Inhibitory effect of inhaled procaterol on anaphylactic bronchoconstriction and thromboxane A2 production in guinea-pigs

This study was designed to examine whether an inhaled beta 2-agonist, procaterol, inhibits thromboxane A2 (TXA2) production induced by antigen challenge in passively sensitized guinea-pigs in vivo. Antigen-induced bronchoconstriction was markedly inhibited by pre-treatment with procaterol. Inhaled procaterol significantly reduced in a dose-dependent manner the increment in TXB2 concentration in bronchoalveolar lavage fluid obtained 5 min after antigen challenge. Aerosol administration of procaterol significantly inhibited bronchoconstriction induced by inhaled histamine. These results suggest that inhalation of procaterol has an inhibitory effect on antigen-induced TXA2 production as well as a protective effect against bronchoconstriction induced by bronchoactive agents.     

Adult Wilms'' tumor mimicking hemorrhagic renal cyst

A 36-year-old man presented with macroscopic hematuria associated with right flank pain. Examination of the patient revealed a cystic mass in the right kidney. Because the mass had increased in size, enucleation of the mass was performed. Histopathological findings revealed nephroblastoma, therefore, radical nephrectomy was performed. We believe the pathogenesis of the cystic formation to be a process in which a tumor that had developed in the pericalyceal region spontaneously ruptured, exuding urine into the perinephric space, forming a cystic mass. The patient is alive with no evidence of disease 24 months after the operation.     

Experience with flexible video cystoscope equipped with built-in high-frequency cauterizing element for transurethral resection of the bladder

We successfully treated three patients using the flexible video cystoscope (CYF-240A, Olympus, Japan) for superficial bladder cancer under local anesthesia and/or spinal anesthesia. The major advantage of this new technique is that surgeons can use digital pictures and high frequency cauterization. This new system provides good quality of life for bladder cancer patients experiencing frequent recurrences.     

Diagnostic Value of 201Tl-chloride Scintigraphy for Thyroid Tumors

Among 114 patients with thyroid disease examined by ²⁰¹Tl-chloridescintigraphy, 101 were given a histological diagnosis. Of 28cases of thyroid carcinoma, 22 (78.6%) were positive. In threeof the 22, an obvious accumulation of ²⁰¹Tl-chloride was revealedin the metastatic lymph nodes of the neck and mediastinum. Only 12 of 50 (24%) cases of thyroid adenoma were positive.In comparison, all cases of hyperthyroidism and chronic thyroiditiswere positive and all cases of subacute thyroiditis were negative.The histological types of thyroid tumor were examined. Of 22cases of papillary carcinoma, 18 (81.8%) were positive. In fourcases which revealed negative figures, the tumor was almostcompletely encysted in three and the tumor was small in theother. Of the adenomas, eight cases of tubular adenoma and threeof trabecular adenoma were all positive, but colloid adenomaand thyroid cyst cases were all negative. It was concluded that ²⁰¹Tl-chloride has no specific affinityfor malignant tumors and cannot be used to discriminate betweencarcinoma and adenoma, but surgery should be indicated for noduleswhich are positive scanning by ²⁰¹Tl-chloride.     

INVOLVEMENT OF PACAP IN ACID-INDUCED HCO3RESPONSE IN RAT DUODENUMS

Pituitary adenylate cyclase activating polypeptides (PACAP) stimulate duodenal HCO₃⁻secretion in the rat. The present study was performed to determine whether endogenous PACAP is involved in the mechanism of acid-induced HCO₃⁻response in the duodenum, using a PACAP antagonist, PACAP6-27. Under urethane anaesthetised conditions, a duodenal loop that was made between the pylorus and the area just above the outlet of the common bile duct was perfused with saline, and the HCO₃⁻secretion was measured at pH 7.0 using a pH-stat method and by adding 10 mmHCl. Duodenal HCO₃⁻secretion was significantly stimulated by i.v. administration of PACAP-27 (8 nmol kg⁻¹) as well as vasoactive intestinal polypeptide (VIP: 8 nmol kg⁻¹). The effect of PACAP-27 (8 nmol kg⁻¹) was equivalent to that induced by prostaglandin E₂(300 μg kg⁻¹, i.v.) and significantly suppressed by either PACAP6-27 (40 nmol kg⁻¹, i.v.) or VIP antagonist (Ac-Tyr¹,d-Phe²-VIP: 40 nmol kg⁻¹, i.v.). These peptide antagonists suppressed duodenal HCO₃⁻secretory response to VIP but did not have any effect on either basal or PGE₂-stimulated HCO₃⁻secretion. On the other hand, the duodenal mucosa responded to acidification by increasing HCO₃⁻secretion in a indomethacin-sensitive manner, and this process was also significantly suppressed by both PACAP6-27 and VIP-antagonist. Duodenal damage induced by acid perfusion (100 mmHCl for 4 h) was significantly worsened by PACAP6-27, VIP antagonist as well as indomethacin at the doses that suppressed acid-induced HCO₃⁻secretion. These findings suggest that PACAP may play a role in local modulation of the duodenal mucosal integrity, by mediating the HCO₃⁻secretory response induced by mucosal acidification.     

Effects of transforming growth factors on the wound repair of cultured rabbit gastric mucosal cells

We have evaluated the role of two different transforming growth factors in the restoration of rabbit primary cultured gastric mucosal cells using a new wound repair model. After forming confluent monolayer cell sheets, a wound with a constant size (2 mm²) was made using a rotating silicon tip. Either TGFα (0.1–100 ng/mL) or TGFβ₁ (0.1–10 ng/mL) was added to the medium and the process of wound repair was monitored and analysed quantitatively by an image analyser. Cell proliferation was examined by BrdU staining. After wounding, the cells fronting the wound formed lamellipodia and migrated towards the centre of the wound. In the control group, the wound healed completely 48 h after wounding. TGFα promoted wound healing and the wound healed within 36 h in the presence of TGFα. TGFα increased the number of proliferative cells and they appeared in an earlier phase of healing than in controls. TGFβ did not have any effect on the wound repair process. In conclusion, TGFα promotes mucosal cell repair processes in the rabbit primary cultured gastric mucosal wound repair model in a dose-dependent manner by accelerating migration and proliferation. TGFα may modulate the healing process of a gastric ulcer or erosion in vivo.     

Anaesthetic considerations in a child with adrenoleukodystrophy

A child with asymptomatic adrenoleukodystrophy (ALD) who uneventfully underwent an operation for undescended testis under halothane-nitrous oxide anaesthesia is presented. The normal hormonal responses to surgical stress were observed. The potential problems of disorders of the adrenal cortex, the central nervous system, and skeletal muscle associated with the condition are discussed. Rapid-ACTH test may be a useful method for the evaluation of the adrenocortical function in this disease. It is proposed that a patient with ALD should receive a single dose of steroid regardless of the result of the rapid ACTH test.     

Assessment of energy status and fructose metabolism of liver in obstructive jaundice by 31P magnetic resonance spectroscopy

The effect of cholestasis on hepatic energy status and fructose metabolism in jaundiced rats and patients was investigated using ³¹P magnetic resonance spectroscopy. Rats with obstructive jaundice (OJ group) were studied 7 days after bile duct ligation. Drainage rats were studied at 3 days (DR3 group) and 7 days (DR7 group) after the relief of 1 week obstruction of the common bile duct. In the bile duct ligated rat, the β-adenosine triphosphate (ATP)/Pi (inorganic phosphate) ratio was significantly lower than in sham-operated controls. This ratio recovered rapidly in the DR3 and DR7 groups. The maximum increase in the phosphomonoester peak (PMEmax) after an intravenous bolus of fructose was significantly reduced in both the OJ and DR3 groups, and was accompanied by a decrease in hepatic fructokinase activity. The PMEmax and the fructokinase activity recovered in the DR7 group. In a clinical study, the β-ATP/Pi ratio in six healthy volunteers was comparable to that of 15 patients with obstructive jaundice, regardless of their biliary drainage status. The PMEmax in all patients (serum bilirubin ≥ 5 mg/dL), irrespective of biliary drainage, was significantly lower than in volunteers. Furthermore, the PMEmax in four of the eight patients with biliary drainage (serum bilirubin < 5 mg/dL) was lower than in volunteers. It is concluded that while energy status in jaundiced patients is well maintained, fructose phosphorylation is inhibited and recovery is delayed after the relief of obstruction compared with serum bilirubin. For the non-invasive evaluation of damaged liver function in jaundice, ³¹P magnetic resonance spectroscopy is a useful technique.