EFFECT OF LEUCOTRIENE E 4 ON THE ULTRASTRUCTURE OF THE TERMINAL MUCOSAL VESSELS OF THE GUT

No abstrac

ULTRASTRUCTURE OF THE WALL OF THE TERMINAL VESSELS OF THE STOMACH MUCOSA

The infrastructure of the wall of the terminal gastric mucosa vessels (of Corpus and pars pylorica) of 15 adult rats was investigated. It was established that the number of fenestrated vessels as well as the degree of fenestration in direction to the glandular cells enhanced along with vascidar caliber increasing. While the thickness of the endothelial cells and the amount of their organelles reduced there was an elevation of the count and length of luminal evaginations. The basal membrane became thinner and the pericytes reduced in number. These alterations could be better established in the subepithelial vessels (mainly in the venous capillaries and postcapillary venules) which was more outlined in the pyloric region. The gastric mucosal veins were presented by venules without myocytes but with pericytes. Some arteries could be observed in the submucosa only. The fenestration was interpreted in the sense of possible participation in the ionic transport

MORPHOLOGICAL ALTERATIONS OF THE CEPHALIC VEIN WALL AS A PAT OF A NATIVE RTERIOVENOUS FISTULA FOR CHRONIC HEMODIALYSIS

The creation of an internal arterio-venous fistula according to Brescia and Cimino (1966) changes the functional conditions of cephalic vein and radial artery. Arterial blood enters under high pressure the cephalic vein and turbulent blood flow appears. The pathomorphology of the cephalic vein incorporated in the internal native arterio-venous fistula (NAVF) for chronic hemodialysis was studied. Single portions of the vein were surgically removed from 16 patients aged from 20 to 60 years with failed NAVF and then excised because of repeated NAVF creation (group one) and from 3 patients where the vein was removed during the primary NAVF creation (group two). Light and transmission electron microscopy was used. In the first group, the intima and media of the cephalic vein was much ticker than that of the veins of the patients of the second and control group. The increased thickness of the venous intima was accompanied by an augmented number of smooth muscles cells and appearance of new layers while that of the media was followed by structural changes of its elastic network. These alterations depend on the duration of NAVF functioning

Ustekinumab as Induction and Maintenance Therapy for Crohn’s Disease

BACKGROUND Ustekinumab, a monoclonal antibody to the p40 subunit of interleukin-12 and inter-leukin-23, was evaluated as an intravenous induction therapy in two populations with moderately to severely active Crohn’s disease. Ustekinumab was also evaluated as subcutaneous maintenance therapy. METHODS We randomly assigned patients to receive a single intravenous dose of ustekinumab (either 130 mg or approximately 6 mg per kilogram of body weight) or placebo in two induction trials. The UNITI-1 trial included 741 patients who met the criteria for primary or secondary nonresponse to tumor necrosis factor (TNF) antagonists or had unacceptable side effects. The UNITI-2 trial included 628 patients in whom conventional therapy failed or unacceptable side effects occurred. Patients who completed these induction trials then participated in IM-UNITI, in which the 397 patients who had a response to ustekinumab were randomly assigned to receive subcutaneous maintenance injections of 90 mg of ustekinumab (either every 8 weeks or every 12 weeks) or placebo. The primary end point for the induction trials was a clinical response at week 6 (defined as a decrease from baseline in the Crohn’s Disease Activity Index [CDAI] score of ≥100 points or a CDAI score <150). The primary end point for the maintenance trial was remission at week 44 (CDAI score <150). RESULTS The rates of response at week 6 among patients receiving intravenous ustekinumab at a dose of either 130 mg or approximately 6 mg per kilogram were significantly higher than the rates among patients receiving placebo (in UNITI-1, 34.3%, 33.7%, and 21.5%, respectively, with P≤0.003 for both comparisons with placebo; in UNITI-2, 51.7%, 55.5%, and 28.7%, respectively, with P<0.001 for both doses). In the groups receiving maintenance doses of ustekinumab every 8 weeks or every 12 weeks, 53.1% and 48.8%, respectively, were in remission at week 44, as compared with 35.9% of those receiving placebo (P = 0.005 and P = 0.04, respectively). Within each trial, adverse-event rates were similar among treatment groups. CONCLUSIONS Among patients with moderately to severely active Crohn’s disease, those receiving intravenous ustekinumab had a significantly higher rate of response than did those receiving placebo. Subcutaneous ustekinumab maintained remission in patients who had a clinical response to induction therapy. (Funded by Janssen Research and Development; ClinicalTrials.gov numbers, NCT01369329, NCT01369342, and NCT01369355.