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1.
Ann Bot ; 104(2): 325-34, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19482878

ABSTRACT

BACKGROUND AND AIMS: Previous studies have reported effects of pollen source on the oil concentration of maize (Zea mays) kernels through modifications to both the embryo/kernel ratio and embryo oil concentration. The present study expands upon previous analyses by addressing pollen source effects on the growth of kernel structures (i.e. pericarp, endosperm and embryo), allocation of embryo chemical constituents (i.e. oil, protein, starch and soluble sugars), and the anatomy and histology of the embryos. METHODS: Maize kernels with different oil concentration were obtained from pollinations with two parental genotypes of contrasting oil concentration. The dynamics of the growth of kernel structures and allocation of embryo chemical constituents were analysed during the post-flowering period. Mature kernels were dissected to study the anatomy (embryonic axis and scutellum) and histology [cell number and cell size of the scutellums, presence of sub-cellular structures in scutellum tissue (starch granules, oil and protein bodies)] of the embryos. KEY RESULTS: Plants of all crosses exhibited a similar kernel number and kernel weight. Pollen source modified neither the growth period of kernel structures, nor pericarp growth rate. By contrast, pollen source determined a trade-off between embryo and endosperm growth rates, which impacted on the embryo/kernel ratio of mature kernels. Modifications to the embryo size were mediated by scutellum cell number. Pollen source also affected (P < 0.01) allocation of embryo chemical compounds. Negative correlations among embryo oil concentration and those of starch (r = 0.98, P < 0.01) and soluble sugars (r = 0.95, P < 0.05) were found. Coincidently, embryos with low oil concentration had an increased (P < 0.05-0.10) scutellum cell area occupied by starch granules and fewer oil bodies. CONCLUSIONS: The effects of pollen source on both embryo/kernel ratio and allocation of embryo chemicals seems to be related to the early established sink strength (i.e. sink size and sink activity) of the embryos.


Subject(s)
Pollen/physiology , Seeds/chemistry , Seeds/embryology , Zea mays/chemistry , Zea mays/embryology
2.
J Calif Dent Assoc ; 37(12): 859-62, 2009 Dec.
Article in English | MEDLINE | ID: mdl-20066873

ABSTRACT

OBJECTIVE: To develop digital multimedia instruction on intraoral suturing. METHODS: A DVD was developed to describe instruments, materials, and techniques. Two groups of dental students were asked to close an incision in a simulated model. One used written materials only and another used additional DVD. The performance was evaluated using 10 grading criteria. RESULT: Students who used the DVD performed better than students who did not. CONCLUSION: This DVD could be used widely in teaching dental students.


Subject(s)
Education, Dental , Multimedia , Surgery, Oral/education , Suture Techniques , Teaching/methods , Clinical Competence , Computer-Assisted Instruction , Educational Measurement , Humans , Models, Anatomic , Students, Dental , Videotape Recording
3.
Thorax ; 59(2): 100-4, 2004 Feb.
Article in English | MEDLINE | ID: mdl-14760145

ABSTRACT

BACKGROUND: Leukotrienes play a key role in the pathophysiology of chronic asthma. Activation of leukotriene pathways is accompanied by rises in detectable urinary levels of leukotriene E4 (LTE4). The relationship between urinary LTE4 levels and factors associated with acute asthma has not been determined. METHODS: Adults aged 15-54 years presenting with moderate to severe acute asthma were evaluated at emergency departments in 16 US sites. Forced expiratory volume in 1 second (FEV1) was measured during the first 60 minutes after arrival and at specified times until discharge or admission. Urine samples for measurement of LTE4 levels were obtained either on arrival at the study site and/or before discharge. Patients were seen 2 weeks later for follow up, at which time repeat FEV1 measurements and urine samples for LTE4 were obtained. RESULTS: One hundred and eighty four patients were evaluated; LTE4 results from both the acute and follow up periods were available for analysis in 146. Urinary LTE4 levels were increased during asthma exacerbations compared with levels obtained 2 weeks later (geometric means 111.7 and 75.6 pg/mg creatinine, respectively, mean percentage change -32.3; 95% confidence interval (CI) for the mean percentage change -39.6 to -24.3, p<0.001). The correlation between improvement in FEV1 and decline in LTE4 over the 2 week interval was significant (p<0.001, r=0.43). CONCLUSIONS: Activation of leukotriene pathways in acute asthma is correlated with the degree of airflow obstruction, and resolution of the asthma exacerbation is associated with a reduction in leukotriene levels.


Subject(s)
Asthma/urine , Leukotriene E4/urine , Acetates/administration & dosage , Acute Disease , Adolescent , Adult , Anti-Asthmatic Agents/administration & dosage , Asthma/drug therapy , Asthma/physiopathology , Cyclopropanes , Forced Expiratory Volume/physiology , Humans , Infusions, Intravenous , Leukotriene Antagonists/administration & dosage , Middle Aged , Quinolines/administration & dosage , Sulfides
4.
J Synchrotron Radiat ; 8(Pt 2): 737-9, 2001 Mar 01.
Article in English | MEDLINE | ID: mdl-11512914

ABSTRACT

We performed iodine L edge XAFS measurements on blue-black amylose-iodine complex to obtain information about the electronic and geometrical structures of polyiodide chain included in amylose helix. Measurements were also carried out on crystalline alpha-cyclodextrin-iodine complex (alpha-cyclodextrin)2 x Cd0.5 x I5 x 27H2O, in which the polyiodide chain is known to consist of I(5)- unit. It was found that the XANES spectra of these complexes have similar line shapes except for some minor differences, indicating that there are close similarities in the nature of polyiodide chains in these complexes. Besides their similarity, difference in the intensity of the peak at the L1 absorption edge was observed. Its implication for the electronic and geometrical structures is also discussed.

5.
J Clin Pharmacol ; 40(10): 1109-20, 2000 Oct.
Article in English | MEDLINE | ID: mdl-11028250

ABSTRACT

Steady-state inhibitory activity of rofecoxib (Vioxx) on COX-2 versus COX-1 was compared with that of commonly used nonsteroidal anti-inflammatory drugs (NSAIDs) in 76 healthy volunteers randomized to placebo, rofecoxib 12.5 mg qd, rofecoxib 25 mg qd, diclofenac 50 mg tid, ibuprofen 800 mg tid, sodium naproxen 550 mg bid, or meloxicam 15 mg qd. All of these doses include the high end of the approved clinical dose range. Ex vivo whole-blood assays were used to determine the effect on COX-2 and COX-1 activity, respectively. Urinary prostanoids were also measured. Mean inhibition of COX-2 (measured as the weighted average inhibition [WAI] of lipopolysaccharide [LPS]-induced PGE2 generation over 8 hours on day 6 vs. baseline) was -2.4%, 66.7%, 69.2%, 77.5%, 93.9%, 71.4%, and 71.5% for placebo, rofecoxib 12.5 mg, rofecoxib 25 mg, meloxicam, diclofenac, ibuprofen, and naproxen, respectively. Corresponding values for mean inhibition of COX-1 (measured as TXB2 generation in clotting whole blood) were -5.15%, 7.98%, 6.65%, 53.3%, 49.5%, 88.7%, and 94.9%. Rofecoxib had no significant effect on urinary excretion of 11-dehydro TXB2, a COX-1-derived product. These data support the contention that rofecoxib is the only drug of the regimens tested that uniquely inhibits COX-2 without affecting COX-1.


Subject(s)
Cyclooxygenase Inhibitors/pharmacology , Isoenzymes/antagonists & inhibitors , Adolescent , Adult , Bleeding Time , Cyclooxygenase 1 , Cyclooxygenase 2 , Cyclooxygenase 2 Inhibitors , Cyclooxygenase Inhibitors/adverse effects , Diclofenac/adverse effects , Diclofenac/pharmacology , Dinoprostone/metabolism , Female , Humans , Ibuprofen/adverse effects , Ibuprofen/pharmacology , Isoenzymes/metabolism , Lactones/adverse effects , Lactones/pharmacology , Lipopolysaccharides/pharmacology , Meloxicam , Membrane Proteins , Middle Aged , Naproxen/adverse effects , Naproxen/pharmacology , Platelet Aggregation/drug effects , Prostaglandin-Endoperoxide Synthases/metabolism , Prostaglandins/urine , Sulfones , Thiazines/adverse effects , Thiazines/pharmacology , Thiazoles/adverse effects , Thiazoles/pharmacology , Thromboxane B2/blood
6.
Hinyokika Kiyo ; 46(4): 287-9, 2000 Apr.
Article in Japanese | MEDLINE | ID: mdl-10845165

ABSTRACT

Down's syndrome is an inherited disorder caused by trisomy of chromosome 21. In patients with Down's syndrome, an increased risk of leukemia has been observed. Recently, the coincidence of testicular cancer with this syndrome has been also emphasized. We present a case of Down's syndrome associated with testicular seminoma. This is the 19th case of Down's syndrome associated with testicular tumor in Japan.


Subject(s)
Down Syndrome/complications , Seminoma/etiology , Testicular Neoplasms/etiology , Adult , Humans , Male , Orchiectomy , Seminoma/pathology , Seminoma/surgery , Testicular Neoplasms/pathology , Testicular Neoplasms/surgery
7.
Anticancer Res ; 20(1A): 423-6, 2000.
Article in English | MEDLINE | ID: mdl-10769690

ABSTRACT

Grape seed extracts were more cytotoxic than grape peel extracts. Methanol and 70% methanol extracts of grape seed selectively killed two human oral tumor cell lines, more efficiently than human gingival fibroblasts. ESR spectroscopy revealed that these extracts produced radicals under alkaline conditions and enhanced the radical intensity of sodium ascorbate at higher concentrations. On the other hand, lower concentration of these extracts slightly reduced the radical intensity of sodium ascorbate, and scavenged superoxide anion, generated by hypoxanthine and xanthine oxidase reaction. These properties of grape seed extracts suggest their possible application for cancer prevention.


Subject(s)
Anticarcinogenic Agents/pharmacology , Antineoplastic Agents, Phytogenic/pharmacology , Carcinoma, Squamous Cell/pathology , Mouth Neoplasms/pathology , Plant Extracts/pharmacology , Rosales/chemistry , Anticarcinogenic Agents/isolation & purification , Anticarcinogenic Agents/toxicity , Antineoplastic Agents, Phytogenic/isolation & purification , Antineoplastic Agents, Phytogenic/toxicity , Ascorbic Acid/pharmacology , Electron Spin Resonance Spectroscopy , Fibroblasts/drug effects , Free Radical Scavengers/pharmacology , Free Radicals , Gingiva/cytology , Humans , Hydrogen-Ion Concentration , Methanol , Oxidation-Reduction , Oxidative Stress , Plant Extracts/isolation & purification , Plant Extracts/toxicity , Seeds/chemistry , Solvents , Superoxides/metabolism , Tumor Cells, Cultured/drug effects
8.
J Gastroenterol ; 35(2): 120-6, 2000.
Article in English | MEDLINE | ID: mdl-10680667

ABSTRACT

It is well known that endothelin-1(ET-1) is a factor involved in the pathogenesis of ischemia-reperfusion injury. This study was undertaken to investigate the optimal route (intravenous vs intraportal) for administering mixed endothelin receptor antagonist (TAK-044) in a liver transplantation. First, in a rat isolated liver cold-perfusion model, the pharmacodynamics of TAK-044 and endothelin-1 (ET) in the liver tissue and the systemic circulation after cold perfusion were compared in the different administration routes. Next, in a rat orthotopic transplantation model, we compared the hepatoprotective effect of TAK-044 among different administration routes. In each model, there were three groups: IV group, intravenous injection of TAK-044 (10mg/kg) immediately before cold perfusion or anhepatic phase; IP group, intraportal administration with cold perfusion solution or with reflush solution for the graft; control group, no treatment. In the cold perfusion model, liver tissue ET level increased to a similar extent after reperfusion in the three groups, and the plasma and liver tissue TAK-044 concentrations after reperfusion were highest in the IV group. However, the increase in plasma ET was also greatest, and therefore, the ratio of liver tissue to plasma TAK-044 was lower in the IV group compared with the IP group. In the transplantation model, elevation of plasma ET was significantly higher in the IV group. Leakage of serum alanine aminotransferase (ALT), sinusoidal narrowing, and cell swelling after grafting were significantly suppressed in the IP group. We conclude that intraportal administration before reperfusion offers more efficient accumulation of TAK-044 in the liver tissue, without harmful systemic elevation of ET, and achieves a hepatoprotective effect on the graft compared with intravenous administration.


Subject(s)
Endothelin Receptor Antagonists , Liver Transplantation , Peptides, Cyclic/administration & dosage , Reperfusion Injury/prevention & control , Alanine Transaminase/metabolism , Animals , Disease Models, Animal , Drug Administration Routes , Endothelin-1/metabolism , Immunoenzyme Techniques , Liver/drug effects , Liver/metabolism , Liver/pathology , Liver Function Tests , Liver Transplantation/pathology , Male , Peptides, Cyclic/pharmacokinetics , Rats , Rats, Wistar , Receptors, Endothelin/metabolism , Reperfusion Injury/metabolism , Reperfusion Injury/pathology
9.
J Am Acad Dermatol ; 41(4): 550-4, 1999 Oct.
Article in English | MEDLINE | ID: mdl-10495374

ABSTRACT

BACKGROUND: Data suggest that androgenetic alopecia is a process dependent on dihydrotestosterone (DHT) and type 2 5alpha-reductase. Finasteride is a type 2 5alpha-reductase inhibitor that has been shown to slow further hair loss and improve hair growth in men with androgenetic alopecia. OBJECTIVE: We attempted to determine the effect of finasteride on scalp skin and serum androgens. METHODS: Men with androgenetic alopecia (N = 249) underwent scalp biopsies before and after receiving 0.01, 0.05, 0.2, 1, or 5 mg daily of finasteride or placebo for 42 days. RESULTS: Scalp skin DHT levels declined significantly by 13.0% with placebo and by 14.9%, 61.6%, 56. 5%, 64.1%, and 69.4% with 0.01, 0.05, 0.2, 1, and 5 mg doses of finasteride, respectively. Serum DHT levels declined significantly (P <.001) by 49.5%, 68.6%, 71.4%, and 72.2% in the 0.05, 0.2, 1, and 5 mg finasteride treatment groups, respectively. CONCLUSION: In this study, doses of finasteride as low as 0.2 mg per day maximally decreased both scalp skin and serum DHT levels. These data support the rationale used to conduct clinical trials in men with male pattern hair loss at doses of finasteride between 0.2 and 5 mg.


Subject(s)
5-alpha Reductase Inhibitors , Alopecia/drug therapy , Androgens/metabolism , Enzyme Inhibitors/therapeutic use , Finasteride/therapeutic use , Scalp/metabolism , Adolescent , Adult , Alopecia/metabolism , Androstane-3,17-diol/analogs & derivatives , Androstane-3,17-diol/metabolism , Dihydrotestosterone/metabolism , Double-Blind Method , Enzyme Inhibitors/adverse effects , Finasteride/adverse effects , Humans , Male , Middle Aged , Scalp/drug effects , Testosterone/metabolism
11.
J Surg Res ; 85(2): 279-85, 1999 Aug.
Article in English | MEDLINE | ID: mdl-10423330

ABSTRACT

BACKGROUND: The liver and portal circulation contribute to production and clearance of endothelin-1 (ET-1). This study was undertaken to investigate what variables relate to the dynamics of ET-1 in hepatic resection and its clinical implication. PATIENTS AND METHODS: On 20 patients with (n = 8) or without (n = 12) chronic liver disease who underwent hepatic resection, peripheral arterial and portal venous ET-1 were serially measured to determine a correlation with pre-, intra-, and postoperative variables. RESULTS: The preoperative factors with which the portal ET-1 showed a positive correlation were the indocyanine green retention rate at 15 min (ICG R15) and portal venous pressure. The ET-1 clearance, as calculated from the difference between the portal and the peripheral ET-1 concentrations, was also correlated with the ICG R15. The peripheral ET-1 elevated significantly in the patients with increasing intraoperative blood loss or hepatic inflow occlusion. An increase in the portal ET-1 was correlated with an elevation of portal venous pressure after hepatectomy. Postoperative increase in serum bilirubin was closely correlated with the peripheral ET-1 at closure. CONCLUSION: The peripheral and portal ET-1 are correlated with not only preoperative hepatic reserve and portal venous pressure but also invasiveness of hepatectomy and postoperative course.


Subject(s)
Endothelin-1/blood , Hepatectomy , Portal Vein/metabolism , Blood Loss, Surgical , Female , Humans , Intraoperative Period , Liver/blood supply , Liver/metabolism , Liver Function Tests , Male , Middle Aged , Portal Pressure/physiology , Postoperative Period , Time Factors
12.
Hepatogastroenterology ; 46(25): 417-24, 1999.
Article in English | MEDLINE | ID: mdl-10228833

ABSTRACT

BACKGROUND/AIMS: The crucial points of hepatic segmentectomy include an accurate mapping of proposed segment(s) to be resected and minimization of intra-operative blood loss. This study reports a surgical technique of hepatic resection for segment 7 and 8, and a benefit of supplemental use of topical cooling during consecutive right hepatic inflow occlusion. METHODOLOGY: From January 1993 to December 1996, ten hepatocellular carcinoma patients with pathologic livers underwent hepatic segmentectomy for segment 7 and 8. The mapping of the target segments was guided by en-bloc test occlusion of the relevant portal pedicles and subsequent discoloration, often after the opening hilum method. Of these, five tumors were resected with topical cooling by ice slush seeding during consecutive right inflow occlusion (cooling group) and the remainder without cooling (Normothermic group). In the normothermic group, inflow occlusion was carried out by cyclic clamping and unclamping method. RESULTS: The inflow occlusion time was 54 +/- 9.4 min in the cooling group, much longer than in the normothermic group. Although the post-operative peak transaminase values were twice as high as those in the normothermic group, the blood loss was significantly less, and there was no detrimental effect of prolonged, consecutive ischemia on the other intra- and post-operative data. CONCLUSIONS: En-bloc taping of the target portal pedicles with or without the opening hilum method is useful in the mapping of segments, and the use of topical cooling is beneficial in prolonged inflow occlusion during complicated right-sided segmentectomy.


Subject(s)
Blood Loss, Surgical/prevention & control , Hepatectomy/methods , Liver Neoplasms/surgery , Portal System , Adult , Aged , Female , Humans , Liver Neoplasms/blood supply , Male , Middle Aged , Temperature
14.
Hepatogastroenterology ; 45(19): 29-33, 1998.
Article in English | MEDLINE | ID: mdl-9496482

ABSTRACT

This article describes the surgical techniques and indications of laparoscopic partial hepatectomy, which is not as widely available as laparoscopic cholecystectomy. Three patients with hepatocellular carcinoma and associated severe liver cirrhosis were candidates for this technique from July 1993 to August 1994. The tumor size was 4 cm or less and all the tumors were located in segment 5 or 8 which had grown nodularly and protruded from the liver surface. A microwave tissue coagulator was used for parenchymal dissection under ultrasonographic guidance in a gas-less method with or without low-pressure pneumoperitoteum of 4 mmHg. The principle of dissection consists of tissue coagulation and fragmentation with dissecting forceps. Three hepatectomies were performed uneventfully without blood transfusion and the patients rapidly returned to their preoperative conditions. The laparoscopic partial hepatectomy can be an option of treatment in selected cases where the tumor can be removed by minor, superficial resection.


Subject(s)
Hepatectomy/methods , Laparoscopy , Carcinoma, Hepatocellular/surgery , Electrocoagulation , Humans , Liver Neoplasms/surgery , Male , Middle Aged
15.
J Hepatobiliary Pancreat Surg ; 5(4): 463-6, 1998.
Article in English | MEDLINE | ID: mdl-9931399

ABSTRACT

A rare case of idiopathic benign biliary stricture is reported. A 50-year-old man with liver dysfunction underwent ultrasonography, which revealed dilation of the intrahepatic bile ducts, and endoscopic retrograde cholangiopancreatography, which revealed a short, ring-like stenosis at the junction of the left and right hepatic ducts. Although a benign stricture was suspected, radiologic tests alone were insufficient to make a firm diagnosis. Therefore, a cholecystectomy and resection of the extrahepatic biliary tract were performed. Microscopic examination of the resected specimen demonstrated no evidence of malignancy. The final diagnosis was mild, localized, chronic cholangitis. The patient had not had previous biliary tract surgery, choledocholithiasis, nor did he have a congenital abnormality of the biliary tract, bile duct carcinoma, or pancreatic disease. Since there was no evidence of primary sclerosing cholangitis, the stricture was considered to be idiopathic.


Subject(s)
Bile Duct Diseases/diagnosis , Anastomosis, Surgical , Bile Duct Diseases/surgery , Cholangiopancreatography, Endoscopic Retrograde , Cholangitis, Sclerosing/diagnosis , Cholecystectomy , Chronic Disease , Constriction, Pathologic , Diagnosis, Differential , Humans , Male , Middle Aged , Tomography, X-Ray Computed
16.
Hepatogastroenterology ; 44(17): 1390-6, 1997.
Article in English | MEDLINE | ID: mdl-9356860

ABSTRACT

BACKGROUND/AIMS: Experimental and clinical studies have found a relationship between blood transfusion and altered immune function. We estimated the risk of transfusions for shorter survival on patients with hepatocellular carcinoma who underwent hepatic resection. METHODOLOGY: The impact of perioperative blood transfusions on 235 patients with hepatocellular carcinoma who had resections from January 1981 to December 1988 was retrospectively examined. All patients underwent hepatic resection and received no additional chemotherapy. RESULTS: Using the Cox proportional hazard model, the number of perioperative blood transfusions was found to be a significant prognostic factor for patient outcome (p = 0.03). Overall, patients who received less than 12 transfused units had a significantly better 5-year survival rate than those who received more than 13 transfused units (46.3% vs. 24.5%, p < 0.001). This result was also seen when the patients were subdivided by stage: 5-year survival in the early stage group (57.2% vs. 35.5%, p < 0.01) and in the advanced stage group (30.0% vs. 18.2%, p < 0.05). The number of perioperative blood transfusions also influenced the survival of patients who underwent a curative resection (66.2% vs. 38.5%, p < 0.01), but did not affect the survival of those who received a non-curative resection (7.9% vs. 7.4%). CONCLUSION: This study suggests that the number of perioperative blood transfusions is a significant prognostic factor in patients with hepatocellular carcinoma who undergo hepatic resection.


Subject(s)
Carcinoma, Hepatocellular/mortality , Carcinoma, Hepatocellular/surgery , Liver Neoplasms/mortality , Liver Neoplasms/surgery , Transfusion Reaction , Case-Control Studies , Female , Follow-Up Studies , Humans , Life Tables , Male , Middle Aged , Prognosis , Proportional Hazards Models , Retrospective Studies , Survival Rate , Time Factors
17.
J Surg Res ; 70(2): 156-60, 1997 Jul 01.
Article in English | MEDLINE | ID: mdl-9245565

ABSTRACT

This study was designed to investigate whether or not a novel nonselective endothelin A/B (ETA/ETB) receptor antagonist (TAK-044) provides hepatoprotection during porcine liver transplantation. The grafts were stored in chilled Euro-Collins solution and recirculated following reflush with lactated Ringer's with (TAK group) or without (control group) TAK-044 (10 mg/kg). Intracellular (cytoplasma, mitochondria, and nucleus) calcium (Ca) concentrations were measured in the hepatic biopsy materials obtained serially at varying time point from donor laparotomy to recipient closure using an electron probe X-ray microanalyzer. Liver function tests also were determined. The cold and warm ischemia times of the grafts were comparable between the two groups. The peak endothelin-1 T-1) concentration after recirculation was significantly higher in the TAK group than in the control group (129 +/- 30 pg/ml vs 26 +/- 6.5 pg/ml). However, release of liver enzymes, increases in total bile acid, and deterioration of indocyanine green retention rate were significantly suppressed in the TAK group. In the control group, the intracellular Ca concentrations, especially in the mitochondrial fraction, were elevated markedly following recirculation of the hepatic arterial flow. In the TAK group, this effect was suppressed. Thus, the supplementary use of the nonselective ETA/ETB receptor antagonist TAK-044 via a rinse route may alleviate an early postreperfusion microcirculatory disturbance of the liver grafts without adverse effects by the increased ET-1 on the systemic circulation.


Subject(s)
Endothelin Receptor Antagonists , Liver Transplantation/methods , Peptides, Cyclic/pharmacology , Animals , Calcium/metabolism , Cell Nucleus/metabolism , Endothelin-1/blood , Female , Liver/physiology , Mitochondria, Liver/metabolism , Reperfusion Injury/prevention & control , Swine
18.
J Clin Endocrinol Metab ; 82(5): 1373-7, 1997 May.
Article in English | MEDLINE | ID: mdl-9141518

ABSTRACT

Two isozymes (types 1 and 2) of 5alpha-reductase (5alphaR; EC 1.3.99.5), with differential tissue distribution, catalyze the reduction of testosterone (T) to dihydrotestosterone (DHT) in humans. This study examined sequentially increasing oral doses of MK-386 (4,7beta-dimethyl-4-aza-5alpha-cholestan-3-one), an azasteroid that specifically inhibits the human 5alphaR1 isozyme in vitro. Finasteride, a selective inhibitor of 5alphaR2, was included for comparison. One hundred men were evaluated in a double blind, randomized, placebo-controlled, sequential, increasing dose, parallel group trial. Ten to 20 subjects received MK-386, and 2 to 5 received placebo in each of 6 panels. In 1 panel, 10 subjects received finasteride (5 mg), and 5 received placebo. Treatments were given once daily for 14 days, except in 1 panel in which MK-386 was administered 10 mg twice daily for comparison to 20 mg daily. Serum, sebum, and semen DHT concentrations and serum and sebum T concentrations were measured before and after treatment. The mean changes from baseline on day 14 for serum DHT after placebo and 0.1, 0.5, 5, 20, and 50 mg MK-386 were 6.9%, 4.6%, -2.7%, -1.2%, -14.1% (P < 0.05 vs. placebo), and -22.2% (P < 0.05 vs. placebo), respectively. No significant alterations in serum T were observed after any dose of MK-386. Serum DHT fell 65.8% from the baseline 14 days after finasteride treatment (P < 0.05 vs. placebo). The mean changes from baseline on day 14 in sebum DHT were 5.0%, 3.0%, -25.4% (P < 0.05 vs. placebo), -30.1% (P < 0.05 vs. placebo), and -49.1% (P < 0.05 vs. placebo) for the placebo and 0.5, 5, 20, and 50 mg MK-386 groups, respectively. Finasteride also reduced sebum DHT, but to a lesser extent (- 14.9%; P < 0.05 vs. placebo). Reciprocal increases in sebum T concentration were noted at doses of 5 mg or more of MK-386, but not with finasteride. The mean reduction in semen DHT with 5 mg finasteride was approximately 88% (P < 0.01 vs. placebo); no significant change in semen DHT was noted with 20 or 50 mg MK-386. Serum 3alpha-androstanediol glucuronide values were also reduced after the 20- and 50-mg MK-386 treatments in parallel with the changes in serum DHT. No meaningful changes were observed in serum LH after MK-386 treatment. MK-386 was generally well tolerated by all subjects; reversible aspartate aminotransferase/alanine aminotransferase elevations were observed in two subjects at the 50-mg dose. The differential responses in serum, sebum, and semen DHT concentrations associated with MK-386 and finasteride treatments are consistent with those changes anticipated for selective inhibitors of the human 5alphaR isozymes. Dose-dependent suppression of sebum DHT by a 5alphaR1 inhibitor suggests the potential utility of such compounds in the treatment of acne.


Subject(s)
5-alpha Reductase Inhibitors , Azasteroids/pharmacology , Dihydrotestosterone/blood , Dihydrotestosterone/metabolism , Enzyme Inhibitors/pharmacology , Sebum/metabolism , Semen/metabolism , Adolescent , Adult , Androstane-3,17-diol/analogs & derivatives , Androstane-3,17-diol/blood , Finasteride/pharmacology , Humans , Luteinizing Hormone/blood , Male , Middle Aged , Testosterone/blood
19.
Cancer ; 79(8): 1509-15, 1997 Apr 15.
Article in English | MEDLINE | ID: mdl-9118031

ABSTRACT

BACKGROUND: This study investigated the relationship between clinicopathologic features and various viral serologies in patients who underwent hepatectomy in the treatment of hepatocellular carcinoma (HCC). METHODS: Two hundred two patients were allocated to four groups, according to their positivity or negativity for hepatitis B surface antigen (HBsAg) and hepatitis C virus antibody (HCVAb): Group I (HBsAg[-], HCVAb[+], n = 151), Group II (HBsAg[+], HCVAb[-], n = 27), Group III (HBsAg[-], HCVAb[-], n = 20), or Group IV (HBsAg[+], HCVAb[-], n = 4). The mean age of the HBsAg positive patients (Groups II and IV) was 10 years younger than that of the HBsAg negative patients (Groups I and III). RESULTS: The male-to-female ratio was higher in HCVAb negative groups (II and III). The HCVAb positive groups (I and IV) had a significantly poorer hepatic reserve and smaller resections than the HCVAb negative groups. Because the tumors were more advanced (as determined by TNM staging) in Group II, the 3-year crude and disease free survival rates were lower in Group II than in Group I. However, HCVAb negative groups (II and III), when compared at 5 years with the limited subsets of patients who had tumors at earlier stages or a curative resection, had significantly better crude and disease free 5-year survival rates than the HCVAb positive group (I). CONCLUSIONS: Clinicopathologic features differ from one another in accordance with the viral seromarkers in HCC patients. Significantly better crude and disease free survival after complete resection were promising results for patients with non-HCV-related HCC. By comparison, for patients with HCV-related HCC, the risk of intrahepatic recurrences never subsided even in later years after complete resection. Therefore, posthepatectomy follow-up management should be individualized depending on the viral serologic status of HCC patients.


Subject(s)
Biomarkers, Tumor/blood , Carcinoma, Hepatocellular/virology , Hepatitis B Surface Antigens/blood , Hepatitis C Antibodies/blood , Liver Neoplasms/virology , Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Carcinoma, Hepatocellular/immunology , Carcinoma, Hepatocellular/pathology , Carcinoma, Hepatocellular/surgery , Female , Hepatectomy , Humans , Liver Neoplasms/immunology , Liver Neoplasms/pathology , Liver Neoplasms/surgery , Male , Middle Aged , Neoplasm Staging , Survival Rate
20.
Gastroenterology ; 112(3): 725-32, 1997 Mar.
Article in English | MEDLINE | ID: mdl-9041233

ABSTRACT

BACKGROUND & AIMS: Leukotrienes (LTs) are believed to be important in the pathogenesis of ulcerative colitis (UC). The aim of this study was to determine whether inhibition of LT biosynthesis with a 5-lipoxygenase inhibitor (MK-591) induces remission in patients with mild to moderate UC. METHODS: One hundred eighty-three patients with mild to moderately active UC enrolled in this randomized parallel group, double-blind study. Patients received placebo or MK-591 at a dose of 12.5, 50, or 100 mg twice daily for 8 weeks. A subset of patients underwent rectal dialysis to determine LTB4 concentration. RESULTS: MK-591 reduced LTB4 concentrations in rectal dialysate at the final determination. The median percent of baseline LTB4 concentration for 100 mg taken twice daily was 1.4% (n = 4); for 50 mg taken twice daily, 16.5% (n = 6); for 12.5 mg taken twice daily, 12% (n = 6); and for placebo, 78% (n = 6). There was no correlation between reduction of LTB4 and remission. Patients in remission at week 8 were as follows: placebo, 9 of 44 (20.5%); 100 mg taken twice daily, 11 of 43 (25.6%); 50 mg taken twice daily, 8 of 49 (16.3%); and 12.5 mg taken twice daily, 4 of 47 (8.5%) (P > 0.10). CONCLUSIONS: MK-591 markedly inhibited LT biosynthesis, but it did not differ significantly from placebo in clinical efficacy. Inhibition of LT biosynthesis was not effective as a single therapeutic modality in active UC.


Subject(s)
Colitis, Ulcerative/drug therapy , Indoles/therapeutic use , Lipoxygenase Inhibitors/therapeutic use , Quinolines/therapeutic use , Adolescent , Adult , Aged , Aged, 80 and over , Colitis, Ulcerative/pathology , Double-Blind Method , Female , Humans , Indoles/adverse effects , Leukotriene B4/antagonists & inhibitors , Male , Middle Aged , Quinolines/adverse effects
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