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PubMed2005

An expansion of the dual clip-domain serine proteinase family in Manduca sexta: gene organization, expression, and evolution of prophenoloxidase-activating proteinase-2, hemolymph proteinase 12, and other related proteinases.

Prophenoloxidase-activating proteinases (PAPs) take part in insect defense responses including melanotic encapsulation and wound healing. To understand their gene structure and regulation, we screened a genomic library and isolated overlapping lambda clones for Manduca sexta PAP-2, hemolymph proteinase 12 (HP12), and HP24. Complete nucleotide sequence analysis indicated that all three genes encode polypeptides with two regulatory clip domains at the amino terminus, a linker region, and a catalytic serine proteinase domain at the carboxyl terminus. Each gene contains eight exons, with introns located at equivalent positions. Similar sequences are present in introns as well as exons, indicating that these genes arose from recent gene duplication and sequence divergence. We analyzed their 5' flanking sequences and identified putative immune and hormone responsive elements. Reverse transcription-polymerase chain reactions confirmed that PAP-2 and HP12 mRNA levels in the larval fat body and hemocytes increased after a bacterial challenge. However, HP24 expression was barely detected. PAP-2 transcripts in cultured fat body became less abundant after 20-hydroxyecdysone treatment. Thus, PAP-2, HP12, and HP24 mRNA levels are differentially regulated by immune and developmental signals. Comparison with HP15, HP23, and PAP-3 sequences suggested an evolutionary pathway of the dual clip-domain serine proteinases in M. sexta.

5' Flanking Region↗
PubMed1998

Pulmonary vein injury through repetitive clip friction: an unusual cause of hemothorax.

Massive hemothorax developed in a 58-year-old man 12 hours after a left pneumonectomy. The source of bleeding was a tear in the pulmonary vein stump caused by a titanium clip that had been used during mediastinal lymphadenectomy. Postoperatively, the clip progressively sawed through the vascular wall of the pulmonary vein due to friction during the cardiac cycle.

Hemothorax↗
PubMed1993

Surgical clip artefact mimicking arterial stenosis: a problem with magnetic resonance angiography.

In three patients undergoing three-dimensional phase contrast magnetic resonance angiography (MRA) for evaluation of renal transplant arteries, a convincing stenosis was demonstrated that was not present on conventional angiograms. In each patient there was a stainless steel surgical clip in the soft tissues adjacent to the renal artery. Although the clip artefact was easily recognized on the acquired tomographic magnetic resonance slices, it was completely indistinguishable from a true stenosis on the final projection images. This may limit the use of MRA in post-surgical vascular evaluation unless review is made of the phase contrast images.

Adult↗
PubMed2000

Luteal function declines after laparoscopic sterilization by Hulka or Filshie clips.

We evaluated the influence of laparoscopic sterilization by Hulka or Fishie clips on corpus luteum function. Changes in corpus luteum function were evaluated in 46 women, before and after sterilization by Hulka (n = 22) or Filshie clips (n = 24). The mean age of the participants was 37 years (range 31-43 years). All women were healthy with regular menstrual cycles. Serum progesterone (P) was measured in one cycle before, and 3 and 12 months after the sterilization on cycle day 20-24. Endometrial biopsies were performed in the luteal phase before and one year after the procedure. The women measured the basal body temperature daily and kept a menstrual diary. The luteal phase P concentrations declined after the sterilization and the values were at the lowest level 3 months after the procedure (27.9 +/- 14.3 nmol/L vs. 18.7 +/- 13.4 nmol/L, = 0.0016). The values seemed to have recovered by 12 months (23.0 +/- 14.0 nmol/L, = 0.114 vs. baseline). Endometrium tended to be out-of-phase more frequently 1 year after the sterilization than before the surgery (= 0.065). Laparoscopic tubal sterilization is associated with an increased risk of luteal phase deficiency. However, the change may be only temporary in nature.

Adult↗
PubMed1976

Puerperal Weck clip sterilization: study I (first study of two consecutive studies).

One hundred and four puerperal applications have been performed using the (original) Weck pistol-grip applicator and applying the large Weck clip in the inverted V configuration. Follow-up varied from 37 to 42 months. The corrected failure rate was 8.7%. Mechanical difficulties were encountered with the jaws and metal sleeve of the (original) Weck pistol-grip applicator. Recovered clip configuration and tubal tissue histology are presented. Histologic changes suggest possible reversibility.

Animals↗
PubMed1979

Early assessment of a tubal plastic (Bleier) clip.

Fifty patients have been sterilized laparoscopically using a plastic tubal (Bleier) clip having a "snap-shut" mechanism. Initial assessment indicates that the method is simple in principle but there are limitations, including the bulky dimensions of the applicator, absence of a safety-catch mechanism, and faults in the clip design. Modifications are indicated before further evaluation.

Adult↗
PubMed1999

Intraoral technique to adapt a bar and clip in an implant-retained, tissue-supported complete denture.

This article presents a procedure for the attachment of clips to a bar supported by implants. This intraoral procedure prevents the possible locking of the denture onto the bar when autopolymerizing resin is used to attach the clips to the denture. Should the denture get locked onto the bar, this procedure allows for the separation of the denture from the bar extraorally without affecting the implants or the patient.

Acrylic Resins↗
PubMed2003

Aneurysm at the posterior inferior cerebellar artery of extradural origin for preoperative evaluation of safe clipping: case report and review of the literature.

BACKGROUND: As far as we know, 6 cases of extracranial (including craniocervical junction) intradural aneurysms of the posterior inferior cerebellar artery have been previously reported. However, preoperative detailed evaluation of the origin site and a course of the posterior inferior cerebellar artery by means of angiography were not reported in previous papers. CASE DESCRIPTION: We report a rare case of aneurysm of the posterior inferior cerebellar artery, which originated extradurally from the right vertebral artery. A 69-year-old woman experienced a sudden headache 16 years ago and a computed tomography scan showed a subarachnoid hemorrhage around the midbrain. Four-vessel cerebral angiography, however, failed to disclose a source of the hemorrhage. Magnetic resonance angiography incidentally revealed an aneurysm at the craniocervical junction 16 years after the subarachnoid hemorrhage. The aneurysm was exposed and clipped via a suboccipital route. At surgery, it was of no use to apply a temporary clip on the intradural segment of the vertebral artery, because the posterior inferior cerebellar artery was found to enter the intradural space separately from the vertebral artery. The blood flow to such an aneurysm cannot be stopped with this procedure. CONCLUSIONS: Careful neuroimaging study is essential for the accurate diagnosis and successful treatment of such a rare aneurysm.

Aged↗
PubMed1997

A new balloon-controlled temporary vascular clip.

We devised a temporary clip that is manipulated by inflation or deflation of a balloon. Prior application of this temporary clip to the proximal artery is convenient for controlling distal bleeding during microsurgery.

Arterial Occlusive Diseases↗
PubMed1999

Delayed thrombus propagation after parent artery clipping for giant fusiform aneurysms of the circle of Willis.

BACKGROUND: Obliteration of a giant fusiform aneurysm without significant therapeutic morbidity is extremely difficult. Ischemic complications have been often reported. METHODS: Two patients with giant fusiform aneurysms of the circle of Willis are presented. Both patients underwent proximal parent artery clipping after a bypass procedure. Balloon occlusion tests confirmed both patients' ability to tolerate flow reduction after proximal clipping. RESULTS: Although both patients awoke from anesthesia without neurologic deficit, they developed contralateral hemiparesis several hours after the operation as a result of a small infarct in the basal ganglia. These ischemic events might be attributed to the delayed thrombosis involving the orifice of the distal perforating arteries. CONCLUSIONS: In the treatment for giant fusiform aneurysms of the circle of Willis, special attention should be paid not only to flow reduction, but also to delayed thrombus propagation that may not be predicted by preoperative balloon occlusion testing.

Adult↗
PubMed1997

Effects of the CLIP fragment ACTH 20-24 on the duration of REM sleep episodes.

Substances acting upon rapid eye movement (REM) sleep or paradoxical sleep (PS) can affect the number and/or the duration of PS episodes. In the present study, we investigated the effects of the proopiomelanocortin-derived peptide CLIP (corticotropin-like intermediate lobe peptide, ACTH 18-39) and its N-terminal fragments ACTH 18-24 and ACTH 20-24 on the duration of PS episodes in rats. Intracerebroventricular injection of ACTH 20-24 caused a pronounced prolongation of PS episodes (up to 7 min duration, never seen under baseline conditions), whereas ACTH 18-24 acted in a similar way but without reaching statistical significance. We suggest that short N-terminal CLIP fragment(s) may represent endogenous hypnogenic factor(s) involved in the regulation of paradoxical sleep.

Adrenocorticotropic Hormone↗
PubMed1988

Open-field behavior of one-clip, two-kidney hypertensive rats: the influence of pre-handling.

The relation between the development of hypertension and changes in behavior was investigated. Hypertension was induced by unilateral application of a 0.20-mm clip around the renal artery. At 4 weeks, but not at 1 week, after the operation an increase in ambulation was found. Blood pressure was significantly increased at 1 (28 mm Hg) and 4 weeks (78 mm Hg) after the operation. In a second experiment, renal hypertensive rats and controls were either regularly handled (i.e., subjected to indirect tail-cuff blood pressure measurements) or left undisturbed. At 4 weeks after clip implantation, only in the nonhandled rats with renal hypertension, an increase in open-field ambulation was found. Blood pressure was markedly increased in both handled and nonhandled renal hypertensive rats.

Animals↗
PubMed2003

An increase in the synthesis and release of calcitonin gene-related peptide in two-kidney, one-clip hypertensive rats.

Previous investigations have indicated that capsaicin-sensitive sensory nerves play an important role in modulation of the peripheral resistance of the circulation system. In the present study, we examined the role of capsaicin-sensitive sensory nerves in two-kidney, one-clip (2K1C) renovascular hypertension rats. Systolic blood pressure (BP) was monitored by the tail-cuff method throughout the experiment. Concentrations of calcitonin gene-related peptide (CGRP) in the plasma, the level of CGRP mRNA in dorsal root ganglia (DRG) and the density of CGRP immunoreactive (CGRP-ir) fibers in mesenteric artery were measured. Blood pressure was significantly elevated at day 10 postoperation (BP was 143+/-10 and 114+/-7 mm Hg for 2K1C and Sham groups, respectively, p<0.05). Treatment with capsaicin, which selectively depletes neurotransmitters in sensory nerves, enhanced hypertensive responses to clipping (BP was 168+/-7 and 143+/-10 mm Hg at day 10 postoperation for Cap1+2K1C and 2K1C groups, respectively, p<0.05), and BP in the rats treated with a second injection of capsaicin was greater than that in the rats treated with a single injection of capsaicin (At day 30 postoperation, BP was 199+/-7 and 166+/-9 mm Hg for Cap2+2K1C and 2K1C groups, respectively, p<0.01; mean arterial pressure was 185.2+/-6.6 and 150.5+/-4.1 mm Hg for Cap2+2K1C and 2K1C groups, respectively, p<0.01). The expression of alpha-CGRP mRNA in DRG (122.87+/-3.67 arbitrary units, p<0.05), the level of CGRP in the plasma (75.40+/-4.99 pg/ml, p<0.01) and the density of CGRP-ir fibers in mesenteric artery (525.67+/-31.42 intersections, p<0.05) were significantly increased in 2K1C rats. Treatment with capsaicin, a single injection or a second injection, prevented the increased in the expression of CGRP mRNA in DRG. However, the decreased level of CGRP was only observed in the rats treated with a second capsaicin. These results suggest that in 2K1C hypertensive rats, the activity of capsaicin-sensitive sensory nerves is increased, which is playing a compensatory depressor role to partially counteract the increase in blood pressure, and that the cardiovascular actions of CGRP is mediated by the alpha-CGRP isoform.

Animals↗
PubMed2003

Upregulation of phospholipase D1 in the spinal cords of rats with clip compression injury.

This study examined phospholipase D 1 (PLD1) expression in the central nervous system following clip compression spinal cord injury (SCI) in Sprague-Dawley rats. After inducing SCI with a vascular clip, the expression of PLD1 in the affected spinal cord was analyzed by Western blot and immunohistochemistry. Western blot analysis showed that the expression of PLD1 gradually increased in the spinal cord on days 0.5, 1, 2, and 4 post injury. Immunohistochemistry showed that some cells, including neurons, astrocytes, and some inflammatory cells, were positive for PLD1 in the lesions at days 1 and 2 post injury. At day 4, the number of PLD1-positive cells in SCI lesions increased, largely matching the increases in ED1-positive macrophages and glial fibrillary acidic protein-positive astrocytes. At this time, macrophages expressed proliferating cell nuclear antigen in addition to PLD1. These results suggest that PLD1 expression is increased in injured spinal cords, and might be involved in the activation and proliferation of macrophages and astrocytes in SCI.

Animals↗
PubMed2003

Prophenoloxidase-activating proteinase-3 (PAP-3) from Manduca sexta hemolymph: a clip-domain serine proteinase regulated by serpin-1J and serine proteinase homologs.

Phenoloxidase (PO) is a key enzyme implicated in several defense mechanisms in insects and crustaceans. It is converted from prophenoloxidase (proPO) through limited proteolysis by prophenoloxidase-activating proteinase (PAP). We previously isolated PAP-1 from integument and PAP-2 from hemolymph of the tobacco hornworm, Manduca sexta. Here, we report the purification, characterization, and regulation of PAP-3 from the hemolymph. Similar to M. sexta PAP-2, PAP-3 consists of two amino-terminal clip domains followed by a carboxyl-terminal catalytic domain, whereas PAP-1 contains only one clip domain at its amino-terminus. Purified PAP-3 cleaved proPO at Arg51 and generated a low level of PO activity. However, the enzyme efficiently activated proPO when M. sexta serine proteinase homolog-1 and -2 were present. These proteinase-like proteins associate with immulectin-2, a pattern-recognition receptor for lipopolysaccharide. M. sexta PAP-3 was inhibited by recombinant serpin-1J, which formed an SDS-stable complex with the enzyme. PAP-3 mRNA was detected at a low level in the fat body or hemocytes of naive larvae, but was elevated in insects that had been challenged with bacteria. These data, along with our previous results on PAP-1 and PAP-2, indicate that proPO activation by PAPs is a tightly regulated process. Individual PAPs could play different roles during immune responses and developmental processes.

Amidohydrolases↗
PubMed2001

Impact of nonpenetrating clips on intimal hyperplasia of vascular anastomoses.

Non-penetrating, arcuate-legged titanium clips create an interrupted, non-penetrated, yet compliant vascular anastomoses that is associated with significantly reduced anastomotic neointimal hyperplasia. Recent experimental and clinical studies provide evidence that the non-suture alternative changes the biology of vessel-to-vessel and graft-to-vessel connections that reduces the stimulus for hyperplasia at a number of critical points in the response to injury schema. The compliant, "blood-tight" characteristics of clipped vascular reconstructions are associated with no endothelial injury or intraluminal foreign body, minimal platelet aggregation and laminal flow. Clinical applications including vascular access, femoropopliteal bypass, and closure of carotid endarterectomies are remarkable for the absence of restenosis and preserved anastomotic patency.

Anastomosis, Surgical↗
PubMed2001

Laparoscopic supracervical hysterectomy with Filshie clips.

We conducted a retrospective study to evaluate the efficacy of Filshie clips for pedicle ligation during laparoscopic subtotal hysterectomy. The procedure was a combination of endoscopic stapling with lateral movement of the cartridge to the infundibulopelvic or ovarian ligaments, Filshie clips to uterine arteries, cutting diathermy to transect the cervix, and motorized morcellator to remove the uterine body. Two patients had postoperative spotting from the stump. Median return to home activity was 7.5 weeks (range 2-24 wks) and to work was 9.5 weeks (range 2-12 wks). Based on a questionnaire survey, all 12 women were satisfied with the operation. In those who were sexually active it was associated with improved sexual functioning in six and no change in four. (J Am Assoc Gynecol Laparosc 8(1):137-142, 2001)

Adult↗
PubMed1994

Nonpenetrating, arcuate-legged clip reconstruction of the rat uterine horn.

A new method for reconstructing rat uterine horn was developed in which nonpenetrating, arcuate-legged clips are applied in interrupted fashion to everted seromuscular edges, forming an elastomeric flanged joint. This anastomosis has unusual physical and morphologic properties, with improved tissue healing and luminal restitution. Clipping is easier than suturing, and resulted in equivalent fertility rate (50-60%) and litter size. It also is associated with less granuloma formation and hystiocytic infiltration than suture. The new technique has the potential of endoscopic translation for human tubal reconstruction.

Anastomosis, Surgical↗