Mixed base of hydrophilic ointment and purified lanolin to improve the drug release rate and absorption of water of minocycline hydrochloride ointment for treatment of bedsores

A desired ointment bases for better treatment of bedsores was developed to improve the release rate of minocycline hydrochloride (MH) and the water absorption capacity using various types of hydrophobic to hydrophilic ointment base. The influence of purified lanolin (PL) on the release behavior of MH from hydrophilic ointment (HO) base was primarily focused on. It was found that the release rate of drug increased with increase in the hydrophilicity of the base. A linear correlation between the apparent release rate constant of drug from the HO and PL mixed ointment base at various combination ratios and the elution of ointment base was noted. The HO ointment base containing 30% PL had the highest apparent release rate constant of MH. The mixed ointment base with the lowest viscosity showed the highest absorption of water and elution of ointment base. In conclusion, it was found that HO (70%) and PL (30%) mixed ointment base was a promising candidate for better treatment of bedsores.

[Digital rectal examination, transrectal ultrasonography and prostate specific antigen for diagnosis of prostate cancer in clinical urological practice-detection of impalpable cancer]

OBJECTIVE

The clinical usefulness of multimodality detection for prostate cancer by digital rectal examination (DRE), transrectal ultrasonography (TRUS) and serum PSA determination (PSA) was evaluated in this retrospective study.

PATIENTS AND METHODS

A total of 1344 symptomatic male patients who underwent DRE, TRUS and PSA in our outpatient clinic were studied. Prostate biopsies were performed when at least one diagnostic test was positive.

RESULTS

Of 1344 patients, 436 (32.4%) had positive test results. Among 403 patients who underwent biopsy, 121 patients (30.0%) were found to have prostate cancer. The overall cancer detection rate was 9.0%. Among the 121 cancer patients, if examination had been carried out using only one or two tests, cancer would have not been detected in 22 patients (18.2%) by DRE alone, 27 patients (22.3%) by TRUS alone, 18 patients (14.9%) by PSA alone, 12 patients (9.9%) by a combination of DRE and TRUS, and 6 patients (5.0%) by a combination of DRE and PSA. Among the 121 patients with cancer, 22 (18.2%) had impalpable cancer. Impalpable cancer was more likely to be localized (77.3%) than palpable cancer (28.3%, p < 0.001) and more likely to be well or moderately differentiated (72.7%) than palpable cancer (41.4%, p = 0.008).

CONCLUSION

This study confirmed the need for multimodality detection using DRE, TRUS and PSA as complementary methods in order to minimize decrease in cancer detection. In particular, impalbable cancers not detectable by DRE were detected and were revealed to be more likely to be localized and amenable to curative therapy. These results therefore underscore the importance of multimodality detection for early diagnosis of prostate cancer in urological practice.

Spontaneous rupture of the urinary bladder is not a rare complication of radiotherapy for cervical cancer: report of six cases

BACKGROUND

Spontaneous intraperitoneal rupture of the urinary bladder is an extremely rare event. It has been reported to be a rare complication of radiation therapy for cervical cancer, but no studies have ever reported the incidence of this life-threatening complication.

MATERIALS AND METHODS

From August 1981 through December 1988, 143 patients with carcinoma of the uterine cervix were treated with high-dose-rate intracavitary brachytherapy combined with external beam therapy at Kobe City General Hospital.

RESULTS

Of these patients, three (2.1%) suffered spontaneous intraperitoneal rupture of the urinary bladder as a late complication of radiation therapy between August 1995 and February 1998. Three other patients, treated with radiation therapy for cervical cancer at other hospitals, were also admitted to our hospital with this complication between August 1995 and February 1998. All six patients underwent laparotomy and repair of the perforation. However, rerupture of the bladder occurred in three of these patients.

CONCLUSION

Spontaneous intraperitoneal rupture of the urinary bladder after radiation therapy for cervical cancer is less rare than previously expected, and urologists must consider the possibility of occurrence of this life-threatening event following radiation therapy.

Gelatinolytic activity of matrix metalloproteinase in tumor tissues correlates with the invasiveness of oral cancer

We examined whether or not the gelatinolytic activity in tumor tissue was associated with the invasion and metastasis of oral squamous cell carcinoma (OSCC). Tissue homogenates were prepared from 57 biopsy specimens of OSCC. The gelatinolytic activities in the homogenates were measured by gelatin zymography and its densitometric analysis. The Immnunoblot findings revealed the major gelatinolytic activities to be due to matrix metalloproteinase (MMP)-2 and -9. The zymography-detected gelatinolytic activities of MMP-2 and MMP-9 in the tissue specimens significantly correlated with the degree of immunohistochemical staining detected in frozen sections of the same biopsy specimens. According to a histopathological analysis of the mode of invasion, highly invasive cases showed the increased gelatinolytic activities of MMP-2 as well as MMP-9 in the tissue specimens. Although no significant differences were observed in the gelatinase activities between the metastatic cases and the non-metastatic cases, the levels of tissue inhibitor of MMP (TIMP)-1 in the tumor tissue specimens were higher in the non-metastatic cases than in the metastatic cases. The cases with the high levels of MMPs and low levels of TIMP-1 thus seemed to have a high potential to metastasize. As a result, the zymographic measurement of the gelatinolytic activity in biopsy tissue specimens may therefore be useful in predicting the behavior and prognosis of OSCC.

Reduction in terminal excitability of nigrostriatal dopaminergic neurons in rats following chronic L-dopa administration

The effects of chronic L-dopa administration on antidromic excitability and the firing rate of nigrostriatal dopaminergic neurons were investigated in urethane-anesthetized rats. Rats that received daily L-dopa (100 mg/kg) and carbidopa (25 mg/kg) for 60 days showed a marked decrease in terminal excitability compared with the controls. There were no significant differences in the firing rates between the two groups. This finding may be related to impaired striatal dopamine release from exogenous L-dopa subsequent to chronic L-dopa treatment.

Clinical significance of telomerase activity in the non-cancerous epithelial region of oesophageal squamous cell carcinoma

BACKGROUND

The aim of this study was to examine telomerase activity in affected and adjacent tissue in patients with oesophageal squamous cell carcinoma (SCC).

METHODS

Telomerase activity was measured in oesophageal SCC cells, normal oesophageal culture cells, primary cancer tissues and adjacent normal tissues from patients with oesophageal SCC using a polymerase chain reaction-based assay.

RESULTS

All oesophageal SCC cells had telomerase activity, whereas normal cultured cells showed no activity. All 57 cancer tissues showed telomerase activity compared with only five (10 per cent) of 50 normal tissues. Cancer cells infiltrating the vessels of mucosal or submucosal tissues in non-cancerous regions were detected in four of five telomerase-positive normal tissues, whereas such infiltration was detected in only three of 45 telomerase-negative normal tissues.

CONCLUSION

In patients with oesophageal SCC, measurement of telomerase activity in normal epithelium is a highly sensitive method of detecting the microinvasion of cancer cells.

Paraganglioma of the cauda equina: MR findings

The MR findings of a case with paraganglioma of the cauda equina are presented. T2-weighted images showed the tumor to have a hyposignal rim and serpiginous flow voids, suggesting vessels capping the tumor. Contrast-enhanced MR images highlighted the tumor and tumor vessels more clearly. Knowledge of MR findings in this unusual disorder may aid in diagnosis.

Incorporation of N-acetylgalactosamine into consecutive threonine residues in MUC2 tandem repeat by recombinant human N-acetyl-D-galactosamine transferase-T1, T2 and T3

An oligopeptide containing three consecutive Thr residues mimicking the tandem repeat portion of MUC2 (PTTTPLK) was investigated for the acceptor specificity to UDP-N-acetyl-D-galactosamine:peptide N-acetylgalactosaminyltransferase isozymes, UDP-N-acetyl-D-galactosamine:peptide N-acetylgalactosaminyltransferase-T1, T2 and T3. The enzymatic reaction products were fractionated by the reversed-phase high performance liquid chromatography, then characterized by matrix-assisted laser desorption ionization time of flight mass spectrometry and by a peptide sequencing analysis. A maximum of two, one or three N-acetyl-D-galactosamine residues was transferred by UDP-N-acetyl-D-galactosamine:peptide N-acetylgalactosaminyltransferase-T1, T2 or T3, respectively. The preferential orders of N-acetyl-D-galactosamine incorporation were Thr-2, then Thr-4 for UDP-N-acetyl-D-galactosamine:peptide N-acetylgalactosaminyltransferase-T1, Thr-2 for UDP-N-acetyl-D-galactosamine:peptide N-acetylgalactosaminyltransferase-T2 and Thr4, Thr-3, then Thr-2 for UDP-N-acetyl-D-galactosamine:peptide N-acetylgalactosaminyltransferase-T3.

14-3-3 protein eta chain gene (YWHAH) polymorphism and its genetic association with schizophrenia

Recent genetic analyses have suggested a linkage between schizophrenia and the chromosomal region 22q12-q13. 14-3-3 protein, abundant in the brain, mediates interactions between diverse molecules of biological activities; its gene was recently mapped to chromosome 22q12.1-q13.1. We therefore investigated allele frequencies of a variable number of tandem repeat (VNTR) in the 5'-noncoding region of the 14-3-3 eta chain gene in controls and schizophrenics. The frequencies of the two-repeat allele were significantly higher (P < 0.05) in the schizophrenics, and particularly in those with onset before age 22 (early-onset schizophrenics, P < 0.02), than in the controls. The odds ratio was significantly increased in the early-onset schizophrenics homozygous for the two-repeat allele (OR = 3.3, 95% CI = 1.1-9.7). The 14-3-3 eta chain gene is a potential susceptibility gene for schizophrenia, and particularly for early-onset schizophrenia.

Membrane association of a new inositol 1,4,5-trisphosphate binding protein, p130 is not dependent on the pleckstrin homology domain

The 130-kDa protein was isolated as a novel inositol 1,4,5-trisphosphate (Ins(1,4,5)P3) binding protein from rat brain and was molecularly cloned to be found similar to phospholipase C-delta 1 (Kanematsu, T., Takeya, H., Watanabe, Y., Ozaki, S., Yoshida, M., Koga, T., Iwanaga, S. and Hirata, M., 1992. Putative inositol 1,4,5-trisphosphate binding proteins in rat brain cytosol, J. Biol. Chem. 267, 6518-6525; Kanematsu, T., Misumi, Y., Watanabe, Y., Ozaki, S., Koga, T., Iwanaga, S., Ikehara, Y. and Hirata, M., 1996. A new inositol 1,4,5-trisphosphate binding protein similar to phospholipase C-delta 1, Biochem. J. 313, 319-325). The 130-kDa protein and its deleted protein expressed in COS-1 cells were seen in both the membrane and the cytosol fractions. Truncation of 232 residues from the N-terminus, the protein molecule lacking the pleckstrin homology (PH) domain was also localized in the membrane fraction as much as seen with a full-length protein and other deleted proteins, thereby indicating that the PH domain is not primarily involved in the membrane localization. The addition of Mg2+ to homogenates of COS-1 cells caused the translocation of expressed proteins from the cytosol to the membrane fraction, yet further addition of AlF4- which induced the activation of GTP binding proteins did not cause a further translocation. The protein translocated to the membrane by the addition of Mg2+ was hardly extracted with Triton X-100. The inclusion of Ins(1,4,5)P3 or phosphatidylinositol 4,5-bisphosphate in cell homogenates caused the very small reduction in the amounts of membrane-associated proteins expressed by some constructs. These results indicate that (i) the PH domain is not primarily involved in the membrane localization of the 130-kDa protein, (ii) the activation of GTP binding protein does not appear to cause the translocation of the 130-kDa protein, and (iii) intrinsic phosphatidylinositol 4,5-bisphosphate present in the membrane appears to be involved in the membrane association of the 130-kDa protein to a very small extent, probably through the binding site in the PH domain.

[Bilateral breast metastases from prostatic carcinoma: a case report]

We report a case of bilateral breast metastases from prostatic carcinoma. A 49-year-old man with stage D2 prostate cancer, who had been treated by chemoendocrine therapy and radiotherapy for 2 years, complained of bilateral enlarged breasts. Oral administration of diethylstilbestrol diphosphate was started 2 months before the onset of this symptom. A firm mass that was not tender was palpable beneath the skin without fixation on each side. A needle biopsy of the masses showed poorly differentiated adenocarcinoma with positive immunohistopathological staining for prostate-specific antigen. The masses were diagnosed as metastatic adenocarcinoma of prostate gland origin. The patient died 3 months after the diagnosis of breast metastases. Autopsy revealed diffuse lymphogenous metastatic disease. Metastatic prostatic carcinoma to the breast is uncommon. Breast metastases in this patient might be associated with diffuse lymphogenous metastases as well as increased local blood and lymphatic supply caused by extrinsic estrogens.

Adenosine, the anxiolytic-like principle of the Arillus of Euphoria longana

According to traditional usage, the extract of Longan Arillus was tested for its anxiolytic-like effect by application of the Vogel-type anti-conflict method in mice. The extract indicated significant activity at a dose of 2 g/kg, s.c., and results of the bioassay-oriented isolation revealed adenosine to be the active principle. Adenosine produced the anti-conflict effect significantly at a dose of 30 mg/kg, s.c. Adenine, uridine, and 5-methyluridine did not exhibit the effect, although these compounds were isolated from the extract. Some other related compounds such as AMP and c-AMP showed no effect, except for inosine. Adenosine also contributed to the analgesic effect which was observed in the extract by the writhing method.

Systemic granulomatous arteritis associated with Epstein-Barr virus infection

A 61-year-old woman initially presented with symptoms and findings reminiscent of infectious mononucleosis, and her illness then took a rapidly fatal course. Autopsy revealed widespread granulomatous arteritis, with multinucleated giant cells but without eosinophils and fibrinoid necrosis, affecting small arteries and arterioles and infiltration of haemophagocytic histiocytes into many organs. In situ hybridization with Epstein-Barr virus (EBV)-specific oligonucleotide probes showed positive signals in the infiltrating immune cells and epithelial and endothelial cells of the affected organs. EBV-associated haemophagocytic syndrome (EBV-AHS) with systemic granulomatous arteritis was diagnosed. From the immunophenotypes of the infiltrating immune cells, a possible role of CD4+ T-cells in the pathogenesis of this haemophagocytic syndrome and granulomatous vasculitis was suggested.

The effects of nasal massage of the "yingxiang" acupuncture point on nasal airway resistance and sensation of nasal airflow in patients with nasal congestion associated with acute upper respiratory tract infection

The aim of our study was to determine whether nasal massage of the "yingxiang" acupuncture point in patients with nasal congestion had any effect on nasal airway resistance (NAR) measured by posterior rhinomanometry and sensation of nasal airflow measured on a visual analog scale (VAS). Twenty patients were randomized into two groups; one group self massaged the yingxiang point for 30 seconds, while the other group acted as control group without nasal massage. NAR and VAS were measured at baseline, and at 2 and 10 minutes after massage. At the end of the study, patients were asked to score any change in their nasal congestion. There was no statistically significant difference between the two groups in percentage change in NAR or VAS from baseline at any time during the study, although the massage group showed trends toward decongestion and relief from congestion. At the end of the study, more patients in the massage group than the control group felt their nasal congestion was improved (p < 0.005). It is interesting that all three measures (NAR, VAS, and end question) showed that the nasal massage group had greater relief from nasal congestion than the control group. The results of this study, when taken together, indicate that nasal massage may provide some relief from nasal congestion and that further studies involving a larger patient population are warranted to determine whether nasal massage has a significant effect on NAR.

Retrolabyrinthine presigmoid transpetrosal approach for selective subtemporal amygdalohippocampectomy

The retrolabyrinthine presigmoid transpetrosal approach is a modification of the subtemporal approach which is suitable for complete amygdalectomy. By drilling away the retrolabyrinthine presigmoid petrosal bone, at least 1 cm more space below and 1 cm more space medially is obtained than in the subtemporal approach, and temporal retraction pressure is diminished when approaching from below. Operative results according to the Engel's classification of seizure control, and pre- and postoperative Wechsler Adult Intelligence Scale (WAIS), revised WAIS, and Wechsler Intelligence Scale for Children scores were measured in 16 patients treated by normal or modified subtemporal amygdalohippocampectomy. Postoperative follow-up ranged from 8 to 79 months. There has been no morbidity or mortality among these 16 patients, and postoperative seizure frequency has been diminished to less than 10% of the preoperative level in 15 of the 16. In eight patients, seizures have been eliminated totally. Subtemporal amygdalohippocampectomy achieved significantly increased performance and full scale intelligence quotient within 2 months after surgery, compared to preoperative levels. Subtemporal amygdalohippocampectomy is an alternative to the transsylvian approach, but is less invasive.

[Prevalence of upper urinary tract stones in Tajima, north Hyogo, Japan]

Toyooka Hospital is a central hospital in Tajima, a rural area in the northern part of Hyogo Prefecture. Because we possess the sole lithotripter in this area, almost all urolithiasis patients requiring treatment have been referred to our department. Based on the number of urolithiasis patients treated in our institution, we estimated the annual prevalence and incidence of upper urinary tract stones in the Tajima area. The mean annual prevalence of urolithiasis and incidence during the 1991-1993 period were 141 and 93 per 100,000, respectively. The male to female ratio was 2.0 to 1 in prevalence and 2.2 to 1.0 in incidence. Prevalence was highest in the sixties (245) and fifties (235), followed by the forties (205), seventies (162) and thirties (160). The incidence was highest in the fifties (169), followed by the forties (147), sixties (145) and thirties (118). In consideration of sex, the incidence was highest in males in the fifties and the forties. Of the patients with upper urinary calculi, 23.1% were treated by extracorporeal shock wave lithotripsy, while in 23.8% stones passed spontaneously and 50.9% were followed up without treatment. On stone analysis, calcium oxalate and/or calcium phosphate was present in 75.6%, uric acid in 16.4%, struvite and/or carbonate apatite in 5.6% and cystine in 1.4%. In summary, the prevalence and incidence of upper urinary tract calculi in the Tajima area were considerably higher than those in the nationwide survey on urolithiasis in Japan conducted in 1985.

Simplified hepatic resection utilizing absorbable polyglycolic acid-based tape and other ligature apparatus

Hepatic resection has been increasing in frequency in the management of metastatic or primary neoplasms of the liver. Although mortality for this procedure has steadily decreased, the associated morbidity remains high. Morbidity is mainly associated with operative time and blood loss, especially in jaundiced and cirrhotic patients. During hepatic resection, control of bleeding from various sources is the most important problem faced by surgeons. During conventional lobectomy, despite prior control of hepatic artery and portal vein to that lobe, bleeding still occurs from the opposite lobe or back flow from hepatic veins. We usually apply Pringle's maneuver for hemostasis, but consequently there is postoperative hepatic dysfunction. We have previously investigated methods for vascular occlusion at the site of liver resection. We developed a new absorbable polyglycolic acid-based tape (breadth, 3 mm; length, 70 cm) for use in hepatic mass ligation, as well as two types of ligature apparatus. Hemostasis was achieved with these devices, and all lobar, segmental, and non-anatomic resections were performed without prior control of the portal venous system, hepatic arterial inflow, and hepatic venous outflow before parenchymal resection. This significantly shortened the operative time, as well as decreasing the blood loss during hepatic resection, with consequent reduction of postoperative morbidity. The use of this absorbable tape may reduce the incidence of local infection, abscess formation, and septicemia.

Intrinsic inhibitor of inositol 1,4,5-trisphosphate binding

Rat brain cytosol was applied to a heparin column and eluted with 0.9 M-NaCl. The total binding activity of [3H]inositol 1,4,5-trisphosphate to the eluate was increased about 6-fold compared with the original cytosol. When the eluate was mixed with a flow-through fraction from the heparin column, however, the activity returned to the original level, suggesting that the flow-through fraction contained an inhibitory factor(s) which prevented the binding. The factor(s) was purified by sequential column chromatography using gel permeation, a hydrophobic gel, and finally, a hydroxylapatite gel. Silver staining of sodium dedecyl sulfate gel electrophoresis of the sample thus purified showed a broad band located between the authentic molecular weight markers of 580 and 390 k. A carbohydrate staining method showed that the factor is a glycoprotein.

[Retroperitoneal schwannoma: a case report]

A 67-year-old man was admitted for a complaint of lumbago. The patient had had the three operations for the schwannoma in spinal cord at the Neurosurgical Department of our hospital. Magnetic resonance imaging (MRI) revealed a right infrarenal tumor by chance. The tumor compressed the right kidney and measured 6 x 5 cm in size. On the tentative diagnosis of the retroperitoneal tumor, the patient was referred to the department of urology in our hospital and the tumor was excised. The histological diagnosis of the removed retroperitoneal tumor was schwannoma, and was thought to be heterotopic recurrent schwannoma.

Regulation of plasma and liver total cholesterol levels by dietary oleic acid in rats fed a high-cholesterol diet

The effects of diets containing fats and oils or fatty acids on the lipid metabolism were investigated in male rats of the Wistar strain fed hypercholesterolemic diets, especially focusing our attention on the correlation between dietary oleic acid (OLE) contents and the levels of plasma and liver total cholesterol (T-CHOL) or the fatty acid profiles in plasma and liver CHOL-ester. In the rats fed the free (FR)-type fatty acids, the concentrations of plasma and liver T-CHOL were high and the amounts of neutral steroids excreted into the feces were low when compared with those of rats given the triacylglycerol (TG)-type fatty acids, showing that TG-type fatty acids suppress the intestinal CHOL absorption more than the FR-type fatty acids do. The concentrations of plasma T-CHOL were highest in rats fed the oleic acid (OLE)-rich diets, followed in order by rats supplied with the palmitic acid (PAL)-rich diets, the hydrogenated coconut oil (HCO) diet, and the linoleic acid (LIN)-rich diets; the lowest was in rats given tristearin (TSTE) and linseed oil (LIS) diets. A positive correlation was obtained between the dietary OLE contents and the levels of plasma and liver T-CHOL or OLE in the plasma and liver CHOL-ester, and an inverse correlation between dietary OLE contents and the amounts of excreted neutral steroids. These results suggest that the dietary OLE contents regulate the levels of plasma and liver T-CHOL in CHOL-loaded rats.

[A case of noninflammatory corneal edema following anterior-posterior radial keratotomy successfully treated by topical steroids]

BACKGROUND

Corticosteroids seems to affect the functions of corneal endothelial cells directly in addition to its anti-inflammatory effect.

CASE

A 69-year-old male presented with left blurred vision and decreased visual acuity in both eyes. He had undergone anterior-posterior radial keratotomy for myopia in both eyes 40 years before. Both eyes showed mild corneal stromal edema in the pupil area. We diagnosed the condition as corneal edema secondary to cell loss and dysfunction of corneal endothelium after surgery. The stromal edema further advanced in the left eye one month later. The corneal thickness increased from the initial value of 619 to 631 microns. The corrected visual acuity decreased from 0.5 to 0.06. There were no signs suggesting inflammatory reaction. The left eye was then treated with topical corticosteroids as eye-drops and by subconjunctival injection. The corneal thickness decreased to 546 microns two months later with improvement of visual acuity to 0.5.

CONCLUSION

This case illustrates that topical corticosteroids may be effective for corneal edema through their anti-inflammatory effect and possible activation of the endothelium.

An autopsy case of troglitazone-induced fulminant hepatitis

OBJECTIVE

To study an autopsy case of troglitazone-induced fulminant hepatitis.

CASE REPORT

A 58-year-old man contracted severe hepatitis 2 months after administration of troglitazone for the treatment of type 2 diabetes. Liver damage progressed gradually, even after withdrawal of the agent. Despite intensive therapy, the hepatitis became fulminant and the patient died 8 weeks after the onset of liver damage. Autopsy revealed massive hepatic necrosis and cholestasis with inflammatory cell infiltration. The pathological findings and the positive result of the drug-induced lymphocyte stimulation test for troglitazone indicated that the liver damage was mediated by hypersensitivity to troglitazone.

CONCLUSIONS

One report has attributed troglitazone-induced liver damage in less severe cases to idiosyncratic reactions. However, the present case indicates that troglitazone can induce hypersensitivity resulting in fulminant hepatitis. Careful monitoring of serum liver enzymes during troglitazone therapy is therefore essential.