Prostaglandin E1‐effective,transient‐type ischemic colitis developed after surgical resection of sigmoid colon cancer. A case report

A 55‐year‐old‐man had a laparoscopic resection of the sigmoid colon due to colon cancer with submucosal invasion. After the surgery he suffered ileus and had a laparotomy. Six months later he complained of frequent defecation. Colonoscopy confirmed a circular ulcer extending from the anal side of the anastomosis in the sigmoid colon to the mid rectum. Endoscopic ultrasound demonstrated thickening of all layers of the diseased colon and rectum. We diagnosed ischemic colitis. After intravenous drip infusion of prostaglandin, symptoms and colonic stricture gradually improved. Although abdominal angiography revealed a narrowing of the peripheral sigmoid branch of the inferior mesenteric artery, blood flow was unrestricted. Colonoscopy performed 84 days after discharge revealed an ulcer scar.     

Bioavailability of Bropirimine 250 mg Tablet in Dogs: Effect of Food

The postprandial effect on the bioavailability of bropirimine in dogs after oral administration of bropirimine tablets (Bropirimine 250 mg Tablet) was investigated. At a dose of 500 mg bropirimine (two tablets of bropirimine 250 mg), the maximum plasma concentration under the postprandial condition was about twice that observed under the fasting condition, and the area under the plasma concentration vs time curve under the postprandial condition was also twice that under the fasting condition. The absolute oral bioavailabilities of bropirimine were 41.1% under the fasting condition and 83.5% under the postprandial condition. It is considered that the longer gastric residence time and larger volume of the gastric fluid induced by food-intake caused the increase in dissolution of bropirimine which increased the bioavailability after oral dosing of bropirimine 250-mg tablets.     

Cyclosporine therapy affects aminotransferase activity but not hepatitis C virus RNA levels in chronic hepatitis C

Interferon (IFN) therapy is of proven efficacy in chronic hepatitis C, but it is not universally effective and is often limited by side effects. Cyclosporine A (CsA) is a potent immunosuppressant widely used in organ transplantation. We conducted a pilot study to determine whether CsA therapy could affect aminotransferase activity and hepatitis C virus RNA levels in patients with chronic hepatitis C. Cyclosporine A was administered to 10 patients (mean age of 59 years; male: female = 9:1) who did not respond to IFN therapy previously and who had elevated serum alanine aminotransferase (ALT) values for at least 6 months. All patients were positive for HCV-RNA by RT-PCR with genotype 1b. Their mean duration of hepatitis was 15 years. Oral CsA was given for 3 months in a dose that was increased at 1 month intervals from 1.5–2.0 to 2.0–3.0 and 3.0–4.0 mg/kg per day. All patients completed the treatment schedule, although two patients developed mild non-symptomatic hypertension. Serum ALT levels gradually decreased in all but one patient. The mean percentage decrease was 59.5% at the end of therapy (from 153 ± 82 to 62 ± 48 IU/L; P < 0.02). The ALT levels fell to the normal range in five patients, although once therapy was discontinued the enzyme levels tended to return to pretreatment levels. Serum aspartate aminotransferase and g-glutamyl transpeptidase levels similarly decreased. The serum HCV-RNA titre, determined by competitive RT-PCR, did not change in any patient throughout the study period. There were no appreciable alterations in other laboratory tests, such as serum creatinine levels and lymphocyte subsets, except for an increase in serum alkaline phosphatase levels. These findings suggest that CsA, even in a relatively low dose, reduces serum aminotransferase levels without serious side effects in patients with chronic-hepatitis C, although an antiviral effect was not noted.     

Incidence and growth pattern of simple cysts of the kidney in patients with asymptomatic microscopic hematuria

BACKGROUND: We examined the incidence and natural history of simple renal cysts found by ultrasonography (US) in patients referred for asymptomatic microscopic hematuria. METHODS: Among the 906 patients aged 18-78 years, 743 patients who had undergone US were included in the present study. The natural history of simple renal cysts was investigated in 55 patients who underwent periodical US examinations for more than 3 years. RESULTS: The incidence of simple renal cysts was 4.3% for ages 29 years or younger, 15.3% for ages 30-39, 21.8% for ages 40-49, 23.3% for ages 50-59 and 32.6% for ages 60 years or older; thus the incidence increased in older age groups (P = 0.0005 for men, P = 0.0020 for women). Men tended to have a higher incidence than women. The degree of hematuria did not influence the incidence of renal cysts (P = 0.9044). The annual growth rate of the mean maximum diameter was 4.2% during a 3-year follow-up period in 55 patients and 5.1% during a 6-year follow-up in 31 patients. CONCLUSION: Since the diameter of a renal cyst may increase by 5% annually, the diameter of the cyst may increase by 1.6 times in 10 years. The scheduling of follow-up examinations depends on the size at the time of disclosure, the effects on calyceal systems, or the suspicion of a concurrent malignant disease. However, the most simple renal cysts may be followed-up at an interval of more than 10 years, once a diagnosis has been established.     

HYPOURICAEMIA WITH ACUTE VIRAL HEPATITIS

We report five female cases of hypouricaemia accompanied byacute viral hepatitis (serum urate 101 ± 12 µmol/1,mean ± SD). Their urate clearance was increased to 14.2±3.4 ml/min during hyperbilirubinaemia but 24-h urateexcretion was not elevated (2.09 ± 0.64 mmol/24 h). Noother renal tubular abnormalities were detected. Comparing uratemetabolism with that of four cases of inborn renal hypouricaemia,the degree of uricosuria was lower. One patient showed elevationof serum and urinary oxypurine, which normalized with returnof a normal blood uric acid level. In all cases, the serum uratereturned to normal after improvement of liver function. We suggestthat renal uricosuria due to an isolated renal defect of uratetransport might contribute to hypouricaemia in these cases butthat inhibition of xanthine oxidase activity might also contributeto this phenomenon. KEY WORDS: Liver disease, Purine synthesisPurine synthesis, Purine synthesis, Kidney, Tubular function, Xanthine oxidase     

Serum levels of IL-10, IL-15 and soluble tumour necrosis factor-alpha (TNF-α) receptors in type C chronic liver disease

We previously reported that the number of TNF-α-producing cells was increased in the liver of patients with type C chronic liver disease. To understand further the pathophysiology of this change, we examined serum levels of two soluble TNF receptors, TNF-αRI (p55) and -αRII (p75), and IL-10, all of which act as TNF-α buffer, and IL-15, a novel cytokine sharing many immunological activities with IL-2, using ELISA methods. We studied control individuals and patients with type C chronic liver disease, including asymptomatic hepatitis C virus (HCV) carriers with persistently normal serum ALT values, and those with chronic hepatitis (CH), liver cirrhosis (LC) and hepatocellular carcinoma (HCC). Both types of sTNF-αR closely correlated with disease progression. Patients with LC and HCC had significantly elevated levels for sTNF-αRII compared with the other patient groups and controls. Serum IL-10 levels were significantly greater in all chronic liver disease groups than in controls. With respect to IL-15, the values were high in CH, LC and HCC compared with those of controls. Notably, HCC patients showed highest values for both IL-10 and IL-15, with significant differences from the other patient groups. Serial determinations revealed that interferon (IFN) treatment for CH patients resulted in the suppression of circulating IL-10 and IL-15 levels along with decrease in serum aminotransferase values. Both cytokines remained at decreased levels after cessation of therapy in patients who went into clinical and virological remission. On the other hand, treatment did not affect serum levels of sTNF-αRs. These findings indicate that serum levels of these molecules correlated with disease progress in chronic HCV infection, and that IL-10 and IL-15 may reflect the degree of inflammation in the liver. It is also suggested that both cytokines may be related to the development of HCC.     

Transient Depletion of T Cells with Bright CD11a/CD18 Expression from Peripheral Circulation during Acute Kawasaki Disease

To clarify the activation of peripheral blood T cells in Kawasaki disease (KD) patients, we investigated whether expression of lymphocyte function-associated antigen-1 (LFA-1, CD11a/CD18) and/or intercellular adhesion molecule-1 (ICAM-1, CDS4) on peripheral blood T cells increases during the acute stage. Expression of cellular adhesion molecules was measured using flow cytometry. There was a decrease in the percentage of CD3⁺ T cells in the bright LFA-1α and LFA-1β population and a concomitant increase in the dim population of LFA-1α and LFA-1β during the acute stage, in comparison with those of the convalescent stage. In addition, we observed no significant differences in ICAM-1 expression during the acute stage compared with that of the convalescent stage. In our view the present data, in conjunction with previous reports on T-cell function during acute KD, suggest that activated T cells are temporarily withdrawn from peripheral circulation during acute KD.     

Changes in Cell Characteristics Due to Culture Conditions in Cell Lines From Human Small Cell Lung Cancer

Eight cultured cell lines were established from human smallcell lung cancers. Every cell line showed the morphologicaland biochemical characteristics of small cell cancer. Changesin cell characteristics were observed in many of these celllines when culture conditions were changed: "oat cell type"changed to "intermediate cell type" and vice versa when serum-freemedium was changed to serum-supplemented medium; a deficiencyof vitamin A in the medium caused a change to squamous cellsand vice versa; and a tumor promoter (teleocidin B) enhancedthe adherence of these cells to the surface of plastic culturedishes. These findings provide evidence that many small celllung cancer cell lines can change their morphology with changesin the environment of the cells.     

Excretion Profiles of the Mycotoxin Deoxynivalenol, following Oral and Intravenous Administration to Sheep

Excretion Profiles of the Mycotoxin Deoxynivalenol, followingOral and Intravenous Administration to Sheep. PRELUSKY, D. B.,VEIRA, D. M., TRENHOLM, H. L., AND HARTIN, K. E. (1986). Fundam.Appl. Toxicol. 6, 356–363. The excretion profiles of deoxynivalenol(DON) and metabolites (DON glucuronide conjugate, 3,715-trihydroxytrichothec-9,12-diene-8-one(DOM-1), and DOM-1 glucuronide conjugate) were defined in malesheep following either intravenous (iv) or oral administrationof the toxin at levels of 0.5 and 5.0 mg DON/kg body wt, respectively.After iv dosing, urinary DON levels declined in a biphasic fashionwith an average elimination half-life (terminal phase) of 1.2hr. diminishing to baseline concentrations by 8 hr. Maximumurinary excretion rates for the two major metabolites identified(conjugated DON, conjugated DOM-1) occurred 0.5–1.5 hrafter dosing, exhibiting elimination half-lives of 2.2 and 3.1hr, respectively. Total recovery accounted for only about 66.5%of the dose: 63.0% in the urine (24.1% DON, 21.2% conjugatedDON, 0.5% DOM-1, 17.2% conjugated DOM-1) and 3.5% in bile (madeup almost completely of conjugated DOM-1). The peak biliaryexcretion rate for conjugated DOM-1 was found to occur within1 hr postdosing, which rapidly declined to baseline levels by5 hr. Following oral administration, urinary excretion ratesof the major metabolites (DON, conjugated DON, conjugated DOM-1)reached maximum 6–9 hr post-treatment, and declined exponentiallywith t values of 3.2, 4.0, and 5.0 hr, respectively. Urinaryand biliary recovery of administered DON averaged approximately7.1%: 7.0% in urine (2.1% DON, 3.6% conjugated DON, 0.06% DOM-1,1.2% conjugated DOM-1) and 0.11% in bile (predominately conjugatedDOM-1). Between 54 and 75% of the oral dose was recovered inthe feces. These findings indicate that DON and metabolitesdo not persist in the body following either a single oral orintravenous dose of DON and are rapidly excreted. However, followingiv administration, a portion of the dose (33.5%) remained unaccounted,presumably converted to unidentified metabolites. Based on theseresults it appears that metabolism is the major process of eliminationof DON in sheep.