Macroglobulinemia and membranoproliferative glomerulonephritis in a hepatitis C virus-positive patient.

A 72-year-old female was admitted to our hospital for massive proteinuria. She had previously been diagnosed with hepatitis C virus (HCV) infection and macroglobulinemia. Renal histological examination demonstrated membranoproliferative glomerulonephritis (MPGN), and type 2 cryoglobulinemia was positive in her serum. It is generally recognized that MPGN is the most common nephritis associated with HCV infection and cryoglobulinemia, but this is the first report of an HCV-infected patient with macroglobulinemia associated with MPGN. After treatment with prednisolone and melphalan, proteinuria disappeared, but macroglobulinemia and cryoglobulinemia were not improved.

[Multiple colonic ulcers in a patient with Sjögren's syndrome].

A 25-year-old female with Sjögren's syndrome was admitted to our hospital because of fever and abdominal pain. Multiple colonic ulcers were demonstrated by gastrographin enema and colonoscopy. Histological examination revealed the presence of necrotizing vasculitis in the submucosal region. Large dose of prednisolone (60 mg/day) brought a prompt relief of her symptoms and an improvement of positive inflammatory signs. Pseudoaneurysm in the arteria colica media, which had been demonstrated by abdominal selective angiography at the time of diagnosis, became extinct after the steroid treatment. Healing of ulcers were also noted by colonoscopy. A variety of extraglandular symptoms has been reported in Sjögren's syndrome. Multiple colonic ulcers due to vasculitis are rarely complicated but may have a great impact on the prognosis of the disease.

Effect of low-dose cyclosporin A on systemic lupus erythematosus disease activity.

OBJECTIVE: To determine the effect of low-dose cyclosporin A (CSA) treatment on disease activity in systemic lupus erythematosus (SLE). METHODS: All patients in the study had active disease as defined by at least the presence of a low CH50 level. Patients were initially given 3 mg/kg/day of CSA. Dosages were adjusted individually at every visit, according to both clinical and laboratory data. RESULTS: Eleven women with SLE were enrolled in the study; 10 were evaluable. After 20 weeks of CSA treatment, the mean score for disease activity on the SLE Disease Activity Index decreased significantly, from 10.6 to 3.8 (P = 0.02). The titer of antinuclear antibodies decreased in 8 patients and the level of anti-DNA antibodies decreased in 5. Side effects included hypertension (40%), hypertrichosis (30%), gingival hypertrophy (10%), and a rise in the blood urea nitrogen level. Serum creatinine levels remained unchanged. CONCLUSION: The favorable responses observed in our patients strongly suggest that low-dose CSA can reduce the disease activity of SLE.

[5-FU concentration in the blood and tissue of patients with gastric and colorectal cancer after administration of UFT or tegafur].

UFT or tegafur (5, 7.5 and 15 mg/kg, respectively) were given to Donryu rats with AH-130 cancer twice a day for 3 days, and 5-FU concentrations in the blood, tumor, normal stomach and large bowel tissues were measured by chemical assay and compared. The 5-FU concentrations in the tumor were higher than those of normal tissues and still remained 12 hours after the final dosage. According to increased UFT dosage, there were significantly higher levels of 5-FU concentration in tumor tissues but blood levels of 5-FU were low. The peak of concentration occurred at one to two hours after the final dosage. However, increase in tegafur dosage volume did not correlate with 5-FU levels. Clinical cases (74 patients) of gastric and colorectal cancer were orally administered UFT or tegafur at 300 mg twice a day for 3 days preoperatively. Materials were obtained at surgery at 5.5 hours on average after the final dosage and 5-FU levels in tissues were measured by chemical assay. Concentrations of 5-FU in cancerous tissues after UFT administration were 0.177 +/- 0.131 micrograms/g in gastric cancer and 0.130 +/- 0.051 micrograms/g in colorectal cancer, while in patients to whom tegafur had been administered, the concentrations were 0.194 +/- 0.124 micrograms/g and 0.119 +/- 0.075 micrograms/g, respectively. There was no significant difference in 5-FU levels between the UFT-administered group and the tegafur group.

[Study on the correlation between tissue uptake of anticancer agents and prognosis -- with special reference to Tegafur].

Advanced gastric cancer cases (42 cases) undergone gastrectomy were studied on the correlation between tissue uptakes and prognosis. The patients were administrated Tegafur preoperatively and tissue samples were obtained intraoperatively, 5-FU levels in tumor and lymph node were measured by GCMF. The patients, being measured 5-FU uptake by tissue and received Tegafur over 60 g as postoperative adjuvant chemotherapy, were divided into two groups; namely, one with 5-FU up take by tumor tissue and lymph node was higher than 0.05 mcg/g and the other with lower than 0.05 mcg/g. Both groups showed no significant difference in background factors. Each survival rate was calculated by Kaplan-Meier method and examined by generalized Wilcoxon method. As the result, there was no significant correlation in the 5-FU uptake by tumor and prognosis, but prolongation of survival rate in the group of 5-FU uptake by lymph node over 0.05 mcg/g was suggested.

The correlation of antibodies to nuclear ribonucleoprotein (RNP) and nuclear acidic protein (Sm) with nephritis in patients with systemic lupus erythematosus (SLE).

The role of antibodies to Sm and RNP in renal diseases in SLE was investigated using counter immunoelectrophoresis (CIE). Antibody to RNP was found in about 50% of lupus patients irrespective of the degree of renal involvement as evaluated clinically, histologically and immunopathologically. Antibody to Sm was found more frequently in lupus patients with renal lesions than in those without renal disease. Antibody to RNP was demonstrated in 8 of 10 (80%) and antibody to Sm in 4 of 10 (40%) specimens obtained by elution of autopsied kidneys. These results suggest that antibodies to RNP and Sm are also of importance in the pathogenesis of lupus nephritis in addition to the already recognized role of antibody to ds-DNA.