Y Nomura

A NONSPECIFIC COLONIC ULCER OCCURRING AFTER HEPATECTOMY : REPORT OF A CASE

We herein report the case of a 53-year-old man with a nonspecific acute colonic ulcer whose liver function deteriorated after he had undergone hepatectomy. He was referred to our hospital for a hepatoma caused by hepatitis B virus and a right hemihepatectomy was performed. His liver function was poor after the operation, and minor complications such as pleural effusion and biliary fistula developed. A large amount of melena was seen 29 days after the hepatectomy and he developed hemorrhagic shock. Superior mesenteric arteriography revealed pooling of blood in both the hepatic flexure of the ascending colon and the cecum. An emergency right hemicolectomy was performed. There was a 5 x 1-mm ulcer 18 cm distal to the ileocecal valve. Numerous erosions were observed to be scattered throughout the colonic mucosa. The patient recovered slowly and was discharged 6 months after the hepatectomy. This is the first report of an acute colonic ulcer that could have been caused by liver dysfunction.

The synergistic effect of bactobolamine and tacrolimus on in vitro and in vivo experiments

The aim of this study was to examine the immunosuppressive effect of bactobolamine (BBL) alone and in combination with tacrolimus (FK) using in vitro proliferation assays on human peripheral blood lymphocytes (PBLs) and in vivo liver allografts in rats. In the latter setting, the immunosuppressive activity of BBL alone and in combination with FK was compared to that of mizoribine (MIZ). The interactions between BBL and FK and between MIZ and FK were assessed by the combination index (CI) proposed by Chou and Kahan. In the in vitro study, the combination of BBL and FK displayed stronger inhibitory effects on T-cell proliferation than when each drug was applied alone. The mean CI values for the BBL/FK combination were below 1.0, rangin from 0.19 to 0.86, indicating synergism between BBL and FK. In the in vivo study, 50–200 mg/kg/day BBL monotherapy significantly prolonged survival compared with a control group, and the effect was dose-dependent. Conversely, the efficacy of MIZ monotherapy at 2.5–10 mg/kg/day did not increase dose-dependently. The CIs for MIZ at doses of 2.5 and 5.0 mg/kg/day with FK 0.08 mg/kg/day were 0.48 and 0.42, respectively, indicating therapeutic synergism between MIZ and FK. The CI for BBL 100mg/kg/day with FK was 0.26, which indicated further synergism between BBL and FK.

Serum hepatocyte growth factor concentration in patients with various degrees of chronic renal failure

Summary: Serum hepatocyte growth factor (HGF) concentrations were measured in healthy volunteers, chronic renal failure patients without renal replacement therapy and haemodialysis patients. Serum HGF concentrations in healthy volunteers, chronic renal failure patients and haemodialysis patients were 0.18 ± 0.04 (s.d.), 0.28 ± 0.06 and 0.46 ± 0.22 ng/mL, respectively. Serum HGF concentration in chronic renal failure patients was significantly higher than that in healthy volunteers. Serum HGF concentration in haemodialysis patients was significantly higher than those in healthy volunteers and chronic renal failure patients. There was no regression of serum HGF concentration on age, sex, history of haemodialysis, prehaemodialysis serum creatinine concentration, and serum tumour necrosis factor (TNF)‐α concentration. We conclude that chronic renal disease and haemodialysis therapy are contributing factors to an increased serum HGF concentration.