Molecular epidemiology of fecal Oxalobacter formigenes in healthy adults living in Seoul,Korea

BACKGROUND AND PURPOSE: Oxalobacter formigenes is a member of the intestinal flora that degrades oxalate. This bacterium maintains an important symbiotic relation with its hosts by regulating oxalic acid absorption in the intestine as well as oxalic acid concentrations in plasma. We tried to define the prevalence of fecal O. formigenes positivity in healthy adults. MATERIALS AND METHODS: Whole-bacterial DNA was isolated directly from fresh stool samples obtained from 233 healthy adults known to be free of urolithiasis. Genus-specific oligonucleotide sequences corresponding to homologous regions residing in the oxc gene that encodes oxalyl-coenzyme A decarboxylase were designed. A PCR-based assay was done on the stool samples. RESULTS: A PCR product of 416 bp encoding the oxc gene was detected in 197 of the 233 stool samples (76.8%). Adjusted to the Seoul population census 1995, the calibrated fecal O. formigenes-positive rate was estimated to be 76.7%: 79.2% in men and 74.2% in women, with no significance difference according to age or sex. CONCLUSION: These results suggest that O. formigenes inhabits the intestine of three fourths of the normal Korean populations. These data provide a base for further studies to uncover the relation between O. formigenes and urolithiasis.     

188Re-tin-colloid as a new therapeutic agent for rheumatoid arthritis

Radiation synovectomy is a useful treatment modality in patients with refractory synovitis. We have developed a 188Re-tin-colloid as a new radiopharmaceutical agent and investigated its efficacy and safety in patients with rheumatoid arthritis. Radiation synovectomy was performed using 188Re-tin-colloid in 22 knees from 21 rheumatoid arthritis patients refractory to intra-articular corticosteroid injection. The efficacy and safety of administration of 370-1110 MBq of 188Re-tin-colloid were evaluated after 1, 3, 6, 9 and 12 months. Pain intensity on a visual analogue scale decreased significantly 12 months after therapy (mean+/-SD: 68.0+/-26.1 mm vs. 25.1+/-23.4 mm; P=0.0001 by the paired t-test). Pain decreased in 19 cases (86.3%), joint tenderness improved in 14 cases (63.6%) and joint swelling was reduced in all cases (100%). 188Re-tin-colloid was safe. The residual activity of 188Re in the blood was 0.077%+/-0.25% of the injected dose. The radioactivity of 188Re in the urine was 0.14%+/-0.13% of the injected dose. Transient reactive synovitis was observed in 18 cases (81.8%). No clinical side-effects or abnormalities in leucocyte count, platelet count, liver function tests or urine analysis were observed in any patient. In conclusion, in this first study of radiation synovectomy using 188Re-tin-colloid for patients with rheumatoid arthritis, the treatment resulted in the improvement of arthritis and was well tolerated.     

The urethra and its supporting structures in women with stress urinary incontinence: MR imaging using an endovaginal coil

OBJECTIVE: The objective of this study was to evaluate the urethra and its supporting structures in patients with stress urinary incontinence using MR imaging with an endovaginal coil. SUBJECTS AND METHODS: We reviewed MR images obtained using an endovaginal coil in 63 patients with stress urinary incontinence and in 16 continent women. We compared the two groups for the thickness of the striated muscle, smooth muscle, and mucosa-submucosa of the urethra; degree of asymmetry of the puborectalis muscle; frequency of distortion in the periurethral, paraurethral, and pubourethral ligaments; degree of the vesicourethral angle; and dimension of the retropubic space. Using the status of the urethra and its supporting structures as our basis, we scored the risk of stress urinary incontinence for each woman on a scale of 0-5. RESULTS: The striated muscle layer of the urethra was thinner in the group with stress urinary incontinence (mean +/- SD, 1.9 +/- 0.5 mm) than that in the continent group (2.6 +/- 0.4 mm) (p < 0.001). A high degree of asymmetry of puborectalis muscle (>1.5) was more frequent in the group with stress urinary incontinence (29%) than in the continent group (0%) (p = 0.015). Supporting ligaments were more frequently distorted in the incontinent group than in the continent group. Distorted periurethral ligaments were found in 56% of the patients with stress urinary incontinence versus 13% of the women who were continent; distorted paraurethral ligaments were found in 83% of the patients with stress urinary incontinence versus 19% of the women who were continent; and distorted pubourethral ligaments were found in 54% of the patients with stress urinary incontinence versus 19% of the women who were continent (p < 0.05). The group with stress urinary incontinence had a greater vesicourethral angle (148 degrees vs 125 degrees ) and larger retropubic space (7.5 vs 5.1 mm) than did the women who were continent (p < 0.05). The score for the risk of stress urinary incontinence was higher in the group with stress urinary incontinence (3.3 +/- 1.4) than in the women who were continent (1.0 +/- 1.2) (p < 0.001). CONCLUSION: MR imaging with an endovaginal coil revealed significant morphologic alterations of the urethra and supporting structures in patients with stress urinary incontinence.     

Transcatheter arterial chemoembolization with paclitaxel-lipiodol solution in rabbit VX2 liver tumor

PURPOSE: To evaluate the antitumor effects of transcatheter arterial chemoembolization (TACE) with a solution of an anticancer drug (Paclitaxel; Bristol-Myers Squibb, Princeton, NJ) and iodized oil (Lipiodol; Laboratoire Gurerbet, Aulnay-Sous-Bois, France) (hereafter, the solution), as well as intratumor concentration and hepatotoxicity, in experimentally induced liver tumor. MATERIALS AND METHODS: VX2 carcinoma was grown in livers of 30 rabbits. In 18 rabbits, TACE was performed with the high-dose solution (4 mg anticancer drug and 0.4 mL iodized oil, n = 6), the low-dose solution (1 mg anticancer drug and 0.4 mL iodized oil, n = 6), or iodized oil alone (0.4 mL, n = 6) in a control group. One week later, the growth ratio and residual viable proportion of the tumors were calculated on the basis of findings at spiral computed tomography and histopathologic examination. Hepatic and hematologic toxicities were evaluated by means of biochemical analysis. Differences between the three groups were statistically assessed with the Kruskal-Wallace and Mann-Whitney U tests. The remaining 12 animals were treated with the high-dose solution and serially sacrificed for clarification of chronologic change of concentration of the anticancer drug in liver tissues. RESULTS: Growth ratios and residual viable proportions of the tumors were significantly lower in the solution groups (high dose, 3.3% +/- 6.2 [mean +/- SD] and 2.8% +/- 3.6, respectively; low dose, 18.7% +/- 7.4 and 12.7% +/- 6.1, respectively) than in the control group (68.3% +/- 12.7 and 31.1% +/- 8.8, respectively) (P <.05). Hepatotoxicity was transient in all but one rabbit, which died 2 days after TACE with substantial biochemical changes. The anticancer drug accumulated in tumor where the concentration peaked at day 3 and returned to levels comparable to those for normal hepatic parenchyma at 7 days after TACE. CONCLUSION: TACE with the Paclitaxel-Lipiodol solution has dose-dependent antitumor effects without major toxicities in VX2 liver tumor.     

Pharmacologic interaction between cannabinoid and either clonidine or neostigmine in the rat formalin test

BACKGROUND: Although spinal cannabinoid receptor agonist (WIN 55,212-2) has been shown to encounter various models of pain, the role of two subtypes of cannabinoid receptor for the antinociceptive effect of cannabinoids has not been investigated at the spinal level. Spinal alpha 2 receptor agonist (clonidine) and cholinesterase inhibitor (neostigmine) are also active in the modulation of nociception. The authors examined the properties of drug interaction after coadministration of WIN 55,212-2-clonidine, and intrathecal WIN 55,212-2-neostigmine, and further clarified the role of cannabinoid 1 and 2 receptors in cannabinoid-induced antinociception at the spinal level. METHODS: Catheters were inserted into the intrathecal space of male Sprague-Dawley rats, and 50 microl of 5% formalin solution was injected into the hind paw to evoke the pain. Isobolographic analysis was used for evaluation of pharmacologic interaction. RESULTS: Intrathecal 55,212-2, clonidine, and neostigmine dose-dependently suppressed the flinching observed during phase 1 and 2 in the formalin test. Isobolographic analysis revealed a synergistic interaction after intrathecal delivery of WIN 55,212-2-clonidine or WIN 55,212-2-neostigmine mixture in both phases. The antinociceptive effect of WIN 55,212-2 was antagonized by cannabinoid 1 receptor antagonist (AM 251) but not by cannabinoid 2 receptor antagonist (AM 630). No antinociceptive effect was seen after intrathecal administration of cannabinoid 2 receptor agonist (JWH 133). CONCLUSIONS: Intrathecal 55,212-2, clonidine, and neostigmine attenuate the facilitated state and acute pain. WIN 55,212-2 interacts synergistically with either clonidine or neostigmine. The antinociception of WIN 55,212-2 is mediated through the cannabinoid 1 receptor, but not the cannabinoid 2 receptor, at the spinal level.     

Small bowel complication caused by magnetic foreign body ingestion of children: two case reports

Accidental ingestion of foreign bodies is a common pediatric problem. The majority of such cases occur between 6 months and 3 years. When several magnets are ingested, they can be attracted to each other through the intestinal wall, causing necrosis and intestinal perforation or fistula, so they should be removed while they are still in the stomach. The authors experienced 2 cases of unusual small bowel complication caused by the ingestion of magnets. The first case was in a 10-month-old boy with ileal perforation caused by to 2 ingested magnetic beads, and the second case was in a 22-month-old boy with ileo-ileal fistula caused by to 7 ingested magnetic beads.     

New type of reconstruction method after subtotal gastrectomy (Noh's operation)

Abstract The aim of this study was to compare a new type of reconstruction method (Noh’s operation) with Roux-en-Y operation after subtotal gastrectomy. Noh’s operation described herein includes a jejunal occlusion, an end-to-side gastrojejunostomy, a side-to-end jejunoduodenostomy, and a side-to-side jejunojejunostomy after subtotal gastrectomy. A series of 43 patients who had the new operation were compared with 47 patients with the Roux-en-Y procedure. The postgastrectomy syndromes, and the mucosal change of the remnant stomach and esophagus were evaluated after surgery. In the new operation, the Roux stasis syndrome occurred in 34.9% at 3 months, in 23.3% at 6 months, in 14.0% at 12 months, and in 11.6% at 24 months. In patients undergoing the Roux-en-Y operation, the syndrome occurred in 42.6% at 3 months, in 34.0% at 6 months, in 31.9% at 12 months, and in 29.8% at 24 months. This study shows that the new type of operation (Noh’s operation) can be a good option for reconstruction after subtotal gastrectomy. Electronic Publication     

ACE inhibition modulates transforming growth factor-β receptors in the young rat

The renin-angiotensin system plays an important role in renal growth and development. Exposure of the neonate to angiotensin converting enzyme (ACE) inhibitors increases mortality and results in growth retardation and abnormal renal development. It has been demonstrated that ACE inhibition in the developing kidney reduces the renal expression of growth factors, which may account for renal growth impairment. This study was designed to investigate the relationship between renal growth impairment and the expression of transforming growth factor-1 (TGF-1), TGF- receptor I [TRI, activin-like kinase (ALK)-1 and ALK-5], and TGF- receptor II (TRII). Newborn rat pups were treated with enalapril (30 mg/kg per day) or vehicle for 7 days, and kidneys were removed for Western blotting of TGF-1, ALK-1, ALK-5, and TRII, and for RT-PCR of ALK-5 and TRII. TGF-1, ALK-1, ALK-5, and TRII were also detected by immunohistochemistry. Enalapril treatment resulted in an increased mortality (30.4%) by day 7, and reduced body weight and kidney weight (P<0.05 versus vehicle). Enalapril decreased renal TGF-1, ALK-1, and ALK-5 protein expression (P<0.05). Also, enalapril decreased ALK-5 mRNA expression (P<0.05). TRII expression was not changed by enalapril treatment. These results indicate that ACE inhibition in the developing kidney decreases TGF-1, ALK-1, and ALK-5 expression, which may account for renal growth impairment. TRII may not be modulated by ACE inhibition in the developing kidney.     

Effect of Scutellariae radix extract on the high glucose-induced apoptosis in cultured vascular endothelial cells

Endothelial cell apoptosis has been postulated as the initial trigger of the progression of microvascular disease in patients with diabetes mellitus. To investigate the role of Scutellariae radix extract, we examined its effect on the endothelial cell proliferation using the [3H]-thymidine incorporation method. Scutellariae radix extract significantly stimulated endothelial cell proliferation in a dose-dependent manner. We focused on the protective action of Scutellariae radix extract on the endothelial cell apoptosis induced by high glucose concentrations. Determination of endothelial cell apoptosis was performed using DNA gel electrophoresis, terminal deoxynuclotidyl transferase-mediated dUTP nick end-labeling (TUNEL) assay, and an ELISA kit. Exposure of vascular endothelial cell to high glucose (16.7 mM) for 72 h resulted in a significant increase in apoptosis, compared with the normal glucose concentrations (5.5 mM). Scutellariae radix extract inhibited high glucose-induced endothelial cell apoptosis. This result suggests that Scutellariae radix extract may contribute to antiapoptotic action against vascular endothelial cells, resulting in a beneficial effect in preventing diabetes-associated microvascular complications.