Significance of renal function in changes in acid–base metabolism after orthotopic bladder replacement: Colon neobladder compared with ileal neobladder

BACKGROUND: The objective of this study was to determine whether renal function influences the acid-base metabolism in patients undergoing orthotopic bladder replacement using intestinal segment. METHODS: Acid-base balance, serum electrolytes and renal function were studied in 30 patients with colon neobladder and 18 patients with ileal neobladder. Mean follow up was 51 months. Effects of renal function on acid-base metabolism in both types of bladder replacement were compared. Therapeutic efficacy of the sodium bicarbonate administration was also evaluated in cases with hyperchloremic acidosis. RESULTS: No significant differences were observed in any of the variables examined between the colon and ileal neobladder groups, except for potassium concentration. Although metabolic acidosis was detected using the Siggard-Anderson acid-base nomogram in eight (26.7%) and seven (38.9%) patients in the colon and ileal neobladder groups, respectively, this difference was not significant. In both the colon and ileal neobladder groups, the serum creatinine concentrations in patients diagnosed with metabolic acidosis were significantly higher than in those diagnosed with a normal metabolic status. Furthermore, as a result of severe metabolic acidosis, three (10.0%) and three (16.7%) patients in the colon and ileal neobladder groups, respectively, were administered sodium bicarbonate and their metabolic status was fully normalized. CONCLUSIONS: Despite there being no statistical difference, patients with ileal neobladder may more easily develop metabolic acidosis compared with those with colon neobladder. In addition, a close association between the serum creatinine level and the degree of metabolic acidosis was observed in both groups. However, even if severe metabolic acidosis occurs, it is relatively easy to correct using sodium bicarbonate. These findings suggest that it might be safe to use a colon segment for orthotopic bladder reconstruction in patients with higher serum creatinine levels, despite no significant difference in acid-base metabolism and detection rates of metabolic acidosis between the colon and ileal neobladder groups.     

Relationship between interleukin-8 levels and myeloperoxidase activity in human gastric mucosa

Although interleukin (IL)-8 is well known as a chemotactic agent for neutrophil migration in vitro, the relationship between IL-8 activity and the degree of neutrophil infiltration in gastric mucosa is still unclear. In the present study, we investigated IL-8 and myeloperoxidase activity, a marker of neutrophil infiltration, in gastric antral mucosa using biopsy samples in 23 patients with no gastric lesions. The results indicate that there is a good correlation between IL-8 and myeloperoxidase activity (y = 0.173x + 13.9; r = 0.49, P<0.01). Furthermore, IL-8 and myeloperoxidase activity are significantly higher in Helicobacter pylori-positive patients than in H. pylori-negative patients. In conclusion, an increase of IL-8 activity in the gastric mucosa causes increased neutrophil infiltration in human gastric mucosa and H. pylori infection acclerates these reactions in the mucosa.     

Immunogenicity of the whole antigen and glycoprotein I of varicella-zoster virus (VZV) and the VZV skin test antigen

Specific cellular immunity against the whole antigen and glycoprotein I (gp I) of varicella-zoster virus (VZV) and the skin test antigen were determined for 13 healthy immune adults to compare the immunogenicity of these antigens using a lymphoproliferative assay. The stimulation index values (mean ± s.d.) were 16.4 ± 11.2 against the whole VZV antigen, 4.2 ± 2.9 against the VZV skin test antigen and 1.1 ±0.5 against gp I. The immunogenicity of the skin test antigen, which mainly contains gp III and gp IV, appears to be more favorable than that of gp I alone, but to be weaker than that of the whole VZV antigen.     

Flow cytometric analysis of cell proliferation kinetics during duodenal ulcer healing

Cell proliferation in the gastroduodenal mucosa of patients with duodenal ulcers was evaluated using flow cytometry. Forty patients with duodenal ulcers and 12 normal subjects were investigated. Biopsy samples were obtained during endoscopic examination and subjected to DNA analysis by flow cytometry. Thirty patients with duodenal ulcers were healed within 3 months with H₂ blockers (tractable or responsive ulcers), whereas 10 patients did not respond to treatment (intractable ulcers). The percentage of cells at the DNA-synthetic phase, an index of cell proliferation, was constant in the adjacent duodenal mucosa 2cm from ulcer margin and antral mucosa during duodenal ulcer healing. The index at the margin of tractable ulcers was elevated during the active stage (12.9 ± 1.3), peaked during the healing stage (15.4 ± 2.8) and returned to the same level at the scarring stage (10.9 ± 2.0) as normal controls (10.3 ± 1.7). However, the index was not elevated in intractable ulcers (10.3 ± 1.7 in the healing stage) and was smaller than in tractable ulcers. These data indicate that augmented mucosal cell proliferation at the ulcer margin plays an important role in duodenal ulcer healing and intractable ulcers are characterized by an abnormal failure to accelerate DNA synthesis to achieve ulcer repair.     

Purification and characterization of gonadotropin I and II from pituitary glands of tuna (Thunnus obesus)

The duality of teleost pituitary gonadotropins was established in an advanced marine fish, the tuna (Thunnus obesus). Two different molecular forms of gonadotropins, designated tGTH I and tGTH II, were isolated from an alcoholic extract of pituitary glands following ion-exchange chromatography and reversed-phase HPLC. Both tGTH I and tGTH II stimulated estradiol-17β and testosterone production in tuna ovarian follicles in vitro, although responses to tGTH II were significantly greater than those to tGTH I. Each gonadotropin consisted of α- and β-subunits. tGTH I was stable in acidic conditions, whereas tGTH II dissociated into two subunits after acid treatment. Alpha subunits of tGTH I and tGTH II had identical amino acid sequences of 94 amino acid residues. The tGTH Iβ and tGTH IIβ consisted of 102 and 115 amino acid residues, respectively, and showed 35% sequence identity. tGTH Iβ is structurally more similar to salmon GTH Iβ than to salmon GTH IIβ, whereas tGTH IIβ is more similar to salmon GTH IIβ. Thus it is evident that the tuna pituitary gland produces two chemically distinct gonadotropins.     

Biliary excretion and microfloral transformation of major conjugated metabolites of 2,4-dinitrotoluene and 2,6-dinitrotoluene in the male Wistar rat

1. Major biliary conjugates of the male Wistar rat dosed orally with 2,4-dinitrotoluene (2,4-DNT) or 2,6-dinitrotoluene(2,6-DNT) were examined by hplc using potassium 2,4- dinitrobenzyl glucuronide (potassium 2,4-DNB- G), potassium 2,6-dinitrobenzyl glucuronide (potassium 2,6-DNB- G), pyridinium 2,4-dinitrobenzyl sulphate (pyridinium 2,4- DNB- S) and pyridinium2,6-dinitrobenzylsulphate (pyridinium2,6-DNB- S) as authentic compounds. Other metabolites were also examined by hplc. In addition, metabolites formed by incubation of potassium 2,4-DNB- G and potassium 2,6-DNB- G with rat intestinal microflora under nitrogen were examined by hplc. 2. Conjugates detected directly from bile following administration of 2,4-DNT and 2,6-DNT were 2,4-DNB- G and 2,6-DNB- G, which accounted for 35 0 and 51 5 % of the administered dose respectively. No peaks corresponding to pyridinium 2,4-DNB- S and pyridinium 2,6-DNB- S were detected in bile samples. 3. 2-Amino- 4-nitrotoluene,4-amino- 2-nitrotoluene,2,4-diaminotolueneand 4-acetylamino- 2-nitrobenzoic acid (0 02-0 12 % of the dose excreted in 24?h), in addition to the known metabolites 2,4-dinitrobenzyl alcohol (2,4-DNB), 2,4-dinitrobenzalde hyde and 2,4-dinitrobenzoic acid (0 09-0 14 %), were detected in ether extracts of bile of rat given 2,4-DNT. 2,6-Dinitrobenzylalcohol (2,6-DNB), 2-amino- 6-nitrotolueneand 2,6-dinitrobenzaldehyde(0 02-0 03 %), which are known metabolites, were detected in ether extracts of bile from rat given 2,6-DNT. 4. Potassium 2,4-DNB- G was transformed by the anaerobic incubationof rat intestinal microflora into 2,4-DNB, 4-amino- 2-nitrobenzyl alcohol and 2-amino- 4-nitrobenzyl alcohol. Potassium 2,6-DNB- G was transformed into 2,6-DNB and 2-amino- 6-nitrobenzyl alcohol by the anaerobic incubation. Time-course studies showed that 2,4-DNB, 4-amino- 2-nitrobenzyl alcohol, 2-amino- 4-nitrobenzyl alcohol and 2,6-DNB, 2-amino- 6- nitrobenzyl alcohol peaked at 30, 75, 120 and 10, 50?min respectively. 5. These results, together with previous findings, show that 2,4-dinitrobenzalde hyde and 2,6-dinitrobenzalde hyde, which are potent mutagens, are formed either by the hepatic metabolism of 2,4-DNB and 2,6-DNB formed by the intestinal metabolism of 2,4-DNBG and 2,6-DNB- G excreted in bile or by the direct hepatic metabolism of 2,4-DNT and 2,6-DNT.     

Endotoxin and pro-inflammatory cytokines stimulate endothelin-I expression and release by airway epithelial cells

Endothelin is a potent bronchoconstrictor peptide first identified as a novel vasoconstrictor produced by vascular endothelial cells. Recent reports suggest that airway epithelial cells are also capable of releasing this active peptide. To investigate the regulatory mechanism of endothelin expression, we studied the effects of endotoxin and pro-inflammatory cytokines such as interleukin-1 and tumour necrosis factor on the expression and release of endothelin-1 by airway epithelial cells. Both endotoxin and the cytokines stimulated endothelin-1 release by human bronchial epithelial cells. Northern blot analysis showed increased expression of preproendothelin-1 mRNA by these factors. These results suggested that airway epithelial cells might play a role in the local airway smooth muscle tone through the production of endothelin, which might be upregulaled by inflammatory products in the airways.     

Transurethral fulguration for empyema of ectopic ureteral stump

A 55-year-old woman who had undergone left nephrectomy 7 years prior because of pyonephrosis, suffered from refractory cystitis and was diagnosed with empyema of the left ureteral stump associated with ectopic ureter. Although removal of the stump is a popular treatment for this disease, transurethral fulguration of the stump lumen was performed in the patient described here. The procedure was technically easy and safe, resulting in the disappearance of the dilated stump and cessation of recurring cystitis.