Apparently increased trough levels of tacrolimus caused by acute infantile diarrhea in two infants with biliary atresia after liver transplantation

Two infants with biliary atresia who exhibited three-fold increased trough levels of tacrolimus and required reduced doses during episodes of acute infantile diarrhea within 5 months of liver transplantation are described. The cause of the increase was not explained simply by hemoconcentration as a result of significant loss of extracellular fluid during these episodes. It does highlight an important issue: that of the continuing need to carefully monitor the trough levels of tacrolimus in such infants.     

Serum markers for fibrosis and plasma transforming growth factor-β1 in patients with hepatocellular carcinoma in comparison with patients with liver cirrhosis

In order to elucidate collagen metabolism in hepatocellular carcinoma (HCC) tissue, we compared levels of different potential markers of collagen metabolism and plasma transforming growth factor-β₁ in patients with HCC and in patients with liver cirrhosis. Serum levels of prolyl hydroxylase and the tissue inhibitor of metalloproteinase-1 in patients with HCC were significantly higher than those in patients with liver cirrhosis and increased with the size of the HCC tumour, whereas the serum levels of procollagen type III propeptide and type IV collagen 7S domain were similar in the two groups. In HCC, the increased plasma transforming growth factor-β₁ levels were closely correlated with serum levels of prolyl hydroxylase and the tissue inhibitor of metalloproteinase-1. These findings suggest that, in HCC tissue, the intracellular biosynthesis of collagen is enhanced, whereas the secretion of procollagen is disturbed and the degradation of collagen is suppressed by the excess production of the tissue inhibitor of metalloproteinase-1. The results also suggest that plasma transforming growth factor-β₁ plays an important role in the altered metabolism of collagen in HCC.     

Spectral analysis of changes in electroencephalographic activity after the chewing of gum

Abstract  The present study aimed to examine the psychosomatic effect in the chewing of marketed gum using eletroencephalogram (EEG) as an index. The EEG were taken in two sets: (i) a resting period before chewing (control recording) and a resting record (post-resting recording) for examining reproducibility; and (ii) a control recording and resting period after gum-chewing for 3 min (post-chewing recording). The ratio of each frequency band to the total frequency power, the mean frequency of the alpha band and laterality of the frequency power was calculated. In the examination of the reproducibility, no statistically significant differences were observed between control recording and post-resting recording in all indices. In the reflection of EEG after gum-chewing, there were no significant differences between control recording and the post-chewing recording. However, a significant interaction was observed among these indices by analysis of variance. In addition, the alpha power in the post-chewing recording was significantly higher than that in the control recording at almost all the positions. In conclusion, the intra-individual reproducibility of EEG was confirmed in the recording method. Furthermore, it was suggested that a significant interaction and a rising trend of the mean frequency of the alpha band after gum-chewing reflected 'arousal' psychosomatic responses by the chewing of marketed gum.     

Determinant of QT Dispersion in Patients with Hypertrophic Cardiomyopathy

KAWASAKI, T., et al. : Determinant of QT Dispersion in Patients with Hypertrophic Cardiomyopathy. QT dispersion is thought to reflect a regional difference in repolarization process although QT interval is composed of depolarization and repolarization. This study was designed to investigate the effect of depolarization and repolarization on QT dispersion in hypertrophic cardiomyopathy. Standard 12-lead ECG was recorded in 70 hypertrophic cardiomyopathy patients with anteroseptal wall hypertrophy (HC-As), 8 patients with lateral wall hypertrophy (HC-L), 8 patients with diffuse hypertrophy (HC-D), and 46 normal controls. QRS, JTc, maximum and minimum QTc, and QTc dispersion were compared. The maximum QTc was greater in HC-As and HC-L than in the control; the minimum QTc was similar in all 3 groups; consequently, QTc dispersion was greater in HC-As and HC-L. In HC-D, the maximum QTc and the minimum QTc were greater than the control, which produced QTc dispersion similar to that in the control. JTc did not differ among 4 groups. In hypertrophic cardiomyopathy, both QTc and QRS duration were increased in the leads coinciding with the left ventricular portion of localized hypertrophy. We conclude that QTc dispersion depended on the heterogeneity of QRS duration or depolarization rather than repolarization, which in fact may be ascribed to the regionally different hypertrophy of the left ventricle in hypertrophic cardiomyopathy. (PACE 2003; 26[Pt. I]:819–826)     

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.     

Expression of β‐Adrenoceptor Subtypes in Urothelium,Interstitial Cells and Detrusor of the Human Urinary Bladder

Objective: We examined whether interstitial cells (ICs) of the human urinary bladder expressed β‐adrenoceptor (AR) subtypes, and semiquantitatively compared the staining intensity among urothelium, ICs and detrusor muscles. Methods: Paraffin sections of the human urinary bladder were obtained from histologically normal areas of formalin‐fixed specimens removed for bladder carcinoma. Double‐labeling immunohistochemical methods using antibodies against each β‐AR subtype and vimentin were performed to identify ICs of the human urinary bladder. The staining intensity of β‐ARs was semiquantitatively compared among urothelium, ICs and detrusor muscles. Further, gender‐related difference or age‐related correlation in the staining intensity of β‐ARs was compared in the same cell types. Results: The expression of β₁‐, β₂‐, and β₃‐AR was observed in vimentin‐positive ICs localized in suburothelium, between detrusor muscle bundles, and within these bundles of the human urinary bladder. The rank order of the staining intensity was urothelium > ICs = detrusor muscles in β₁‐AR, urothelium > ICs > detrusor muscles in β₂‐AR, whereas its order was ICs = detrusor muscles > urothelium in β₃‐AR. Except for urothelial β₁‐AR, there was no gender‐related difference in the signal intensity of β‐ARs in the urothelium, ICs or detrusor muscles. Age negatively correlated with the signal intensity of all β‐AR subtypes. Conclusion: β‐ARs were expressed in vimentin‐positive ICs of the human urinary bladder. As for β₂‐ and β₃‐AR, there was no gender‐related difference or age‐related correlation in urothelium, ICs and detrusor muscles. In the human urinary bladder, β‐ARs expressed in ICs may play a role in bladder physiology.