Spermidine/Spermine N-Acetyltransferase, a New Biochemical Marker for Epithelial Proliferation in Rat Bladder

We examined the activity of spermidine/spermine N ¹-acetyltransferase (SAT), a rate-limiting enzyme of the biodegradation of polyamines, in N -butyl- N -(4–hydroxybutyI)nitrosamine-induced transitional cell carcinoma (TCC) and melamine-induced papillomatosis of rat bladder, and compared the activity to that of ornithine decarboxylase (ODC). Both activities were higher in both lesions than in control rats. The difference between SAT and ODC activities in cancerous tissue and papillomatosis was not significant. Cells stained for proliferating cell nuclear antigen (PCNA) were abundant in papillomatosis. TCC had areas with much PCNA. The results indicated that an elevation of SAT activity occurs in both reversible and irreversible proliferation of bladder epithelium and could be important in bladder carcinogenesis.     

A case of chronic pulmonary emphysema with a past history of bilateral carotid body resection]

A 76-year-old man, whose carotid bodies had been resected for treatment of bronchial asthma 40 years previously was admitted for evaluation of abnormal arterial blood gases and exertional dyspnea. The case was diagnosed clinically as chronic pulmonary emphysema. His peripheral chemoreceptor function, estimated by hypoxic ventilatory and P0.1 response tests and withdrawal test was non-functioning. His PaCO2 value tended to rise over 50 Torr either after light exercise or during airway infection, though it was normal at rest. In addition his dyspnea had continued for 40 years in spite of carotid body resection. It was concluded that the effect of carotid body resection lasts more than 40 years and it does not have a good effect on COPD.     

A case of hair loss induced by carbamazepine]

We report a 52 year-old man presenting with an acute considerable hair loss induced by carbamazepine (CBZ). The remarkable scalp hair loss started within a week after CBZ administration. There was no evidence of dermatitis or allergic reaction, or other cause for the hair loss. The serum concentration of CBZ was 8.6 microg/ml (therapeutic range 8-12 microg/ml). CBZ was discontinued, and the hair loss stopped within several days with new hair growth. Medication-induced hair loss is an occasional adverse effect of many drugs used for neuropsychological diseases. CBZ also induces hair loss and its frequency was reported below 2%. Only a limited number of detailed case reports describing CBZ-induced hair loss were available, and we found these cases could divide into two groups with regard to a delay in starting hair loss after administration of CBZ. In one group, the hair loss started within a week suggesting anagen effluvium and in another it started after two or three months suggesting telogen effluvium. This finding suggests the causative mechanism of CBZ-induced hair loss is not unitary.     

Renovascular hypertension: a unique cause of unilateral focal segmental glomerulosclerosis.

A 48-year-old man presented with malignant hypertension and massive proteinuria. Renal angiography showed complete obstruction of the left renal artery and 99mTc-mercaptoacetylglycine (MAG3) renography showed a nonfunctioning left kidney. Percutaneous transluminal renal angioplasty of the left renal artery was unsuccessful; hence, the patient underwent left nephrectomy because of uncontrolled hypertension and proteinuria. Histological examination of a right kidney specimen revealed lesions of focal segmental glomerulosclerosis with benign nephrosclerosis. In contrast, histology of the left kidney showed typical ischemic kidney with hypertrophy of arteriolar smooth muscle cells. The patient responded favorably to the nephrectomy, as his blood pressure and urinary protein dramatically decreased with no antihypertensive medication. This case illustrates the heterogeneous effect of the renin-angiotensin system on either kidney in patients with renovascular hypertension due to unilateral renal artery stenosis.     

Changes in left ventricular function during exercise after lung resection--study with a nuclear stethoscope]

In 29 cases undergoing lung resection, effects of the surgery on left ventricular function were investigated indirectly with a Nuclear Stethoscope. Various parameters were measured following an exercise load before and after surgery. There were significant decreases in post-operative resting levels of stroke volume (SV) (p < 0.001), end-diastolic volume (EDV) (p < 0.001), ejection fraction (EF) (p < 0.05) and ejection rate (ER) (p < 0.001) and significant increase in heart rate (HR) (p < 0.001) when compared to pre-operative resting levels. Neither filling rate (FR) nor cardiac output (CO) showed significant difference. At maximum exercise load, there were significant decreases in post-operative EDV (p < 0.005), SV (p < 0.005), ER (p < 0.001) and FR (p < 0.005), but no significant differences were detected in HR and EF; consequently, there was a significant decrease in CO (p < 0.005). Ratio of the levels at maximum load to those at resting of each parameter did not show significant difference between before and after operation with regard to any parameters except CO and FR which showed significant decrease (p < 0.005 and p < 0.001, respectively). Effects of the surgery on left ventricular function were studied according to amount of lung resection. In 13 cases where more than two lobes were resected, similar significant differences to those mentioned above were found in all parameters except EF. In cases where a single lobe was resected, only ER and FR showed similar tendency to that described above. Effects of the surgery on left ventricular function were also studied according to age of patients.(ABSTRACT TRUNCATED AT 250 WORDS)     

Blood pressure changes following extracorporeal shock wave lithotripsy for urolithiasis.

Hypertension after extracorporeal shock wave lithotripsy (ESWL) has been a controversial subject. Changes in blood pressure were studied in 262 patients (mean age 47.8 years) 18.6 months after ESWL. According to World Health Organization criteria the number of patients who showed a decrease exceeded those who showed an increase in blood pressure. The patients who have been on antihypertensive therapy showed a significantly greater decrease in blood pressure than those without medication. Of 192 normotensive patients diastolic pressure increased 1.2 mm. Hg and 2 (1.0%) had hypertension 18.4 months after ESWL. Annualized increase in diastolic pressure and new onset of hypertension were calculated to be 0.78 mm. Hg and 0.65%, respectively. Significant elevation of diastolic pressure was noted in the patients who received a larger number of shock waves. Blood pressure should be carefully followed after ESWL especially in patients who have been treated by a greater number of shock waves.     

Japanese guidelines for the management of herpes simplex encephalitis; comparison with those from the International Management Herpes Forum]

Herpes simplex encephalitis (HSE) is still recognized as a severe sporadic encephalitis, although the mortality and morbidity rates have been decreased to 10% and 30%, respectively. This disease is diagnosed using clinical symptoms, CSF, EEG, CT, MRI, and virologic tests such as polymerase chain reaction (PCR) or enzyme immunosorbent assay (EIA). Early diagnosis and treatment are essential for HSE. However, the early symptoms of this disease are various, and the laboratory diagnostic criteria are unclear to the non-specialist. In 2005, Japanese guidelines for the management of HSE have been issued via two sets of Workshops at the Japanese Neuroinfectious Disease Congress. The diagnostic and therapeutic criteria were discussed in comparison with those from the International Management Herpes Forum (IMHF) in 2004. For a definitive diagnosis, CSF PCR for herpes simplex virus (HSV) is recommended, and the detection rate has been reported to be 60 to 80% within the 7th day of the illness. In the IMHF, the PCR method has also been the primary method for early diagnosis and for monitoring the therapy. Further, quantitative real-time PCR has become available for measuring the effectiveness of aciclovir therapy. To measure HSV antibody levels, complement antibody (CF), neutralizing antibody (NT), or enzyme-linked immunosorbent assay (ELISA or EIA) are available. Significant elevation of EIA IgG or intrathecal HSV antibody production should be shown, although these antibody responses often appear two weeks after the onset of HSE. Regarding anti-herpesvirus drugs, in both Japanese and IMHF guidelines aciclovir is consistent with the first choice, and it is recommended that its administration would be started as soon as HSE is suspected on the basis of clinical pictures, CT * MRI, EEG, or CSF findings. However, antiviral therapy may be discontinued if a negative CSF HSV PCR is obtained at > 72 hours after onset. A recent Japanese study shows the efficacy of a combination therapy of aciclovir and corticosteroid for this disease. Further prospective investigation is expected.     

Intravitreal injection of 0.3 ml of SF6 gas for persistent subfoveal fluid after scleral buckling for rhegmatogenous retinal detachment

Purpose  To determine the efficacy of intravitreal injection of sulphur hexafluoride (SF6) gas for reducing persistent subfoveal fluid after scleral buckling surgery for macula-off rhegmatogenous retinal detachments. Methods  We injected 0.3 ml of SF6 gas into the vitreous cavity of two eyes of two patients with persistent macular retinal detachment 3 and 5 months after successful scleral buckling. Optical coherence tomography was performed before and after surgery. Results  Subfoveal fluid was displaced peripheral to the fovea immediately after gas injection and the fluid was absorbed gradually in both eyes. Conclusions  Persistent subfoveal fluid after scleral buckling may be treated with intravitreal SF6 gas injection. The authors have no proprietary interest in any aspect of this report