Spontaneous recovery from renal infarction resulting from renal artery dissection

A 31-year-old, previously normotensive healthy man developed right flank pain and was admitted to a medical service. Right renal infarction was suspected by enhanced abdominal computed tomography (CT) and arteriography. Fourteen days after the onset, he was transferred to the Oita University Hospital, Oita, Japan. Renal angiography revealed an isolated renal artery dissection causing renal atrophy due to main stem narrowing of the right renal artery. Renogram and renal scintigram with (99m)Tc-diethylene triamine pentaacetic acid revealed a remarkable decline in the glomerular filtration rate and almost no uptake in the right kidney. Four months later, in spite of our belief that functional recovery could not be expected, intravenous pyelography and enhanced abdominal CT scans revealed a functioning right kidney that had spontaneously recovered from the renal artery dissection through conservative management.     

AP-811, a novel ANP-C receptor selective agonist

AP-811 is a derivative of the Phe8-Ile15 region of atrial natriuretic peptide (ANP) and is one of the smallest linear ligands for ANP receptors. The binding and agonist activities of AP-811 have been compared with those of other ANP analogs for the ANP-A and ANP-C receptors. AP–811 binds with a high binding affinity to and is a strong agonist for the ANP-C receptor, indicating that the binding and agonist sites for this receptor are the same or near each other in the ANP sequence. In contrast, AP-811 showed no agonistic effect for the ANP-A receptor, although it could bind to this receptor. Comparing the biological activities of AP-811 with those of other ANP analogs, we propose that the binding and agonist sites for the ANP-A receptor may consist of separate regions of ANP. In conclusion, AP-811 is the smallest C-receptor-selective agonist.     

Intestinal Absorption of Stable Cyclic Glycylphenylalanine: Comparison with the Linear Form*

The absorption, especially the stability and transportability, of the cyclic peptide cyclic glycylphenylalanine (cyclo(Gly-Phe)) and the linear peptides glycylphenylalanine, glycyl-d -phenylalanine and phenylalanylglycine have been studied in rat small intestine. Linear peptides were degraded on the mucosal side and only glycyl-d -phenylalanine appeared on the serosal side. However, cyclo(Gly-Phe) was stable on the mucosal side and appeared on the serosal side. Furthermore, the absorption clearance of cyclo(Gly-Phe) was higher than that of glycyl-d -phenylalanine. In the presence of the peptidase inhibitor bestatin, the degradation of linear peptides was reduced and linear peptides appeared on the serosal side, but only phenylalanylglycine, which is transported by the oligopeptide transporter, was absorbed faster than cyclo(Gly-Phe). The absorption clearance of cyclo(Gly-Phe) was reduced as its concentration was increased from 125 μm to 500 μm . Furthermore, the absorption clearance of cyclo(Gly-Phe) at 125 μm was reduced at 4°C or in the presence of glycylsarcosine and cephalexin, which are transported by the oligopeptide transporter. These results indicated that cyclo(Gly-Phe) was stable enough to be absorbed and was transported in part by the oligopeptide transporter rather than completely by passive diffusion.     

Rapid screening for amyloid-related variant forms of transthyretin is possible by electrospray ionization mass spectrometry

We have used a new and rapid method to detect three variant forms of transthyretin (TTR): methionine for valine at position 30 (Met-30), serine for cysteine at position 6 (Ser-6) and methionine for leucine at position 111 (Met-111). By using an anti-transthyretin antibody and a centrifugal concentrator, transthyretin was isolated from plasma samples and analysed for variant forms by electrospray ionization mass spectrometry. Differentiation between homozygous and heterozygous transthyretin Met-30 and Met-111 posed no problems. However, a clear separation of transthyretin Ser-6 and Met-111 peaks in one patient with concordant Ser-6 and Met-111 mutations could not be achieved. The present method enables a quick and reliable detection of variant TTR. It can be used to screen families or small populations for abnormal TTR. Knowledge of TTR polymorphism and the variable expression of different amyloidogenic mutations should be taken into consideration when applying the methods in clinical practice.     

The Efficacy and Diagnostic Significance of Sodium Thiosulphate Solution Spraying After Iodine Dyeing of the Esophagus

Abstract: Spraying with Sodium Thiosulphate Solution (STSS, Detoxol®) is reported to be useful in reducing the side effects of Iodine dyeing on the esophagus. In order to determine the optimal concentration of STSS and its efficacy, STSS was administered in the following concentrations. Group A: 10% (Original Solution), Group: B 5%. Group C, 2.5%. Group D: 1.7% and Group E: saline with no STSS, and a questionnaire was conducted to assess the side effects. The results showed that the higher the concentration, the less frequent and short lasting the side effects were. The effects of STSS on diagnostic efficacy was also evaluated. After spraying with STSS, the 2.5% solution removed iodine gradually but there were differences in discoloration among the various degrees of inflammation. When iodine dyeing was repeated, clear images with a good contrast were obtained. Excess iodine was neutralized and details of the surface and vascular pattern were more readily observed. Spraying with STSS seemed to increase the diagnostic ability of the procedure.     

Herpes simplex on nipples inoculated from herpetic gingivostomatitis of a baby

Herpes simplex on the nipples of a 31-year-old woman inoculated from herpetic gingivostomatitis of her baby is described. It is proposed that this condition is another special form of cutaneous inoculation herpes simplex.     

Development of multiple calculi in the duplex system ureterocele

A 61-year-old man presented complaining of pollakisuria and nocturia. A plain radiograph of his kidney, ureter and bladder and intravenous urography revealed numerous calculi in the upper kidney of his left renal pelvis and ureterocele. A transurethral incision of ureterocele (TUI-ureterocele) and extracorporeal shock wave lithotripsy were performed. On TUI-ureterocele, the many calculi were found to be almost the same size and spherical in form. The postoperative clinical course was uneventful.     

Electrophysiological and Anatomical Substrates for Late Potential Recorded by Signal Averaging in Seven-Day-Old Myocardial Infarction in Dogs

A filtered QRS (fQRS) was recorded by signal averaging in 7-day-old myocardial infarction (MI) in dogs to detect late potential (LP). The criteria for the LP included a duration of fQRS (D) greater than or equal to 60 msec and a voltage in the last 15 msec (V15) less than or equal to 10 microV. These parameters were determined from the control data from 15 dogs without infarction (D: 45 to 60 msec and V15: 12.0 to 83.6 microV). On the seventh day of infarction, the D had increased from 53.5 +/- 4.7 to 62.2 +/- 9.6 msec (P less than 0.05) and the V15 decreased from 38.6 +/- 19.5 to 18.4 +/- 16.0 microV (P less than 0.01). Of 23 dogs, 14 met the LP criteria (group A) and 9 did not (group B). Sustained ventricular tachycardia (SVT) was induced in 12 group A dogs and in none of the group B dogs. The delayed epicardial activation (DEA) was recorded after the end of QRS at 5.1 +/- 4.7 sites in group A dogs and 1.3 +/- 1.8 sites in group B dogs (P less than 0.05). The maximum value of epicardial activation time was more prolonged in group A than in group B (70.0 +/- 28.3 vs 44.4 +/- 9.8 msec, P less than 0.01). The area of MI was more extensive in dogs with DEA than those without (24.9 +/- 5.8% vs 10.3 +/- 9.0% of the total left ventricular weight, P less than 0.01). In 72 of 90 sites with DEA, the thickness of the surviving epicardial muscle was less than or equal to 1 mm. The sensitivity and specificity of the criteria for LP in detecting DEA were 71.4% and 55.6%, and 100% and 81.8% for predicting inducibility of SVT. It was thus concluded that LP, reflected the DEA, was identified from infarct areas of slow conduction within a reentry circuit of SVT.     

Endoscopic Mucosal Resection (EMR) of Early Gastric Cancer

Abstract: We conducted this study to clarify the effectiveness of aspiration endoscopic mucosal resection (EMR) using a cap-fitted scope for early gastric cancer in the C and M regions of the stomach. EMR was performed in 111 early gastric cancer patients with 123 lesions in the C and M regions. The patients were divided into three groups. The EMR-1CS group consisted of patients who had undergone EMR with a one-channeled scope, the EMR-2CS group those who had received EMR in which a two-channeled scope was utilized. The EMRC group consisted of patients who had undergone aspiration EMR with a cap-fitted scope. The rate of complete resection improved to a statistically significant degree in the EMRC group in comparison with that in the EMR-1CS group. In type lie, a statistically significant improvement was achieved in the EMRC group in comparison with the EMR-2CS group. In the M region or in lesions 10 mm or less in diameter, the rate of complete resection improved in the EMRC group as compared with that in the EMR-2CS group. Our results suggest that EMRC is useful for lesions of early gastric cancer in the C and M regions.