Emetic responses of Sorex unguiculatus

We have shown previously that Suncus murinus, a species of the insectivore, can vomit in response to various emetogenic stimuli. In the present study we investigated whether or not Sorex unguiculatus, which belongs to different subfamily (Soricinae) of insectivore, vomits in response to emetogenic drugs. Subcutaneous injection of veratrine and oral administration of copper sulfate caused emesis in the animal. Histological study showed that bilateral structure of the area postrema was not important for the emetic reflex. Therefore, the capability of emesis may be common to the family of soricidae of the insectivore, and the Sorex unguiculatus is the smallest known mammal which can vomit.

[Effects of inhibitors of intracellular signal transduction on lipopolysaccharide-induced increase in permeability of cultured pulmonary endothelial cell monolayers]

To investigate the mechanism of lipopolysaccharide (LPS)-induced endothelial response, we measured the permeability to albumin of cultured pulmonary endothelial cell monolayers. PMA and SC-9, used as activators for protein kinase C (PCK), failed to cause an increase in permeability to albumin. H-7, a potent PKC inhibitor, did not prevent the LPS-induced increase in permeability to albumin. In contrast, H-8, which strongly inhibits cyclic nucleotide-dependent protein kinases, and a calmodulin antagonist prevented the LPS-induced increase in permeability to albumin. These results suggest that calmodulin and protein kinases other than PCK are implicated in the mechanism of LPS-induced increase in permeability to albumin.

[Pulmonary disease as the chief manifestation of chronic graft-versus-host disease after allogeneic bone marrow transplantation]

A 17-year-old man diagnosed as acute myelogenous leukemia (M5a) underwent allogeneic bone marrow transplantation from his HLA-identical, MLC non-reactive sister on the occasion of the second complete remission. On day 14 engraftment was confirmed by karyotypic expression. The patient had no evidence of acute graft-versus-host disease (GVHD), therefore cyclosporine A was discontinued on day 62. Having complained of cough and dyspnea by day 100, the patient was diagnosed as interstitial pneumonitis (IP) based on chest X-ray findings. However, no other typical signs of chronic GVHD were present except for modest abnormality of liver function. Since there was no evidence of infection on bronchofiberoscopic examination and prednisolone was very effective, it was considered that the IP might be pulmonary disease of chronic GVHD. It has been reported that HLA-DR which is not normally found, is expressed on epithelial tissues of the patient with GVHD. In this case alveolar epithelial cells were positive for LN-3 (anti-HLA-DR). In conclusion, pulmonary disease in this case may represent a possible manifestation of chronic GVHD, thus suggesting that the current case could provide information to ascertain the mechanism of chronic GVHD.

Increase in the activity of alkaline phosphatase by L-ascorbic acid 2-phosphate in a human osteoblast cell line, HuO-3N1

The activity of alkaline phosphatase (ALPase) was significantly enhanced in a human osteoblast cell line, HuO-3N1, when it was cultured in the presence of L-ascorbic acid 2-phosphate (AsA-P; a stable ascorbic acid derivative). With AsA-P in the culture, the level of ALPase activity increased approximately 3-fold without any effect on either the morphology or growth rate. This increase was dependent on the AsA-P concentration in the range of 0.2-2 mM and required at least 48 h incubation with AsA-P. The ALPase mRNA level, however, remained rather constant irrespective of the enzyme activity. Removal of AsA-P from the precultured medium decreased the stimulatory effect of ascorbic acid on the ALPase activity, indicating that the effect was reversible. Dexamethasone, an inducer for osteoblastic differentiation, enhanced the level of ALPase activity irreversibly, in parallel with the increase in the level of its mRNA. The enhancement of the ALPase activity by ascorbic acid in this cell line appeared to be independent of cell differentiation.

[Pulmonary blood flow measurement by acetylene rebreathing method in subjects without respiratory function disturbance]

Simultaneous measurement of pulmonary blood flow by the acetylene rebreathing method and cardiac output by the thermodilution method was performed in subjects without respiratory function disturbance during right heart catheterization. After the measurement of cardiac output, the subjects rebreathing a gas mixture containing acetylene and argon from the end tidal level. The inspiratory and expiratory gases were measured by a mass-spectrometer. Results were analyzed by a lung model consisting of two compartments (rebreathing bag compartment and lung compartment), while taking into account the volume reduction due to O2 and CO2 exchange and the fluctuation of end tidal gas concentration until equilibrium between the bag and the lung. The correlation coefficient between these two methods was 0.944, which was statistically significant. The regression line was near the line of identity. The measurement of pulmonary blood flow by the acetylene rebreathing method was applicable in cases without lung function disturbance.

[Clinical evaluation of sulbactam/cefoperazone for severe infections associated with hematological disorders]

The combination therapy of sulbactam/cefoperazone (SBT/CPZ) and piperacillin (PIPC) was evaluated in 49 patients with severe infections associated with hematological disorders. Clinical responses in 43 evaluable patients out of the 49 patients were excellent in 12, good in 18, thus, overall efficacy rate was 69.8% (excellent plus good). Efficacy rates of this combination therapy were 60% (3/5) for sepsis, 75% (21/28) for suspected sepsis, and 50% (4/8) for pneumonia. The efficacy rate was 71.4% (10/14) in patients with neutrophil counts less than 200/microliters; this combination therapy was highly effective even in the neutropenic patients. Transient increases in hepatic function test values were observed in 2 patients, but no other side effects were observed during the combination therapy. From these observations it appears that the combination therapy of SBT/CPZ and PIPC is a very useful empiric therapy for severe infections associated with hematological diseases.

Tensile adhesion evaluation in a new universal test

A tensile testing jig was designed to test adhesion between various materials and tooth surfaces, and between materials of various consistencies, modes of setting and properties. This study examined the adhesion of both flowable and condensable, light cured and chemically cured, direct and indirect restorative materials to dentin. All materials were mixed and placed according to manufacturer's directions. The bonds were tested in tension after 24 hours. The substrate was dentin, except in group 1. Results in MPa +/- SD: 1. Photobond & Photoposterior to enamel 15.84 +/- 3.93; 2. Superbond C&B and metal inlay 6.20 +/- 3.00; 3. SuperBond C&B and amalgam 5.76 +/- 1.89; 4. All-Bond and metal inlay 4.46 +/- 1.16; 5. Mirage Bond and Newbond and amalgam 2.97 +/- 0.85; 6. Vitrebond 2.06 +/- 0.95; 7. Newbond and amalgam 1.70 +/- 0.61; 8. Ketac-Bond 0.73 +/- 0.40. The groups (2,3,4), (4,5), (5,6,7) and (6,7,8) were not significantly different at the 95% confidence level, calculated by the Student-Newman-Keuls test. The testing method was useful for all materials studied.

Diffusely calcified renal cell carcinoma: CT features

Calcifications of renal masses are common. They are usually dense, partial, small, punctate, and linear opacities. Diffuse calcification is an extremely rare feature of renal masses. Generally, calcified renal cell carcinomas are hypovascular, with calcifications in the interstitium, and they also contain fibrotic capsules, necrotic areas, or hyalinization. We recently observed a renal neoplasm with diffuse calcification on CT and intermediate vascularity on angiography, which was diagnosed histologically as renal cell carcinoma, clear cell type. Interestingly, there were numerous calcific deposits within the tumor cells.

Synthesis and biodistribution of a fluorine-18 labeled analogue of D-talose: 2-deoxy-2-[18F]fluoro-D-talose

A fluorine-18 labeled analogue of D-talose, 2-deoxy-2-[18F]fluoro-D-talose ([18F]FDT), was synthesized via nucleophilic fluorination with [18F]fluoride ion and its biodistributions in animals were examined. Radiofluorination of benzyl 3,5,6-tri-O-benzyl-2-O-(trifluoromethanesulfonyl)-alpha-D-galac tof uranoside (5) with aminopolyether supported potassium [18F]fluoride (K18F/Kry222) in acetonitrile followed by deprotection of the [18F]fluorinated intermediate (6) with boron tribromide in CH2Cl2 gave [18F]FDT in an average radiochemical yield of 29% with a radiochemical purity greater than 98%. Biodistribution studies of [18F]FDT in mice bearing fibrosarcoma showed the highest uptake of radioactivity in the liver (34.9% dose/g), followed by the kidney (15.9%dose/g), the small intestine (12.9%dose/g) and fibrosarcoma (5.7%dose/g), at 30 min after i.v. administration. Although the radioactivity in the kidney and small intestine decreased with time, the uptake in the liver and the tumor slightly increased until 120 min. The high liver uptake of [18F]FDT was also observed in normal rats and this uptake was strongly inhibited by co-administration of D-galactose. These preliminary results suggest that [18F]FDT might be metabolized through the galactose metabolic pathway as analogously observed with 2-deoxy-2-[18F]fluoro-D-galactose which is an isomer with respect to carbon-2 of [18F]FDT, and that it may be another candidate for studying liver function by positron emission tomography.

Cisplatin-induced emesis in Suncus murinus

Emetic responses to cisplatin and participation of vagal innervation in emesis were studied in suncus. Intraperitoneal and intravenous administration of cisplatin caused dose-dependent emesis. ED50 values, latencies and frequencies were not significantly different between the two administrations. Cis-diaqodiammineplatinum (DAP), an active metabolite of cisplatin, also induced emesis, but with significantly shorter latency. Vagotomy completely abolished both types of vomiting. These results suggest that cisplatin is metabolized to DAP that subsequently causes emesis through stimulation of the vagus afferent.

Fetal development of mice following intrauterine exposure to a static magnetic field of 6.3 T

The study was undertaken to investigate possible teratogenic effects of a high magnetic field on fetal development in mice. Eighty-four pregnant CD-1 mice (ICR) were exposed to a static magnetic field of 6.3 T for 1 hr a day from day 7 through day 14 of gestation, a period corresponding to major organogenesis. Fifty mice served as controls. Dams were sacrificed on day 18 of gestation. Fetuses were examined for both external and skeletal abnormalities. No significant differences between exposed and control groups were observed regarding litter size, fetal weight, intrauterine mortality rate, or external and skeletal anomalies. The effects of static magnetic field of 6.3 T on the parameters studied appear negligible.

5-Hydroxytryptamine is emetogenic in the house musk shrew, Suncus murinus

The emetic effects of 5-hydroxytryptamine (5-HT) and 5-HT3 receptor agonists were investigated in the house musk shrew, Suncus murinus. 5-Hydroxytryptamine (5-HT; i.p., i.v., s.c.) and 2-methyl-5-HT (2-Me-5-HT; i.p.) but not 5-hydroxyindoleacetic acid (i.p.) or 5-methoxytryptamine (i.p.) induced emesis with very short latency. Tropisetron (ICS 205-930, a 5-HT3 receptor antagonist, s.c.) blocked the emesis induced by 5-HT (10 mg/kg, i.p.) and 2-Me-5-HT (5 mg/kg, i.p.) with respective ID50 values of 7.8 and 70.9 micrograms/kg. Pindolol (5-HT1 receptor antagonist) and ketanserin (5-HT2 receptor antagonist) were about 100 times less potent than tropisetron. The emesis induced by 5-HT was prevented by surgical vagotomy but not by pretreatment with a combination of atropine (0.1 mg/kg, s.c.) and hexamethonium (10 mg/kg, s.c.). These results clearly indicate that 5-HT is emetogenic probably through a stimulation of peripheral 5-HT3 receptors.

Extramammary Paget's disease arising in mature cystic teratoma of the ovary

We report a case of extramammary Paget's disease in ovarian mature cystic teratoma. The patient was a 70-year-old Japanese woman who complained of lower abdominal pain. Examination showed elevation of carcinoembryonic antigen and CA 19-9. Ultrasonography and computer tomography revealed a cystic tumor of the left ovary. The gross appearance of the resected ovary was typical for mature cystic teratoma. Microscopic observation revealed a lesion of Paget's disease within the squamous epithelium. The tumor cells had intracytoplasmic mucin and positive immunoreactivity for carcinoembryonic antigen, epithelial membrane antigen, and cytokeratin; but they were negative for S-100 protein and vimentin. On multiple and serial sections, underlying adenocarcinomas were not found either in the ovary or other primary sites. From these pathological findings, we concluded that the disease was an intraepithelial adenocarcinoma, possibly derived from multipotential cells in squamous epithelium of ovarian mature cystic teratoma. This is the first reported case, to our knowledge, of extramammary Paget's disease arising in mature cystic teratoma of the ovary.

[Role of MRI in diagnosis of adrenal tumors]

The authors evaluated the ability of magnetic resonance imaging (MRI) at 1.5 T to characterize 33 adrenal masses, using visual analysis and the following quantitative variables: signal intensity ratios of tumor/liver, tumor/muscle, and (tumor--muscle)/(fat--muscle) on T2- and T1-weighted images, and the calculated T2 relaxation time of the adrenal masses. All 15 tumors of less than 3 cm in diameter were visually homogeneous on all pulse sequences, whereas the other 18 tumors of over 3 cm appeared to be inhomogeneous. The signal intensity ratios of tumor/liver and tumor/muscle and the calculated T2 relaxation time were not helpful in distinguishing tumors from one another. The ratios of tumor/fat and (tumor--muscle)/(fat--muscle) were useful in distinguishing pheochromocytoma and myelolipoma from other tumors on T2- and T1-weighted images, respectively. However, differentiation among other adrenal tumors appeared to be difficult. The authors concluded that, although MRI might have considerable potential in characterizing adrenal masses, the use of conventional MRI in such analysis is still quite limited.

[Study on flomoxef in the perinatal period]

The placental passage and the the therapeutic efficacy of flomoxef (FMOX, 6315-S) were studied in patients in the perinatal period. A summary of the obtained results is as follows: 1. Concentrations of FMOX in maternal serum, umbilical cord serum and amniotic fluid obtained upon one-shot intravenous injections to 12 patients were compared with those obtained upon 1 hour drip infusions to 9 patients. It was found that the former means of administration gave higher concentrations that the latter. 2. Concentrations of FMOX in maternal serum, umbilical cord serum and amniotic fluid at 1 to 6 hours after administration through either method were all higher than MIC80's of recognized bacteria. 3. Clinical efficacies were evaluated in 10 patients with puerperal intrauterine infection, 7 patients with endometritis, 2 patients with pyelonephritis and 1 patient each with endo-cervicitis, amniotic fluid infection, mastitis and perineal wound infection. Clinical efficacies were excellent in 5 patients (21.7%), good in 17 patients (73.9%) and poor in 1 patient (4.4%), thus the overall efficacy rate was 95.7%. 4. Eradication of causative bacteria were obtained in all 8 cases tested, hence the eradication rate was 100%. 5. Mild diarrhea in 1 patient was the only side effect observed. No abnormal clinical laboratory test results were found in any patients.

Differentiation of central lung tumor from postobstructive lobar collapse by rapid sequence computed tomography

When central lung tumor is associated with lobar collapse, discrimination of tumor from atelectasis is important for determining operability or for field planning should radiation therapy be utilized. Because tumor and collapsed lung have similar attenuation values, they cannot always be distinguished with usual contrast-enhanced CT. The article describes separation of tumor from collapsed lung by means of RSCT with bolus injection of nonionic contrast medium. With this technique collapsed lung is appreciably enhanced, but tumor enhancement is slow and minimal. The difference is most marked from 40 seconds to 2 minutes after scanning begins. This phenomenon is probably related to the marked increase in blood flow per unit area of collapsed lung due to crowding of relatively large pulmonary arteries compared to tumor blood supply through small bronchial arteries. Tumor can also be delineated from atelectasis by differences in internal structure with this technique.

[Therapeutic efficacy of imipenem/cilastatin sodium on respiratory tract infections in lung cancer patients]

Imipenem/cilastatin sodium (IPM/CS) was used to treat respiratory tract infections (RTI) in 54 patients with lung cancer. Out of the 54 patients studied, 53 were evaluable for the utility of IPM/CS; 42 had pneumonia, 9 had obstructive pneumonia, 1 had a lung abscess and 1 had acute bronchitis. The efficacy rate was 71.7%. Seventeen causative organisms were isolated from 14 patients. They included Staphylococcus aureus 5 strains, Staphylococcus epidermidis 4 strains, Staphylococcus sp. 2 strains, Enterococcus faecalis 1 strain, Pseudomonas aeruginosa 2 strains, Pseudomonas fluorescens 2 strains, Acinetobacter sp. 1 strain, and the eradication rate was 81.8%. Clinical adverse effects (nausea and vomiting) were observed in 1 patient. Abnormalities in laboratory test results were observed in 3 patients. They disappeared or returned to normal values after completion of therapy or discontinuation of IPM/CS administration. IPM/CS appears to be a useful antibiotic for RTI in patients with lung cancer.

MECHANISMS OF SPONTANEOUS MUTAGENESIS IN ESCHERICHIA COLI

WE HAVE OBTAINED A SPECTRUM OF MUTATIONS OCCURRING BOTH IN THE SUPF GENE ON THE PLASMID AND IN THE TONB GENE ON THE CHROMOSOME. TWENTY SUPF MUTATIONS WERE ANALYZED. BASE CHANGES COMPRISED 55% OF EVENTS, AND TRANSVERSIONS WERE PREDOMINANT. IS ELEMENTS CONTRIBUTED 30% OF THE EVENTS. ONE OF THE TWO DELETIONS WAS ASSOCIATED WITH THE PRESENCE OF 10 BP DIRECTLY REPEATED SEQUENCES, AND A SECOND ONE DID NOT HAVE REPEATS AT THE JUNCTION. A FRAMESHIFT RESULTED FROM THE LOSS OF C IN A RUN OF 5 C RESIDUES. SIX OUT OF THE 7 TONB MUTATIONS OBTAINED FROM THE WILD-TYPE E. COLI WERE IS ELEMENT INSERTIONS WHICH WERE CLUSTERED WITHIN A 100 BP 5' REGION OF THE GENE INCLUDING THE PROMOTER REGION. THE REMAINING MUTATION WAS A DELETION AND DID NOT HAVE REPEATS AT THE JUNCTION. IN THE RECA56 STRAIN, ALL THE TONB MUTATIONS (6 CASES) WERE CAUSED BY THE IS INSERTIONS THAT OCCURRED DISPERSED THROUGHOUT THE GENE. THERE MAY EXIST AN IS INSERTION "HOT SPOTS" IN TONB. THESE RESULTS PROVIDE DIRECT INFORMATION CONCERNING THE NATURE OF SPONTANEOUS MUTATION ARISING IN E. COLI.

Selective blockade of cytotoxic drug-induced emesis by 5-HT3 receptor antagonists in Suncus murinus

Antiemetic effects of serotonin 5-HT3 receptor antagonists (ICS205-930, zacopride, BRL43694, GR38032F) were investigated in Suncus murinus. Veratrine, nicotine, copper sulfate, cisplatin, cyclophosphamide and motion sickness were used as emetic stimuli. Serotonin 5-HT3 receptor antagonists did not inhibit emetic responses to veratrine, nicotine, copper sulfate and motion sickness. However, cisplatin- and cyclophosphamide-induced emesis was strongly blocked by them. Both subcutaneous and intravenous injections of 5-HT3 antagonists were effective. Serotonin 5-HT1 and 5-HT2 receptor antagonists were less effective. These results clearly indicate that a 5-HT3 receptor-mediated mechanism(s) is involved in the emesis caused by cancer chemotherapeutic agents and that 5-HT3 receptor antagonists are very effective as prophylactic drugs.

Bonding ability of light cured composite resin to enamel and dentin promoted by various bonding systems--microleakage and bond strength studies

The purpose of this study was to estimate bond strength between light cured composite resin and enamel or dentin, and marginal sealing ability of composite resin promoted by five commercial bonding systems. At first, tensile bond strength between light cured composite resin and enamel or dentin promoted by these bonding systems were measured. Next, class V cavities were prepared at cementoenamel junction of extracted human molars and filled with light cured composite resin, using the same bonding systems. Microleakage around the restoration was estimated by dye penetration test. All bonding systems presented high bond strength and good marginal sealing between composite resin and enamel. The bonding systems which presented high bond strength between composite resin and enamel or dentin inhibited microleakage around restoration effectively. However, no bonding system could inhibit microleakage completely at the cementum/dentin-composite resin interface.

[Echo guided percutaneous needle biopsy for diagnosis of thoracic lesions]

Echo guided percutaneous needle biopsy was performed in 32 cases with thoracic lesions. A definitive diagnosis was made histopathologically in 11 (100%) of 11 malignancies, 4 (67%) of 6 benign tumors and 7 (47%) of 15 inflammatory lesions. Furthermore, using cytological specimens, definitive diagnosis was successfully made in 10 (91%) of 11 malignancies and 1 (17%) of 6 benign tumors. Such highly accurate diagnostic rates were due to 1) the accurate puncture of the lesions under real time sonographic guidance, 2) repeated biopsy in case in which sample was inadequate for cytological diagnosis, and 3) aggressive application of needle biopsy for histopathological diagnosis. Following this procedure, three patients suffered from a minor pneumothorax. To prevent pneumothorax, great care is necessary, especially in high risk cases, such as with a pneumatic pattern and thin lesion. One patient suffered from minor hemoptysis but recovered without any medication. No complications were noticed in cases of extrapulmonary lesions. We conclude that echo guided percutaneous needle biopsy is not only a complementary method for biopsy of mediastinal, peripheral pulmonary and chest wall lesions, but due to its simplicity and convenience, it should be a routine method for biopsy of thoracic lesions.

[Pharmacokinetic and clinical studies on aztreonam in perinatal period]

Pharmacokinetic and clinical studies were carried out on aztreonam (AZT), a monobactam antibiotic with a high activity against Gram-negative bacteria. The results obtained are summarized as follows: 1. Following 2 g bolus intravenous injection, transfers of AZT to umbilical cord serum and amniotic fluid were found to be satisfactory. AZT level in amniotic fluid was higher than 1 micrograms/ml at 40 minutes after administration and it was at 3.7 micrograms/ml in 23.5 hours. 2. In the treatment of 9 patients with perinatal infections, clinical efficacies of AZT were judged excellent in 3 cases and good in 6 cases. 3. No side effects and abnormal laboratory findings due to the drug were observed in any case. These results indicate that AZT may be a useful antibiotic for the treatment of perinatal infections.

[A case of pigeon breeder's disease]

A 73-year-old woman developed dry cough and exertional dyspnea. She had been breeding pigeons for thirty years. Her serum showed positive precipitin reaction against pigeon serum. Furthermore the lymphocyte stimulation test against pigeon serum was positive. An X-ray film of the chest showed diffuse ground glass infiltrate, fine nodular shadows and reticular shadows. Histopathology revealed diffuse interstitial infiltration with mononuclear cells and occasional giant cell formation as well as granuloma formation in the bronchiole. The symptoms subsided after admission. From these results, this case was diagnosed as pigeon breeder's disease. She had the subacute form probably because of her old age and smoking. It could be that exacerbation of pneumonitis was caused by cessation of smoking in an attempt to alleviate the symptoms. This is the fifth case reported in Japan.

[Evaluation of imipenem/cilastatin sodium in the treatment of respiratory tract infections]

Imipenem/cilastatin sodium (IPM/CS) was administered to 55 patients with respiratory tract infections (RTI). A clinical evaluation of IPM/CS was carried out in 51 patients, 28 with pneumonia, 4 with pulmonary abscess, 1 with pyothorax, 6 with bronchitis, 9 with bronchiectasis, 1 with diffuse panbronchiolitis and 2 with RTI with chronic obstructive pulmonary disease, and the clinical efficacy rate was 78.4%. Causative organisms were isolated in 23 strains out of 20 patients, such as Staphylococcus aureus 4 strains, Staphylococcus epidermidis 1 strain, Streptococcus pneumoniae 1 strain, Branhamella catarrhalis 1 strain, Haemophilus influenzae 2 strains, Klebsiella pneumoniae 4 strains, Pseudomonas aeruginosa 6 strains, Pseudomonas sp. 1 strain, Acinetobacter calcoaceticus 1 strain, Acinetobacter sp. 1 strain and glucose non-fermentative Gram-negative rod 1 strain. An eradication rate of 70.6% was obtained. An overall eradication rate of main causative organisms in RTI including S. aureus, S. pneumoniae, H. influenzae and K. pneumoniae was 75.0%. Clinical adverse effects were observed in 5 patients, and these were eruption in 2, itching in 1, vomiting in 1 and drug fever in 1. Abnormalities in laboratory test results were observed in 8 patients. These disappeared or returned to normal values after completion or discontinuation of IPM/CS administration. IPM/CS appears to be a useful antibiotic for the treatment of RTI, especially severe infections.

Giant Meckel diverticulum containing enteroliths diagnosed by computed tomography and sonography

A 23-year-old male patient with giant Meckel diverticulum containing enteroliths is presented. Computed tomography (CT) and sonography were useful for correctly suggesting the diagnosis. The unique manifestations of this rare lesion are described.

[A case of mandibular metastasis from primary hepatocellular carcinoma]

A mandibular metastasis which appeared as the first symptom from a hepatocellular carcinoma is reported. Bone metastasis related to hepatocellular carcinoma is relatively infrequent. Even less frequent is the occurrence of a mandibular metastasis as a prior symptom of hepatocellular carcinoma. In this case, also, the metastatic lesion was detected as hypervascular mass on a CT scan, thus the nature of lesion was disclosed before a biopsy was performed.

[Comparison of intravenous drip infusion excretory urography using ionic and non-ionic contrast media]

Ionic and non-ionic contrast media were compared for use in intravenous drip infusion excretory urography. Sixty consecutive cases were classified alternately into two groups, ionic and non-ionic, excluding cases which were known to have factors affecting contrast ability adversely, such as hydronephrosis, renal failure and so on. Each group consisted of 30 cases. A hundred ml of the ionic contrast medium (Diatrizoate--60% Urografin) or non-ionic contrast medium (Iopamidol--Iopamiron 300) was administered I.V. by drip infusion, each infusion taking less than 10 minutes, using a 18 G needle, and 0-minute, 10-minute and 20-minute films were obtained. Visibility of nephrogram, calyceal system, renal pelvis, ureters and bladder were evaluated, ranging from 0 to 3, by six radiologists who were not informed of the contrast medium used. Some detailed factors such as radiographic contrast and fullness of the collecting system and of the bladder were also analyzed. Visualization rate of the ureters was defined as the length of visualized ureters divided by the distance between the renal pelvis and the ureteral orifice of the bladder. There was no significant difference in visualization of nephrogram between the two groups. However, the non-ionic group was superior to the ionic group in visualization of the calyceal system and ureters with statistical significance, probably due to higher radiographic contrast of non-ionic medium. There was no statistical significance between the two groups, in fullness of the calyceal system and visualization rate of the ureters, whereas the ionic group was superior to the non-ionic group in fullness of the bladder.(ABSTRACT TRUNCATED AT 250 WORDS)

HLA and sarcoidosis in the Japanese

One hundred fourteen patients with sarcoidosis, who were diagnosed as having sarcoidosis histologically, have been typed for HLA class 1 (A, B, and C) and class 2 (DR and DQ) antigens. Controls consisted of 478 healthy Japanese subjects. The frequencies of HLA-A1, HLA-Bw46, HLA-Cx46, HLA-DRw8, HLA-DRw9, and HLA-DRw52 were significantly increased in sarcoidosis compared to control subjects, but only four patients were positive for HLA-A1. Increased frequencies of HLA-Bw46 and HLA-Cx46 were thought to be attributable to linkage disequilibrium with HLA-DRw8. Patients with HLA-DRw52 were the most frequent (84 cases of 113). No significant differences were observed between HLA-DRw52-positive and HLA-DRw52-negative patients in their clinical features, but all of the patients with muscular involvement (six cases) were positive for HLA-DRw52. Among patients positive for HLA-DRw52, those with HLA-DR5 showed a significantly better clinical course and earlier onset of the disease than those with HLA-DRw8. These results suggest that HLA antigens may play an important role in the pathogenesis of sarcoidosis.

[A clinical evaluation of injectable fluconazole in the treatment of deep mycosis associated with hematological malignancy]

The clinical efficacy and the safety of fluconazole as given at an intravenous dose of 100-400 mg daily were assessed in 7 patients with deep mycosis associated with hematological malignancy. Enrolled in the study were 1 patient with acute lymphatic leukemia, 1 with acute myelocytic leukemia, 2 with acute myelomonocytic leukemia, 2 with malignant lymphoma and 1 with myelodysplastic syndrome. Pathogens isolated from 4 patients were all Candida species including 2 Candida albicans, 1 Candida parapsilosis and 1 Candida krusei. Diagnoses of fungal infections of the patients were Candida pneumonia in 3 patients, candidemia in 1 and fungemia suggested in 3. Assessment of the clinical efficacy was made on 4 patients from whom pathogens were isolated. The global clinical improvement was good in 2 patients and fair in 1 with Candida pneumonia and good in 1 with candidemia. In the mycological assessment, pathogenic fungi were eradicated in 3 patients and decreased in 1 patient. No significant adverse reactions nor abnormality in clinical laboratory tests related with the dosing of fluconazole were observed in any of the patients.

Roles of endogenous leukotrienes and prostaglandins in the healing of gastric ulcers induced by acetic acid in rats

We investigated the roles of endogenous leukotrienes (LTs) and prostaglandins (PGs) in the healing of gastric ulcers induced by acetic acid in rats. The mucosal levels of LTB4 and sulfidopeptide LT at the ulcer edge had increased by one day after the induction of ulcers. AA-861, a selective inhibitor of 5-lipoxygenase, did not affect the ulcer healing. Indomethacin delayed the healing. Cimetidine did not affect this delay, but ornoprostil, a PGE1, derivative, prevented it. These results suggest that endogenous LTs are not related to the healing of gastric ulcers and that a deficiency in endogenous PGs may be involved in the persistence of gastric ulcers.

[Effects of cefotaxime single administration and of cefotaxime + fosfomycin administration against respiratory tract infections]

Subjects in a cefotaxime (CTX) single administration group and in a CTX + fosfomycin (FOM) administration group were randomly selected for a comparative study on the utility of each product against respiratory tract infections. Overall improvement rates were 81.3% in 32 cases of the CTX single administration group, and 75.6% in 41 cases of the CTX + FOM concomitant administration group. No statistical difference was observed. As for adverse reactions and abnormal laboratory test results, pyrexia, thrombocytopenia, increases in GOT and GPT, and increase in GPT were observed in 4 cases of the CTX single administration group, while angialgia, increases in GOT and GPT (3 cases), and increases in BUN, (totalling 5), were observed in the CTX + FOM group. However, all the symptoms were transient, and none was serious in nature.

[Fundamental and clinical studies on aztreonam in obstetrics and gynecology]

Aztreonam (AZT), a monobactam antibiotic, is known to have a high activity against Gram-negative bacteria. Fundamental and clinical studies were carried out on AZT with the following results. Following 1 g of bolus intravenous injection, the transfer of AZT to uterine artery and internal genital organs was found to be satisfactory. The levels of the drug in uterine artery showed 34.28, 4.50 micrograms/ml at approximately 2, 6 hours, and those in internal genital organs showed 3-34 micrograms/g at 2 hours. Clinical efficacy was; excellent in 4 cases, good in 13 cases and poor in 1 case, with the very high overall efficacy rate of 94.4%. Abnormal laboratory findings and side effects due to the drug were not noted.