Bibliothek

Notizen: In Korea, Rhus has been used as a folk medicine to cure gastrointestinal diseases and as a health food. We review the clinicopathological and laboratory findings in patients with systemic contact dermatitis caused by intake of Rhus. We reviewed medical records and histopathological sections from 31 patients during a 10-year period. The male/female ratio was 1·4 : 1 and the average age was 43·8 years (range 22–70). Ten patients (32%) had a known history of allergy to lacquer. Rhus was ingested to treat gastrointestinal problems including indigestion and gastritis (45%), and as a health food (39%), in cooked meat, in herbal medicine, or taken by inhalation. The patients developed skin lesions such as a maculopapular eruption (65%), erythema multiforme (EM, 32%), erythroderma (19%), pustules, purpura, weals and blisters. Erythroderma was very frequent in patients with a known history of allergy to lacquer, but maculopapular and EM-type eruptions were more frequently observed in those without a history of allergy. All patients experienced generalized or localized pruritus. Other symptoms included gastrointestinal problems (32%), fever (26%), chills and headache; many developed leucocytosis (70%) with neutrophilia (88%), while some showed toxic effects on liver and kidney. Fifty-nine per cent of patients observed cutaneous or general symptoms within a day after ingestion of Rhus. There was no difference in the time lag for symptoms to develop between patients allergic and not allergic to Rhus. All patients responded well to treatment with systemic steroids and antihistamines. Common histopathological findings were vascular dilatation, perivascular lymphohistiocytic infiltration, and extravasation of red blood cells in the upper dermis. Rhus lacquer should not be ingested in view of its highly allergic and toxic effects.

Notizen: Summary Serial MRI findings of changes in corpus callosum lesions in two cases of Marchiafava-Bignami disease are presented. In both, MRI displayed diffuse swelling of the corpus callosum in the acute stage, thought to represent oedema and demyelination. In the chronic stage, in addition to atrophy of the corpus callosum with presumed focal necrosis, previously undescribed focal hypointensity on T2-weighted images, of unknown cause, was observed in the corpus callosum.

Notizen: Abstract The intranephron distribution of two major cysteine S-conjugate β-lyases was determined in order to clarify the role of these enzymes in promoting the nephrotoxicity associated with certain halogenated xenobiotics. Various nephron segments [i.e., glomerulus, early, middle, and terminal portions of the proximal tubule (S1, S2, and S3 respectively), the thick ascending limb, the distal tubule, and the collecting tubule] were isolated by microdissection from collagenase-treated rat kidneys. Each segment was dissected in Hanks' solution, solubilized with Triton X-100, and applied to a micropolyacrylamide gel constructed with a continuous gradient. The gels were subjected to electrophoresis and then incubated in the dark in a solution containing S-(1,2 dichlorovinyl)-l-cysteine (DCVC), sodium α-keto-γ-methiolbutyrate, phenazine methosulfate, and nitroblue tetrazolium. The position of cysteine S-conjugate β-lyase- and l-amino acid oxidase activities in the gels was revealed by the presence of blue formazen dye bands. The relative intensities of the bands were determined by optical scanning with a microdensitometer. Three bands were detected: band I (Mr ˜ 330 000) corresponds to a recently described high Mr cysteine S-conjugate β-lyase whereas band III (Mr ˜ 90 000) corresponds to a lower Mr cysteine S-conjugate β-lyase (identical to cytosolic glutamine transaminase K). Band II (Mr ˜ 240 000) corresponds to l-amino acid oxidase (a unique activity of the B isoform of rat kidney l-hydroxy acid oxidase). β-Lyase activity with DCVC as substrate was detected in the S1, S2, and S3 segments of the nephron but not in other regions of the kidney. The activity was in the order: S2 = S3 〉 S1. In another series of experiments, rats were killed 24 h after treatment with hexachloro- 1,3-butadiene (HCBD). In whole kidney homogenates the relative intensity of band III (per 22.2 μg tissue wet weight) after a 30 min incubation was induced significantly (by 50%), but the relative intensities of the other two bands were unchanged. On the other hand, in proximal tubules isolated from HCBD-treated rats the relative intensities (per 5 mm of nephron) of peak I of S2, peak II of S3, and peak III of S3 were significantly reduced by 28, 33, and 72%, respectively. These findings suggest that the low Mrβ-lyase is induced by HCBD and that impaired cell function in the segments (especially S3) results in proteins leaking out of the target cells. To examine the relationship between the nephrotoxic effect of HCBD and cysteine S-conjugate β-lyase activity, the intracellular ATP:protein ratio was quantitated in each nephron segment and in whole kidney homogenates. In HCBD-treated rats the ATP:protein ratio of the S1, S2, and S3 segments was unchanged, decreased by ˜50%, and increased by ˜30%, respectively. In the kidney homogenates of HCBD-treated rats the ATP content was decreased by 32%. However, the loss of ATP was significantly less when the rats were pretreated with aminooxyacetate (a general inhibitor of pyridoxal 5′-phosphate-dependent enzymes, including β-lyase) 1 h before HCBD administration. The results strongly suggest that HCBD is converted to toxic metabolites within the kidney and that this process leads to metabolic derangement and reduction of ATP in susceptible kidney cells.

Notizen: Abstract. Background: To establish the value of saline-filled appendiceal ultrasonography in the the diagnosis of clinically equivocal acute appendicitis. Methods: Saline-filled ultrasonography was performed in 43 patients with an equivocal clinical diagnosis of acute appendicitis. Results: Sonography diagnosed 31 of 32 patients without acute appendicitis (97%). A normal appendix was visualized in 15 patients (47%), and we identified a normal appendix in 15 of 22 patients (68%) in whom the colon was cleansed with Golytely®. Sonography diagnosed 10 of 11 patients with acute appendicitis (91%). In three of 10 patients, the findings corresponded to sonographic pitfalls. Conclusion: Saline-filled appendiceal ultrasonography enables the detection of a normal appendix and may overcome sonographic pitfalls in acute appendicitis.

Notizen: Abstract. US, portal venous phase CT, and MRI-CSE (MRI with conventional spin-echo sequence) findings in three cases of hepatic involvement in hypereosinophilic syndrome are presented. These showed varied imaging findings, but portal venous phase CT showed multiple, poorly marginated, and hypodense hepatic lesions in all three cases. The result suggested that portal venous phase CT is the optimal method for depicting hepatic involvement.

Notizen: Abstract Recently, vinyl sulfones have been observed to selectively inhibit glyceraldehyde-3-phosphate dehydrogenase (GAPDH), which is an important ATP-generating enzyme in glycolysis. The possibility of using GAPDH as a biochemical parameter of cytotoxicity by vinyl sulfones was investigated using mouse lymphocytes. Incubation of lymphocyte GAPDH with ethylvinyl sulfone resulted in a pseudo-first-order loss of enzyme activity. The exposure of lymphocytes to ethylvinyl sulfone resulted in the decrease of GAPDH activity followed by ATP depletion and cell death, which were both dependent on the concentration of ethylvinyl sulfone. A further study on the time-dependent change indicated that cell death was preceded by ATP loss. Compared to ethylvinyl sulfone, divinyl sulfone was more than 8 times more potent in causing either ATP depletion or cell death.