Mitogenic effects of propoxur on male rat bladder urothelium

Propoxur produces bladder tumors in rats, but not other species. The hyperplastic and tumorigenic effects do not occur if urinary pH is lowered by administering propoxur in a semi-synthetic diet or co-administering it with ammonium chloride (NH4Cl). We fed propoxur at 8000 p.p.m. in Altromin 1321 diet to male Wistar rats for 4 weeks, with or without NH4Cl as 10,000 p.p.m. of the diet. The urine of rats fed control diet with or without propoxur had a relatively high urinary pH (approximately 8); the addition of NH4Cl lowered the urinary pH by approximately 0.5-1.0 units. There was no evidence of urinary calculi or amorphous precipitate nor was there an increase in microcrystals or formation of different crystals than occur in normal rat urine. Propoxur produced hyperplasia of the urothelium, as observed by light and scanning electron microscopy, and increased the labeling index for proliferating cell nuclear antigen. These effects were significantly inhibited by co-administration with NH4Cl. There was no evidence of urothelial necrosis. Thus, the hyperplasia appears to result from a direct mitogenic effect of propoxur or a metabolite on the urothelium, rather than from toxicity and consequent regeneration. Based on the present study and previous investigations, the urothelial effects of propoxur in the rat are dependent on high urinary pH and high administered doses, factors which need to be incorporated into any mechanistic model for the chemical and into any extrapolation to potential effects in humans.

Technetium-99m-red blood cell scintigraphy in the localization of nonenteric hemorrhage

Rapid detection and localization of the bleeding site(s) are important factors in successful management of actively bleeding patients. Technetium-99m-red blood cell imaging is a sensitive, noninvasive modality commonly used for localization of gastrointestinal bleeding. Outside the gastrointestinal tract, experience with this technique has been limited. In this report, we present three cases of nonenteric bleeding successfully located using 99mTc red blood cells. The current literature regarding the scintigraphic localization of nonenteric bleeding is reviewed and discussed.

Kinetics of the chloride-anion exchanger of brush-border membrane vesicles isolated from chicken jejunum

The kinetic parameters of the apical Cl(-)-anion exchanger of chicken jejunum have been evaluated using brush-border membrane vesicles. SITS inhibited pH gradient-driven Cl- uptake in a dose-dependent manner with a IC50 of 700 microM. In the presence of a pH gradient (pH 7.7 inside, 5.5 outside), Cl- uptake tends to saturate with increasing external Cl- concentration. With 5 mM SITS the relationship between 36Cl- uptake and external Cl- concentration was linear. SITS-insensitive Cl- uptake may represent a diffusion component and has an apparent diffusion constant, Kd, of 0.068 +/- 0.002 nmol/mg protein per 15 s per mM. Eadie-Hofstee analysis of the data obtained by subtracting the SITS-insensitive component from the total uptake indicates a single transport system with a Km of 5 +/- 0.9 mM. A 50 mM outwardly directed bicarbonate gradient increased the Vmax from 3.63 +/- 0.33 to 6.40 +/- 0.54 nmol/mg protein per 15 s. The initial rate of H2-DIDS-sensitive Cl- uptake increased as the intravesicular pH increased, with a Hill coefficient greater than one. An intra- to extravesicular gradient of Cl-, I- and HCO3- stimulated Cl- uptake in the absence of a pH gradient.

A comparison of the effects of sodium saccharin in NBR rats and in intact and castrated male F344 rats

High doses of sodium saccharin (NaSac) increase proliferation in the bladder of the rat, with a male preponderance. The possibility that alpha 2u-globulin is involved in its mechanism of action was evaluated by feeding it at 7.5% of the diet to NCI-Black-Reiter (NBR) male rats, which do not synthesize liver-derived alpha 2u-globulin. NaSac affected urinary parameters similarly in F344 and NBR male rats, but NBR rats consumed more water leading to greater urinary volume. NaSac produced less proliferation in NBR than in intact F344 rats, with intermediate changes in castrated F344 males, which had intermediate urinary alpha 2u-globulin levels.

[Lipid profile of hyperandrogenic women undergoing treatment with ketoconazole and its relationship with the evolution of the hormone pattern]

BACKGROUND

Previous studies have demonstrated changes in the lipidic profile following treatment with ketoconazole. However, the possible influence in patients with hyperandrogenism treated with this drug and its possible relation with the evolution of the hormonal pattern is unknown.

RESULTS

Thirty-seven women with no tumoral hyperandrogenism treated with ketoconazole for 9 months (400 mg/day) were studied during treatment and one month after suppression of the medication. The study included the evaluation of total cholesterol, HDL cholesterol, triglycerides, LDL cholesterol and hormonal determinations of estradiol, androstenedione, testosterone, dehydroepiandrosterone, sulphate and sex hormone binding globulin.

RESULTS

A rapid and significant decrease of LDL cholesterol and total cholesterol was observed (p < 0.01) which was reversible upon discontinuation of treatment. The HDL cholesterol levels and triglycerides did not modify. The final hormonal profile was more favorable with a significant reduction of testosterone and dehydroepiandrosterone sulphate (p < 0.01) and an increase in estradiol (p < 0.01). No statistical correlation was observed between the changes of sexual steroids and the changes in the lipidic pattern.

CONCLUSIONS

In patients with non tumoral hyperandrogenism treated with ketoconazole the modifications of the steroid hormone profile do not appear to be related with changes in lipidic metabolism.

Chloride transport in brush-border membrane vesicles from chick jejunum

This study sought to characterize the mechanism(s) of Cl- transport across brush-border membrane vesicles (BBMV) isolated from chick jejunum. An inwardly directed proton gradient stimulated chloride (36Cl-) uptake. This uptake was inhibited by SITS and H2-DIDS. pH-gradient-stimulated Cl- uptake was electroneutral, since it was only slightly decreased by voltage clamping the BBMV with K+ and valinomycin. An outwardly directed HCO3- gradient significantly increased chloride uptake in the presence of a pH gradient. pH-driven chloride uptake was reduced by the presence of several anions in the uptake buffer. The rank order of potency for inhibition of pH-driven Cl- uptake was Cl- > SCN- > HCO3- > I- > Glu- > HPO4(2-). In the absence of a pH gradient, chloride was less concentrated inside the vesicles than outside. Chloride uptake under these conditions was stimulated by a positive electrical potential inside the vesicles. This stimulation was inhibited by the addition of several anions outside the vesicles. The order of inhibitory potency was SCN- > I- > Cl- > HCO3- > Glu- > HPO4(2-). The results are consistent with the presence of a Cl-/base exchanger and a chloride conductance pathway in the brush-border membrane of chick small intestine.

Application of scanning electron microscopy and X-ray analysis to urinary tract cancer in animals and humans

Scanning electron microscopy (SEM) has proven useful in various aspects of urinary bladder carcinogenesis research and these are reviewed as they pertain to our research involving sodium saccharin in the rat. Sodium saccharin-carcinogenesis in rats requires administration at high doses beginning at birth or earlier. Administration beginning at ages of 5 weeks or later results in much lower incidences of bladder tumors. Methods were developed for examining the rat fetal and neonatal bladder to further evaluate effects at these critical ages. Several significant differences were found by SEM between the fetal bladder compared to the adult. The typical polygonal superficial cells of the bladder with asymmetric unit membrane were present before birth, but the slow turnover rate of the adult bladder did not occur until 3-4 weeks of age. Sodium saccharin causes increased proliferation rates and hyperplasia of the urothelium which is dose-dependent. SEM was found to be more sensitive than either light microscopy or labeling indices to detect the earliest lesions induced by sodium saccharin. More recently, amorphous and crystalline material in the urine of rats fed high doses of sodium saccharin were detected by SEM examinations which contained silicon as well as calcium, phosphate, and magnesium as detected by energy dispersive X-ray analysis (EDS) with the SEM. These parameters may be relevant to differences between rats and humans and pertain to extrapolations regarding risk assessment.

Modification of antigen expression in human and hamster pancreatic cancer cell lines induced by sodium butyrate

The effects of sodium butyrate (NaB) on the growth, morphology, and expression of blood group A, Lewis(a), and CA 19-9 antigen in the hamster pancreatic cancer cell lines, PC-1 (well differentiated) and PC-1.0 (poorly differentiated), and of blood group A, DU-PAN-2, and CA 19-9 antigens in four human pancreatic cancer cell lines, HPAF and CD11 (well differentiated) and CD18 and PANC-1 (poorly differentiated), were examined. NaB inhibited the growth of all cell lines and induced cell enlargement, an increase in secretory material, microfilaments, and pseudopodia. NaB stimulated the production of blood group A antigen in PC-1.0 cells dose dependently, but no change in the expression of this antigen was observed in the human cell lines. However, NaB treatment increased the presence of cells positive for CA 19-9 in PANC-1 but not in the remaining cell lines, none of which reacted with the anti-CA 19-9 antibody before or after NaB treatment. Untreated PANC-1 cells did not produce either blood group A or DU-PAN-2 antigen, but expressed these antigens after NaB treatment in a dose-dependent manner. The results suggest that NaB stimulates the differentiation of the hamster and human pancreatic cancer cell lines and increases or induces the expression of some tumor-associated antigens.

Improvement of the hydrodynamic response of a ventricular assist device: a false auricle solution

We propose a new design of the auricular cannula in ventricular assist devices (VADs), consisting of a collapsible large cannula with a capacity approximately equal to the ejection volume of the VAD. The device works as a false auricle and filters the negative pressure that occurs during diastole. We show that the use of this type of cannula improves the hydrodynamic efficiency and the stability of the working conditions. Moreover, during chronic implantation in sheep, hemolysis stays well below pathological levels. These improvements result in much better controllability of the whole VAD.

Removal of toxic metals and nonmetals from contaminated water

The effects of the application of potassium ferrate to remove possible toxic compounds are presented. Potassium ferrate (K2FeO4) is shown in this work to be an effective means to remove toxic metals and nonmetals from aqueous solution. The toxic material present in water is precipitated from aqueous solution and readily removed. Potassium ferrate removes itself from solution. Discolored contaminated water may be made clear by utilizing potassium ferrate. In addition, turbidities of solutions induced by dissolved substances are eliminated by the action of potassium ferrate. The efficacy of potassium ferrate in cleaning contaminated water shows great potential in application to municipal and industrial waste water.

Acute urinary tract toxicity of tetraethylorthosilicate in rats

Acute stomach, kidney, and bladder toxicity was evaluated in F344 rats after gastric gavage of tetraethylorthosilicate (TES) at daily doses of 0, 0.111, 0.223, and 0.333 g. Five rats of each sex at each dose were sacrificed after 1, 2, and 4 days. In TES-treated groups, silicate accumulated in the stomach glands and the muscle layer of the forestomach and glandular stomach. Serum chemistries demonstrated acute onset of renal failure. In the kidneys, acute tubular necrosis, accumulation of silicates, and superficial necrotizing papillitis were observed. In the renal pelvis and bladder, there was urothelial simple hyperplasia, focal erosion of the mucosa, edema, and inflammation. These acute toxic changes were dose and time dependent, but significant sex differences were not observed. The microscopic changes in the urothelium were similar to those observed following administration of high doses of sodium saccharin to male rats in which urinary silicate precipitate and crystals form.

[Treatment of acute coronary dissection by angioplasty during diagnostic catheterization by the Sones' technique]

Male, 50 year-old, white, who underwent coronary arteriography and exhibited proximal dissection of the left anterior descending coronary artery induced by the Sones catheter with subsequent acute vessel occlusion. The patient was immediately treated by balloon angioplasty with excellent outcome.

A proposed role for silicates and protein in the proliferative effects of saccharin on the male rat urothelium

High doses of sodium saccharin, a non-genotoxic chemical, lead to the formation of silicate-containing precipitate and microcrystals in urine of male rats. Differences in urinary protein, pH, sodium and other factors affect silicate-containing precipitate and microcrystal formation as well as the bladder effects of sodium saccharin. Total urinary silicon concentration (mostly soluble) in sodium saccharin-fed rats is similar to or lower than the concentration in control rats. Binding of saccharin to male rat urinary proteins was demonstrated by equilibrium-gel filtration. We propose that by binding to urinary proteins under appropriate conditions, saccharin produces a nidus for the formation of silicate-containing precipitate and crystals. These appear to be cytotoxic to the superficial bladder epithelium, with cell death resulting in regenerative hyperplasia. Factors that influence the formation of these silicate-containing materials might provide a rationale for sex, species, dose and dietary differences in response to sodium saccharin.

Pharmacokinetics of vancomycin in patients undergoing hemodialysis with polyacrylonitrile

The pharmacokinetics of vancomycin in patients undergoing dialysis with cuprophane membranes are well known, however little has been reported of the use of polyacrylonitrile membranes in dialysis. We studied, in a crossover design, eight dialysis patients (7 men, 1 woman) aged 30 to 66 years who prospectively received 1 gram of vancomycin i.v. before first dialysis and were subsequently hemodialyzed with cuprophane every second day for a total of three times. A month later trial was repeated using polyacrylonitrile. A mono-compartment model was used to calculated pharmacokinetic parameters. Mean +/- standard deviation of vancomycin clearance varied from 5.2 +/- 2.1 ml/min in the interdialysis period to 9.7 +/- 2.7 ml/min during dialysis with cuprophane and to 58.4 +/- 15.6 ml/min during dialysis with polyacrylonitrile (p less than 0.001). Vancomycin half-life varied from 71.5 +/- 23.0 to 35.9 +/- 9.8 and to 6.1 +/- 1.4 hours, respectively (p less than 0.001). Fractional removal of vancomycin increased from 4% using the cuprophane dialyzer to 34% using the polyacrylonitrile dialyzer (p less than 0.001). Serum vancomycin levels at 100 and 168 hours were higher with cuprophane than with polyacrylonitrile (7.0 +/- 2.2 vs 3.9 +/- 1.2 micrograms/ml) (p less than 0.001). Moreover, the mean levels at 100 hours were suboptimal on polyacrylonitrile. Approximately 208 +/- 53 mg of vancomycin were removed during one polyacrylonitrile dialysis. Thus, those patients who undergo dialysis with polyacrylonitrile and are treated with vancomycin may need supplementary doses post dialysis or to lessen dosage intervals than those traditionally used for dialysis patients since clearance of the drug is significantly higher than with cuprophane dialyzers. Continuous monitoring of vancomycin levels is also recommended.

First clinical implantation of the BCM 3.5 ventricular assist device (VAD)

We report on the first human implantation of the BCM 3.5 ventricular assist device in a 46-year-old man suffering from terminal stage cardiomyopathy. The circulatory support was used as a bridge to heart transplantation. The patient was in cardiogenic shock and was on assisted circulation for 18 days after which he underwent cardiac transplantation. While receiving support from the ventricular assist device, the patient's condition improved remarkably and 50 days after transplantation he was discharged from hospital. We give a detailed description of the surgical technique, with special emphasis on the procedures for air extraction. We describe the evolution of the hemodynamic status before and after implantation. Final inspection of the device and cannulae after removal showed no thrombi and only small fibrin deposits in the membrane-wall junction.