[Diagnosis and treatment of adult polycystic kidney disease]

A review of 20 polycystic kidney disease patients in admitted to Kaohsiung Medical College Hospital is herein reported. In this series 60% of the patients were in the fourth to sixth decades of life at the time of diagnosis. The average age was 50 years. The disease was generally more commonly found in the females than in male subjects. Flank pain and gross hematuria was the most common presenting symptom in these cases. In 70% of the patients hypertension were noted, besides 55% of patients have associated liver cysts and 9% of the patients have associated pancreatic cystic diseases. In a comparison of ultrasonography, CT scans, renal angiography, intravenous pyelography and retrograde pyelography in the evaluation of polycystic kidney disease, it was found that CT scans and ultrasonography had more than a 90 per cent diagnostic accuracy rate, while intravenous pyelography had only a 30 percent accuracy rate. Because of improved treatments such as antibiotic and hemodialysis techniques the five-year survival rate of patients, with polycystic kidney diseases, may be increased.

Aseptic synovitis

We report the first case of aseptic synovitis that occurred after a titanium knee prosthesis failed. This complication should be considered when a patient with a titanium prosthesis develops tenderness, erythema, and swelling of that joint.

[Clinical experience of treatment of urethral stricture]

The records of 53 patients treated for urethral stricture at Kaohsiung Medical College Hospital over a 8-year period were reviewed. Young men those affected and trauma appeared to have been the most frequent etiological cause. Of the 53 patients 12 were treated by filiform dilatation , 33 were treated by metal sound dilatation , and 8 underwent a pull-through technique. Good results were noted in 29 cases (54.7%), fair in 10 (18.9%) and poor results in 14 (26.4%). When the results were analyzed according to the method of treatment, poor results were most common among those who had underwent the pull-through technique and the metal sound dilatation as compared to filiform dilation group.

[Urethral injuries: analysis of 24 cases]

Cases analysis of 24 operations for the anterior urethral injuries is presented. 7 patients were treated one-stage transperineal end-to-end anastomosis and 17 underwent an immediate urethral realignment over a fenestrated catheter. Hospital stays were generally short and the rate of complication was low as well as the number of blood transfusions needed in both groups. The operating time however was longer in patients in the anastomosis group. Postoperatively, urethral strictures occurred in 71% of the patients who underwent one-stage transperineal end-to-end anastomosis and in 65% of those treated by realignment over a fenestrated catheter. The high incidence of postoperative stricture formation caused both techniques indicated neither procedure as a valuable modality for the primary and early treatment of anterior urethral injuries. According to the authors the suprapubic cystostomy and delayed urethroplasty offer a better choice of therapy.

Immunoassay detection of drugs in racing horses. IX. Detection of detomidine in equine blood and urine by radioimmunoassay

Detomidine is a potent non-narcotic sedative agent which is currently in the process of being approved for veterinary clinical use in the United States. Since no effective screening method in horses is available for detomidine, we have developed an 125I radioimmunoassay for detomidine in equine blood and urine as part of a panel of tests for illegal drugs in performance horses. Our 125I radioimmunoassay has an I-50 for detomidine of approximately 2 ng/ml. Our assay shows limited cross-reactivity with the pharmacodynamically similar xylazine, but does not cross-react with acepromazine, epinephrine, haloperidol or promazine. The plasma kinetic data from clinical (greater than or equal to 5 mg/horse) as well as sub-clinical doses indicate first-order elimination in a dose-dependent manner. Within the first 30 minutes after intravenous (IV) administration of 30 mg/horse, plasma levels peak at approximately 20 ng/ml and then decline with an apparent plasma half-life of 25 minutes. Diuresis can occur with administration of clinical doses of detomidine and this effect was accounted for in the analysis of urine samples. Using this method, administration of 30 mg/horse can be readily detected in equine urine for up to 8 hours after IV injection. Additionally, doses as low as 0.5 mg/horse can be detected for short periods of time in blood and urine with use of this assay. Utilization of this assay by research scientists and forensic analysts will allow for the establishment of proper guidelines and controls regarding detomidine administration to performance horses and assurance of compliance with these guidelines.

Immunoassay detection of drugs in racing horses. VI. Detection of furosemide (Lasix) in equine blood by a one step ELISA and PCFIA

A one step enzyme-linked immunosorbent assay (ELISA) and a particle concentration fluorescent immunoassay (PCFIA) test for furosemide were evaluated as part of a panel of pre- and post-race tests for illegal medication of racing horses. These tests are very sensitive to furosemide with an I-50 for furosemide of about 20 ng/ml. The test is also rapid; an average pre-race complement of 10 samples can be analyzed in 90 minutes or less. The ELISA test results can be read with an inexpensive spectrophotometer, or even by eye. Both the PCFIA test and the ELISA test readily detect the presence of furosemide in equine blood for up to five hours after administration of the recommended therapeutic dose of this agent. The principal utility of these tests lies in rapid screening of samples for compliance with regulations governing the use of furosemide. Thus these tests can be used pre-race to determine whether horsemen have treated their horses with furosemide, and post-race to perform an initial evaluation of whether certain blood concentrations of furosemide have been exceeded. Pilot trials with these systems in Kentucky and Illinois suggest that these tests are economical and effective, and can form part of an analytical approach to substitute for the detention barn system of monitoring furosemide administration.

[Effect of the tumor-bearing host serum on the leukocyte adherence inhibition reaction mediated by immune RNA]

51Cr-labelled leucocyte adherence inhibition (LAI) assay was used as an index to study the activity of xenogenic immune RNA (iRNA) in inducing normal LACA mouse spleen lymphocytes to mediate tumor specific response in vitro. RNA was extracted from the spleen and lymph nodes of the guinea pigs immunized by S180 or H22 ascitic tumor cells and from those of the normal guinea pigs. Extracts of S180 or H22 tumor cells and that of normal LACA mouse livers were prepared by PBS method respectively. Three kinds of RNA and three kinds of cell (tissue) extracts were grouped into nine combinations. A defined number of 51Cr-labelled lymphocytes was added to each group. The results showed that only in the combination of two kinds of iRNA and the corresponding tumor cell extract, adherence of normal lymphocyte was significantly inhibited. Serum from tumor bearing host inhibited LAI reaction mediated by iRNA. The "blocking" effect was specific since it occurred only when the serum and tumor extract in the reaction system were taken from the same tumor-bearing donor.

Protection of crocin dyes on the acute hepatic damage induced by aflatoxin B1 and dimethylnitrosamine in rats

Chemopreventive agents are compounds that inhibit carcinogenesis when administered prior or subsequent to a course of carcinogen administration. The effects of dietary administration of crocin dyes on the hepatic damage induced by aflatoxin B1 (AFB1) and dimethylnitrosamine (DMN) in rats were investigated. Female Sprague-Dawley rats were treated with different dosages of AFB1 (0.9 or 4.5 mg/kg) or DMN (8 or 20 mg/kg) by i.p. administration, and the different degrees of hepatic damage were revealed by the elevations of levels of serum marker enzymes such as aspartate amino-transferase, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase and lactic dehydrogenase. Pre-treatment of the animals with crocin dyes 50 mg/kg daily for three consecutive days, the enzyme elevations were significantly suppressed. This suggested that the crocin dyes possessed chemopreventive effects on the early acute hepatic damage induced by AFB1 or DMN. Feeding experiments demonstrated that crocin dyes at 0.1% in the diet could suppress partially the chronic hepatic damage induced by multiple dosages of AFB1 or DMN, but at a higher concentration of 1% crocin dye failed to do so because of their host toxicity. Crocin dyes are extracted from the fruits of Gardenia jasminoides and consist of carotenoids and geniposides as active principles. The protective mechanisms of crocin dyes may be attributed to their carotenoids which are converted metabolically to retinoids in rats.

Reversible hepatic black pigmentation and enzyme alteration induced by prolonged feeding of high dose of crocin dyes in rats

Crocin dyes, isolated from Gardenia jasminodes, did not affect hepatic function when they were orally administered to rats in a daily dose of 50 mg/kg for 8 days, but could induce acute hepatic discoloration. A high dosage of 100 mg/kg for 2 weeks could induce both hepatic damage and black pigmentation, but a lower dose of 100 mg/kg for 40 days did not. Rats fed on diet containing 1% of crocin dyes for four months were shown to have mild hepatic functional disorders and pigmentation. The black pigmentation of the liver and the acute hepatic damage associated with the discoloration were completely reversible. During the period of hepatic pigmentation caused by high dose of crocin dyes, the urine had abnormally increased porphyrin excretion and tended to display a blackish green color. The skin also appeared purplish black. The mechanism of black pigmentation seemed to correlate with the gradual accumulation of crocin dyes. In summary, the crocin dyes have a very low toxicity in rats even in high experimental dosage which would hardly happen in human practice. It is therefore suggested that the crocin dyes are safe for coloring foods.

Fluorescence polarization immunoassay. iii. an automated system for therapeutic drug determination

A fully automated system for performing fluorescence polarization immunoassay has been developed. Reagents for each assay are contained in coded reagent packs, and no reagent reconstitution is required. A common buffer is used for all assays, minimizing changeover and set-up times for each assay. A single sample may be assayed in 5 min, or 20 samples in 10 min. A single-tube blank subtraction for each sample results in highly precise polarization values and obviates sample interferences. We have used this method for assays of gentamicin, theophylline, phenytoin, and phenobarbital. CVs are 1-4%, and the results correlate well with those by other methods. Because of the instrument design and the stability of the reagents, daily calibration is not required; samples may therefore be run immediately upon receipt or batched as desired.

Fluorescence polarization immunoassay. iii. an automated system for therapeutic drug determination

A fully automated system for performing fluorescence polarization immunoassay has been developed. Reagents for each assay are contained in coded reagent packs, and no reagent reconstitution is required. A common buffer is used for all assays, minimizing changeover and set-up times for each assay. A single sample may be assayed in 5 min, or 20 samples in 10 min. A single-tube blank subtraction for each sample results in highly precise polarization values and obviates sample interferences. We have used this method for assays of gentamicin, theophylline, phenytoin, and phenobarbital. CVs are 1-4%, and the results correlate well with those by other methods. Because of the instrument design and the stability of the reagents, daily calibration is not required; samples may therefore be run immediately upon receipt or batched as desired.

Preparation and in vitro antifungal activities of some quinolizidine derived hemiaminals and beta-tert-amino sulfides

New alpha-thiohemiaminals, 7alpha-phenylthio-7-epideoxynupharidin-6-ol, the diasteriomeric 7beta-phenylthiodeoxy-nupharidin-6-ol, and 3-methyl-3-methylthio-4-hydroxyquinolizidine, were prepared and reduced to the corresponding beta-tert-amino sulfides. The configuration at C-7 of the beta-tert-amino sulfides was determined by observing the direction of the solvent-induced shift of the C-7 methyl proton resonance. The configuration at C-7 of the new alpha-thiohemiaminals was established by correlations with the beta-tert-amino sulfides and confirmed, in the case of the deoxynupharidine derivatives, by circular dichroism and ascertaining the sterochemistry of deuteride incorporation upon sodium borodeuteride reduction of the alpha-thiohemiaminal. The in vitro antifungal activities of six compounds possessing the quinolizidine skeleton, including all the newly synthesized compounds as well as some previously reported ones, and amphotericin B were tested against several human pathogenic fungi. Besides amphotericin B, only the two deoxynupharidine alpha-thiohemiaminals were active, especially against Histoplasma capsulatum and Blastomyces dermatitidis. The observations indicate activity is derived from the 3-furyl group and the functionality from which alpha-thioimmonium ions can be produced.

Preliminary studies of some physiological properties of Torula jeanselmei

The morphological characteristics of pathogenic and saprophytic strains of Torula jeanselmei (Fungi Imperfecti) are indistinguishable. Some basic physiological properties of T. jeanselmei were investigated in the hope of separating the human pathogenic strain from common saprophytes in a clinical laboratory. Nitrogen and carbon assimilation tests were not useful for distinguishing the pathogen, since all strains, pathogenic and saprophytic, were able to assimilate nitrogen from ammonium, nitrate, and nitrite sources, and all were able to utilize glucose, fructose, galactose, cellobiose, lactose, glycerol, and starch. It appeared that temperature range for growth might be useful in the identification of the pathogen. All pathogenic strains grew well at 37 C but poorly at 10 C; in contrast, all saprophytes could grow at 10 C but were unable to grow at 37 C (with two exceptions).