Insulin-like growth factor II in follicular fluid of the patients with in vitro fertilization and embryo transfer

OBJECTIVE

To investigate whether insulin-like growth factor II (IGF-II) is present in follicular fluids (FF) and whether IGF-II in FF plays an important role on human ovarian function.

DESIGN, SETTING, PATIENTS

Insulin-like growth factor II concentrations were measured using an RIA technique in 46 samples of human FF obtained from 20 patients who were undergoing IVF and ET. The distribution profiles of unsaturated IGF-II binding protein were also investigated. Moreover, the effect of IGF-II on steroidogenesis by cultured granulosa cells (GCs) obtained simultaneously in the IVF-ET program was investigated.

RESULTS

The IGF-II levels in FF (92.7 +/- 7.5 nmol/L) were approximately eight times greater than those of IGF-I (11.4 +/- 1.0 nmol/L), and significant positive correlations were observed between these IGFs in FF. By Sephadex G-150 gel-chromatography of FF, two apparent peaks of unsaturated IGF-II binding protein could be detected in the high molecular weight (MW) (150 kd) and low MW (approximately 36 to 38 kd) regions. Additionally, IGF-II dose dependently increased the release of P and E2 from the cultured human GCs.

CONCLUSIONS

These findings suggest that the large quantity of IGF-II in FF may play possibly some roles in the ovarian steroidogenesis.

Treatment of adult T-cell leukemia/lymphoma with MST-16, a new oral antitumor drug and a derivative of bis(2,6-dioxopiperazine). The MST-16 Study Group

BACKGROUND

MST-16, a new orally administered bis(2,6-dioxopiperazine) analogue and an inhibitor of topoisomerase II, was given to 24 patients with adult T-cell leukemia-lymphoma (ATLL) in a Phase I-II multi-institutional cooperative study.

METHODS

MST-16 was administered orally daily for 7 days, with courses repeated at intervals of 2-3 weeks in 24 patients.

RESULTS

Two complete remissions (CR) and eight partial remissions (PR) were obtained in 23 evaluable patients who received 1200-2800 mg/day of MST-16. Among 13 acute-type ATLL, one CR and five PR were obtained. Among eight lymphoma-type ATLL, two PR were detected. Among two chronic-type ATLL, one CR and one PR occurred. Remissions were obtained at 7-232 days (median, 23 days) and lasted 43-374 days (median, 68 days). The major toxic effects were leukopenia (68%), anemia (52%), thrombocytopenia (35%), and gastrointestinal disorders (22%).

CONCLUSIONS

MST-16 was shown to be effective in ATLL, which has no standard therapy. This drug deserves further clinical trials because it shows little cross resistance to currently available antitumor drugs.

Reactive lymphoid hyperplasia of the liver

A patient with reactive lymphoid hyperplasia of the liver was symptom free and had no underlying disease except for diabetes mellitus. The hepatic tumor was found by ultrasound examination at routine checkup. The preoperative diagnosis of the tumor was unsuccessful despite various radiological examinations. Histological examination of the resected tumor showed that it was composed of benign-appearing lymphocytic proliferations forming lymphoid follicles that included numerous germinal centers. The germinal center was mainly composed of B-cell marker, L26-positive lymphocytes, but a few T cells were also found. Lymphocytes surrounding germinal centers were mainly T-cell marker, UCHL1-positive T-cells, and a small number of B cells. The B cells in the lymphoid follicles were stained for both kappa and lambda light chains at equal frequency, indicating polyclonal and benign nature. A diagnosis of reactive lymphoid hyperplasia of the liver seems justified.

A comparative study of hepatic resection and transcatheter arterial embolization for the treatment of primary hepatocellular carcinoma

BACKGROUND

Because transcatheter arterial embolization (TAE) has been shown to be effective in patients with unresectable hepatocellular carcinoma (HCC), the question arises whether TAE has an equivalent or superior effect on resectable HCC compared with surgery. To clarify this point, the authors compared the therapeutic results achieved by surgery and TAE in patients with early-stage HCC and well-preserved liver function, who were independently treated by two different policies in two separate departments of the same university hospital during the same period.

METHODS

From 1983 to 1987, 67 patients with HCC underwent hepatic resection at the Department of Surgery of Kyushu University Hospital. During the same period, TAE was the treatment of first choice for HCC, and surgical resection was not chosen in the Department of Internal Medicine of the hospital. TAE was done in 68 patients, who were evaluated blindly in terms of liver function reserve and roentgenographic resectability of the tumor. Among the 68 patients, 20 were thought to have anatomically and functionally resectable disease. The therapeutic results obtained in the two groups were compared.

RESULTS

The 1-year, 3-year, and 5-year cumulative survival rates for 67 patients undergoing surgery, including one operative death and four hospital deaths, were 89.1%, 74.6%, and 54.6%, respectively. However, the rates were 90.0%, 50.0%, and 17.5%, respectively, for the 20 patients treated with TAE; these differences were statistically significant (P < 0.05).

CONCLUSIONS

Surgery can offer more favorable results in patients with early-stage HCC compared with TAE.

Inhibitory effects of insulin-like growth factor (IGF)-binding proteins-1 and -3 on IGF-activated glucose consumption in mouse BALB/c 3T3 fibroblasts

We have examined the biological effects of insulin-like growth factor-binding proteins (IGFBPs) on insulin-like growth factor (IGF)-activated glucose consumption in a BALB/c 3T3 subline. The method employed was a colorimetric measurement of glucose consumption, allowing the detection of changes from the initial glucose concentration in conditioned medium, following the addition of IGFs and IGFBPs. Human IGFBP-1, purified from amniotic fluid, inhibited IGF-activated glucose consumption, although it had no effect on insulin-activated glucose consumption. The median effective dose (ED50) of IGFBP-1 to cause inhibitory effects on IGF-activated glucose consumption was 100-200 micrograms/l and was similar for both IGF-I and IGF-II at a concentration of 1.0 microgram IGF/l. Therefore, at IGF concentrations of comparable activity, the inhibitory effects of IGFBP-1 were greater for IGF-I than for IGF-II, because of the higher activity of IGF-I in this assay. Recombinant human IGFBP-3 also inhibited IGF-activated glucose consumption, without affecting insulin-stimulated glucose consumption. The inhibitory effects of IGFBP-3 were greater for IGF-II than for IGF-I when IGFBP-3 was coincubated with either of the IGFs, at both IGF concentrations of comparable activity and equivalent molar concentrations. Thus, it became clear that the inhibitory effects of these IGFBPs on IGF biological action depended primarily upon their affinity for the specific IGF ligand and molar ratio of IGFBP/IGF peptide. Interestingly, when cells were pretreated with IGFBP-3, prior to the simultaneous addition of IGFs and IGFBP-3, the inhibitory effect was higher for IGF-I than for IGF-II. Either no effect or a minor inhibitory effect on IGF-activated glucose consumption was detected with IGFBP pretreatment alone. When the ED50 for inhibition of IGF action by IGFBPs in this in-vitro assay was compared with the physiological concentrations of IGFs and IGFBPs in normal human serum and in amniotic fluid, it was estimated that the IGFBP-1 concentration present in serum was not sufficient to modulate IGF action effectively while the concentration in amniotic fluid was enough for effective suppression. IGFBP-3 exhibited an ED50 low enough to suppress IGF-II and possibly IGF-I action when cells were pretreated with IGFBP-3. Thus, our data suggested that IGFBP-1 in amniotic fluid and IGFBP-3 in serum could be a potent inhibitor for IGF action. IGFBP-1 in serum, however, may not be able to function as a direct inhibitor under physiological conditions but, rather, may modulate IGF action together with other IGFBPs.

[Eosinophil activation evaluated by using a anti-human secreted form of ECP antibody (EG2)]

EG2 is a monoclonal antibody which recognize activated eosinophils, and the increased number of eosinophils stained by EG2 suggest activation of the disease. In bronchial epithelium of patient with asthma, not only EG2-positive eosinophils but CD25-positive T lymphocytes are increased, and support the theory that asthma is a nonsuppurative inflammatory disease of bronchial tree. Bronchial hyperresponsiveness of patient with asthma, which was assessed by a methacoline provocation test, was correlated significantly with the number of EG2 positive-eosinophils in bronchial epithelium. Moreover, most of eosinophils infiltrated to bronchial epithelium in patient with fatal asthma were EG2 positive. The severity of acute asthma attack however did not correlate with EG2-positive rate of eosinophils, but significantly correlated with releasability of granules from eosinophils in sputum of patients with asthma indicated by BMK-13 staining. There are many reports that EG2-positive eosinophils participate in the pathogenesis of other allergic diseases, several types of collagen disease and cancer therapy.

Effects of beta-carotene-rich algae Dunaliella bardawil on the dynamic changes of normal and neoplastic mammary cells and general metabolism in mice

As a possible step to estimate the mechanism of the inhibitory role of Dunaliella bardawil (Db) in the initial progression of spontaneous mammary tumours of SHN virgin mice, the DNA synthesizing enzyme activities and the in vivo 31P-NMR spectroscopy of normal and neoplastic mammary cells were examined in mice fed Db. The blood levels of glucose and free fatty acids and 1H-NMR spectroscopy of serum or urine were also studied in these animals to check the general metabolic background. Beginning at 4 months of age, the experimental and the control mice were given a vitamin A deficient AIN-76TM diet supplemented with Db (the concentration of beta-carotene was 5.1 x 10(-5)%) and AIN-76TM diet containing retinyl palmitate (2.2 x 10(-4)%), respectively, until 3 weeks after mammary tumour appearance (tumourous) or 9 months of age (non-tumourous). An increasing rate of thymidine kinase activity in mammary tumour was decreased by Db, while the thymidylate synthetase activity was affected little by the treatment. Lipid synthesis was accelerated by Db in normal mammary cells; however, no difference was observed between the experimental and the control groups in energy and lipid metabolism of mammary tumour cells. The growth of preneoplastic mammary hyperplastic alveolar nodules was also enhanced by Db. Db prevented an increase of blood levels of glucose and free fatty acids and a decrease of cholin plus phosphorylcholin level after tumour appearance. Liver weights of mice given Db were greater than those of the control in both the tumourous and non-tumourous groups. Db had little effect on the urinary component levels before and after the appearance of mammary tumours. These results indicate that Db promotes the growth of normal mammary gland cells, but inhibits that of neoplastic cells, and that the inhibitory effect of Db on mammary tumour progression is due to its normalizing both the organ specific and the general metabolism.

Effect of a leukotriene antagonist, ONO-1078, on bronchial hyperresponsiveness in patients with asthma

To evaluate the involvement of sulphidopeptide leukotrienes on bronchial hyperresponsiveness in asthma, we examined the effects of a specific orally active leukotriene antagonist (ONO-1078) on bronchial responsiveness to methacholine in stable asthmatic subjects by a double-blinded, randomized, two-phase crossover study. Eleven asthmatic subjects received ONO-1078 (225 mg twice a day) or placebo. After 1 week administration of ONO-1078 or placebo, the subjects underwent methacholine challenge test. Test drug administrations were then discontinued for 1 week, and the subjects were then crossed over to the alternative treatment regimen. After 1 week of the alternate regimen, the subjects underwent a second methacholine challenge. Mean baseline values of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) and geometric mean value of provocative concentration of methacholine causing a 20% fall in FEV1 (PC20-FEV1) were equal between the first and the second methacholine test. The geometric mean value of PC20-FEV1 after the administration of ONO-1078 was 0.48 (geometric SEM, 1.48) mg ml-1, which was significantly (P < 0.01) greater than the value after the placebo administration (0.30 geometric SEM, 1.41 mg ml-1), but the baseline values of FVC and FEV1 were not altered by ONO-1078. We conclude that sulphidopeptide leukotrienes are significantly involved in the development of bronchial hyperresponsiveness in asthma but the degree of the involvement may be small.

[Isolated trochlear nerve palsy caused by mixed dural-pial arteriovenous malformation of the anterior cranial fossa: a case report]

A 62-year-old male was admitted to our hospital in May, 1985, with double vision, which had persisted for 1 month. The neurological examination revealed left trochlear nerve palsy. A cerebral angiogram showed an arteriovenous malformation at the anterior cranial fossa. The malformation was mainly fed by the left anterior ethmoidal artery which branched off from the orbital branch of the left middle meningeal artery. There was a marked enlargement of anastomosis between the orbital branch of the middle meningeal artery and the recurrent meningeal branch of the lacrimal artery. Bilateral distal branches of the internal maxillary arteries, bilateral anterior falx arteries and the left fronto-orbital artery were also involved in supplying the AVM. The dilated fronto-orbital vein was the main drainer which emptied into the pterygoid plexus via the uncal vein and the sphenoparietal vein. In June 1985, the nidus involving the dura at the region of the cribriform plate and olfactory bulb was totally removed through a left frontal craniotomy. Postoperatively, the isolated left trochlear nerve palsy improved completely within a few days. This is the first reported case of isolated trochlear nerve palsy caused by a mixed dural-pial arteriovenous malformation of the anterior cranial fossa. We concluded that the etiology of isolated trochlear nerve palsy consisted of nerve compression due to the dilated orbital branch of the middle meningeal artery within the superior orbital fissure.

[Severe bleeding in a case of factor VIII inhibitor associated with intravascular lymphomatosis]

A 70-year-old man was admitted to Jichi Medical School Hospital on October 1, 1990, complaining of spontaneous severe hemorrhage in his extremities. He had prolonged APTT value and normal PT value. Factor VIII level was markedly diminished, and a high titer of factor VIII inhibitor was observed. He was diagnosed as having idiopathic factor VIII inhibitor because of no sign of underlying disorders. He received prednisolone and immunosuppressants, subsequently with plasma exchange and bolous factor VIII, resulting in disappearance of the inhibitor. He was admitted again in February 1991, because of the reappearance of factor VIII inhibitor. In June, furthermore, bone marrow smears showed infiltration of atypical B cells, although no evidence of organomegaly and adenopathy was observed. Therefore, he was suspected to have primary bone marrow lymphoma. He received CHOP therapy, but he died of multiorgan failure. Postmortem autopsy demonstrated multifocal intravascular lymphomatosis with marked intravascular involvement of the lung, liver, kidney, adrenal glands, spleen and bone marrow. Lymph nodes were not swollen, showing little evidence of intravascular lymphomatosis.

Comparison of the bronchodilator activities of oxitropium bromide, fenoterol, and their combination in patients with chronic obstructive pulmonary disease and bronchial asthma

The effects of an antimuscarinic agent, oxitropium bromide (200 micrograms), a beta-2 adrenoceptor agonist, fenoterol (200 micrograms), and their combination, were compared in ten patients with chronic obstructive pulmonary disease and ten patients with bronchial asthma, in a placebo-controlled, single blind crossover trial. In patients with chronic obstructive pulmonary disease, oxitropium and fenoterol produced a significant and similar degree of bronchodilatation. The duration of the bronchodilator effect was 3 h after oxitropium and 4 h after fenoterol, respectively. The combination of oxitropium and fenoterol produced a significantly greater degree of bronchodilatation than either drug alone. The duration of bronchodilatation in combination was 7 h and was considerably longer than that of each drug alone. In patients with bronchial asthma, oxitropium and fenoterol also caused bronchodilatation. Their combination produced a significantly greater degree of bronchodilatation than when either drug was used. The duration of the bronchodilator effects were 5 h after oxitropium, 4 h after fenoterol and 5 h after the combination. We conclude that the combination of oxitropium and fenoterol causes greater bronchodilatation in patients with chronic obstructive pulmonary disease and bronchial asthma than when compared to each drug alone. In the former, the duration of bronchodilatation is additionally prolonged. These combination effects may be of value in the clinical management of these common respiratory disorders.

Relative activities of thymidylate synthetase and thymidine kinase in human mammary tumours

Thymidylate synthetase (TS) and thymidine kinase (TK) are known to catalyse the methylation of dUMP for the de novo synthesis of dTMP and the phosphorylation of thymidine for the salvage synthesis of dTMP in the pyrimidine pathway, respectively. High activities of TS and TK have been observed in rapidly proliferating tissues. In the present study, both enzyme activities were measured in 8 specimens of normal mammary tissues, 12 fibroadenomas and 10 adenocarcinomas in the human breast. The average activities of TS in fibroadenomas and adenocarcinomas were approximately 5- and 7-fold that in normal mammary tissues, respectively. The average activities of TK in fibroadenomas and adenocarcinomas were 4- and 14-fold that in normal mammary tissues, respectively. Thus, DNA synthesis in benign and malignant mammary tumors may be relatively predominant in de novo and salvage pathways, respectively.

Striosomal arrangement of met-enkephalin and substance P expression in parkinsonism-dementia complex on Guam

This report concerns a topographic immunohistochemical analysis of Met-enkephalin (MEnk) and substance P (SP) expression in the striatum from seven patients with parkinsonism-dementia complex on Guam (PDC). The striatum of seven neurologically normal subjects served as controls. MEnk-positive striosomes were readily visualized in both the caudate nucleus and the putamen of the PDC cases. Although the immunoreactivity was less than that of MEnk, SP-positive patches were detected in the PDC striatum. The patches were similar to those seen in the normal controls. These results provide additional evidence that the striatum and its efferent system appear to be preserved in patients with PDC.

Effects of danazol on DNA synthesis in rat prostate

Effects of danazol, an isoxazol derivative of the synthetic steroid 17 alpha-ethinyltestosterone, on activities of thymidylate synthetase and thymidine kinase, which are the DNA-synthesizing enzymes included in de novo and salvage pathways of pyrimidine metabolism, respectively, were investigated in rat prostate. Danazol markedly reduced plasma levels of luteinizing hormone and testosterone, and organ weight, both enzyme activities and bromodeoxyuridine-immunoreactive cells which were regarded as the S-phase cells in prostate. These results indicate that danazol shows a property as a potent antigonadotropin.

Effects of luteinizing hormone-releasing hormone analogue on DNA synthesis in rat prostate and uterus

Buserelin, a potent LH-RH agonist, has been used for the treatment of hormonal disorders such as precocious puberty, endometriosis, cystic mastitis and prostatic carcinoma. Prolonged treatment with buserelin has been known to induce a refractory phase of pituitary desensitization. In the present study, we found that two-week treatment with buserelin strongly suppressed the activities of thymidylate synthetase and thymidine kinase, and markedly reduced the appearance of BrdU-immunoreactive (S-phase) cells in both prostate glands and uteri in male and female adult rats, respectively.

In vivo studies of the effect of magnetic field exposure on ontogeny of choline acetyltransferase in the rat brain

Developmental increases of the activity of choline acetyltransferase (ChAT) were examined in the brains of fetuses and offspring from parent rats continuously exposed to a 500 mG, 60 Hz circularly polarized (CP) magnetic field (MF) prior to pregnancy, and further, during pregnancy and lactation. In developing rats between 12 days and 20 days of embryogenesis that were housed in a control unit, i.e., nonexposed to MF, the specific activity of ChAT in whole brain specimens increased from 2.4% to 6.9% of adult activity, while specific activity of ChAT in rat brain specimens between 12 days of embryogenesis and 10 days of postpartum increased from 2.4% to 21.6% of adult activity. On the other hand, the specific activity of ChAT in whole brain specimens from rats under housed MF exposure conditions was found to increase from 2.6% to 6.7% of adult activity between 12 days and 20 days of embryogenesis and from 2.6% to 21.6% of adult activity between 12 days of embryogenesis and 10 days postpartum. Furthermore, the effect of the same test magnetic environment on the specific activity of ChAT in the brains of parental rats was examined in order to determine whether magnetic field exposure of parental rats might reflect onto the development of fetal brain. It was observed that continuous exposure of parental rats to a 500 mG, 60 Hz CP MF did not show any significant changes in the specific activity of ChAT in the septodiagonal band complex, dorsal and ventral hippocampus, striatum, and frontoparietal cerebral cortex, as compared with the same brain regions of control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

[Human cultured retinal pigment epithelial cells produce interleukin-6]

Production of interleukin 6 (IL-6) from cultured human retinal pigment epithelial cells (RPE) was demonstrated using an enzyme-linked immunosorbent assay. Production of IL-6 occurred without any stimulation and significantly increased approximately 2-5 times by lipopolysaccharide (LPS) or interleukin 1 alpha stimulation. Hydrocortisone reduced the production of the LPS-stimulated IL-6 to a half level. Both gel filtration and western blotting analysis indicated the molecular weight of IL-6 as 30,000-35,000. IL-6 produced in the RPE may play a role in amplifying ocular immune and inflammatory responses.

Suppression of spontaneous development of uterine adenomyosis and mammary hyperplastic alveolar nodules by Chinese herbal medicines in mice

The effects of traditional Chinese herbal remedies, Shakuyaku-kanzo-to (SKT) and Hachimijiou-gan (HJG), on the spontaneous development of uterine adenomyosis and mammary hyperplastic alveolar nodules (HAN) were examined in an experimental animal model using SHN strain of mice. Female mice were provided with the chow containing 1% of SKT or HJG during 25-150 days of age. At 150 days of age, SKT treatment showed significantly lower incidence of adenomyosis, and HJG treatment resulted in a significantly lower incidence of HAN when compared to a control chow containing no medicines. Long-term exposure to these herbal medicines affected little serum prolactin (PRL) level, estrous cycle, food intake and body growth. Thus, the present mouse data suggest that the oral administration of these herbal medicines is a useful tool for the treatment of uterine adenomyosis or mammary disorder such as cystic mastitis.

Tachyphylaxis to capsaicin-induced cough and its reversal by indomethacin, in patients with the sinobronchial syndrome

Cough reflex testing with capsaicin has been used to study the pathophysiology of the cough reflex and the antitussive effects of various drugs. Although the reproducibility of capsaicin-induced cough has been well established in normal subjects, it is not known if prior challenge with capsaicin reduces the subsequent cough response to inhaled capsaicin in patients with the sinobronchial syndrome, a condition characterized by chronic upper and lower airway inflammation. Measurement of the capsaicin cough threshold, defined as the lowest concentration of capsaicin eliciting five or more coughs, was repeated four times at intervals of 15, 30 and 60 min in eleven patients with the SBS and ten normal subjects. The cough thresholds at 15, 30 and 60 min were greater than the initial value in patients with the SBS but not in normal subjects. In addition, we examined the effect of 4 days treatment with indomethacin (100 mg/day) on the cough thresholds measured twice at an interval of 15 min in eight patients with the SBS. Indomethacin increased the initial cough threshold and reduced the increment in the post-15 min cough threshold from the initial value compared with placebo, thus reducing the tachyphylaxis. These results indicate that chronic airway inflammation may be responsible for the decreased response (tachyphylaxis) to repeated inhalation of capsaicin, and suggest that cyclooxygenase products released by the airway inflammation may be involved in tachyphylaxis, cough receptor sensitivity to inhaled capsaicin, or both, in patients with the SBS.

Hepatocellular carcinoma not detected with plain US: treatment with percutaneous ethanol injection under guidance with enhanced US

To evaluate the usefulness of contrast material-enhanced ultrasound (US) in detection and treatment of hepatocellular carcinoma (HCC), carbon dioxide was injected as a contrast agent into the hepatic artery in 22 patients with HCC. Plain US had enabled detection of 24 HCC nodules in these patients. Contrast material-enhanced US enabled detection of seven additional nodules, which were confirmed as HCC by means of fine-needle aspiration biopsy performed under guidance with contrast-enhanced US. Six of these seven nodules were detected incidentally during examination of other suspected HCC nodules. Five of the seven nodules were treated with percutaneous ethanol injection (PEI) performed under guidance with contrast-enhanced US; the two other nodules were resected. Contrast-enhanced US made the HCC lesions visible for 15-60 minutes, sufficient time to mark the nodule with an iodized oil-ethanol solution for PEI. Because contrast-enhanced US enabled detection of additional nodules and performance of PEI in lesions not detected with plain US, it may help improve the treatment of HCC.

Clinical significance of the serum levels of the 7S domain of type IV collagen in patients with primary biliary cirrhosis

The serum levels of the 7S domain of type IV collagen were measured with a radio-immunoassay in 42 patients with primary biliary cirrhosis (asymptomatic: n = 28; symptomatic: n = 14), 10 patients with chronic active hepatitis, 10 patients with liver cirrhosis and 10 healthy female controls. Serum levels of the 7S domain of type IV collagen were: 4.28 ng/mL (3.88-4.72 ng/mL; mean and range of mean +/- s.d.) in healthy controls; 5.97 ng/mL (5.07-7.02 ng/mL) in patients with chronic active hepatitis; 8.23 ng/mL (6.40-10.58 ng/mL) in patients with liver cirrhosis; and 6.79 ng/mL (4.76-9.67 ng/mL) in patients with primary biliary cirrhosis. Patients with liver cirrhosis and primary biliary cirrhosis had higher levels of serum 7S domain of type IV collagen than healthy controls (P < 0.001, respectively). Serum levels of the 7S domain of type IV collagen in patients with asymptomatic primary biliary cirrhosis, 5.83 ng/mL (4.55-7.48 ng/mL) were significantly lower than those in symptomatic primary biliary cirrhosis, 9.18 ng/mL (6.53-12.91 ng/mL; P < 0.001). Serum levels of the 7S domain of type IV collagen increased significantly along with advancement of the histological stages of primary biliary cirrhosis. Serum levels of the 7S domain of type IV collagen in the paired sera of eight patients with asymptomatic primary biliary cirrhosis (mean interval 30 months, range 12-48 months) showed significant rises during the intervals (P < 0.05), while serum levels of albumin and total bilirubin did not change significantly during these intervals.(ABSTRACT TRUNCATED AT 250 WORDS)