Absorption of unconjugated bile acids and tauroursodeoxycholate in the rat intestine

The absorption of ursodeoxycholate and its tauro-conjugate by the jejunum and the terminal ileum of rat intestine was compared with that of other unconjugated bile acids and taurocholate. In the ligated jejunum, the efficacy of absorption of unconjugated bile acids was in the following order: ursodeoxycholate = deoxycholate > chenodeoxycholate = cholate > lithocholate. This order cannot be explained by the theory that the passive diffusion of bile acids is faster the less hydroxyl bonds in the molecule. These findings on the unconjugated bile acids in the ligated jejunum were further confirmed by perfusion experiments. In the ligated terminal ileum, ursodeoxycholate, cholate and deoxycholate were absorbed as fast as taurocholate or tauroursodeoxycholate, whereas absorption of chenodeoxycholate was significantly slower. The Na⁺-dependency of the absorption of ursodeoxycholate and cholate in the terminal ileum was confirmed by perfusion studies. In conclusion, intestinal absorption of ursodeoxycholate was efficient in both the jejunum and ileum and these results may contribute to the high availability of ursodeoxycholate in various hepatobiliary diseases.     

Clinically isolated cerebellar metastasis of renal pelvic urothelial cancer

A 70-year-old man who had undergone radical surgery for renal pelvic transitional cell carcinoma 9 months previously developed solitary cerebellar metastasis. Despite neurosurgical removal, the patient died and post-mortem pathological examination revealed microscopic metastatic lesions within microvessels of the lung. No other lesion, including local residual cancer, was detected.     

Teratogenic Characteristics by Single Dosing of Antineoplastic Platinum Complexes in Rats

We investigated the embryolethality and teratogenicity of a new platinum complex, 254-S, and cisplatin (CDDP) by single dosing to dams on one day during the period of organogenesis. The results are summarized as follows: (1) Embryolethality was maximal after 254-S treatment on day 7 of gestation (Day 7) and after CDDP treatment on Days 6 to 9. It decreased with advancing gestational age. (2) Both 254-S and CDDP were teratogenic. The critical period for induction of malformation appeared twice for 254-S, at Days 6 to 9 and at Days 14 to 15, and once for CDDP, at Days 5 to 8. (3) The types of malformations induced by 254-S or CDDP were different, indicating different mode of teratogenesis. 254-S caused malformations mainly in the craniofacial or limb bud areas in the biphasic manner, whereas CDDP caused malformations mainly of the limb buds in the monophasic manner. (4) Malformations of the limb/digit and tail that are known to have critical periods during the late stage of organogenesis were induced by treatment with 254-S on Day 7 and with CDDP on Day 5 or 6.     

Laparoscopic pyeloplasty for ureteropelvic junction obstruction: Outcome of initial 12 procedures

BACKGROUND: Open pyeloplasty has been the gold standard for surgical treatment of ureteropelvic junction (UPJ) obstruction, enjoying a long-term success rate exceeding 90%. Unfortunately, this procedure requires a muscle incision that entails some degree of morbidity. We have, therefore, investigated the feasibility of laparoscopic pyeloplasty for UPJ obstruction and report here the outcomes of our early cases. The median follow up is 25 months (range, 12-42 months). METHODS: Between March 1999 and September 2001 we performed laparoscopic pyeloplasty on 12 ureters in 11 patients presenting with symptomatic hydronephrosis, secondary to a short stenosis of the UPJ or to ventrally crossing vessels; bilateral pyeloplasty was performed as a single procedure in one patient. We performed dismembered Anderson-Hynes pyeloplasty, Fenger plasty and Y-V plasty in eight, two and two ureters, respectively. All procedures were carried out transperitoneally. RESULTS: The procedure was completed successfully in all cases. Crossing vessels were noted in six of 12 ureters (50.0%). Mean operative time and blood loss in 11 patients (including one bilateral case) were 272.8 min (range, 175-480 min) and 96.4 mL (range, 20-340 mL), respectively. Postoperative complications were noted in two patients (18.2%): one instance of prolonged urine leakage and one anastomotic re-stricture. Eleven of 12 ureters (91.6%) demonstrated a patent UPJ on excretory urography and/or improvement of renal function on diuretic renography at a minimum follow up of 12 months. CONCLUSION: Although the procedure requires advanced laparoscopic skills, it can be safely and successfully completed as frequently as the conventional open procedure. Laparoscopic pyeloplasty seems to be a valuable alternative to open pyeloplasty for UPJ obstruction.     

Early experience of laparoscopic radical nephrectomy for T3b renal cell carcinoma

We report our experience with laparoscopic radical nephrectomy for a 79-year-old man who had renal cell carcinoma (RCC) with a renal vein thrombus. For the transaction of the renal vein with the thrombus, we used an endoscopic gastrointestinal anastomosis stapler. The operating time was 4 h and blood loss was 400 mL. The patient could walk and drink on the first postoperative day. He recovered normal activity 30 days postoperatively. There were no intraoperative and postoperative complications. The present report demonstrates the feasibility of laparoscopic radical nephrectomy in patients with T3b RCC who suffer from tumor thrombus in the renal vein.     

Protective Effects of Dilazep and its Derivative K-7259 on the Haemolysis Induced by Amphiphiles in Rat Erythrocytes

The effects of dilazep and K-7259, a dilazep derivative, on the haemolysis (as evidenced by release of haemoglobin) induced by palmitoyl-l -carnitine (PAL-CAR) or palmitoyl 1-α-lysophosphatidylcholine (PAL-LPC) have been determined in rat erythrocytes. At concentrations above the critical micelle concentration both PAL-CAR and PAL-LPC induced haemolysis; the concentrations of PAL-CAR and PAL-LPC producing 50% haemolysis were approximately 13 and 14 μm , respectively. The 50% haemolysis induced by PAL-CAR or PAL-LPC was attenuated by dilazep (1, 10 or 100 μm ) but not at the highest concentration used (1 mm ). K-7259 attenuated the 50% haemolysis induced by PAL-CAR or PAL-LPC at concentrations ranging from 1 μm to 1 mm . Similarly, dilazep (1 to 100 μm ) and K-7259 (1 μm to 1 mm ) significantly or insignificantly attenuated the 25% and 75% haemolysis induced by PAL-CAR or PAL-LPC. Neither dilazep nor K-7259 affected micelle formation by PAL-CAR or PAL-LPC, nor, at concentrations of 1 and 10 μm , did they attenuate the haemolysis induced by osmotic imbalance (hypotonic haemolysis). These results suggest that both dilazep and K-7259 protect the erythrocyte membrane from the damage induced by PAL-CAR or PAL-LPC. The protective effects of dilazep and K-7259 are mediated by some mechanism other than prevention of micelle formation or protection of the erythrocyte membrane against osmotic imbalance.     

Perinephric angiomyolipoma: A unique development pattern surrounding the kidney

We report a case of a 31-year-old man with extrarenal angiomyolipoma of the perinephric space. He presented with asymptomatic macrohematuria. Computed tomography of the abdomen revealed a large perinephric mass which was separated from the right kidney and its unique growth appeared to have surrounded the kidney. Extrarenal angiomyolipomas of the perinephric fat are rare and they should be considered in the differential diagnosis of a retroperitoneal mass where asymptomatic macrohematuria was presented at the onset.     

The pH Measurement of Fasting Gastric Juice in Acute Gastric Mucosal Lesions

Abstract: Fasting gastric juice acidity was assessed to elucidate its role in the cause of acute gastric mucosal lesions (AGML). Gastric juice was aspirated through an auxiliary endoscopic channel during routine endoscopic examinations, and its pH was measured with a glass electrode PH meter. The pH of 100 cases with AGML (acute hemorrhagic erosions (AHE), acute gastric ulcer and acute hemorrhagic gastritis), and 586 cases with other ulcerative or inflammatory lesions were compared with the gastric juice pH in 1775 endoscopically normal subjects. The pH value was classgied into four acid groups: Hyperacidity (pH < 1.4), Normoacidity (1).5 < pH < 2.0), Hypoacidity (2).1 < pH <4.0) and Anacidity (4). 1 < pH). In cases with AHE, a signifcant hyperacidity was recognized both in the periods preceding and just after the onset. This hyperacidity was followed by signgicant anacidity, and thereafter a return to normoacidity. These pH changes coincided well with endoscopic appearances; preceding stage-hypernormacidity, black-slough stage—hyperacidity, white-slough stage-anacidity and scarring stage-;normoacidity. These results suggest that an elevation of gastric acidity etiologically relates with the formation of AGML, especially Shin.