Adding low-dose antidepressants to interferon alpha treatment for chronic hepatitis C improved psychiatric tolerability in a patient with schizoaffective psychosis

Treatment of chronic hepatitis C with interferon alpha (IFN-alpha) is relatively contraindicated in patients with psychiatric disorders because of possible severe psychiatric side effects. We report on a case of a female patient with a chronic schizoaffective psychosis, who was treated for 3 months with 3 x 3 mio IE IFN-alpha s.c./week because of a chronic hepatitis C (genotype Ib). Psychosis was stable with flupentixol monotherapy. After 2 months, she developed a severe depressive syndrome which lead to suicidal ideation. Until this time, she was without any antidepressive medication. Depressive symptoms disappeared after interferon therapy was stopped. Under prophylactic treatment with low-dose trimipramine (50 mg) or nefazodone (200 mg/day) therapy with IFN-alpha 3 x 3 mio IE/week was re-established after several months and again 2 years later adding ribavirin 1200 mg/day, a virustaticum. In contrast to the symptoms during monotherapy with IFN-alpha, during the time of both combination treatments, no psychiatric side effects occurred. While for ribavirin antidepressant effects are not known, we suppose that antidepressants may in serotonergic or noradrenergic caused by IFN-alpha. prevent changes neurotransmission caused by IFN-alpha. Copyright (C) 2000 S. Karger AG, Basel

»Dicke Bohnen« als Auslöser einer akuten hämolytischen Anämie

Bei einem bisher gesunden 17jährigen Griechen trat akut eine Gelbverfärbung der Skleren und der Haut auf. Zudem war er auffallend blaß bei sonst unauffälligem körperlichem Untersuchungsbefund. Er berichtete ferner über Müdigkeit und Schwäche. Die klinisch-chemische Untersuchung ergab einen Hämoglobinspiegel von 9,6 g/dl, eine Lactatdehydrogenase-Aktivität von 335 U/l, eine Gesamtbilirubinkonzentration von 3,2 mg/dl (direkt 0,7 mg/dl, indirekt 2,5 mg/dl) und eine Haptoglobinkonzentration von 48,8 mg/dl. Danach wurde eine hämolytische Anämie vermutet; es stellte sich durch gezieltes Nachfragen heraus, daß der Patient 3 und 2 Tage vor Auftreten des Ikterus zum ersten Mal in seinem Leben etwa 300 g »dicke Bohnen« gegessen hatte, die in der Literatur als Sau- oder Pferdebohnen (Vicia faba) bezeichnet werden. Der biochemische Nachweis des Fehlens der Glucose-6-Phosphat-Dehydrogenase-Aktivität in den Erythrozyten sicherte die Diagnose Favismus. Die Lactatdehydrogenase-Aktivität und der Bilirubinspiegel fielen unter rein symptomatischer Therapie innerhalb einer Woche in den Normbereich ab, der Hämoglobinspiegel lag nach 4 Wochen wieder bei 15,7 g/dl

Decrease in thyroid adenoma associated (THADA) expression is a marker of dedifferentiation of thyroid tissue

<p>Abstract</p> <p>Background</p> <p><it>Thyroid adenoma associated (THADA) </it>has been identified as the target gene affected by chromosome 2p21 translocations in thyroid adenomas, but the role of THADA in the thyroid is still elusive. The aim of this study was to quantify <it>THADA </it>gene expression in normal tissues and in thyroid hyper- and neoplasias, using real-time PCR.</p> <p>Methods</p> <p>For the analysis <it>THADA </it>and 18S rRNA gene expression assays were performed on 34 normal tissue samples, including thyroid, salivary gland, heart, endometrium, myometrium, lung, blood, and adipose tissue as well as on 85 thyroid hyper- and neoplasias, including three adenomas with a 2p21 translocation. In addition, <it>NIS </it>(<it>sodium-iodide symporter</it>) gene expression was measured on 34 of the pathological thyroid samples.</p> <p>Results</p> <p>Results illustrated that <it>THADA </it>expression in normal thyroid tissue was significantly higher (<it>p </it>< 0.0001, exact Wilcoxon test) than in the other tissues. Significant differences were also found between non-malignant pathological thyroid samples (goiters and adenomas) and malignant tumors (<it>p </it>< 0.001, Wilcoxon test, t approximation), anaplastic carcinomas (ATCs) and all other samples and also between ATCs and all other malignant tumors (<it>p </it>< 0.05, Wilcoxon test, t approximation). Furthermore, in thyroid tumors <it>THADA </it>mRNA expression was found to be inversely correlated with <it>HMGA2 </it>mRNA. <it>HMGA2 </it>expression was recently identified as a marker revealing malignant transformation of thyroid follicular tumors. A correlation between <it>THADA </it>and <it>NIS </it>has also been found in thyroid normal tissue and malignant tumors.</p> <p>Conclusions</p> <p>The results suggest <it>THADA </it>being a marker of dedifferentiation of thyroid tissue.</p

Kinetische Studien der D-Glucoseresorption im proximalen Konvolut der Rattenniere / Kinetic study of the local active transport of D-glucose in the proximal convoluted tubule of rat kidney

The proximal convoluted tubule of rat kidney was continuously perfused with a steady state solution containing 0.5 to 2.0 mM of D-glucose. The gradual decrease of intraluminald-glucose concentration was investigated with repeated collections of perfusate from the same tubule whereby the sequence of punctures proceeded towards the site of perfusion. The rate of D-glucose transport per unit area decreased with decreasing intraluminald-glucose concentration. This relationship could be expressed by a two parameter system corresponding to the Michaelis-Menten equation. It was found that the local maximal transport rate Vmax equals 6×10−10 mol×cm−2×sec−1 and Km equals 0.6 mM. Our data on active resorption and passive permeability ofd-glucose in the proximal convolution have been subjected to computer analysis. The sum of both components ofd-glucose transport alone as measured under the condition of zero netflux of sodium chloride and water did not match the amount of net glucose transport found for the whole kidney under free-flow-conditions

Stimulation of sodium transport and Na⁺-K⁺-ATPase activity in the hypertrophying rat cecum

The rat cecum is suitable to study ion transport in a hypertrophying mammalian epithelium. When the nonabsorbable polymer polyethylene glycol 4000 was added to the drinking water of adult rats, the gross surface area and dry weight of the cecum increased continuously over a period of two months. In contrast, an observed stimulation of sodium and volume transport rate per unit cecal area or weight reached its maximum within one week. In the absence of net salt and volume transport (stationary state), the transmural concentration difference for sodium and chloride but not for potassium was higher following hypertrophy, and the lumen was electrically more negative. Furthermore, hypertrophy was accompanied by an increase in Na+-K+-ATPase activity per unit area, weight or protein while other enzymes in cecal mucosa homogenates remained unaltered. Sodium and chloride were transported out of the lumen, and potassium secreted into the lumen, against an electrochemical potential difference in both the normal and hypertrophying cecum. The consideration of electrochemical driving forces and fluxes along with the enzymatic findings suggest that the stimulation of active sodium transport was the prominent functional change connected with cecal hypertrophy

Cecal Enlargement Combined with Sodium Transport Stimulation in Rats Fed Polyethylene Glycol

The organ enlargement and stimulation of solute–coupled water transport observed in the cecum of germfree rats can also be produced in conventional rats by adding polyethylene glycol 4000 to their drinking water. In these rats, the electrical potential difference across the cecal wall is increased during solute–coupled water flow. The structural and functional changes induced by polyethylene glycol are reversible and do not extend to the rest of the small intestine and the distal ileum

Differenzierung zwischen aktiver und passiver Komponente des D-Glucosetransports am proximalen Konvolut der Rattenniere / Differentiation of the active and passive components of d-glucose transport in the proximal tubule of rat kidney

Both, the net and unidirectional transport of d-glucose across the proximal tubule of rat kidney were studied by the technique of continuous microperfusion under the condition of zero netflux of water and sodium chlorid. When the active transport component was completely abolished by 10−4 M of phlorizin a small passive component could be demonstrated. The passive component was also observed in the non-phlorizin-poisoned stat to be additive to the active transport. Vmax of the actived-glucose transport was 6×10−10 mol×cm−2×sec−1. The passive glucose flux is proportional to the concentration difference between perfusate and serum. There is no difference between data of influx and efflux measurements. From this it is concluded that the passive d-glucose flux is a simple diffusion process. The permeability coefficient ford-glucose (PG) calculated from 3 different sets of experiments is 1.7×10−5 cm×sec−1. Active and passive glucose transport component can cancel out each other at a transtubular concentration difference of 33 mmol/l. Changes of the specific activity in the perfusate were measured under three different conditions (d-glucose concentration lumen: > plasma, lumen = plasma, lumen max and PG for the calculation (see appendix). The permeability of d-glucose across the proximal tubules is small. Therefore, under normal free flow condition the passive transport component plays no role in the d-glucose absorption. However, with greatly increasing transtubular concentration difference of d-glucose, e.q. due to a low glomerular filtration rate and a high serum d-glucose concentration, the passive transport component may be the rate limiting factor for the net transport of d-glucose