Ketoconazole activates Cl- conductance and blocks Cl- and fluid absorption by cultured cystic fibrosis (CFPAC-1) cells

The role of arachidonic acid metabolites in the regulation of apical cell membrane Cl- conductance and transepithelial transport of fluid and Cl- by cultured pancreatic cells from cystic fibrosis (CFPAC-1) and corrected (PAC-1) cell lines was evaluated by the use of inhibitors. CFPAC-1 cells did not exhibit an apical membrane Cl- conductance, absorbed Cl- and fluid, and did not respond to stimulation or inhibition of cAMP action. PAC-1 cells exhibited a cAMP-responsive apical Cl- conductance, which was blocked by indomethacin, a cyclooxygenase inhibitor. Ketoconazole, an epoxygenase inhibitor, had virtually no effects on PAC-1 cell Cl- conductance but caused CFPAC-1 cells to develop a cAMP-insensitive Cl- conductance, blocked Cl- and fluid absorption, and reduced transepithelial electrical resistance. Ketoconazole treatment effectively reversed the cystic fibrosis defect in these cultured cells.

[Evaluation of umbilical cord pH and its relationship with Apgar score in term newborn infants]

The value of the Apgar score as an index of birth asphyxia has been recently questioned. The purpose of the present study is to evaluate the relationship between cord blood pH and Apgar score in term newborn infants.A cross-sectional study involving 76 term newborn infants was performed from March through September 1995 at the Obstetric Unit of Hospital de Clínicas de Porto Alegre. The blood samples were obtained from umbilical cord artery and vein at the moment of delivery. Infants were divided in three different groups according to the Apgar score: Group A (n=60): >or=7 at one and five minutes; Group B (n=13): < 7 at one minute and >or=7 at five minutes; Group C (n=3): < 7 at one and five minutes. The frequency of acidemia in Group A was 18.3% (11 newborn infants) considering arterial pH < 7.20 and 5% considering arterial pH <or= 7.10. Three newborn infants (23%) of Group B had arterial pH >or= 7.20 and nine (56.2%) had arterial pH > 7.10. None of the newborn infants in Group C had arterial pH > 7.10. The sensitivity and specificity values for Apgar score less than 7 at one minute for detection of fetal acidemia were, respectively, 54.1% and 94.1%. This study confirms a poor correlation between Apgar score and umbilical blood cord pH, even in a term newborn, and emphasizes the importance of obtaining umbilical cord pH to consider the diagnosis of perinatal asphyxia.

[Two rare congenital malformations of the female urethra]

Two cases of incontinent females due to malformations of the dorsal wall of the urethra are presented and surgical corrections are discribed. The causal factors for the development of the malformations are explained by irregularities of the Wolffian ducts' regression during the transition period between in gonadal development between the 3rd and 5th week of gestation. The new medical technical term "indifference-syndrome" is proposed, to distuingish these malformations of the female urethra from true hypospadia.

Understanding homologous recombination repair deficiency in biliary tract cancers: clinical implications and correlation with platinum sensitivity

BACKGROUND

Biliary tract cancers (BTCs) exhibit high mortality rates and significant heterogeneity in both clinical and molecular characteristics. This study aims to molecularly characterize a cohort of patients with BTC, with a specific focus on genomic alterations within homologous recombination repair (HRR) genes in a real-world setting.

PATIENTS AND METHODS

We carried out a retrospective analysis on 256 patients with BTC treated at five Austrian centers and one German comprehensive cancer center between 2016 and 2023 utilizing comprehensive genomic profiling platforms to assess HRR status and its correlation with clinical outcomes after platinum-based chemotherapy.

RESULTS

A total of 67 patients (27.5%) exhibited HRR gene mutations (HRRm), with the most common pathogenic alterations in BAP1 (9%), ARID1A (7.8%), and ATM (6.1%). Time to failure of the first-line strategy (TFS) between patients with HRRm and non-HRRm treated with platinum agents was 7.9 and 6.7 months, respectively [hazard ratio (HR) 0.89; P = 0.49]. The overall survival (OS) estimates at 6, 18, and 24 months were 82%, 45%, and 39% in the HRRm group (median 16.01 months) and 81%, 42%, and 22% in the HRR group (median 15.68 months), respectively (Fleming-Harrington test P = 0.0004; log-rank P = 0.022). Significance did not persist in the multivariate analysis (HR 0.72; 95% confidence interval 0.489-1.059; P = 0.095). An interaction between HRRm status and molecular-informed therapeutic strategies in later lines was noted. In the second-line treatment, OS following an irinotecan-based regimen was comparable to re-exposure to platinum-based agents (12.36 versus 10.13 months; HR 0.92; P = 0.85). No better outcome was noted for patients with HRRm versus patients with non-HRRm with second-line platinum agents (HR 1.45; P = 0.35).

CONCLUSIONS

Patients with HRRm with BTC showed a potential advantage in OS following platinum-based first-line chemotherapy, presumably attributed to enhanced opportunities for targetable coalterations. Further investigation is needed to outline HRR within the scope of BTCs and detail a clinically meaningful sensitivity to platinum agents or targeted approaches with poly (ADP-ribose) polymerase (PARP) inhibitors.

[Combined surgical and cytostatic therapy in patients with advanced metastatic nonseminomatous testicular cancer (author's transl)]

Lymphadenectomy and chemotherapy were carried out on 18 patients with grossly disseminated nonseminomatous testicular cancer. Of the 14 patients so far evaluable, remission was obtained in 13 (92%), complete remission in 7 (50%). Results suggest that even when the disease is advanced, lymphadenectomy is of diagnostic, therapeutic, and palliative value.

[Urinary calculi in children (author's transl)]

From a total of 274 children with urinary calculi, 192 cases were analyzed. 63% of these were male. In 19% a familiar disposition was noticed. Phosphate containing stones were found in 81%. Most of these had an urinary tract infection caused by urea splitting organisms. There was no correlation between the chemical composition of the stones and infection with coli and enterococci. One-third of the analyzed cases exhibited malformations of the urinary tract. Of these, 92% had urinary infections due primarily to urea splitting bacteria. This infection rate was markedly higher than in the children without combined malformations of the urinary tract. The peak incidence was around 2 years of age. In the last group symptoms were atypical but more severe than in those cases without malformations of the urinary tract.