[Idiopathic myointimal hyperplasia of mesenteric veins: an unusual cause of diarrhoea]. / Idiopathische myo-intimale hyperplasie van de mesenteriale venen: een ongewone oorzaak van diarree.

BACKGROUND: The analysis of diarrhoea can be a diagnostic challenge. We present a patient with chronic diarrhoea, caused by idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV). IMHMV is a rare condition characterized by thickening of the vessel wall due to proliferation of smooth muscle cells in mesenteric veins, eventually causing intestinal ischemia. CASE DESCRIPTION: A 62-year-old man visited the gastroenterologist because of frequent watery diarrhoea. Initial endoscopic evaluation demonstrated venous congestion and erythema of the left-sided colon. Subsequently, he developed bloody diarrhoea, where endoscopy now revealed ischemic characteristics. CT scans and biopsies showed neither an occlusion of large arteries or veins nor histological features of inflammatory bowel disease. Eventually, the patient presented with an acute abdomen. Left hemicolectomy was performed, which resulted in the diagnosis of IMHMV. CONCLUSION: Prolonged diarrhoea, with a remarkable biphasic clinical and endoscopic presentation, without evidence of inflammatory bowel disease or occlusion of large arteries and veins, may be caused by IMHMV.

[Endoscopic removal of large colonic lipomas]. / Endoscopische verwijdering van grote dikkedarmlipomen.

Lipomas are benign tumours that are sometimes found in the colon, where they may cause symptoms through constriction and blood loss. Until recently, surgical removal of large lipomas was the therapy of choice, because of the danger of bleeding and perforation during endoscopy. The endoloop (PolyLoop, Olympus Medical Systems Corp., Tokyo, Japan), by use of which the base of the lipoma is constricted by a nylon loop, has changed this approach. We describe the successful removal of a large lipoma located in the ascending colon in 2 patients who were referred shortly after one another to the endoscopy department of our hospital. This endoscopic technique should be considered for removal of large pedunculated polyps in the intestine.

The impact of ANG II and IV on INS-1 cells and on blood glucose and plasma insulin.

The impact of angiotensin (ANG) for peripheral, global effects is well known. Local ANG systems including that of the insulin-releasing beta cell are not well investigated. In insulin-secreting cell line (INS-1), AT(1) and AT(4) receptors for ANG II and IV were demonstrated by Western blots. Only small amounts of ANG II-binding sites of low affinity were observed. ANG II and SARILE displaced binding of (125)I-ANG II. ANG II and IV as well as their non-degradable analogs SARILE and Nle-ANG IV increased the glucose-induced insulin release in a bell-shaped way; the maximum effect was at approximately 1 nM. The increase was antagonized by 1 microM losartan or 10 microM divalinal (AT(1) and AT(4) receptor antagonists, respectively). The insulin release was accompanied by a (45)Ca(2+) uptake in the case of ANG II and ANG IV. Divalinal abolished the effect of ANG IV and Nle-ANG IV on this parameter. ANG IV reduced the increase in blood glucose during a glucose tolerance test with corresponding, albeit smaller effects on plasma insulin. Using confocal laser scanning microscopy, transfected insulin-regulated aminopeptidase (IRAP) with AT(4) receptors was shown to be accumulated close to the nucleus and the cytosolic membrane, whereas GLUT4 was not detectable. IRAP was inhibited by ANG IV. In conclusion, AT(1) and AT(4) receptors may be involved in diabetic homeostasis. Effects are mediated by insulin release, which is accompanied by an influx of extracellular Ca(2+). The impact of ANG IV/IRAP agonists may be worth being used as antidiabetics.

Alcohol consumption and alcohol-related liver disease in The Netherlands.

BACKGROUND: No data have so far been published concerning the extent of the problem of alcohol-related liver diseases in The Netherlands. METHODS: Figures on alcohol consumption and admission and mortality rates due to alcohol-related liver disorders in The Netherlands in 1994 were obtained from various sources and the data were considered in a historical perspective. Special attention was paid to regional differences. RESULTS: The per capita alcohol consumption in 1994 in The Netherlands was 86 litres of beer, 16 litres of wine and 1.8 litres of pure alcohol as spirits. The total alcohol per capita consumption of individuals upwards of 15 years of age showed a decrease from 11.7 litres in 1975 to 9.7 litres in 1994. In the same period the estimated number consuming more than 10 cl pure alcohol (8 units) per day remained at about 180,000. The number of general hospital admissions as a result of alcohol-related liver disease as well as the number of deaths because of cirrhosis has hardly changed since 1985. In 1994, 657 men and 407 women were admitted due to alcohol-related liver disease, and 269 men and 125 women died from an alcohol-related liver disorder. The admission and mortality rates from alcohol-related liver disease differed markedly among the various provinces of The Netherlands.

[Immune thrombocytopenia attributed to norfloxacin]. / Immuuntrombocytopenie toegeschreven aan norfloxacine.

A 65-year-old woman developed haemorrhagic diathesis due to a profound thrombocytopenia (thrombocyte count: 1 x 10(9)/l) within one week after a 10-day course of norfloxacin (2 x 400 mg/day), prescribed for cystitis. On account of increased megakaryopoiesis in the bone marrow and absence of other causes of thrombocytopenia norfloxacin-induced immune thrombocytopenia was diagnosed. No norfloxacin-dependent antibodies against platelets were detected. Treatment with prednisone (1.5 mg/kg/day) resulted in the normalization of the platelet count within 5 days.

Heterochromatin in the chromosomes of the gorilla: characterization with distamycin A/DAPI, D287/170, chromomycin A3, quinacrine, and 5-azacytidine.

The chromosomes of the gorilla were extensively studied with various staining techniques labeling the different classes of heterochromatin. The chromosomal distribution of distamycin A/DAPI-, D287/170-, quinacrine-, and chromomycin A3-positive heterochromatic regions, as well as the nucleolus organizer regions, is described and compared with the karyotypes of other hominoid species. Lymphocyte cultures were treated with low doses of 5-azacytidine during the last hours of culture. This cytidine analog induces distinct undercondensation in 37 heterochromatic regions in the 24 gorilla chromosomes. The 5-azacytidine-induced undercondensations are localized not only in most of the distamycin A/DAPI-bright heterochromatic regions but also in many telomeric C-bands of the chromosomes. Furthermore, 5-azacytidine preserves the somatic pairing between heterochromatic regions from the interphase nuclei into the metaphase stage. The homeologies and differences in the chromosomal localization of the various classes of heterochromatin, 5-azacytidine-sensitive regions, 5-methylcytosine-rich DNA sequences, and satellite DNAs in the gorilla, chimpanzee, orangutan, and man are discussed.