[The liver first pass effects and bile concentrations of (-)-, (+)- and (+/-)-praziquantel in rabbits]

Praziquantel (PQT) is a racemic mixture. Intragastric gavage of (-)-, (+)- and (+/-)-PQT 100 mg/kg were used to study the liver first pass effects in rabbits. HPLC was used to determine the concentration of each compound in the portal and systemic circulation, and in the bile within 4h. The results showed that all drugs were absorbed rapidly from the gut into the portal vein. The serum concentration in the portal vein were similar. However, over 90% of PQT and its enantiomers were extracted in the first passage through the liver. Intrinsic metabolic clearances of the liver of (-)-, (+)- and (+/-)-PQT were 50.3, 174.4 and 52.6 L/h, respectively. The serum concentrations of the three drugs markedly decreased in the systemic circulation, especially that of (+)-PQT. The AUC of (+)-PQT was apparently lower than that of (-)- or (+/-)-PQT. From these results, it is assumed that the first pass effects of PQT and its enantiomers in the liver are pronounced and most likely stereoselective. Also, unchanged PQT and its enantiomers were found in the bile of the rabbits.

Studies on the regulation of malignant phenotype and gene expression in human promyelocytic leukemia cell mutant (HL-60-AR)

The present study has investigated the regulation of malignant phenotype and gene expression in a human promyelocytic leukemia cell mutant (HL-60-AR) by means of cellular engineering technique of cybridization between the fusions of the mutant cells with enucleated mouse reticulocytes. Results indicate that the cybrid cells (HL-R) incorporated with reticulocyte cytoplasts become differentiated, and the malignancy is obviously suppressed or reversed to a certain degree when compared with those of parental tumor cells. They lose the growth ability to form colony soft agar medium, become non-tumorigenic under heterotransplantation to nude mice, and are accompanied by decrease in growth rate, cellular mitotic index and DNA synthesis. No gene transcripts or homologous sequence of mRNA corresponding to c-myc oncogene can be detected in cybrid cells by Northern blot technique with cloned c-myc gene probe, suggesting that the expression of originally active c-myc has been inhibited. On the other hand, analysis, by the same molecular hybridization technique with human globin gene probe and by PAGE method, of the expression of globin gene products in cybrid cells detected at the transcription (globin mRNA) and translation (hemoglobin) levels demonstrates consistently that originally inactive human globin gene has been activated to express in passages. These results suggest that some regulatory factors existing in reticulocyte cytoplasm can regulate gene expression and reverse malignant phenotype of leukemia tumor cells.

Subacute infantile mountain sickness

A description is given of a disease of infants occurring in Lhasa, Tibet at an altitude of 3600 m. Typically if affects infants who have been born at low altitude and subsequently brought to residue in Lhasa, and it is usually fatal within a few weeks or months. There is extreme medial hypertrophy of muscular pulmonary arteries and muscularization of pulmonary arterioles, together with dilatation of the pulmonary trunk and massive hypertrophy and dilatation of the right ventricle. The disease is distinct from acute or chronic mountain sickness and appears to be the human counterpart of 'brisket disease' in cattle.

[Prostatic carcinoid and neuroendocrine tumors--a case report]

This paper reports a rare primary prostatic adenocarcinoid tumor confirmed by electron microscopy as well as immunohistochemical method including prostate specific antigen and prostatic acid phosphatase. Electron microscopy showed the presence of neuroendocrine granules in the cytoplasm of some tumor cells and the latter method ruled out the possibility of secondary tumor from other organs. It is noted that prostatic adenocarcinoid tumor is one of the diffuse neuroendocrine system tumors. Although the histogenesis of these tumors is not entirely clear, it is believed to be of multiple origins, and may transform through metaplasia into neoplasm.

Moyamoya disease in Taiwan

Moyamoya disease occurring in Chinese has been inadequately described. Here we report 13 cases of this disease identified by review of 3,200 cerebral angiograms performed between August 1979 and March 1986. Nine were males and four were females; there were 12 adults (aged 34-51 years) and one child (aged 11 years). All had hemorrhagic strokes with one exception, a patient with an occipital infarction. Intraventricular hemorrhage was noted by computed tomography in 10; five of these emanated from the caudate nucleus. A localized hematoma without intraventricular hemorrhage was found in two. All 13 angiograms had smokelike basal anastomoses with various degrees of stenosis or occlusion of the anterior portion of the circle of Willis; the involvement was bilateral in 12 and unilateral in one. Aneurysms were found in two patients, one in the anterior communicating artery and the other in the left anterior choroidal artery. Eleven patients recovered from the initial stroke, but two died with recurrent hemorrhage. This series differs from the series reported in Japan by the predominance of adult males. The high incidence of intraventricular hemorrhage and intracerebral hematoma is not in keeping with the previous Chinese series, in which subarachnoid hemorrhage was suspected to be the major clinical manifestation.

[Clinicopathological study of combined preoperative radiotherapy with intracavitary hyperthermia in rectal cancer]

118 specimens of rectal cancer were studied pathologically. 40 cases were treated by both preoperative radiotherapy and intracavitary hyperthermia (group 1), 38 treated by preoperative radiotherapy alone (group 2) and 40 by operation alone (group 3). The tumor disappearance rates by gross observation were 57.5% and 5.3% in groups 1 and 2 (P less than 0.001). The moderate to severe damage of cancer cells (X2-X4) was observed in 90% of cases in group 1 and 31.6% in group 2 (P less than 0.05). In the former, the cancer cell disappearance was observed in 8 cases, while in the latter, only 1 case. The cell degenerations by 30 Gy plus hyperthermia were similar to those by 40 Gy plus hyperthermia, but both were more marked than by 30 Gy alone or 40 Gy alone (P less than 0.05). The lymphocyte, plasma cell infiltration and hyperplasia of fibrous tissue around the tumor in group 1 were more marked than those in groups 2 and 3 (P less than 0.05). The thrombosis around the tumor was more in group 1 than in group 2 (P less than 0.01). Every histological type of the tumor was sensitive to radiotherapy combined with hyperthermia. The lymph node metastatic rates were 35% in group 1 and 31.6% in group 2, both being lower than that in group 3 (52.5%). Immune function of the lymph nodes and the damage of the normal tissues around the tumor are observed. It has been clinically confirmed that neither resection rate is influenced nor postoperative complications are increased by preoperative radiotherapy combined with hyperthermia.

[Prognostic factors of primary non-Hodgkin's lymphoma of the stomach--clinicopathologic study of 21 cases]

Clinical, X-ray and pathological materials of 21 cases of primary non-Hodgkin's lymphoma (NHL) of the stomach were reviewed. According to NHL classification--working formulation for clinical usage sponsored by NCI, USA, there were 13 (61.9%) intermediate grade, 6 (28.6%) high grade and 2 (9.5%) low grade malignant lymphomas. By X-ray manifestations, they were classified into 5 types: multinodular type (4 cases), infiltrative (4), ulcerative (3), giant rugal (1) and mixed (9). Clinically, 10 lesions were stage I, 4 stage II, 1 stage III and 4 stage IV, 2 unclassified. The median survivals were 101 months for stage I, 15 months for stage II and less than 6 months for stages III and IV. The 5 and 10 year survival rates were 70% and 40% in stage I patients. The prognosis is related to clinical stage, depth of the tumor infiltration and histology type but not related to the tumor size or X-ray manifestations.

Persistence of both proatlantal arteries with absence of vertebral arteries

A case of bilateral persistence of the proatlantal arteries with absence of both vertebral arteries proved by angiography is reported.

Measurement of three-dimensional anatomy and function of pulmonary arteries with high-speed x-ray computed tomography

Pulmonary arterial geometry was quantitatively evaluated in five dogs. One was a control dog, two were subjected to monocrotaline administration, and two had a subclavian-to-pulmonary artery shunt. Measurements of pulmonary arterial anatomy were made with the dynamic spatial reconstructor (DSR), a high-temporal-resolution, volumetric, roentgenographic, computed tomographic scanner. In the control dog, pulmonary arterial cross-sectional areas and segment lengths were measured both from images generated from DSR scans obtained during injection of contrast medium and from a methylmethacrylate cast of the same vascular tree. The correlations between the DSR and cast-based measurements of cross-sectional area and segment lengths were 0.98 and 0.97, respectively. Over periods of eight and 11 months' observation, the pulmonary arterial pressure in the two dogs with surgically created left-to-right shunts increased from 29/15 to 42/17 mm Hg and 19/12 to 25/16 mm Hg, respectively. The cross-sectional areas increased progressively in the proximal portion of the main lobar arteries, remained unchanged in the midportion, and decreased in the distal portion of these arteries. Similar changes occurred in one of the two dogs treated with monocrotaline injections, while in the other the taper of the distal vessels did not change significantly. Pulmonary vascular resistance, computed from cardiac output and pulmonary artery pressure, increased proportionately to the decrease of the cross-sectional areas of distal vessel in both the monocrotaline administration dogs; the resistance decreased proportionately to the increase of the pulmonary arterial cross-sectional areas in both of the surgical dogs.

Angiography for delineation of systemic-to-pulmonary shunts in congenital pulmonary atresia: evaluation with the dynamic spatial reconstructor

In patients with pulmonary valve atresia, the arterial supply to the lungs is derived entirely from the aorta or its major branches. The anatomic detail of this arterial supply is usually identified by obtaining multiple selective arteriograms involving numerous injections of contrast material and x-ray exposures. In this study, we demonstrated that the information obtained from conventional diagnostic angiography in two patients with congenital pulmonary atresia was also clearly evident on scans from the dynamic spatial reconstructor (DSR), a high-speed three-dimensional computed tomographic system. Thus, numerous shunts, stenoses, and systemic collateral arteries were demonstrated by DSR scanning, which involved only one or two nonselective injections of a contrast agent and less x-ray exposure than that normally necessitated by angiographic study.