Composite tumor of mucinous cystadenoma and somatostatinoma of the kidney

Approximately 30 cases of carcinoid tumor of the kidney have been reported in the English literature, including three cases found as components of teratomas. Renal composite tumors associated with somatostatinoma have not been described. A 53-year-old female presented with an incidentally found right renal cystic lesion. Computed tomography demonstrated a cystic lesion associated with a solid nodule in the right kidney and postcontrast dynamic MRI revealed enhancement of the solid nodule. The patient underwent radical nephrectomy for the kidney lesion and is now well without recurrence 21 months after the operation. From the histopathological findings we diagnosed the cystic lesion as a composite tumor composed of mucinous cystadenoma and carcinoid tumor. Immunohistochemistry demonstrated the majority of cells of in carcinoid portion to be positive for antisomatostatin staining. The present case is the first documented composite tumor of mucinous cystadenoma and somatostatinoma of the kidney.     

Emergence of basophils at sites of local allergic reactions using a skin vesicle test

Vesicular exudate, produced by the application of cantharides plaster over normal skin and sites of intradermal allergen injection, was examined for the presence of basophils and eosinophils in normal subjects and patients with bronchial asthma. In comparison with the normals, the asthmatic group demonstrated a high rate of basophil appearance in vesicular fluid derived from areas of untreated skin. Basophil appearance was even more prominent in vesicular fluid from skin injected intradermally with various allergens. Modest numbers of basophils appeared at skin sites injected with house dust, but relatively large numbers appeared in areas injected with Candida, ragweed or tuberculin extracts. Patients with severe, intractable asthma frequently demonstrated large numbers of basophils in vesicular exudates. Intradermal injections of anti-IgE caused the greatest number of basophils to appear in the vesicular fluid, The numbers of eosinophils migrating into such vesicular lesions were not statistically significant though their numbers were proportional to those of the basophils. A significant correlation was shown to exist between both basophil and eosinophil blood counts and the numbers of these cells appearing in cutaneous vesicular fluid. This study demonstrates that basophil leukocytes, together with eosinophils, migrate from blood into extravascular tissues at sites of allergic reaction—especially reaginic hypersensitivity. The skin vesicle technique described is simpler than the skin window technique and may be of use in detection of allergens and evaluation of allergic disease states.     

Cyclic peptides

A cyclic tetradepsipeptide with a sequence corresponding to AM-toxin III (a phytotoxic peptide) was synthesized by a conventional method in order to confirm the proposed structure. This was mediated through a deamination reaction of precursor cyclotetradepsipeptide containing a d -2, 3-diaminopropionic acid residue by the Hofmann degradation method. The synthetic peptide and natural AM-toxin III were identical in regard to t.l.c., crystal form, mass spectrum and biological activity in causing necrosis on apple leaves. Two analogs, [1-O-methyl-l -tyrosine]-AM-toxin and [1-l -tyrosine]-AM-toxin, were synthesized simultaneously. [1-l -Tyrosine]-AM-toxin showed extremely weak activity; the relationship between the bulkiness of an aromatic side chain at position 1 of AM-toxin III and its biological activity is discussed.     

Effect of Activated Charcoal and Atropine on Absorption and/or Exsorption of Organophosphorus Compounds in Rats

Effects of activated charcoal and atropine for the removal of organophosphorus compounds, which remain in the gastrointestinal tract or have already been absorbed into the systemic circulation, were investigated in rats. Activated charcoal extensively adsorbed the organophosphates fenitrothion, tolclofos methyl, piperophos and salithion, and its immediate administration after oral ingestion of fenitrothion remarkably reduced serum fenitrothion levels, but had no effect on the serum levels of the compound which had been absorbed from the gastrointestinal tract. Thus, all of the organophosphorus compounds were poorly exsorbed (0.002-0.39% of the dose in 120 min) from the blood into the intestinal lumen probably due to their extensive protein binding and large distribution volumes. Atropine inhibited absorption of fenitrothion in the perfusion in-situ and also delayed the absorption of the compound in-vivo, but had no significant effect on exsorption of fenitrothion. The serum fenitrothion levels on treatment with both atropine and charcoal significantly decreased compared with those of the control. We conclude that, oral activated charcoal will not be able to enhance the elimination of organophosphorus compounds which have already been absorbed into the systemic circulation, but constitute a useful method for the removal of the compounds remaining in the gastrointestinal tract because of its excellent adsorptive capacity.     

CASE REPORT: Fibrosing cholestatic hepatitis after living related-donor renal transplantation

A 43-year-old man underwent living related-donor renal transplantation because of chronic renal failure in 1991. During the transplant period, both donor and recipient were seronegative for hepatitis B surface antigen (HBsAg). The donor was seropositive for antibody to hepatitis B surface antigen (anti-HBs) due to hepatitis B virus (HBV) vaccination. After transplantation, FK506 and methylprednisolone had been administered to the patient as immunosuppressants. In 1993, HBsAg appeared in his serum. His alanine aminotransferase level elevated gradually during 1995 and then in 1996, general fatigue, ascites and jaundice developed. At this time his serum was positive for hepatitis B e antibody, contained more than 100000 Meq/mL HBV-DNA and 100% precore mutant. Despite subsequent intensive therapy, liver dysfunction progressed and this patient died of hepatic failure 2 months following admission. At autopsy, the liver exhibited cholestasis, fibrosis extending from the portal tracts, mild inflammation and hepatocytes with a ground-glass appearance. In addition, HBsAg and hepatitis B core antigens had accumulated in the hepatocytes. Consequently, the final diagnosis was fibrosing cholestatic hepatitis (FCH) due to precore mutant HBV infection contracted after renal transplantation. It is unclear when and where the recipient liver became HBV infected. Nevertheless, after renal transplantation, while receiving immunosuppressive drugs, HBV appeared to have the potential to cause hepatic failure and FCH may have been a fatal complication for the recipient.     

Cardiac rhabdomyoma of a neonate: An autopsy case report

A primigravida delivered a cyanosed female infant with a very low Apgar score. Cardiac anomaly of the fetus was detected at 32 weeks of gestation by ultrasonography. The baby died on the day of delivery. Autopsy revealed multiple tumor masses in the interventricular septum and ventricular walls. The tumor originating from the interventricular septum was the largest and measured 3.7 × 3 cm. Histologically, the tumor was composed of large polygonal glycogen-laden cells and ‘spider-cells’. Eosinophilic giant histiocytic cells were also observed in the spleen. Ultrastructural features of the tumor cells correlated with those of typical cardiac muscle cells.     

The Inhibitory Effects of Cephalosporin and Dipeptide on Ceftibuten Uptake by Human and Rat Intestinal Brush-border Membrane Vesicles

Abstract— The types of inhibitory effects caused by compound V (an analogue of ceftibuten) and alanylproline (dipeptide) on the uptake of ceftibuten by brush-border membrane vesicles (BBMV) prepared from human and rat small intestine were analysed. In the presence of an inward H⁺-gradient, the initial uptake rate of ceftibuten by both human and rat intestinal BBMV was concentration-dependent with apparent K_m and V_max values of 0·35 min and 2·052 nmol (mg protein)^?1 min^?1 for human BBMV, and 0·50 mm and 3·056 nmol (mg protein)^?1 min^?1 for rat BBMV, respectively. For both human and rat BBMV, kinetic analysis by Dixon and Lineweaver–Burk plots demonstrated that the uptake of ceftibuten was competitively inhibited by compound V, whereas inhibition by alanylproline was noncompetitive or partially competitive. These results suggest that there is a stereospecific transport system which is common to ceftibuten and compound V, and that this system is not identical to the carrier system for the dipeptide, alanylproline.     

Suppression of acetylcholine-induced relaxation by local anesthetics and vascular NO-cyclic GMP system

Background: Local anesthetics have been demonstrated to attenuate acetylcholine-induced relaxation of vascular smooth muscle, but the mechanism responsible has not been elucidated. The present study was undertaken to ascertain whether this effect of local anesthetics is due to suppression of the vascular nitric oxide (NO)-cyclic GMP (cGMP) system. Methods: Isolated rat aortae were cut into helical strips and mounted in bathing solution to measure isometric tension changes. They were precontracted with phenylephrine (0.3 μM)then exposed to cumulative concentrations of relaxants including acetylcholine, sodium nitroprusside (SNP) and papaverine, in the absence or presence of local anesthetics. Aortaefor cGMP measurements were cut longitudinally into pairs of strips and bathed in the solution without tension. In the absence or presence of anesthetics, they were stimulated with acetylcholine or SNP, and the cGMP content of each strip was radioimmunoassayed. Results: Acetylcholine-induced, endothelium-dependent relaxation of phenylephrine-precontracted aortae was attenuated by lidocaine (30–300 μM), tetracaine (10–30 μM), bupivacaine (10–100 μM) and ropivacaine (30–100 μM). SNP-inducedrelaxation was attenuated by lidocaine (300 μM), tetracaine (30 μM), bupivacaine (10–100 μM) and ropivacaine (30–100 μM). Papaver-ine-induced relaxation was attenuated by lidocaine (300 μM), bupivacaine (30–100 μM) and ropivacaine(30–100 μM), and augmented by tetracaine (30 μM). Cyclic GMP levels in acetylcho-line-stimulated aortae were reduced significantly by lidocaine (300 μM), tetracaine(100 μM) and bupivacaine (300 μM) treatment, but not by ropivacaine (300 μM). SNP-stimulated cGMP levels were reduced by tetracaine (100 μM) but not by any other anesthetics at the concentrations tested. Conclusion: We conclude that lidocaine, tetracaine and bupivacaine suppress acetylcholme-stimulated formation of cGMP. However, the attenuation of acetylcholine-induced relaxation by local anesthetics is not totally ascribable to reduced cGMP levels.     

Social support and pregnancy:I. Factorial structure and psychosocial correlates of perceived social support

Abstract In a questionnaire survey among 1329 first-trimester pregnant women, social support providers were divided by factor analysis into husband, 'premarital network' (parents and friends) and 'postmarital network' (children and mother-in-law), while social support contents were divided into 'given' (emotional, informational and instrumental support) and 'giving' (nurturing opportunity and general confiding). The husband was most frequently nominated by the woman as the support provider in both of these categories. Multiple regression analyses revealed that a husband's poor 'given' support was predicted by the presence of premenstrual irritability, a lower level of the woman's own education, her smoking habits and past experience of pregnancy termination, while a husband's poor 'giving' support was predicted by current older age, smoking habits and past experience of delivery.     

Cyclic peptides

In order to explore the route for cyclization of linear oligopeptide containing a ΔAla (α, β-dehydroalanine) residue, AM-toxin II was synthesized. As a preliminary experiment, synthesis of [L-Phe³] AM-toxin II, containing L-Phe in place of L-App (L-2-amino-5-phenylpentanoic acid), was attempted. Cyclization of H-L-Phe-ΔAla-L-Ala-L-Hmb-ONSu in pyridine at 3 mM concentration yielded a mixture of cyclic dimer and cyclic polymers. Cyclization of H-L-App-ΔAla-L-Ala-L-Hmb-ONSu under the same conditions gave similar results; however, cyclization at 0.3 mM concentration yielded a mixture of desired cyclic monomer and cyclic dimer. An appreciable amount of cyclic monomer was isolated from the mixture. Characteristic features of the monomer were identical to those of natural AM-toxin II.