Effect of albendazole on Ancylostoma caninum larvae migrating in the muscles of mice

When mice inoculated with 1,000 third-stage larvae of Ancylostoma caninum for 1 week were treated intragastrically (ig) with albendazole (Alb) 75, 150 or 300 mg/kg.d for 3 days, the mean larva numbers collected from the muscles of each group were 2.7 +/- 1.7, 2.0 +/- 1.5 and 1.0 +/- 1.0, respectively, being much less than that 205 +/- 68 of the control group. In mice treated ig with Alb 150 mg/kg.d for 3 days, the concentrations of Alb and its effective metabolite, albendazole sulfoxide (AlbSO), were determined in plasma and the muscles at different intervals after the last medication using high performance liquid chromatography. The results showed that only low concentrations of Alb were detected in both plasma and the muscles. However, higher concentrations of AlbSO were found not only in the plasma (5.4-10.5 micrograms/ml), but also in the muscles (2.2-4.6 micrograms/g). The higher contents of AlbSO in the muscles would be helpful for killing the Ancylostoma larvae migrating in the muscles of mice.

Preliminary report on cardiovascular responses to urapidil during intubation and extubation

Urapidil (Ebrantil), a new antihypertensive agent with central and peripheral sites of action, has proven effective in the management of both chronic and acute hypertension. This study investigates its effects on cardiovascular responses during intubation and extubation under general anesthesia. Thirty normotensive patients (ASA I-II) were randomized into control (I, without urapidil, n = 10); lower dose (II, 0.4 mg/kg, n = 10); and higher dose (III, 0.6 mg/kg, n = 10) groups. A significant fall of blood pressure was observed in all patients within 1 min after urapidil administration (P < 0.05), and the magnitude of the decrease was related to blood pressure before treatment. However, no transient drop of blood pressure to hypotensive values was observed. The results suggest that urapidil could be used under general anesthesia in patients to control fluctuating blood pressure during intubation and extubation. The increased heart rate (P < 0.05) seen for several minutes after urapidil administration may have been due to the patients' hypovolemic state.

Total gastrectomy via thoracotomy for cancer of the cardia or fundus of the stomach (report of 90 cases)

From 1978 through 1990, 90 total gastrectomies with esophagojejunostomy via thoracotomy were performed for the treatment of cancer of the cardia or fundus of the stomach in our hospital. Eighty-five patients were in TNM-stage III and five in stage IV. The 30-day postresectional mortality was 1.1%, and the 5-year survival rate was 13.8%. 14CO2 breathing test and clinical evaluation of 34 postoperative patients (not included in the 90 patients) showed that total gastrectomy may decrease the incidence of positive residual cancer along the incision lines, and may help to avoid small stomach syndrome. There was no statistical difference in postoperative fat absorption between patients treated by ordinary proximal subtotal gastrectomy and those receiving total gastrectomy via thoracotomy.

Hepatitis B virus infection in Honolulu students

OBJECTIVES

To determine hepatitis B virus (HBV) carrier and infection rates and HBV epidemiology in Honolulu students.

DESIGN

Cross-sectional survey.

SETTING

Honolulu public elementary, intermediate, and high schools.

PATIENTS

A volunteer sample of 4936 students from 43 Honolulu schools.

MAIN OUTCOME MEASURES

HBV carrier rate (presence of hepatitis B surface antigen) and infection rate (presence of either hepatitis B surface antigen, antibody to hepatitis B surface antigen, antibody to hepatitis B core antigen, or any combinations of these) by school grade, ethnicity, and place of birth.

RESULTS

Eighty-three (1.68%) students were identified as HBV carriers, and a total of 353 (7.15%) students had serologic evidence of infection. Infection rates increased from elementary school age to high school age, more so in Asian/Pacific Island-born students. The prevalence of infection was higher in Asian/Pacific Island-born students than in those born in the United States. The majority of infected Hawaiian-born students were first-generation Asian/Pacific Island Americans.

CONCLUSIONS

Horizontal transmission of HBV occurs in Honolulu school-age children. HBV immunization of all infants in Hawaii, not just those born to carrier mothers, is necessary to reduce HBV transmission in Hawaii.

Long survival with giant cell myocarditis

Several aspects of giant cell myocarditis remain controversial, including the natural history of the disease and the nature of the giant cells. We have observed three patients who had long survival with chronic active giant cell myocarditis. The first patient was a 59-yr-old female who had a 10-yr history of complete heart block which was found at autopsy to have been caused by giant cell myocarditis. The second patient is a 36-yr-old female who received a heart transplant 5 yr after a biopsy proven episode of active myocarditis, and examination of the explanted heart revealed giant cell myocarditis. The third patient was a 41-yr-old male who received a heart transplant 2 yr after developing progressive heart failure, and the explanted heart had giant cell myocarditis. On immunohistochemical study of the three hearts, the giant cells stained with the macrophage markers lysozyme and KP-1 (CD-68). Staining of the same cells with desmin and actin was focally positive in a punctate pattern, correlating with the ultrastructural presence of myofibrils within giant cell phagolysosomes. The associated lymphocytic infiltrate stained primarily for the T-cell markers CD-3, CD-45RO, and CD-43 whereas only a few of the lymphocytes stained with the B-cell marker CD-20. The long histories of cardiac dysfunction in the three patients show that giant cell myocarditis may have a protracted course. The morphologic studies show that the giant cells are of histiocytic origin but can contain phagocytosed components of myocytes, observations that may account for the controversy surrounding the nature of the giant cells in giant cell myocarditis.

[Bronchial disruption due to blunt chest trauma--a report of 6 cases]

Six cases with bronchial disruption due to blunt chest trauma are reported. Clinical symptoms were dyspnea in 5 patients, hemopneumothorax in 3 cases, and hemoptysis and subcutaneous emphysema in 4 cases each. Pneumothorax was not found on immediate radiological examination in 3 patients. Bronchial disruption was defined by exploratory thoracotomy in one case three days after trauma. In the remaining 5 cases, the diagnosis was demonstrated by lipiodol bronchography and fibrobronchoscopy 70 days to 6 years later. End-to-end anastomosis of the bronchus was performed in 5 patients, whereas right middle and lower lobectomy was done in one case. Five patients with bronchial repair suffered transient atelectasis of the lung, which reexpanded in 4 to 10 days.

Misdiagnosis of lung cancer in patients under age 40--a clinical analysis of 47 cases

Diagnosis of lung cancer in 47 patients aged younger than 40 years was delayed as a result of misdiagnosis, accounting for 70.1% of all cases of lung cancer in those aged less than 40 years treated in PUMC Hospital in the same period. Pulmonary tuberculosis and tuberculous pleurisy were diagnosed in 26 cases (55.3%). Pulmonary inflammation was suspected in 24 cases (51.1%). The delay in diagnosis was one to three months in 28 cases and longer than 3 months in 19 cases. Twenty-eight (59.6%) of the 47 patients underwent surgery, including exploratory thoracotomy (21.4%) and pneumonectomy (40.9%). The five-year survival rates in the resectable group and in the non-surgical group were 31.6% and 5.3%, respectively. We recommend that accessory examinations should be performed wherever possible in younger patients with suggestive pulmonary nodules in order to collect sufficient evidence to confirm or rule out the diagnosis of lung cancer and thereby reduce the rate of misdiagnosis in such younger people.

Identification of an ethanol-soluble protein as beta-amylase and its purification from soybean seeds

In the 60% ethanol extract of soybean seeds, a prominent protein band was visible after polyacrylamide gel electrophoresis, which had a molecular weight of about 55 x 10(3) M(r). This protein was purified to homogeneity by buffered ethanol extraction and preparatory gel electrophoresis. Since the N-terminus was apparently blocked, the protein was cleaved with cyanogen bromide and the largest fragment was isolated and a partial sequence determined. The sequence of the 27 N-terminal amino acid residues matched a published soybean beta-amylase peptide sequence. In addition, the purified protein had a high specific activity for beta-amylase and was not a glycoprotein. Furthermore, the partial sequence (106 nucleotides) of a cDNA clone, isolated from a soybean seed cDNA library by antibody screening, matched the cDNA sequence of soybean beta-amylase except for one base. Therefore, the ethanol-soluble protein was identified as beta-amylase. The enzyme was purified to homogeneity using a two-step purification procedure with a yield of over 50%.

Serum tumor necrosis factor (TNF) in the pathogenesis of clinical hepatic failure of HCV and/or HBV infection

Serum TNF and IL-6 levels were measured in 48 patients with liver disease positive for anti-HCV only or concurrent HBV infection. High serum TNF levels were observed in patients with liver disease positive for anti-HCV and/or HBV infection (P < 0.001). Serum TNF levels varied with the severity of liver disease. Serum TNF levels of anti-HCV positive patients with hepatic failure were higher than those with CAH (P < 0.01). Serum TNF levels of patients infected with HCV or concurrent HBV were also significantly higher than those with HBV infection alone (P < 0.001). However, no difference in serum IL-6 levels was observed in either group of patients. Serum TNF in the deceased patients with hepatic failure induced by HBV and HCV infection was higher than in those who survived (P < 0.05), and it also seemed significantly different in patients with and without multiple organ failure (P < 0.05). In vitro, HSS showed marked inhibitory activity on TNF production from PBM induced by endotoxin, but had no significant effect on the TNF cytotoxicity of L929 cells. It seems that high serum TNF level is an important mediator in the pathogenesis of liver necrosis and failure of microcirculation in HCV and/or HBV infection. These observations favor the attempt to treat hepatic failure with HSS or anti-TNF. Encouraging results were achieved using HSS in the treatment of subacute liver necrosis in our institute.(ABSTRACT TRUNCATED AT 250 WORDS)

Apoxesis of primary tracheal tumor. A clinical analysis of 23 cases

During a 17-year period, 23 patients with primary tracheal tumors underwent surgical treatment in the Department of Thoracic Surgery, PUMC Hospital (11 cases of benign tumor of the trachea, 12 cases of low malignancies). Fourteen times of apoxesis were performed in 11 patients with benign tumors who were followed up for an average of 6.3 years. Fifteen operations were performed in 12 cases including local resection of the tracheal wall and tumor in 4, and curettage of tumor plus electric cauterization on the basis in 10. Eight of 9 patients with adenoid cystic carcinoma received postoperative adjuvant irradiation, with a 5-year postoperative survival rate of 75% (6/8) and 3 cases survived over ten years. The desirability of apoxesis and local resection of tracheal tumor is discussed. The authors suggest that these two surgical patterns can be regarded as a simple and effective treatment for patients with primary tracheal tumors.

[Evaluation of local resection for primary tracheal tumor: a clinical analysis of 23 cases]

During a 17 year period, 23 patients with primary tracheal tumor underwent surgery in the PUMC Hospital. Of them, 11 cases were benign tumors and 12 had low malignancies. 11 patients with benign tumors received 14 times of apoxesis of the tumor. 12 cases with low malignancies underwent 15 times of operations including local resection of the tracheal wall and tumor in 4 cases, and tumor apoxesis as well as electrocautery on the basis in 10 cases. Eight of 9 patients with adenoid cystic carcinoma were treated postoperatively with irradiation. Eleven cases with benign tumors were followed up for an average 6.3 of years. Nine cases with adenoid cystic carcinoma were followed up for an average 7.6 of years and 5 year survival rate was 75% (6/8). Among them 3 cases survived longer than 10 years. The authors consider that the local resection and tumor apoxesis can yet be regarded as a simple and effective way of surgical treatment for primary tracheal tumor.

Thymic carcinoid tumor--a report of 7 cases

The thymic carcinoid tumor is a rare neoplasm which is often clinically misdiagnosed as thymoma. But the two differ in origin, biological behavior, accompanying syndromes, pathological features, and prognosis. The characteristics of the thymic carcinoid tumor are: difficulty in diagnosis, high malignancy, frequent recurrence and extrathoracic metastasis over a prolonged period postoperatively. Complete surgical resection of original and recurrent tumors is the important treatment. Microscopic, electron microscopic and immunohistochemical examinations may be required in making an accurate pathological diagnosis. This paper reports 7 cases of thymic carcinoid tumor.

Isotope-edited multidimensional NMR of calcineurin B in the presence of the non-deuterated detergent CHAPS

At the concentration needed for NMR, the calcium-saturated form of calcineurin B dissolved in water shows resonance line widths that indicate aggregation of this protein. Although the line width or aggregation state can be influenced to some degree by temperature, pH, and salt concentrations, in the absence of detergent no conditions could be found where the protein behaved as a monomeric unit. In the presence of a 10- to 20-fold molar excess of the zwitterionic detergent 3-[(3-cholamidopropyl)-dimethyl-ammonio]-1-propanesulfonate (CHAPS), resonance line widths were considerably narrower and were compatible with a protein of approximately 25 kDa. The presence of the NMR signals of the non-deuterated CHAPS does not interfere with modern isotope-directed NMR studies as the signals from protons not attached to 15N or 13C are removed by isotope filtering and purge pulses.

A study of the effect of magnetized water on enzyme activities by potentiometric enzyme electrode method

A very promising glutamate decarboxylase electrode, which has linear response range of 5.6 x 10(-5)-1.2 x 10(-2) mol/L. Nernstian slope of 50 mV/decade, detection limit of 3.2 x 10(-5) mol/L and response time less than 3 min, has been designed to observe and evaluate quantitatively the effect of magnetized water on enzyme activities by potentiometric enzyme electrode method. It was found that the activity of glutamate decarboxylase can increase by 30% in magnetized water. The mechanism of increased enzyme activity was discussed in the present paper. Such a new finding will probably lead to some new explanations for the physiological and biological mechanism of the effect of magnetized water on living organisms, thus providing a new approach to the study of the effect of magnetized water.

The effect of multi-glycosides of Tripterygium wilfordii Hook f. (GTW) on the survival time of cardiac allografts in rats

Heterotopic heart transplantation was carried out in rats and the influence of multi-glycosides of Tripterygium wilfordii Hook f. (GTW) and a subtherapeutic dose of cyclosporine A (CsA) on the mean survival time (MST) of the cardiac allografts was investigated. The results showed that the MSTs of cardiac allografts in both the GTW and CsA-treated groups were significantly prolonged (P < 0.01 vs control). The rate of allograft rejection in the drug-treated groups was much lower than that in the control group.

[Effect of compound and minor prescription of heat-nature products radix Aconiti lateralis preparata, rhizoma Zingiberis and cortex Cinnamomi on the sympathetic nervous system, adrenal gland, TSH and LH]

The effect of compound and minor prescriptions of Radix Aconiti Lateralis Preparata, Rhizoma Zingiberis and Cortex Cinnamomi on sympathetic nervous system, adrenal gland, TSH and LH of rats was studied. Results showed that both prescriptions made the heart rate quicken, estrous cycle shorten, improved the adrenal cortex hormone and promote TSH and LH synthesis and secretion. The two Heat-nature products (Radix Aconiti Praeparata and Rhizoma Zingiberis) may be used instead of all the three products to make a Heat Syndrome animal model.

[Hepatocyte stimulatory peptide and its clinical significance in viral hepatitis]

Hepatocyte stimulator peptide (HSP) is a new hepatic stimulator substance. Its monoclonal antibodies have been obtained in our laboratory. In this study, HSP was determined in the sera of 315 subjects including patients with various forms of hepatitis and healthy persons with enzyme-linked immunosorbent assay (sandwich method). It is shown that HSP level in the sera of patients with fulminant hepatitis was high and correlated with the level of tumour necrosis factor (TNF), serum bilirubin (SB) or prothrombin time (PT). It is suggested that level of HSP in the sera of the patients reflected the degree of hepatocyte injury. A formula was recommended to predict the outcome of the patients with fulminant hepatitis.

[Tumor necrosis factor and interleukin 6 in hepatitis C virus infection]

Tumor necrosis factor (TNF) was determined with ELISA in 72 patients with hepatitis C and hepatitis B virus infections. Interleukin 6 (IL-6) was determined at the same time. TNF and IL-6 were significantly increased in patients with hepatitis C virus infections when compared with normal subjects and hepatitis B patients. There was a significant positive correlation between TNF and IL-6. It is suggested that increased TNF and IL-6 may play an important role in pathogenesis of hepatitis C virus infection.

Cloning, expression, and characterization of the unique bovine A1 adenosine receptor. Studies on the ligand binding site by site-directed mutagenesis

The bovine brain A1 adenosine receptor (A1AR) is distinct from other A1ARs in that it displays the unique agonist potency series of N6-R-phenylisopropyladenosine (R-PIA) greater than N6-S-phenylisopropyladenosine (S-PIA) greater than 5'-N-ethylcarboxamidoadenosine and has a 5-10-fold higher affinity for both agonists and antagonists. The cDNA for this receptor has been cloned from a size-selected (2-4-kb) bovine brain library and sequenced. The 2.0-kb cDNA encodes a protein of 326 amino acid residues with a molecular mass of 36,570 daltons. The amino acid sequence fits well into the seven-transmembrane domain motif typical of G protein-coupled receptors. Northern analysis in bovine tissue using the full length cDNA demonstrates mRNAs of 3.4 and 5.7 kb with a tissue distribution consistent with A1AR binding. Subcloning of the cDNA in a pCMV5 expression vector with subsequent transfection into both COS7 and Chinese hamster ovary cells revealed a fully functional A1AR which could inhibit adenylylcyclase and retained the unique pharmacologic properties of the bovine brain A1AR. The A1AR was found to have a single histidine residue in each of transmembrane domains 6 and 7. Histidine residues have been postulated by biochemical studies to be important for ligand binding. Mutation of His-278 to Leu-278 (seventh transmembrane domain) dramatically decreased both agonist and antagonist binding by greater than 90%. In contrast, mutation of His-251 to Leu-251 decreased antagonist affinity and the number of receptors recognized by an antagonist radioligand. In contrast, agonist affinity was not perturbed but the number of receptors detected by an agonist radioligand was also reduced. These data suggest that both histidines are important for both agonist and antagonist binding, but His-278 appears critical for ligand binding to occur.

[Primary pulmonary chemodectoma. Report of 2 cases and review of the literature]

The authors report two cases of primary pulmonary chemodectoma. The patients were admitted to the PUMC Hospital because of nodular lesion in the lung. The diagnosis was documented by postoperative pathology. Primary pulmonary chemodectoma is rare. Ten cases has been reported in the English literature. The clinical characteristic features is pulmonary single lesion on chest X-ray film. No correct diagnosis was made pre-operatively. A typical histopathological finding is observed. NSE and S-100 proteins is positive with immuno-histological stain. Surgery operation is the only reliable treatment.

[Esophageal diverticulum]

During a 25-year period, nineteen patients with esophageal diverticulum were treated surgically in PUMC Hospital. Of them, eleven cases underwent resection of the diverticulum (10 pulsion type and 1 traction type); and four cases were treated by inversion suturing of the diverticulum (all traction type). The results of follow-up showed that pulsion diverticulum resection was satisfactory, and the resection was better than inversion suturing for traction-type diverticula. In this series, diverticulitis and esophagitis were present in all cases. Carcinoma of the esophagus developed at site near the diverticulum in 4 cases. Pathologic examination demonstrated severe submucosal inflammatory infiltration and epithelial hyperplasia of the esophagus associated with the diverticulum, with these changes being increasingly severe with the precondition of the carcinoma to the diverticulum. Carcinoma of the esophagus as a complication of diverticulum may be associated with chronic diverticulitis and esophagitis.

Esophageal diverticulum associated with carcinoma of the esophagus--a report of four cases

During a 25-year period, four patients with esophageal diverticulum associated with carcinoma of the esophagus underwent surgery. The results were satisfactory. The clinical features included a long history of diverticulum and the presence of a carcinoma of the esophagus in close proximity to the former. Inflammation within the diverticulum and in the mucosa around the diverticulum was noted. The closer the diverticulum to the carcinoma, the more severe the inflammation. Therefore, diverticulitis and esophagitis may be important factors leading to the development of carcinoma of the esophagus, and patients with esophageal diverticulum should be followed up regularly and the diverticulum resected as early as possible if inflammation within the diverticulum or peri-diverticular esophagitis is found.