Tem Specimen Preparation of Tial Alloy Powders Produced by Plasma Rotating Electrode Process

TEM specimens of PREPed Ti -48 at.% Al powders can be prepared reproducibly in a straight-forward manner. There are two kinds of powders with respect to surface and crosssectional morphologies. One is with an Widmanstitten-like structure and or a surface relief of martensitic phase and the other is with a dendritic structure. The primary phase during solidification and relative cooling rate in both the powders are discussed by comparing the macroscopic and microscopic features.

Repeat renal biopsy in a girl with tubulointerstitial nephritis and uveitis syndrome

A Japanese girl aged 8 years who presented with a 2-month history of uveitis subsequently developed tubulointerstitial nephritis. A percutaneous renal biopsy revealed massive interstitial mononuclear cell infiltrates consisting of CD4-positive T cells. Despite administration of topical corticosteroids, the ocular symptoms persisted. Systemic corticosteroid therapy dramatically reduced the ocular symptoms and urinary beta2-microglobulin (beta 2MG) concentration. However, reducing the prednisolone dosage induced recurrence of uveitis associated with increased levels of urinary beta 2MG. The CD4-positive T cell infiltration persisted in the second renal biopsy performed 6 months after the first renal biopsy. These observations suggest that the interstitial cell infiltration persists for a relatively long time in a proportion of patients with tubulointerstitial nephritis and uveitis syndrome (TINU). Although the renal outcome of TINU has been reported to be favorable, prolonged interstitial cell infiltration may affect long-term renal outcome. Selected patients with TINU should be followed with close observation.

Methylprednisolone pulse therapy in Japanese children with severe lupus nephritis

Six Japanese children with severe lupus nephritis received prompt initiation of methylprednisolone pulse therapy (MPT). After three courses of MPT, oral prednisolone combined with a 12-week course of oral cyclophosphamide was given and prednisolone was tapered. At presentation, urine protein excretion and histological indices of the mean activity index and the mean chronicity index in the patients were 2.2 +/- 1.5 g/day, 10.3 +/- 2.0, and 2.8 +/- 1.2, respectively. Urine protein excretion and the activity index decreased significantly at the second renal biopsies obtained at a mean interval of 8 months after the first [0.1 +/- 0.1 g/day and 3.5 +/- 1.4 (P<0.05), respectively], while the chronicity index did not change. At the latest observation (mean interval 53 months), all showed clinical and serological improvement. Complete remission was achieved in two patients, and no patient showed renal impairment. Although this case series is without controls, our treatment protocol may be of benefit to Japanese children with severe lupus nephritis.

Thrombotic stroke in a child with diarrhea-associated hemolytic-uremic syndrome with a good recovery

A boy aged 3.5 years with post-diarrheal hemolytic-uremic syndrome (HUS) was referred to our hospital because of convulsion and stupor. He had been admitted to a regional hospital with a 3-day history of bloody diarrhea, colic abdominal pain and fever. Two days later, he had complained of generalized seizures and oliguria. On admission, he developed anuria, and serum blood nitrogen and creatinine increased to 56 mg/100 ml and 2.8 mg/100 ml, respectively. Platelets decreased to 42,000/microl. Under the diagnosis of HUS, a continuous hemodiafiltration treatment had to be instituted. Computed tomography of his head at hospital day 5 revealed abnormal low density area of infarction with edema in both the basal ganglia involving with the posterior limb of internal capsule. Serum titer of IgM antibody to Escherichia coli O157 showed positive value. Although his anuria and stupor persisted over 10 days, he recovered without serious complications. These clinical observations may indicate that patients with similar lesions do not necessarily have serious morbidity.

Contribution of macromolecular IgA1 to IgA abnormality in IgA nephropathy

To evaluate the contribution of macromolecular IgA1 to IgA abnormality in childhood IgA nephropathy, serum samples from 29 healthy children and 26 patients with IgA nephropathy in different age-groups (7-9, 10-12, and 13-15 years) were each separated by sucrose density gradient ultracentrifugation and assayed for IgA1 using an enzyme-linked immunosorbent assay. IgA1 in fraction I (sedimentation coefficient >11.4s) was significantly greater in patients 7-15 years of age (median 36.3-57.0 mg/dl) than in the age-matched controls (median 8.8-10.4 mg/dl). IgA1 in fraction II (11.4-9.3s) was significantly greater in patients 10-15 years of age (median 46.7-52.6 mg/dl) than in the controls (median 27.8-35.5 mg/dl), and IgA1 in fraction III (<9.3s) was significantly greater in patients 13-15 years of age (median 156.9 mg/dl) than in the controls (median 120.7 mg/dl). The ratio of IgA1 in fractions I-III was higher in the patients of each age-group (median 0.233-0.314) than in the controls (median 0.067-0.082), while the ratio of IgA1 in fractions II-III was not significantly high in patients 7-12 years old (median 0.268 to 0.318) compared with the controls (median 0.182-0.264). Thus, IgA abnormality in childhood IgA nephropathy would be better represented by an increase in macromolecular IgA1 of >11.4s than by an increase in IgA1 in fractions of 11.4-9.3s or <9.3s.

Psychological effects of aromatherapy on chronic hemodialysis patients

Effects of aromatherapy (odorless condition, lavender, and hiba oil) on mood and anxiety were investigated in 14 female patients who were being treated with chronic hemodialysis. A control period consisting of natural hospital smells was established before each test session, and then aromatic test conditions were systematically evaluated for odorless conditions as well as aromatic conditions containing lavender and hiba oil aromas. The effects of aromatherapy were measured using the Hamilton rating scale for depression (HAMD) and the Hamilton rating scale for anxiety (HAMA). Hiba oil aroma significantly decreased the mean scores of HAMD and HAMA, and lavender aroma significantly decreased the mean scores of HAMA. The mean scores of HAMD and HAMA in an odorless condition were not significantly different from those of the control conditions. These results indicate that in chronic hemodialysis patients hiba oil is an effective, non-invasive means for the treatment of depression and anxiety, and that lavender alleviates anxiety.

Interstitial cystitis and ileus in pediatric-onset systemic lupus erythematosus

A girl aged 11 years presented with autoimmune hemolytic anemia with thrombocytopenia, and subsequently developed severe abdominal pain, vomiting, and pollakiuria. X-ray findings of her abdomen demonstrated paralytic ileus with intestinal wall thickening. Intravenous pyelography revealed bilateral hydroureter with mild hydronephrosis and contracted bladder. Pathological examination of her bladder revealed interstitial cystitis, with evidence of focal deposition of IgG and C3 in a granular pattern on small blood vessel walls. She was diagnosed as having systemic lupus erythematosus (SLE) associated with paralytic ileus and chronic interstitial cystitis. Although initiation of high-dose prednisolone therapy resulted in a gradual improvement in clinical symptoms, reducing the dosage of prednisolone caused a relapse. To our knowledge, the combination of paralytic ileus and chronic interstitial cystitis is quite uncommon in pediatric-onset SLE.

Complete occulusion of left renal artery in pediatric-onset Takayasu's arteritis

A-16-year-old male adolescent with a 4-year history of protean clinical manifestations such as fever, abdominal pain, back pain, erythema nodosum and uveitis developed complete occlusion of left renal artery. Although he had been suspicious of having an autoimmune disease and treated with prednisolone, a definite diagnosis was not made. Finally, an angiography disclosed stenosis of abdominal aorta just beneath the origin of the renal arteries as well as complete occlusion of left renal artery. It has been reported that pediatric-onset Takayasu's arteritis sometimes shows protean clinical manifestations as in ours. Takayasu's arteritis should be considered as one of the underlaying disease, when a child develops protean manifestations suggesting an autoimmune disease.

Acute tubulointerstitial nephritis following intravenous immunoglobulin therapy in a male infant with minimal-change nephrotic syndrome

A boy aged 4 years with nephrotic syndrome (NS) was referred to our hospital because of the third relapse of NS. Hypogammaglobulinemia associated with massive proteinuria was observed at the presentation. Residual urinary tract infection required intravenous piperacillin and immunoglobulin therapy (IVIG). Soon after IVIG, he complained of high fever with chills, bilateral knee joint pain, dry cough and chest discomfort. Although he did not develop renal insufficiency, a transient increase in the urinary beta2-microglobulin and decrease in the serum complement hemolytic activity were observed. These clinical manifestations spontaneously ceased. A percutaneous renal biopsy for his NS performed 19 days after the episode of allergic reaction revealed tubulointerstitial nephritis (TIN) with marked eosinophil infiltrates. Glomeruli showed minor glomerular abnormalities. Renal complications associated with IVIG treatment have been reported to date, however, acute TIN has rarely been seen.

IgA interaction with carboxy-terminal 43-kD fragment of fibronectin in IgA nephropathy

IgA deposition in the glomerular mesangial matrix is a prerequisite for the diagnosis of IgA nephropathy, and circulating IgA-containing complex has been implicated in this process. Since fibronectin is known to be involved in the assembly of extracellular matrix, this study was conducted to investigate whether fibronectin and its fragments are present in sera of patients and are capable of binding IgA1. Sera from patients with IgA nephropathy were purified by heparin-affinity chromatography, and column eluate were analyzed for the presence of fibronectin using Western blot and a set of anti-fibronectin monoclonal antibodies. Native fibronectin was digested with cathepsin D to obtain fragments similar to those of serum fibronectin. The capacity of fibronectin to bind IgA was examined with a mixture of purified IgA1 and cathepsin D-digested fibronectin fragments. A 43-kD carboxy-terminal fragment of fibronectin was detected in samples derived from sera of patients with IgA nephropathy but not in healthy control subjects. A similar-sized fragment was generated by cathepsin D digestion of the native molecule and was shown to bind to IgA1 in vitro. Since the carboxy-terminal domain is known to be critical in assembling exogenous fibronectin into the extracellular matrix, the affinity to IgA1 to a fragment found in patients may have pathogenic potential to mediate extracellular IgA deposition in IgA nephropathy.

Relation of olfactory event-related potentials to changes in stimulus concentration

OBJECTIVE

The aim of this study was to investigate the influence of odorant concentration on the olfactory event-related potential (OERP).

METHODS

OERP were evaluated in 8 men and 8 women (17-34 years of age) in response to 4 concentrations of vanillin (7, 28, 56 and 84% v/v). Sixteen presentations of each concentration (stimulus duration 200 ms, interval 40 s, flow 81/min) were applied in a randomized order. EEG recordings were made at 3 midline sites (pos. Fz, Cz, Pz). Amplitudes and latencies of four peaks were measured (latencies in ms at Pz after stimulation with 84% v/v vanillin): P1 (277), N1 (348), P2 (412) and P3 (496). Statistical analysis was performed with MANOVAs ('concentration', 'recording site' = within-subject-factors; 'age' as covariate).

RESULTS

With increasing stimulus concentration amplitudes became significantly larger; this was most pronounced for P3 (P1N1: F = 2.90, P < 0.05; N1P2: F = 5.15, P < 0.01; N1P3: F = 35.7, P < 0.001; P3: F = 38.6; P < 0.001). Correspondingly, latencies shortened with increasing concentrations (P1: F = 25.2; N1: 17.51; P2: 14.8; P3: 13.4; all P < 0.001). While there was no correlation between OERP amplitudes and butanol odor detection thresholds, latencies were the shorter the lower the subjects' thresholds (coefficients of correlations for peak latencies at Cz for 84% v/v: P1 rl5 = -0.59; N1 rl5 = 0.58; P2 r15 = -0.55; P3 r15 = -0.45).

CONCLUSIONS

The results indicated that both OERP amplitudes and latencies are related to the concentration of olfactory stimuli. They also suggested that latencies exhibit a stronger relation to changes in stimulus intensity compared to OERP amplitudes.

Acute tubulointerstitial nephritis associated with piperacillin therapy in a boy with glomerulonephritis

An 11-year-old boy with glomerulonephritis developed acute renal failure 4 days after beginning piperacillin (PIPC) treatment. Renal biopsy revealed acute tubulointerstitial nephritis (ATIN) with marked eosinophils. A lymphocyte stimulation test (LST) for PIPC demonstrated an extremely high LST index of 626%. The serum levels of immunoglobulin E and eosinophil cationic protein also showed a significant increase at 9021 IU/mL and greater than 150 micrograms/L, respectively. These observations suggest that a hypersensitivity reaction might play a role in the pathogenesis of ATIN. This is the first report to describe PIPC-induced ATIN in a child.

Laser-assisted uvulopalatoplasty with Nd:YAG laser for sleep disorders

We evaluated the apnea index (AI), the oxygen saturation above 95% (SA95), the lowest oxygen saturation (LSAT), and snoring before and after laser-assisted uvulopalatoplasty (LAUP) in 106 patients with obstructive sleep apnea syndrome (n=59) or snoring (n=47). Type 1 LAUP was performed in 42 patients and type 2 LAUP in 64 patients. A 50% or greater reduction in AI was observed in 15 patients (35.7%) who underwent type 1 LAUP and 37 patients (57.8%) who underwent type 2 LAUP. Snoring was diminished in 18 (51.4%) of 35 patients who underwent type 1 LAUP and 30 (55.6%) of 54 patients who underwent type 2 LAUP. SA95 and LSAT showed no difference. No serious complications such as significant bleeding, postoperative episodes of asphyxia, nasopharyngeal stenosis, or nasal regurgitation were observed. LAUP was an effective outpatient treatment.

An adolescent case of anti-neutrophil cytoplasmic autoantibodies-associated crescentic glomerulonephritis complicated with subclinical autoimmune thyroiditis

We report here a 15-year-old girl with myeloperoxidase anti-neutrophil cytoplasmic antibodies (MPO-ANCA)-associated crescentic glomerulonephritis (CreGN) and subclinical autoimmune thyroiditis. She was found to have proteinuria and hematuria by a school mass-screening a year before the first visit to the hospital, where a routine examination revealed blood urea nitrogen (BUN) 36.8 mg/dl and serum creatinine concentration of 1.63 mg/dl, although she had no apparent disabilities. On admission, the additional laboratory findings showed proteinuria of 1.06 g/day, hematuria of 3+, and a creatinine clearance of 30.1 ml/min. Hypocomplementemia was not observed. A renal biopsy revealed pauci-immune CreGN with 95% fibrocellular crescents, 84% sclerosis and/or hyalinosis and a massive cellular infiltration in the interstitium. She had MPO-ANCA of 865 EU/ml and an anti-thyroid microsome antibody titer of 1:1,600 without the detection of anti-glomerular basement membrane antibodies. Laboratory tests and scintigraphies for the thyroid gland did not show any abnormalities. Under the diagnosis of MPO-ANCA-associated CreGN, cocktail therapy consisting of prednisolone, cyclophosphamide, dilazep hydrochloride and warfarin was started. Improvement of urinary abnormalities and suppression of further deterioration of renal function were observed. Serial renal biopsy 6 months after the initiation of therapy showed decrement of interstitial cell infiltration and no generation of other crescentic glomeruli. The patient's serum titer of anti-thyroid microsome antibody was not affected by the adsorption of MPO-reacted IgG, suggesting that MPO-ANCA was not cross-reactive to thyroid microsome antigen.

[Amrinone (50 micrograms.kg-1.min-1) does not impair regional myocardial tissue metabolism during the 40%-decrease of left anterior descending coronary flow]

We investigated the effects of amrinone on metabolism of regional myocardial tissue during the 40%-decrease of left anterior descending coronary (LAD) flow in anesthetized dogs. Fourteen adult mongrel dogs weighing 15.4 +/- 5.1 kg were anesthetized with 0.5% isoflurane in 50% oxygen and ventilated mechanically to maintain normocapnia. After thoracotomy, regional myocardial tissue PO2 was measured using a monopolar polarographic needle electrode inserted in the myocardium. Electromagnetic blood flow probes were placed around LAD and circumflex artery. A 23-gauge catheter was inserted into a coronary vein which runs along LAD to obtain coronary venous blood for measuring oxygen content, lactate and pyruvate. A variable constrictor was placed distal to the flow-probe. After decreasing LAD flow for 40%, cardiac index (CI) decreased. Systemic venous resistance was decreased and CI was increased by amrinone (50 micrograms.kg-1.min-1) infusion. Myocardial tissue oxygen tension, venous lactate, lactate extraction, lactate-pyruvate ratio and excess lactate were all unchanged by amrinone. In conclusion, amrinone does not impair myocardial aerobic metabolism and increases CI under the stenosis of coronary artery.

[Effects of arterial carbon dioxide (PaCO2 not equal to 60 mmHg) on regional myocardial tissue oxygen tension and metabolism]

We investigated the effects of increased arterial carbon dioxide (PaCO2 not equal to 60 mmHg) on myocardial tissue oxygen tension and metabolism in anesthetized dogs. Ten adult mongrel dogs weighing 15.3 +/- 4.1 kg were anesthetized with 0.5% isoflurane in 50% oxygen and ventilated mechanically to maintain normocapnia. After thoracotomy, regional myocardial tissue PO2 was measured using a monopolar polarographic needle electrode inserted in the myocardium. Electromagnetic blood flow probes were applied on the left anterior descending artery and the circumflex artery. A 23-gauge catheter was inserted into a coronary vein to obtain coronary venous blood for measuring oxygen content, lactate and pyruvate. After control normocapnic ventilation, hypercapnia (PaCO2 62.7 +/- 3.2 mmHg) was induced by adding 10% carbon dioxide to the inspired gas for 20 minutes. As a result, the coronary blood flow and myocardial oxygen tension increased during hypercapnia. The myocardial lactate extraction and coronary venous lactate were unchanged and excess lactate was kept below zero, although coronary venous L/P ratio increased during hypercapnia. These results indicate that hypercapnia (PaCO2 not equal to 60 mmHg) increases coronary blood flow and myocardial oxygen tension, while myocardial aerobic metabolism is not impaired under hypercapnia.

[Myocardial metabolism, oxygen demand and oxygen supply during prostaglandin E1 induced hypotension]

The effects of hypotensive anesthesia induced by PGE1 on myocardial metabolism, oxygen demand and oxygen supply were studied. Nine mongrel dogs were anesthetized with pentobarbital and isoflurane. Mean blood pressure (MBP), cardiac output (CO), blood gases (BG), coronary blood flow (CBF), and myocardial tissue oxygen tension (MPO) were measured. Arterial and coronary venous lactate and pyruvate concentrations were also measured. We calculated myocardial oxygen consumption, L/P ratio, excess lactate, oxygen extraction ratio and lactate extraction ratio to estimate the adequacy of myocardial aerobic metabolism. CO and CBF decreased in accordance with MBP depression. Myocardial oxygen consumption decreased significantly with PGE1 administration. Lactate and pyruvate concentrations, L/P ratio, excess lactate and myocardial tissue oxygen tension were unchanged. These results suggest that PGE1 exerts no significant effect on myocardial metabolism during hypotensive anesthesia.

[The effects of adenosine-induced hypotension on myocardial metabolism]

The effects of hypotension induced by adenosine on myocardial metabolism were studied in ten mongrel dogs anesthetized with 0.5% isoflurane. Adenosine was infused intravenously to reduce mean arterial blood pressure by approximately 30% during a period of 20 min. Although heart rate was unchanged, cardiac output increased and coronary blood flow increased 3-fold of the preinfusion value. Oxygen tension of the myocardium, and oxygen extraction as well as lactate extraction of the myocardium decreased. Myocardial oxygen uptake and myocardial lactate uptake were unchanged, but lactate production was observed in three of ten dogs. In addition, coronary venous lactate/pyruvate ratio and excess lactate increased, and excess lactate became positive in five of ten dogs. The results suggest that adenosine-induced hypotension may inhibit the myocardial aerobic metabolism.

[Effect of 10% carbon dioxide on regional myocardial tissue oxygen tension and myocardial metabolism]

We investigated the effects of arterial carbon dioxide tension on myocardial blood flow, tissue oxygen tension and metabolism in the anesthetized dogs. Eighteen adult mongrel dogs weighing 13.4 +/- 3.6 kg were anesthetized with 0.5% isoflurane, intubated and ventilated mechanically with 50% oxygen to maintain normocapnia. Endtidal CO2 fraction (FECO2) was monitored continuously by capnograph. Regional myocardial tissue PO2 was measured using a monopolar polarographic needle electrode inserted to the myocardium. Electromagnetic blood flow probes were applied on the left anterior descending artery and circumflex artery. For cardiac venous blood sampling, a 23G intravenous catheter was inserted into the cardiac veins (great coronary veins) carefully. After normocapnic ventilation, hypocapnia was induced by increasing the respiratory rate, and hypercapnia was induced by adding 10% carbon dioxide to the inspired gas. The coronary blood flow and myocardial tissue oxygen tension increased during hypercapnia and the myocardial lactate extraction decreased, while excess lactate and cardiac venous L/P ratio increased during hypercapnia. These results indicate that hypercapnia increase coronary flow and myocardial tissue oxygen tension but myocardial aerobic metabolism is impaired during hypercapnia.

[Effect of hypotensive anesthesia on tissue oxygen tension of the heart, kidney and liver]

The effects of hypotensive anesthesia by prostaglandin E1 (PGE1: 8 dogs) or trimetaphan (TMP: 8 dogs) on tissue oxygenation were studied in 16 mongrel dogs anesthetized with pentobarbital. Mean blood pressure (MBP), heart rate (HR), cardiac output (CO), blood gases (BG), the blood flow and tissue oxygen tension of the heart, the kidney and the liver were measured. The blood flow and oxygen tension were measured by electromagnetic flowmeters and by polarographic oxygen electrodes respectively. PGE1 or TMP was injected intravenously to decrease MBP by 30%. MBP, CO, HR and BG of PGE1 were not significantly different with those of TMP. Coronary blood flow decreased for 12% with PGE1 and for 33% with TMP. Though blood flows of the renal and the hepatic arteries were well maintained with PGE1, they decreased for 36% and 34% respectively with TMP. Oxygen tensions of the myocardium (both outer and inner layers) and the liver were well maintained with PGE1. But with TMP, oxygen tension decreased for 23% in outer layer, for 16% in inner layer and for 31% in the liver. Oxygen tension of the kidney remained unchanged with PGE1 and TMP. The results suggest that PGE1 is more useful for the maintenance of the tissue oxygenation than TMP during hypotensive anesthesia.

Displacing effects of chenodeoxycholic acid, ursodeoxycholic acid and sulfadimethoxine on plasma protein binding of tolbutamide

The interactions between chenodeoxycholic acid (CDCA) or ursodeoxycholic acid (UDCA) and tolbutamide including its displacement from plasma protein binding sites were investigated pharmacokinetically. An increasing concentration of unbound tolbutamide was observed in the in vitro experiment, conducted by equilibrium dialysis method at 30 degrees C after the addition of CDCA and UDCA to human serum albumin (HSA), bovine serum albumin (BSA) and rabbit plasma containing tolbutamide. Small changes in total plasma concentration of tolbutamide were noted after high dose (0.167 mg/kg/min) intravenous infusion of CDCA to rabbits receiving a constant intravenous infusion of tolbutamide, but, such an observation was not obtained with low dose (0.083 mg/kg/min) of CDCA or with either high or low dose of UDCA. These results seem to indicate the displacement of high doses of CDCA. The coadministration of sulfadimethoxine which not only displaces tolbutamide from binding sites but also inhibits its metabolism was investigated. A different plasma pattern was obtained under the same intravenous infusion conditions, as compared with the plasma pattern resulting from tolbutamide-CDCA or UDCA combination.

Factors affecting the cholesterol dissolution ability of human bile

Bile samples were obtained from 13 patients with cholesterol gallstones at laparotomy. Control bile samples were obtained from 15 patients with gastric cancer or gastric ulcer. One mixed stone was cut in half and serial thin sections, 10 micrometers in thickness, were prepared from the cut surface. The solubility of cholesterol in these gallstone sections after immersion in the bile samples was observed microscopically after 1, 3, 5 and 24 hr. Of 15 control bile samples, 9 showed a marked cholesterol dissolution after 1 hr, and 6 showed it after 3 and 5 hr. Three out of 13 bile samples from the patients with cholesterol stones dissolved the gallstone section after 1 hr, and 7 after 3 and 5 hr. The dissolution was not observed in the remaining 3 bile samples. Cholesterol and total bile acid concentrations of the control bile were significantly higher than those of the bile from the cholesterol gallstone patients (p less than 0.05 and p less than 0.02, respectively). Correlative studies of the composition of bile and its ability to dissolve cholesterol revealed that bile samples with a high total bile acid concentration possessed a higher dissolution ability, even when the ratios of total bile acid to cholesterol were almost the same in control and cholesterol gallstone bile. On the basis of these findings, it may be concluded that the solubility of cholesterol in bile cannot simply be explained in terms of relative concentrations of cholesterol, phospholipids and total bile acid, because the absolute concentration of total bile acid also plays a significant role for the dissolution ability.

Bile acid composition affecting cholesterol dissolution rate: a use of multiple regression analysis

The dissolution rate of cholesterol in human gallbladder bile was measured by a rotating-disk method using 14C-labeled cholesterol, and was compared with concentrations of the biliary lipids. Computed multiple regression analysis of the results showed that the dissolution rate of cholesterol could be presented as a function of the concentrations of deoxycholic and chenodeoxycholic acid (multiple correlation 0.905; F-value 51.8 (p less than 0.001)). To examine the effect of different kinds of bile acids on cholesterol solubilization, the cholesterol solubility in a gallbladder bile with addition of a conjugated bile acid was determined. Greater solubilization of cholesterol was observed in the bile with addition of sodium deoxycholylglycine and chenodeoxycholylglycine than that with addition of sodium cholylglycine. There was no additional enhancement of the solubility with addition of sodium ursodeoxycholylglycine. These results suggest that the cholelitholytic effect of chenodeoxycholic acid may be greater than that of ursodeoxycholic acid, since the administration of chenodeoxycholic or ursodeoxycholic acid to patients with cholesterol gallstones induced different alterations of biliary bile acid composition.

Metabolism of chenodeoxycholic acid in hamsters

The study on the metabolism after oral administration of chenodeoxycholic acid-24-14C was performed by analysis of radioactivity that had appeared in bile and feces of male hamsters. The radioactive bile acids were analyzed by thin layer chromatography and identified by the isotope dilution method. In the bile of the hamsters with bile fistula, radioactivity was originated from unchanged chenodeoxycholic acid for the most part, and 7-ketolithocholic acid, lithocholic acid, and beta-muricholic acid for the remainder. In the feces lithocholic acid, dehydrolithocholic acid, isolithocholic acid, and unchanged form were identified. After the multiple dosing of chenodeoxycholic acid-24-14C for 6 days, beta-muricholic acid was also identified in the feces.