BACKGROUND: Crohn's colitis, frequently accompanied by stenosis or narrowing, can be difficult to assess through conventional methods. We evaluated the usefulness of virtual computed tomographic colonography (CTC) for the detection of colonic lesions due to Crohn's disease. METHODS: Forty-two lesions in 33 patients with Crohn's disease were examined by CTC and barium enema (BE). Twenty-two patients also were examined by colonoscopy (CS). The visualization ability of CTC was compared with those of the other two methods. RESULTS: In the visualization of elevated lesions, there was no significant difference between CTC and BE (18 of 20, p = 0.487) or between CTC and CS (15 of 16, p = 0.99); however, ulcerative lesions were less often visualized by CTC. However, CTC enabled identification of serious lesions in the colon proximal to the stenosis in nine patients and was superior to BE and CS in terms of its ability to visualize the proximal site of the stenosis (p = 0.003). CONCLUSION: CTC is clinically useful for the evaluation of Crohn's colitis, especially those with stenotic lesions.

Adult↗

PubMedDate not supplied

Induction of sister-chromatid exchanges by N-nitrosocimetidine in cultured human lymphocytes and its inhibition by chemical compounds.

The effect of nitrosocimetidine (NC) on the frequency of sister-chromatid exchanges (SCEs) in human lymphocytes has been studied. The frequency of SCEs induced by a 1-h exposure to 2.6 X 10(-4) M NC was 4-fold greater than that in the solvent control. A 72-h exposure to NC had a similar dose-related effect. We also examined the effect of the sulfhydryl compounds cysteine, cysteamine, cystamine and glutathione, the reducing agent dithionite, and vitamins C and E on the NC-induced SCEs. None of these compounds induced SCEs. Cysteine, cysteamine, and cystamine significantly reduced the number of NC-induced SCEs, and the others did not.

Ascorbic Acid↗

PubMedDate not supplied

Effects of diltiazem on renin-aldosterone and ACTH-adrenocortical function during upper abdominal surgery.

STUDY OBJECTIVE: To observe the effects of continuous intravenous infusion of diltiazem on the renin-aldosterone system and ACTH-adrenocortical axis responses during surgical stimulation. DESIGN: Randomized study of intravenous diltiazem. SETTING: Operating room at the Hyogo Medical College Hospital. PATIENTS: Twenty-three patients undergoing upper abdominal surgery were divided into two groups: the control group (n = 10) and the diltiazem group (n = 13). All the patients were without any complications and classified as ASA physical status I. INTERVENTIONS: Patients in the diltiazem group received an infusion of 10 micrograms/kg/min for 90 to 120 minutes following skin incision. MEASUREMENTS AND MAIN RESULTS: Plasma adrenocorticotropic hormone, plasma aldosterone and cortisol concentrations, and plasma renin activity were determined with radioimmunoassay before the induction of anesthesia at 10, 30, 60, and 90 minutes after skin incision and at the end of anesthesia. Renin activity did not change significantly. Maximal increases in plasma adrenocorticotropic hormone, aldosterone, and cortisol observed 90 minutes after skin incision were 355 +/- 95 pg/ml, 118 +/- 30 pg/ml, and 14.2 +/- 2.3 micrograms/dl in the control group versus 246 +/- 41 pg/ml, 119 +/- 25 pg/ml, and 15.0 +/- 1.8 micrograms/dl in the diltiazem group, respectively, and there were no significant differences between these groups. Adrenocorticotropic hormone was significantly lower in the diltiazem group compared with that in the control group 60 minutes after the start of surgery (p less than 0.05). There was marked natriuresis (40 +/- 25 microEq/min vs 470 +/- 147 microEq/min at the 90-minute mark) and diuresis (0.16 +/- 0.13 ml/min vs 2.53 +/- 0.88 ml/min) in the diltiazem group. CONCLUSIONS: Diltiazem at this dose increased urine output and sodium excretion without affecting most of these hormonal responses to surgical stimulation. These findings suggest that diltiazem has beneficial renal effects independent of hormonal concentrations.

Abdomen↗

PubMedDate not supplied

Increased basal levels of plasma nitric oxide in Type 2 diabetic subjects. Relationship to microvascular complications.

To assess the underlying mechanisms of decreased endothelial function and advanced vascular complications in patients with Type 2 diabetes, we determined basal levels of plasma nitric oxide (NO(x): NO(2)(-) and NO(3)(-)) using a newly developed high-performance liquid chromatography (HPLC)-Griess method in hospitalized 129 diabetic and 76 nondiabetic subjects, and examined their clinical characteristics. Serum lipid peroxide and advanced glycation end products (AGEs) as markers of oxidative stress were also measured, and intima-media thickness (IMT) of the carotid artery was evaluated as a marker of atherosclerosis. In diabetic subjects, microvascular complications were newly evaluated during their admission. There were no differences in age or sex between the diabetic and nondiabetic subjects. Although there was no difference in basal plasma NO(2)(-) levels between the two groups, the basal levels of plasma NO(3)(-) in diabetic subjects were significantly higher than those in nondiabetic subjects. Plasma NO(x) levels in neither diabetic nor nondiabetic subjects correlated with serum lipids, HbA1c, or IMT. In diabetic subjects, plasma NO(3)(-) levels were related not only to the presence of hypertension but also to advanced microvascular complications. Moreover, plasma NO(3)(-) levels were positively correlated with both serum lipid peroxide and AGEs. Multiple regression analysis revealed that serum AGEs level was strongly associated with plasma NO(3)(-) level. Thus, the findings are consistent with the hypothesis that decreased endothelium-dependent vasodilation in diabetic subjects is associated with the impaired action of NO secondary to its inactivation resulting from increased oxidative stress, rather than decreased NO production from vascular endothelium, and that abnormal NO metabolism is related to advanced diabetic microvascular complications.

Biomarkers↗

PubMedDate not supplied

Renal cell carcinoma metastatic to the skin.

BACKGROUND: Cutaneous metastases from renal cell carcinoma are rarely diagnosed during life. We reviewed the cases of our institute and from the Japanese literature and analyzed them to define the clinical features. PATIENTS AND METHODS: Six patients with cutaneous metastases from renal cell carcinoma were treated in our institute. Clinical data and follow-up information of these patients were reviewed. RESULTS: The skin metastatic lesions were found before the renal lesion was discovered in one case and they were found after the diagnosis had been established in 5. Four patients presented with solitary cutaneous metastasis at the time of diagnosis of the skin metastatic lesion. Five patients had other sites of metastases such as the lung, liver and bone at the time of diagnosis of cutaneous metastases. Five patients died of renal cell carcinoma at mean 23.8 months after presenting with cutaneous metastases. CONCLUSION: Our 6 cases bring the total reported in the Japanese literature to 75 cases. The results of these 75 cases revealed that the duration from the time of diagnosis of renal cell carcinoma to detection of the cutaneous metastasis was relatively long but the prognosis of patients with these metastatic skin lesions was poor. Cutaneous metastases from renal cell carcinoma were regarded as a late manifestation of the disease.

Aged↗