RESUMEN
A 17-year-old male who had been diagnosed with ulcerative colitis was prescribed 80 mg prednisolone and 1,500 mg 5-aminosalicylic acid (5-ASA) per day. Two weeks after initiating therapy, he was referred to our hospital for evaluation of chest pain and high fever. Electrocardiography (ECG) showed ST elevation in limb and precordial leads. Chest pain with high fever and ECG changes were resolved after 5-ASA was discontinued. Three weeks later, the administration of a low dose of 5-ASA was associated with the immediate recurrence of pericarditis associated with chest pain, suggesting a hypersensitive reaction to 5-ASA in this patient.
Asunto(s)
Antiinflamatorios no Esteroideos/efectos adversos , Colitis Ulcerosa/tratamiento farmacológico , Mesalamina/efectos adversos , Pericarditis/inducido químicamente , Pericarditis/diagnóstico , Adolescente , Antiinflamatorios/uso terapéutico , Antiinflamatorios no Esteroideos/uso terapéutico , Ecocardiografía , Electrocardiografía , Humanos , Masculino , Mesalamina/uso terapéutico , Pericarditis/sangre , Pericarditis/diagnóstico por imagen , Pericarditis/fisiopatología , Prednisolona/uso terapéutico , Recurrencia , Índice de Severidad de la EnfermedadRESUMEN
The aim of this study was to investigate the regional distribution, molecular forms, and gene expression of adrenomedullin in the rat gastrointestinal tract and to examine physiological changes in gastric adrenomedullin after 24-h fasting. The tissue concentration was measured by radioimmunoassay. The molecular forms were analyzed by high performance liquid chromatography. mRNA levels were quantified by Northern blotting and cells positive for adrenomedullin immunoreactivity were localized by immunohistochemistry. A high concentration of adrenomedullin was found in stomach, cecum, and colon (450-520 fmol/g wet tissue). Adrenomedullin immunoreactivity was also detected in duodenum, jejunum, and ileum (200-250 fmol/g wet tissue). Transcripts of the adrenomedullin gene were widely expressed throughout the gastrointestinal tract. The major form of adrenomedullin immunoreactivity in stomach and colon corresponded precisely with authentic adrenomedullin peptide. Adrenomedullin immunoreactive cells were present in the gastrointestinal endocrine system. The concentration and mRNA level of gastric adrenomedullin after fasting were significantly increased compared with findings in controls. Adrenomedullin is ubiquitous in the gastrointestinal tract, and may be produced by endocrine cells. The results suggest that adrenomedullin, through its potent vasodilating activity, may play some role, in the stomach including the regulation of the mucosal blood flow.
Asunto(s)
Fenómenos Fisiológicos del Sistema Digestivo , Mucosa Gástrica/metabolismo , Mucosa Intestinal/metabolismo , Péptidos/genética , Péptidos/metabolismo , Adrenomedulina , Animales , Técnicas de Cultivo , Ayuno/fisiología , Expresión Génica , Inmunohistoquímica , Masculino , ARN Mensajero/análisis , Ratas , Ratas Sprague-Dawley , Valores de ReferenciaRESUMEN
Proadrenomedullin N-terminal 20 peptide (PAMP) is a novel hypotensive peptide processed from an adrenomedullin precursor. In this study, high concentrations of immunoreactive PAMP (ir-PAMP) were detected in rat cardiac atrium and adrenal gland by the radioimmunoassay (RIA) for rat PAMP. The mean plasma concentration of rat ir-PAMP was 3.8 +/- 0.3 fmol/ml. Analysis in atrium, adrenal gland and plasma with high performance liquid chromatographies showed that most ir-PAMP emerged as one major peak at the position exactly identical to that of the authentic rat PAMP. We further investigated the tissue and plasma concentrations of rat ir-PAMP in spontaneously hypertensive rat (SHR) to elucidate the role of PAMP in hypertension. The ir-PAMP concentration in heart tissue of SHR was found to be increased compared with that of the control rat. Especially, the atrial concentration of ir-PAMP of SHR (5.66 +/- 0.78 fmol/mg wet tissue) was significantly higher than that of the control (3.29 +/- 0.22 fmol/mg wet tissue). Cardiac PAMP might have a role for the protection from systemic hypertension.
Asunto(s)
Glándulas Suprarrenales/química , Atrios Cardíacos/química , Fragmentos de Péptidos/análisis , Péptidos , Proteínas/análisis , Radioinmunoensayo/métodos , Adrenomedulina , Secuencia de Aminoácidos , Animales , Humanos , Hipertensión/sangre , Hipertensión/metabolismo , Datos de Secuencia Molecular , Especificidad de Órganos , Fragmentos de Péptidos/síntesis química , Proteínas/síntesis química , Ratas , Ratas Endogámicas SHR , Ratas Sprague-Dawley , Ratas Wistar , Sensibilidad y EspecificidadRESUMEN
Collections of air in the spinal canal have been observed in patients with spinal disorders, whereas intraspinal air secondary to pneumomediastinum is rare (6). This is a report of 2 patients with pneumomediastinum where collections of air were identified in the spinal canal on CT.
Asunto(s)
Enfisema Mediastínico/diagnóstico por imagen , Canal Medular/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Aire , Humanos , Mediastino/diagnóstico por imagenRESUMEN
A 47 year-old male was admitted to Miyazaki Medical college Hospital for further evaluation of an abdominal mass in the left upper quadrant. Abdominal ultrasound (US) and abdominal computed tomography (CT) showed two cystic masses in the mesenterium, which were suspected to be hematomas, but were not related to the pancreas, kidney or spleen. Superior mesenteric artery angiography and gallium (GA)-scintigraphy showed no definite findings. The patient underwent laparotomy on a suspicion of mesenteric hematoma. Two 4 x 3 x 3 cm soft tumors were found in the small intestinal mesenterium. These masses were histopathologically hematomas and surrounded by thick collagenous granulation tissue. The patient had no recent history of abdominal trauma, taking drugs capable of producing bleeding tendency, and/or vascular disease. The case was diagnosed as spontaneous mesenteric hematoma.