Pseudomyxoma Peritonei with High Carcinoembryonic Antigen (CEA) Level: Report of Two Cases

Two cases of pseudomyxoma peritonei with high serum carcinoembryonicantigen (CEA) are reported. CEA levels in serum increased incorrelation with the accumulation of ascites. Systemic chemotherapywith anticancer agents such as 5-fluorouraciI (5-FU), cyclophosphamide,mitomycin C (MMC) and chromomycin A_a showed no effect on reducingeither the production of mucinous materials or the CEA level,but repeated intraperi-toneal instillation of large amountsof MMC reduced them in one case. In the other case, the CEAlevel returned to normal after removal of the tumor. These resultssuggest that CEA may be a useful indicator of the effect oftreatment and of the prognosis of pseudomyxoma peritonei.     

Relationships Between Histological and Functional Indices of Acute Chemically Induced Nephrotoxicity

Relationships Between Histological and Functional Indices ofAcute Chemically Induced Nephrotoxicity. Miyajima, H., Hewitt,W.R., Côté, M.G., and Plaa, G.L. (1983). Fundam.Appl. Toxicol. 3: 543–551. Acute renal injury was producedin rats with K₂Cr₂O₇ (5–40 mg/kg, sc) HgCl₂ (0.5–5.0mg/kg, sc) or cephaloridine (0.5–3.0 g/kg, sc). Histological(percentage of normal, degenerated or necrotic cells) and functionalindices (relative kidney weight, renal cortical slice accumulationof organic ions, and blood urea nitrogen content) were evaluated48 hours later. The relative sensitivity of each of these indiceswas determined for each nephrotoxicant. Renal cortical accumulationof organic ions appeared to be the most sensitive of the functionalparameters. A quantitative histological evaluation was foundto be as sensitive an indicator of nephrotoxicity as organicion accumulation. Alterations in each of the functional indiceswere significantly correlated with changes in renal histology.     

Hemophagocytic lymphohistiocytosis in a human immunodeficiency virus-positive homosexual high school student

The spread of human immunodeficiency virus (HIV) infection has exploded over the past two decades and such infections in young people are no longer uncommon. However, the major infection route of pediatric patients remains vertical transmission, and sexual, especially homosexual transmission, is highly unusual. We herein describe the case of a 17-year-old boy who developed hemophagocytic lymphohistiocytosis (HLH). Although HLH was remitted soon with dexamethasone therapy, an HIV infection caused by homosexual transmission was detected.     

Conduction Delay in Right Ventricle as a Marker for Identifying High‐Risk Patients With Brugada Syndrome

Conduction Delay as a Marker for Brugada Syndrome. Objectives: To evaluate the significance of conduction delay (CD) in the right ventricle (RV) in Brugada syndrome (BS) as a marker for risk stratification of sudden death. Methods: Twenty‐five patients with BS (7 with documented ventricular fibrillation (VF), 8 with syncope, and 10 without symptoms) and 10 control subjects were paced from the RV apex using 8 beats of drive pacing and a single extra‐stimulus. CDs in the right ventricular outflow tract (RVOT) (CD‐RV) and in the lateral left ventricle (L‐LV) (CD‐LV), and the local electrogram durations at a single extra‐stimulus in RVOT (D‐RV) and L‐LV (D‐LV) were calculated. We also evaluated changes in 12‐lead ECG parameters in 16 patients with BS after pilsicainide challenge test (Pilsicainide‐test). Results: Maximal CD‐RV and maximal D‐RV were significantly larger than maximal CD‐LV and maximal D‐LV in BS (26 ± 10 and 105 ± 15 vs 20 ± 6 and 92 ± 15 ms, P < 0.05, respectively). Maximal CD‐RV and maximal D‐RV in patients with documented VF were the largest among the 3 groups. There was a significant positive correlation between maximal CD‐RV or maximal D‐RV and changes in QRS duration in leads V2 and V5 and in S wave duration in lead II and V5 after Pilsicainide‐test (CD‐RV; r = 0.54, 0.51, 0.56, and 0.53: D‐RV; r = 0.55, 0.5, 0.57, and 0.53, P < 0.05, respectively). In control subjects, there were no significant differences. Conclusions: CD in RV was a useful marker for identifying high‐risk patients with BS. CD in the RV, especially in the RVOT epicardium, may be related to arrhythmias in BS. (J Cardiovasc Electrophysiol, Vol. 21, pp. 688‐696, June 2010)     

The effect of emphysema on lung function and survival in patients with idiopathic pulmonary fibrosis

Background and objective: In this study the prevalence, lung function and prognosis of IPF combined with emphysema were evaluated. Methods: Consecutive patients with usual interstitial pneumonia (UIP) on high‐resolution computed tomography (HRCT), with or without emphysema, were assessed retrospectively. The area of fibrosis in the base of the lungs was assessed by HRCT as minimal (<2 cm from the subpleura), moderate (≥2 cm from the subpleura, <1/3 of the area of the base of the lungs) or severe (≥1/3 of the area of the base of the lungs). Results: Among 660 patients with UIP on HRCT, 221 showed upper‐lobe emphysema. Pulmonary function results for patients with UIP and UIP/emphysema, respectively, were: FVC, 71.8% and 87.1%; FEV1%, 86.7% and 87.9%; and DL_CO, 74.3% and 65.2% of predicted. The relationship between FVC, the extent of fibrosis and survival was investigated in 362 patients with records of pulmonary function tests and no lung cancer at the time of entry into the study. Although the extent of fibrosis was similar between the groups, 71.3% of UIP patients met the lung volume criteria for IPF (FVC <80% of predicted), whereas only 26.5% of UIP/emphysema patients met the lung volume criteria for IPF. Median survival was 7.5 years in the UIP group and 8.5 years in the UIP/emphysema group. Conclusions: Emphysema was a common finding in patients with UIP. Patients with UIP and emphysema had greater lung volumes and better survival compared with those with UIP alone.     

Cystamine-enkephalin dimer

A cystamine-enkephalin dimer, containing two molecules of [D-Ala², Leu⁵] enkephalin cross-linked at the COOH-terminal leucine residue with cystamine, (NH₂-CH₂-CH₂-S-)₂, has been synthesized in order to examine directly the dimerization effect of an enkephalin molecule on the opiate receptor interactions. In a comparison of potencies against [³H]-[D-Ala²,D-Leu⁵]enkephalin (³H-DADLE) and [³H]-[D-Ala²,MePhe⁴,Gly-ol⁵]enkephalin (³H-DAGO) as delta and mu tracers, respectively, enkephalin dimer showed a very high affinity, especially for the delta opiate receptors. Dimer was almost threefold more potent than DADLE, which is one of the most utilized delta ligand to date. When the binding affinity of cystamine-dimer was compared with that of its reduced thiol-monomer, namely [D-Ala²,Leu⁵, cysteamine⁶]enkephalin, the increment in affinity was four to fivefold for both delta and mu receptors. The results strongly indicate that the dimeric enkephalin is more potent presumably due to the simultaneous interaction with the two binding sites of the opiate receptors.     

Defective natural killer cell activity and deficient production of interferon-γ in children with acute lymphoblastic leukemia

Natural killer (NK) cell activity, OK-432-augmented-NK cell activity, concentrations of interferon-γ (IFN-γ) in the culture supernatants of lymphocytes stimulated with OK-432, and subsets of NK cells and memory T cells were analyzed in 42 children with acute lymphoblastic leukemia (ALL) receiving maintenance chemotherapy. Natural killer and augmented-NK cell activities, and concentrations of IFN-γ in the supernatants of cultured lymphocytes, were significantly lower in the patients with ALL than in age-matched control children. Among the NK cell subsets, proportions of CD57⁺ cells in the patients with ALL were significantly higher than in the controls, and proportions of a memory T cell subset (CD4⁺ CD29⁺ T cells) in the patients were also significantly higher than in the controls. These results suggest that the function of NK cells and memory T cells that are considered as IFN-γ producing cells, may be defective in ALL, and that CD57⁺ cells and CD4⁺ CD29⁺ cells may be resistant to or recover rapidly from suppression by cytotoxic chemotherapy.     

Effects of Ageing on the Oral Absorption of D-Xylose in Rats

The effects of ageing on the oral absorption of d -xylose were investigated in rats. The pharmacokinetic analysis of d -xylose concentration in plasma after oral administration showed that the fraction absorbed was increased to 0·998 ± 0·002 and 0·950 ± 0·049, respectively, in old (52 weeks) and very old (102 weeks) rats, compared with 0·768 ± 0·052 in young (9 weeks) rats, while the absorption rate constant was not significantly changed: 0·944 ± 0·233, 0·844 ± 0·143 and 0·725 ± 0·004 h^?1, respectively, in young, old and very old rats. The absorbed fractions estimated from faecal and urinary excretion were in agreement with those by the pharmacokinetic analysis. Thus, the present study demonstrated an increase in the extent of the oral absorption of d -xylose with ageing. The increase in the extent of absorption might be caused by a delay in the intestinal transit, because the absorption rate constant was unchanged. These results suggest potential increases with ageing in the fractions absorbed of hydrophilic drugs such as d -xylose where oral absorption is incomplete.