海南青牛胆非生物碱成分的分离与鉴定（III）

目的：研究防已科一个新种－海南青牛胆Tinospora hainanensis H.S.LoetZ.X.Li的化学成分，方法：采用硅胶柱层析分离纯化，通过理化鉴定和波谱分析鉴定其化学结果，结果：从海南青牛胆藤茎中分离出4种非生物碱成分，它们分别鉴定为24－epi-罗汉松甾酮A（24－epi-makisterone A,I)二十八碳酸（octacosyl acid,II),二十八碳醇（octacosyl alcohol,III)和二十六碳醇(hexacosyl alcohol,IV).结论：以上４种成分均为首次从该植物中分得，其中化合物Ｉ、ＩＩ和ＩＶ为首次从青牛胆属植物中得到。     

Peritoneal carcinomatosis in refractory seminoma

Intraperitoneal metastasis from a testicular germ cell tumor is very rare. We report a case in a 33-year-old man who was referred to Hokkaido University Hospital, Hokkaido, Japan, for further therapy for refractory seminoma. Physical examination revealed abdominal distension as a result of ascites, and cytology of the ascites showed seminoma cells. Although the ascites completely disappeared after treatment with a novel regimen of irinotecan-based chemotherapy, the patient had a recurrence of ascites and died of progressive disease 5 months after the start of the therapy.     

Urethral leiomyoma expressing estrogen receptors

A case of urethral leiomyoma is presented. The patient was a 48-year-old female who was hospitalized with a 4-year history of a progressively enlarging urethral mass. Based on clinical diagnosis of benign urethral tumor, local excision was performed. Histological diagnosis was urethral leiomyoma and the tumor cells demonstrated immunoreactivity for estrogen receptors. We report our experience of a leiomyoma of the urethra expressing estrogen receptors.     

Early Afterdepolarization Abolished by Potassium Channel Opener in a Patient with Idiopathic Long QT Syndrome

Abolished Early Afterdepolarization by Nicorandil. We describe a 17-year-old boy with idiopathic long QT syndrome and repeated syncopal episodes. Early afterdepolarization (EAD) in the monophasic action potential (MAP) was demonstrated in the posterior septum of the left ventricle. Injection of the potassium channel opener nicorandil decreased KAD and shortened MAP duration. The syncopal episodes due to ventricular fibrillation disappeared after administration of the potassium channel opener.     

Kabuki make-up syndrome associated with chronic idiopathic thrombocytopenic purpura

Although susceptibility to infections in Kabuki make-up syndrome (KMS) has frequently been reported, there have been few immunological studies. We describe a 14 year old girl with KMS exhibiting chronic idiopathic thrombocytopenic purpura (chronic ITP), including immunological studies. Corticosteroid therapy was not effective therefore splenectomy was performed. The patient's platelet count increased transiently. Immunological studies revealed normal T cell functions and low serum immunoglobulin A (IgA) levels. Because of the abnormalities of B cell functions in chronic ITP and low serum IgA levels in our patient, we speculate that there may be some abnormalities of humoral immunity in KMS.     

Medical Treatment for Inoperable Insulinoma: Clinical Usefulness of Diphenylhydantoin and Diltiazem

This report describes a 78-year-old woman with insulinoma, treatedwith a combination of diphenylhydantoin and a calcium antagonist.The effectiveness of 200 mg of diphenylhydantoin and 180 mgof diltiazem was evaluated by measuring the levels of plasmaglucose, immunoreactive insulin and immunoreactive insulin/plasmaglucose after fasting or by the oral glucose tolerance test,and by the appearance of hypoglycemic symptoms. The mean concentrationof fasting plasma glucose increased significantly during thetreatment. The levels of immunoreactive insulin/plasma glucoseand C-peptide imniunoreactivity/plasma glucose significantlydecreased. Symptomatically. no episode of hypoglycemia was notedduring the combined treatment.     

Clinical Study of Cyclocytidine in Children With Acute Leukemia

One hundred children with various types of leukemia were given113 treatments with cyclocytidine. Eighty-four of these patientshad been treated previously. Cyclocytidine was daily given intravenouslyfor four to 11 consecutive days in amounts of 20mg/kg or 500mg/m².The treatment course . was repeated, when necessary. Complete remission was obtained in one case of monocytic leukemiaamong six treated by cyclocytidine alone. Combined therapy withsteroid hormone gave 14 complete and eight partial remissionsin 38 cases, the remission rate standing at 58%. There were30 complete and 16 partial remissions in 69 cases treated withcombination therapy with two or more agents, and the remissionrate was 67%. Transient pains in the region of the parotid gland were themost characteristic toxicity. GI tract symptoms were less commonand milder than those of cytosine arabinoside. Dizziness wasnoticed in three cases. Nine children with acute leukemia who were given cyclocytidineorally showed no remarkable response. Cyclocytidine, given parenterally, seems beneficial for varioustypes of leukemia in children.     

Long QT syndrome with insulin-dependent diabetes mellitus: contiguous gene syndrome on chromosome 11p

Abstract. Long QT syndrome (Romano-Ward syndrome) and insulin-dependent diabetes mellitus (IDDM) have been documented as being linked with gene(s) on chromosome 11p although concurrence of the two disorders has not been reported. Our case is a 13-year-old boy with Romano-Ward syndrome accompanied by IDDM. The long QT syndrome seemed to be transmitted in an autosomal-dominant mode because the Q-T intervals of his father and paternal grandfather were longer than normal. There was no family member with an abnormally high level of blood glucose except the patient. The human leucocyte antigen (HLA) haplotypes of the patient and the father were DR4/DR9 and DR2/DR9, respectively. This study suggests that in our patient IDDM, as well as Romano-Ward syndrome, is linked with chromosome 11p in the presence of HLA-DR4. The results support the previous study that chromosome 11p encodes a gene implicated in HLA-DR4-dependent diabetes susceptibility.     

Prolonged liver dysfunction caused by hemosiderosis in a renal transplant recipient

BACKGROUND: Liver dysfunction is a frequent complication that arises in the period following kidney transplantations, often resulting in death. We reported a case proving hemosiderosis as a cause of prolonged liver dysfunction after cadaveric kidney transplantation. METHODS: A 47-year-old man, who had been undergoing hemodialysis, was referred to our hospital on 2 November 1999. On the same day, cadaveric kidney transplantation was performed, and serum creatinine level reached a normal level within 2 weeks after surgery. However, serum transaminase gradually increased in the postoperative period. Serum ALT rose up to 116 IU/L on day 20 after the operation and 215 IU/L on day 30. Microscopic examination by needle biopsy revealed hemosiderosis of the liver. Recombinant human erythropoietin was administered and phlebotomy was performed. Liver function improved as a result. CONCLUSION: Early histological diagnosis can be a useful marker in predicting the course of chronic liver disease.