氢溴酸槟榔碱对大鼠离体结肠平滑肌细胞作用的研究

为研究氢溴酸槟榔碱 (Ah)对结肠平滑肌细胞运动的影响及其作用机制。制备大鼠游离的结肠平滑肌细胞 ,观察Ah引起的结肠平滑肌细胞收缩效应及其他工具药对收缩效应的影响。结果 :Ah可使流离的单个结肠平滑肌细胞收缩 ,在 1× 10 -6～ 1× 10 -3mol/L的浓度范围内 ,呈剂量依赖性 ,最大效应浓度为 1× 10 -3 mol/L。阿托品可阻断其直接收缩作用 ,酚妥拉明则无这种作用 ;钙鳌合剂EGTA可抑制其直接收缩作用 ,而TMB 8阻断胞内Ca2 + 释放后 ,对这种抑制作用无显著影响。结论 :Ah通过M受体引起结肠平滑肌细胞收缩 ,其收缩作用通过细胞外Ca2 + 的内流介导。     

Cardio-cerebrovascular protective effects of valsartan in high-risk hypertensive patients with coronary artery disease (from the Kyoto Heart Study)

The objective was to examine whether previous coronary artery disease (CAD) influences the add-on effects of the angiotensin II receptor blocker (ARB) valsartan on cardio-cerebrovascular morbidity and mortality in high-risk hypertensive patients who participated in the Kyoto Heart Study. The primary end point was the same as in the main study: a composite of new-onset and/or worsening of cardiovascular and cerebrovascular events. Median follow-up was 3.27 years. According to the presence of previous CAD at baseline, the study population was divided into 2 groups (with CAD, n = 707; without CAD, n = 2,324) in which primary end-point events occurred more frequently in patients with CAD than in patients without CAD (15.1% vs 5.6%, hazard ratio [HR] 2.68, 95% confidence interval [CI] 2.11 to 3.42). Add-on valsartan significantly decreased the occurrence of the primary end-point events in patients with CAD (11.3% vs 19.0%, HR 0.59, 95% CI 0.41 to 0.85) and without CAD (3.7% vs 7.6%, HR 0.49, 95% CI 0.34 to 0.70) compared to non-ARB treatment. In the presence of previous CAD, patients with valsartan add-on treatment had a significantly lower prevalence of angina pectoris and stroke than those with non-ARB treatment, whereas the valsartan add-on effects on angina and stroke were not significant in the absence of CAD. Changes in blood pressure during the follow-up period did not differ significantly between study subgroups. In conclusion, in the presence or absence of previous CAD, valsartan add-on treatment prevented more cardio-cerebrovascular events than conventional non-ARB treatment in high-risk hypertensive patients. In addition, valsartan add-on treatment conferred not only an antianginal effect but also stroke prevention exclusively in hypertensive patients with CAD compared to those without CAD.     

A case of incidentally detected IgG4-related sclerosing disease involving inflammatory abdominal aortic aneurysm and autoimmune pancreatitis

A 59-year-old asymptomatic man was incidentally found to have a periaortic mass and an elevated serum amylase level during his medical check-up. Additional findings, such as infiltration of immunoglobulin G4 (IgG4)-producing plasma cells in the mass lesion, elevation of serum IgG4 (1000 mg/dl), and pancreatic duct narrowing as evidenced on a magnetic resonance cholangiopancreatography scan, confirmed the diagnosis as retroperitoneal fibrosis complicated with autoimmune pancreatitis. The patient responded favorably to steroid treatment before the appearance of symptoms.     

内皮源性缩血管因子花生四烯酸代谢物的作用多样性

Vascular endothelium releases vasocontracting and/or vasorelaxing substances. Here, we report the diversity of endothelium-derived vasocontracting factors (EDCFs), arachidonic acid metabolites, and discuss the pathophysiological significance. In the canine basilar artery and the rabbit intrapulmonary artery, acetylcholine-induced contractions (ACh-induced EDC) are due to endothelial thromboxane A2 (TXA2) (TXA2-type). The ACh-induced EDC in the rabbit coronary artery is due to endothelial leukotrienes (LTs) (LTs-type). In addition, in the rat coronary artery, nicotine and noradrenaline (NAd)-induced EDCs are due to endothelial COX-metabolites (COX metabolite-type). These arachidonic acid metabolites derived from endothelium (activation by vasoactive substances including ACh, NAd and nicotine) cause a contraction of vascular smooth muscle cells and may disturb the local circulation. These EDCFs (TXA2, LTs and COX-metabolites) may be involved in the pathophysiology of cardiovascular immuno-inflammatory diseases.     

Naftopidil versus tamsulosin hydrochloride for lower urinary tract symptoms associated with benign prostatic hyperplasia with special reference to the storage symptom: A prospective randomized controlled study

Objectives: In order to compare the clinical efficacy of naftopidil (Naf) and tamsulosin hydrochloride (Tam), which differ in their selectivity to alpha receptor subtypes, we performed a multi‐center prospective randomized controlled study. Methods: Men complaining of lower urinary tract symptoms due to benign prostatic hypertrophy, were randomized into two treatment groups: one receiving 50 mg Naftopidil daily (Naf group, n = 31 pts), and one receiving 0.2 mg Tam once daily (Tam group, n = 28 pts). Baseline symptom scores were compared to those at 2 weeks and at the end of the observation period (6–8 weeks). Results: In the Naf group at 2 weeks, the score of the daytime frequency significantly improved from 3.5 to 2.2 (P = 0.03), and the score of nocturia improved significantly from 3.5 to 2.2 (P = 0.0004), respectively. In the Tam group at 2 weeks, however, no significant improvement was noted in the increased score of daytime frequency (P = 0.1) or nocturia (P = 0.2). At 2 weeks, the storage symptom score of the frequency to the combined score of daytime frequencies and the score of nocturia was better in the Naf group (improved from 7.0 to 4.4, P = 0.0017) than in the Tam group (from 6.8 to 4.9, P = 0.08) (P < 0.05). At 6–8 weeks, the effects of the two drugs on lower urinary tract symptoms were comparable. Conclusions: Naf demonstrated a significant early response to improve storage symptoms at 2 weeks, including daytime frequency and nocturia, compared with Tam.     

A Study of Cartilage Development in Pulmonary Hypoplasia

To discriminate between different forms of pulmonary hypoplasia (PH), 24 hypoplastic lungs were studied for their development of bronchial cartilage plates and peripheral air spaces. In 6 lungs from premature infants with oligohydramnios, normal amounts of immature and irregularly shaped cartilages were distributed with mitoses concentrated toward the periphery of the bronchi. Pulmonary acini appeared markedly immature. In 5 lungs from infants with diaphragmatic hernia, large numbers of cartilage bars were clustered around the proximal bronchi, whose branching was much reduced. Peripheral air spaces were small but structurally mature. In Potter syndrome, small amounts of tiny, mature cartilages were observed irregularly around the proximal bronchi and poorly distributed into the peripheral bronchi. The acinar structure was very immature. In 4 anencephalic infants, a marked decrease in the volume of mature cartilage was present, with cartilage seen only around proximal bronchi; the acini were atelectatic and less well developed. It is suggested that the earlier the action of a teratogen, the greater the abnormality of bronchial branching, cartilage distribution, and later lung development.     

Impairment of IFN-a production capacity in patients with hepatitis C virus and the risk of the development of hepatocellular carcinoma

AIM: To determine the utility of interferon (IFN) -α production capacity in patients with hepatitis C virus (HCV) infection for the measurement of immuno-surveillance potential and for the early detection of hepatocellular carcinoma (HCC) by investigating the Sendai virus (HVJ) stimulated IFN-α production capacity of patients with HCV infection. METHODS: HVJ stimulated IFN-α production was determined in a large number of patients with HCV infection and the development of HCC was monitored for 3 years in patients with liver cirrhosis (LC). RESULTS: IFN-α production capacity decreases gradually with the progression of liver disease from chronic hepatitis (CH) to HCC. A significant correlation between the duration of HCV infection and impaired IFN-α production capacity was observed. IFN-α production in patients who developed HCC within 3 years was significantly lower than that of patients who remained in LC without developing HCC. CONCLUSION: Measurement of IFN-α production in LC patients may be useful for the early detection of HCC.