Effect of aging on salt sensitivity of blood pressure in patients with essential hypertension

Background. Aging is considered to modulate the salt sensitivity of blood pressure (BP), but its mechanisms have not been precisely elucidated. We investigated aging-related changes in salt sensitivity and their mechanisms in patients with essential hypertension. Methods. A high-sodium (Na, 250 mEq/day, for 6 days) diet was given to 32 essential hypertensive patients of different ages (younger, aged <30 years, n = 8; middle-aged, 30–50 years, n = 10; older, ≥50 years, n = 14) after they had had a low-Na diet (25 mEq Na/day) for 3 days. Cardiac output was measured by dye-dilution, and forearm blood flow (FBF) and venous volume (VV40) by strain-gauge plethysmography. Results. The Na-induced rise in mean BP increased with age (3.2 ± 2.0%; 6.9 ± 2.1%; and 11.7 ± 1.4% respectively, in the younger, middle-aged, and older groups, and this was accompanied by a salt-induced rise in cardiac index and FBF. VV40 decreased with the high-Na diet in older hypertensives (−15.7 ± 6.1%) and the change was significantly less (P < 0.05) than in the younger group (9.3 ± 9.0%). Conclusion. The enhanced salt sensitivity of BP that occurs with aging in patients with essential hypertension is due to increased cardiac output, probably through a venous constriction-related elevation of venous return. Received: May 6, 1998 / Accepted: July 17, 1998     

Carcinoid tumor of the bile duct: Case report

Carcinoid tumor of the bile duct is extremely rare. Ten cases have been reported in the literature. This report describes the eleventh case. A 55-year-old woman was hospitalized with biliary stenosis. Sonography (US) and computed tomography (CT) demonstrated a tumor in the upper common hepatic duct (CHD). Percutaneous transhepatic cholangiography showed extraluminal growth of the tumor. The tumor was resected and histologic examination showed carcinoid tumor of the common hepatic duct.     

A case of tsutsugamushi disease in the urban area of Komatsu City

Most of patients with tsutsugamushi disease are diagnosed by their clinical histories suggesting the opportunities of Rickettsia infection in a rural region. We reported a 76-year-old female patient, who was considered to be infected in her house in the urban area of Komatsu City. She has shown typical clinical manifestations of tsutsugamushi disease, and was remitted successfully by oral administration of minocycline. Although specific antibodies to Rickettsia tsutsugamushi could not be detected in her serum by the complement fixation (CF) method during her clinical course, their significant elevation was confirmed by the indirect immunofluorescence (IF) method.     

Phase I study of MST-16

Phase I study with a new oral anticancer agents. MST-16 (Sobuzoxane), was conducted by 3 administration schedules: single, 5 consecutive days and 10-15 consecutive days. No toxicity was observed in the single administration at doses escalated up to 1,500 mg/m2. Dose-dependent leukopenia was observed from 560 mg/m2/day in consecutive 5 day administration, and median days to the nadir and recovery were about 2 and 1 week, respectively. GI-disorders were also observed sporadically from 800 mg/m2/day. One patient with Hodgkin's disease receiving 1,000 mg/m2/day achieved complete response. Consecutive administration for 10-15 days was carried out at a dose of 800 mg/m2/day. Six out of 7 evaluable patients demonstrated leukopenia, and all 2 patients treated for 15 days experienced leukopenia with a nadir corresponding to grade 3. Median days to nadir and recovery were both about 2 weeks. Doses recommended for phase II study were considered to be 1,600 mg/body/day for 5 days and 1,200 mg/body/day for 10-14 days.