Serum Gastrin Levels in Patients with Pheochromocytoma

Serum gastrin in 11 patients with pheochromocytoma, 26 patientswith essential hypertension and 20 normal volunteers was measuredand the clinical significance of the gastrin was discussed.It was found that elevations in serum gastrin levels in mostpatients with pheochrornocytoma were brought about by increasedepinephrine secretion, while norepinephrine had less influenceon gastrin release. Patients with epinephrine-producing tumorswere found to have high serum gastrin levels, but normal gastrinwas observed frequently in patients with extra-adrenal tumors.From these findings, we believe that the assay of serum gastrinin patients with pheochromocytoma might be helpful in the preoperativesearch for the location of the tumor, although there were someexceptions.     

Combination therapy with ursodeoxycholic acid and colchicine for primary biliary cirrhosis

Twelve patients with primary biliary cirrhosis (PBC), stages I to III, received long-term therapy with a combination of 600 mg ursodeoxycholic acid (UDCA) and 1 mg colchicine given daily for more than 2 years. Drug toxicity was mild; one patient experienced diarrhoea that was probably due to colchicine. Serum levels of bilirubin, alkaline phosphatase (ALPase), gamma-glutamyl transpeptidase and alanine aminotransferase decreased by more than 50% of the initial values. Serum albumin and cholesterol levels also improved, but immunoglobulins and anti-mitochondrial antibody titre did not change. Histologic features in the eight patients who received serial liver biopsies before and 2 years after the beginning of treatment were evaluated. Piecemeal necrosis and portal inflammation were improved, but there was no change in portal fibrosis. Patients were divided into two groups; the first received both drugs from the outset, and the second group were started on UDCA for 3 months followed by the addition of colchicine. After 3 months, the improvement in serum bilirubin and ALPase in the first group was greater than in the second. However, in the second group, the ALPase levels had decreased significantly when measured at 6 and 9 months after the treatment compared with the levels at 3 months. These findings suggest that UDCA and colchicine may have a synergistic effect. This combination therapy appears to be safe and effective, both clinically and histologically, for treating PBC.     

Unidirectional Atrio-Atrial Conduction after Surgical Isolation of the Posterior Part of the Left Atrium and Pulmonary Veins for Atrial Fibrillation:

A 66-year-old woman underwent mitral valve replacement and surgical isolation of the posterior part of the left atrium for persistent AF. During sinus rhythm an isolated atrial rhythm was recorded from the isolated posterior left atrium using an esophageal electrode catheter. After the intravenous administration of adenosine triphosphate sinus rhythm was suppressed and 1:1 conduction from the posterior left atrium to the rest of the atrium was recorded. Unidirectional atrio-atrial conduction was revealed by a simple electrophysiological evaluation.(PACE 2004; 27[Pt. I]:812–814)     

Endotoxin affects the expansion modes of liver macrophages after partial hepatectomy

We studied the effect of increased endotoxin levels on the expansion modes of liver macrophages after two-thirds partial hepatectomy using anti-endotoxin polymyxin B. The expansion consists of dual modes: local proliferation and immigration. Local proliferation of mature cells was evaluated by the S-phase proportion measured by flow cytometric DNA analysis. This proportion (11.8 +/- 1.3% before hepatectomy) decreased to 6.0 +/- 1.1% at 12 h and reached a maximum of 21.9 +/- 2.7% on the 5th day after hepatectomy. In polymyxin B treated rats, the proportion reached a maximum of 21.1 +/- 1.6% at 48 h without any preceding decrease. Immigration of macrophage precursors was evaluated by the decreasing proportion of latex beads-containing cells that were marked as resident liver macrophages by injection of latex beads before hepatectomy. This proportion (98.7 +/- 0.2% before hepatectomy) was significantly decreased to 90.5 +/- 1.6% at 48 h. In polymyxin B treated rats, however, the proportion showed no significant decrease within 3 days. These results indicate that endogenous endotoxin, which suppresses the local proliferation and promotes extrahepatic recruitment, regulates the number of liver macrophages in regenerating rat liver.     

The prognostic value of p53, Ki-67 and matrix metalloproteinases MMP-2 and MMP-9 in transitional cell carcinoma of the renal pelvis and ureter

AIM: To investigate the prognostic and predictive relevance of p53 protein, Ki-67 antigen, MMP-2 and MMP-9 in patients with transitional cell carcinoma (TCC) of the upper urinary tract. METHODS: The expression of p53 protein, Ki-67 antigen, MMP-2 and MMP-9 was examined by immunohistochemistry in 69 patients with TCC of the upper urinary tract. Correlation of p53, Ki-67, MMP-2 and MMP-9 over-expression with conventional pathological parameters and patient survival was examined. RESULTS: p53 over-expression was significantly correlated with histological grade (P < 0.05), but not with pathological stage, vascular invasion, lymphatic invasion or lymph node metastasis. Ki-67 over-expression was significantly correlated with stage, grade, lymphatic invasion and vascular invasion (P < 0.05). In survival analyses, Ki-67 over-expression was a significant prognostic factor in the univariate analysis (P < 0.05), but it did not have a significant impact on survival in the multivariate analysis. Ki-67 labeling index was a significant prognostic factor in patients with a low p53 labeling index, but not in patients with a high p53 labeling index. CONCLUSION: Ki-67 over-expression is of prognostic value in TCC of the upper urinary tract, while p53, MMP-2 and MMP-9 are of limited value.     

Alteration in immunoexpression of glucose transporter 2 in liver of tumour-bearing rats

To elucidate interactions between the glucose transport system and hepatic glucose production in the tumour-bearing state, glycogen storage, expression of glucose transporter isoform 2 (Glut 2) and activities of glucose-6-phosphatase (G-6-Pase) and hexokinase were histochemically examined in hepatocytes of tumour-bearing rats. Five male F344 rats, subcutaneously inoculated with methylcholanthrene(MCA)-induced sarcoma cells were compared with five pair-fed animals and four ad libitum fed controls. Glycogen storage was markedly decreased in liver cells of tumour-bearing rats compared to in those of control animals. Glut 2 immunoreactivity was uniformly seen in the cellular membrane of hepatocytes from control animals. In rats bearing sarcoma, the staining intensity was significantly decreased, suggesting that Glut 2 with its bi-directional transport capacity was down-regulated in the tumour-bearing state. Positive staining for hexokinase activity was located in the perivenous area in livers from control animals and was more diffusely located and more intense in livers from tumour-bearing animals. G-6-Pase activity, limited to the peripheral area in livers from controls, extended to the intermediate area and had stronger reactivity in livers from tumour-bearing animals. In the tumour-bearing cachectic condition, glucose may be partially consumed by a futile cycle, hepatic metabolic zonation was disturbed, and the release of glucose from the liver may not be mediated by a facilitative glucose transporter-2.     

Enhancing Effects of Unsaturated Fatty Acids with Various Structures on the Permeation of Indomethacin through Rat Skin

Effects of straight-chain, cis-type, unsaturated fatty acids with various structures (alkyl chain lengths, numbers of double bonds, position of double bonds and cis- and trans-positional isomers) on the skin permeation of indomethacin were examined by using rat skins in-vitro. Furthermore, the disordering degrees of the intercellular lipid domain in the stratum corneum, which were treated with preparations of unsaturated fatty acids, were measured by the Fourier transform infrared (FT-IR) method using excised rabbit ear skins. Unsaturated fatty acids enhanced the permeation of indomethacin through rat skins. These permeation-enhancing effects by unsaturated fatty acids were affected by changes of their alkyl chain length from C₁₄ to C₂₂. The lag-times on the permeation of indomethacin were shortened by unsaturated fatty acids in the following order: C₂₀ = C₁₈ = C₂₂ < C₁₆ < C₁₄. These fluxes were increased by unsaturated fatty acids in the following order: C₂₀ > C₂₂ = C₁₈ = C₁₃ > C₁₄. Therefore, gondoic acid (cis-11-eicosenoic acid; C₂₀H₃₈O₂) mostly enhanced the skin permeation of indomethacin. However, the enhancing effects of unsaturated fatty acids (C₁₈ chain) were not affected by their differences of position and numbers of double bonds. These permeation-enhancing effects which were evaluated by flux were related to the degrees of wave-number shift in the frequency of the antisymmetric CH bond stretching absorbance (near 2920 cm^?1) on FT-IR spectra of the fatty acid-treated stratum corneum. Therefore, the perturbation increase of lipid domain in the stratum corneum by these fatty acids probably was the cause of the enhancing effects of permeation of indomethacin.