Duodenal lymphangitis carcinomatosa: Endoscopic characteristics and clinical significance

Background and Aim: Duodenal lymphangitis carcinomatosa has been sporadically described, but so far little attention has been paid to duodenal lymphangitis carcinomatosa. Methods: Four cases with duodenal lymphangitis carcinomatosa were endoscopically and histologically examined. Results: The four cases exhibited multiple polypoid lesions along the Kerckring's folds and/or were covered by characteristically granular, non‐ulcerated mucosa upon thickening. The granularity seems to been caused by dilated lymph vessels containing the carcinoma cells. The lesions were microscopically characterized by: (i) involvement of lymph vessels located in the upper portion of the lamina propria; (ii) no inflammatory changes; and (iii) no desmoplastic changes. Primary sites were thought to be the stomach in case 1, the pancreas in cases 2 and 4, and unknown in case 3. All patients died within 6 months after admission or endoscopic examination. Conclusions: As duodenal lymphangitis carcinomatosis shows characteristic endoscopic appearance, endoscopic diagnosis is not difficult. We should realize that the lesion represents extremely poor prognosis, and it should be distinguished from ordinary metastatic duodenal carcinoma.     

沙生蜡菊花中的二氢黄酮类成分

目的：研究沙生蜡菊花的化学成分。方法：采用多种色谱方法（硅胶柱色谱、ODS柱色谱和HPLC柱色谱）分离纯化,依据理化性质、核磁数据分析并结合CD谱进行结构鉴定。结果：从沙生蜡菊花的甲醇提取物中分离得到8个二氢黄酮类化合物,分别鉴定为（2S）-HelichrysinA（1）、（2R）-HelichrysinA（2）、Naringenin-7-O-β-D—glucopyranoside（3）、（2R,3R）-Dihydrokaempferol-7-O-β-D—glucoside（4）、HeliciosideA（5）、（2R）-Eriodictyol-5-O-β-D—glucoside（6）、（2S）-Naringenin-5,7-di—O-β-D—glucoside（7）、（2R）-Naringenin-5,7-di-O-β-D—glucoside（8）。结论：化合物1-8为从该属植物中首次分离得到的化合物,化合物2、3为从该植物中首次分离得到的化合物。     

Long-term administration of natural interferon-α in patients with chronic hepatitis C: Relationship to serum RNA concentration, HCV-RNA genotypes, histological changes and hepatitis C virus

To virologically assess the efficacy of interferon therapy in chronic hepatitis C, either 5 or 10 MU/day natural interferon-α (IFNα) was administered to 57 patients with chronic hepatitis C for 38 weeks. A complete and sustained response (CR-SR), as evidenced by the absence of serum hepatitis C virus (HCV)-RNA during the administration period and at 6 months after the final administration of IFNα and a normal GPT level at 6 months after final administration, occurred in 42.6% (23/54) of subjects. Liver tissue was histologically evaluated using the histological activity index (HAI) score before and after the administration period. In CR-SR cases, significant improvements (P <0.01) occurred in periportal necrosis, intralobular necrosis, portal inflammation and total score. A comparison, by HCV genotypes, revealed that CR-SR occurred in 60% (9/15) of subjects with type 2a and 30.3% (10/33) of subjects with type Ib. A comparison by virus concentration revealed that CR-SR occurred in 71.4% (15/21) of those subjects having a virus concentration of < 10⁵ copies/mL, but in only 24.2% (8/33) of those having a virus concentration of > 10⁵ copies/mL. Analysis by a multiple logistic model revealed a strong correlation between the therapeutic effect of interferon therapy and the pre-administration virus concentration (P=0.0061) and genotype (P=0.0015). These results suggest that the preadministration virus concentration and genotype are both key factors affecting the therapeutic effect of interferon therapy in chronic hepatitis C and that the therapeutic effect of interferon is satisfactorily high, irrespective of virus concentration, in subjects with type 2a HCV, but varies depending on virus concentration in subjects with type 1b.     

Japanese summer-type hypersensitivity pneumonitis: studies using Cryptococcus antigen

Sixty-six patients, diagnosed as Japanese summer-type hypersensitivity pneumonitis at Osaka Prefectural Habikino hospital between 1973 and 1980, were studied. The diagnosis was based on the clinical features and summer-seasonal nature of the disease. The presence of an aetiological agent within patients' home environment was suggested by the recurrence of acute symptoms of high fever, cough and dyspnoea 5–8 hr after coming home from hospital, and by spontaneous improvement on leaving home. Immunological studies revealed the presence of anti-Cryptococcus antibody in sixty-four of sixty-five patients' sera, by indirect immunofluorescence against Cryptococcus neoformans, Precipitating antibody against culture supernatant protein-antigen of Cr. neoformans was detected in more than 80% of sera obtained from patients during the active stage of the disease. The positive result on inhalation provocation-challenge, using culture supernatant protein-antigen, suggested that Cr. neoformans or antigenically related Cryptococcus species may cause Japanese summer-type hypersensitivity pneumonitis.