composite resins. In the composite resins, Knoop hardness was correlated to the filler content. The characteristics of cutting with a diamond point varied largely among materials. The composite resin cores were divided by deterioration of the characteristics of cutting into two groups. The degree of surface roughness of composite resins polished with a finishing diamond point was larger than that of the silver alloys. SEM examination revealed little differences in the composite resin surfaces cut with a diamond point but large differences in surfaces polished with a finishing diamond.

Composite Resins↗
PubMed1988

The use of endoscopic ultrasonography in the diagnosis and staging of carcinoma of the papilla of Vater.

Endoscopic ultrasonography (EUS) was evaluated in the diagnosis of carcinoma of the papilla of Vater. Thirteen cases of carcinoma of the papilla examined by EUS were investigated with the aim of assessing the detection capability of EUS in comparison with other diagnostic tools, and its usefulness in diagnosing the extent of the tumor. The EUS image of the normal papilla of Vater presents as a round protruded region with the layered structure of the duodenal papilla along with images of periampullary organs. All but one of 13 tumors of the duodenal papilla presented as a hypoechoic solid mass at EUS. On the basis of an analysis of the layered structure of the papilla of Vater and/or the duodenal wall, EUS images of 12 cases of ampullary carcinoma confirmed histologically were analysed. The EUS images of the tumors of the duodenal papilla corresponded well with the histological findings. When the extent of carcinoma was classified in 4 stages by EUS, the accuracy rate was 83%. EUS is one of the most promising procedures for determining the extent of tumors of the duodenal papilla.

Aged↗
PubMed1988

Progressive loss of fibronectin-mediated opsonic activity in plasma cryoprecipitate with storage. Role of fibronectin fragmentation.

Septic injured patients often manifest a deficiency of plasma fibronectin. Several studies have shown improvements in organ function in such patients following infusion of fibronectin-rich plasma cryoprecipitate, while other studies found no improvement. One explanation for these differences may be the use of plasma cryoprecipitate which has been stored for various time intervals prior to its use as a source of fibronectin. This investigation tested the hypothesis that the opsonic activity of fibronectin in cryoprecipitate may decline with increased storage duration. Using a bioassay of opsonic activity, we evaluated human plasma cryoprecipitate that was stored at either -20 or -80 degrees C for various intervals (2 weeks to 12 months) after its preparation from fresh donor plasma. Our findings demonstrated that the opsonic activity of fibronectin in cryoprecipitate declined with increasing time of storage. Significant loss (p less than 0.05) of opsonic activity was first evident after 2 months of storage. Storage at -80 degrees C did not prevent this decline in opsonic activity as compared to storage at -20 degrees C. Immunoblot analysis revealed extensive fragmentation of the dimeric fibronectin (440 kdaltons) and the presence of lower molecular weight fragments in 4- to 12-month-old plasma cryoprecipitate. Therefore, plasma cryoprecipitate of varying ages (storage time) when used as a source of fibronectin for replacement therapy to support phagocytic function in septic injured patients may result in different fibronectin-mediated responses. The decline in activity may be due, in part, to fragmentation of the fibronectin molecule.

Biological Assay↗