A hypoxia-dependent upregulation of hypoxia-inducible factor-1 by nuclear factor-κB promotes gastric tumour growth and angiogenesis.

BACKGROUND: The underlying mechanisms involved in the activation of hypoxia-inducible factor-1 (HIF-1) in gastric cancer remain unclear. As nuclear factor-κB (NF-κB) as well as HIF-1 have been implicated in angiogenesis of various cancers, we investigated their relationship in gastric cancer. METHODS: Nuclear expressions of HIF-1α and NF-κB/RelA were assessed in 251 human gastric carcinoma specimens by immunohistochemical tissue array analysis. Stable human gastric cancer cells, infected with a retroviral vector containing super-suppressive mutant form of IκBα (IκBαM), were used for animal studies as well as cell culture experiments. Xenografted tumours were measured and IκBαM effects on angiogenesis and HIF-1α activation were assessed by immunohistochemistry, western blotting, luciferase reporter assay, and semiquantitative reverse transcription-polymerase chain reaction. In addition, NF-κB effects on the HIF-1α degradation and synthesis were examined. RESULTS: Hypoxia-inducible factor-1α activation positively correlated with RelA activation in clinical gastric cancer samples (P<0.001). The IκBαM overexpression suppressed tumour growth, microvessel density, and HIF-1α activation in xenografted tumours. Cell culture experiments showed that hypoxia-induced HIF-1α expression was reduced by NF-κB inhibition under hypoxic conditions at the translational level. CONCLUSION: The hypoxia-dependent activation of the NF-κB/HIF-1α/VEGF pathway contributes, at least in part, to gastric cancer promotion via enhancement of angiogenesis.

Hyperuricaemia and accelerated reduction in renal function.

OBJECTIVES: Hyperuricaemia has been linked to reduced renal function, and evidence indicates that it may be associated with acceleration of the decline in glomerular filtration rate (GFR) and progression of chronic kidney disease (CKD). METHODS: We analysed a population of subjects who had undergone serum uric acid (SUA) and serum creatinine measurements in a hospital-based cohort. Initial and final serum creatinine measurements were used to calculate the estimated glomerular filtration rate (eGFR) and the annual decline in eGFR. Cox regression was used to investigate the relationship between SUA and CKD progression. RESULTS: A total of 63,785 subjects were enrolled in the study during a 12-year follow-up period. The mean age at the time of initial serum creatinine measurement was 50.0 ± 14.9 years. Hyperuricaemic subjects had a significantly larger annual eGFR decline, both in absolute terms (2.5 ± 9.5 mL/min/1.73 m(2) per year) and as a percentage (2.8 ± 11.6% per year), as compared to the normouricaemia group (1.3 ± 9.6 mL/min/1.73 m(2) per year, 1.1 ± 11.1% per year, p < 0.001). After adjustment for age, sex, status of diabetes mellitus (DM) and hypertension, baseline eGFR, azotaemia, hypercholesterolaemia, and hyperglycaemia, hyperuricaemia was associated with a hazard ratio (HR) of 1.28 [95% confidence interval (CI) 1.23-1.33, p < 0.001] for an accelerated eGFR decline ≥ 3 mL/min/1.73 m(2) per year and an HR of 1.52 (95% CI 1.46-1.59) for CKD progression at the end of follow-up. CONCLUSION: Hyperuricaemia was associated with an accelerated decline in eGFR and higher risk of CKD progression. Therefore, renal function should be monitored closely in patients with hyperuricaemia.

Gout and risk of non-alcoholic fatty liver disease.

OBJECTIVES: To investigate the association between gout and non-alcoholic fatty liver disease (NAFLD). METHODS: The study subjects were participants in a health-screening programme at Chang Gung Memorial Hospital from 2000 to 2006. Subjects were classified into eight groups based on serum urate (SU) level and gout status (≤ 4.9, 5.0-6.9, 7.0-8.9, and ≥ 9.0 mg/dL, without and with gout). The association between gout and NAFLD was assessed by multiple logistic regression. RESULTS: Among a total of 54 325 subjects, 1930 (3.6%) had gout and 6169 (11.3%) had NAFLD. The prevalence of NAFLD was significantly higher in subjects with gout (23.1%, n = 445) than in those without gout (10.9%, n = 5724, p < 0.001). Among subjects with NAFLD, the severity of NAFLD was higher in gout patients. Gout was associated with an increased risk for NAFLD [odds ratio (OR) 1.42, 95% confidence interval (CI) 1.25-1.60, p < 0.001], after adjustment for age, sex, presence of metabolic syndrome, and low estimated glomerular filtration rate (eGFR). With SU ≤ 4.9 mg/dL in the absence of gout as reference, the ORs (95% CI) for NAFLD, after adjustment for age, sex, presence of metabolic syndrome, and low eGFR, were, respectively, 2.16 (1.94-2.41), 3.98 (3.55-4.46), and 5.99 (5.19-6.90) for SU levels 2-4 in those without gout and 2.61 (1.39-4.91), 2.87 (2.04-4.04), 4.53 (3.70-5.56), and 6.31 (5.12-7.77) for SU levels 1-4 in those with gout. CONCLUSIONS: There was an independent association between gout and the risk for NAFLD. In addition, there was a dose-response relationship between SU and NAFLD in subjects with and without gout.

Methanolic extract of Kigelia africana exhibits antiatherosclerotic effects in endothelial cells by downregulating RAGE and adhesion molecules.

The Kigelia plant is used in African countries for its medicinal properties. Kigelia africana is an interesting example of a medicinal plant due to its pharmacological activities, including its anti-inflammatory effect. Atherosclerosis, the primary cause of cardiovascular disease, is related to lipoprotein oxidation, inflammation and immune responses involving the vascular endothelium and immune cells. Therefore, in this study we investigated the effects of Kigelia africana (Lam.) extract, focusing particularly on antiatherosclerotic effects in endothelial cells (ECs). The methanolic extract of Kigelia africana (MKA) showed no cytotoxicity on ECs at doses of 10~200 µg/ml. MKA reduced RAGE expression on oxLDL- or TNF-α-stimulated ECs in a dose dependent manner, showing significant inhibition at a concentration of 50 µg/ml. In addition, MKA significantly inhibited the oxLDL- or TNF-αinduced expression of vascular cell adhesion molecule-1 (VCAM-1) in ECs in a dose-dependent manner but did not affect intracellular adhesion molecule-1 (ICAM-1), resulting in downregulation of the migration and adhesion of THP-1 monocytes to ECs. These results suggest that MKA could be used for the treatment of atherosclerosis without cytotoxicity.

Heterogeneity of myocardial sleeve morphology and gap junctions in canine superior vena cava.

BACKGROUND: The myocardial sleeve of the superior vena cava (SVC) has been identified as a potential initiating focus in atrial fibrillation, but information on cell-to-cell linkage at this site is lacking. METHODS AND RESULTS: We examined the SVC in 8 dogs by immunoconfocal and electron microscopy. Cardiomyocytes outlined with vinculin and bearing striations positive for alpha-actinin are found in the proximal segment of the SVC. These cells, grouped in bundles of various orientations according to location, extend cephalically as far as 3 cm from the right atrium (RA)-SVC junction. Comparison between the junctional level and the level 2 cm distal shows that the myocardial layer in the latter is thinner and not as compact and is composed of longer cells (87.3+/-15.7 versus 71.6+/-14.4 micrometer, P<0.01). Gap junctions made of connexin43 (Cx43), Cx40, and Cx45 are aggregated mainly at the intercalated disks, and colocalization of connexins is a common feature throughout the myocardial sleeve. Areas of atypical expression exist, however, characterized by a center of abundant Cx43 labels surrounded by a periphery of scattered tiny Cx40-labeled spots. Although in the ventral subluminal compact myocardial layer, individual cells at both levels are surrounded by similar numbers of cells, the number of aggregation of labeled gap junctions at the distal level is less (2.3+/-0.6 versus 3.7+/-0.9, P<0.01). In addition, electron-microscopic examination demonstrates that the gap junctions at the distal level are smaller in size (0.37+/-0.30 versus 0.55+/-0.34 micrometer, P<0.01). CONCLUSIONS: The myocardial sleeve in the canine SVC is a heterogeneous structure, which could potentially form a substrate for heterogeneity of electrical coupling.

Regional differentiation of desmin, connexin43, and connexin45 expression patterns in rat aortic smooth muscle.

The gap-junctional protein, connexin43, is differentially expressed in vascular smooth muscle cells (SMCs) according to phenotype. Previous studies suggest that desmin-negative SMCs are characterized by high levels of connexin43, whereas desmin-positive SMCs (of a more contractile phenotype) typically have low connexin43 levels. In this study, we examine systematically the inverse relationship between connexin43 and desmin in SMCs of defined regions of the rat aortic media and determine whether additional connexin isotypes are expressed and contribute to this relationship. Immunoconfocal microscopy demonstrated that (1) the inverse relationship between connexin43 and desmin expression holds true for the media of sequential aortic zones, with 1 exception, the ascending aorta, and (2) an additional vascular connexin, connexin45, is expressed by aortic SMCs. Examination of connexin43, connexin45, and desmin expression in sequential aortic zones reveals 3 SMC subpopulations. The first, predominating in the aortic arch and thoracic aorta, is desmin negative and contains high connexin43 levels; the second, predominating in the abdominal aorta and iliac artery, is desmin positive and contains low connexin43 levels; and the third, which is restricted to the ascending aorta, is desmin positive and expresses high connexin43 levels. Connexin45 levels are high in the ascending aorta but low in the other aortic segments. In para-aortic veins, a fourth SMC subpopulation appears, one that is desmin positive and contains connexin45 but not connexin43. These results demonstrate that a diversity of connexin expression patterns characterizes distinctive subpopulations of medial SMCs in situ with a potential to contribute to regional differentiation of vascular function.

Inverse relationship between connexin43 and desmin expression in cultured porcine aortic smooth muscle cells.

Our previous work has shown that in vascular tissues the elastic medial regions express high levels of the gap junctional protein, connexin43, but low levels of desmin, while the muscular medial regions express low levels of connexin43 but high levels of desmin. It is uncertain, however, whether this regional difference at the tissue level extends down to the level of the individual cell, or reflects an averaged relationship of groups of cells of different connexin43 and desmin expression. The present study has addressed this question using cultured porcine aortic smooth muscle cells. Immunoconfocal microscopic analysis of single-labeled cells showed that while smooth muscle alpha-actin, calponin and vimentin were positively labeled in the majority of medial smooth muscle cells both in intact porcine aorta and corresponding cultured cells, desmin and connexin43 labeling was highly heterogeneous. In the cultured cells, 0.3-0.5% of cells were found to be desmin-positive, and quantitative analysis after double labeling for desmin and connexin43 revealed that the desmin-positive cells were smaller, and contained significantly lower numbers and smaller sizes of connexin43 gap-junctional spots than did desmin-negative cells. Our findings demonstrate that an inverse expression pattern of connexin43 and desmin holds true at the level of the individual cell. This suggests a close relationship between intrinsic phenotypic control and the regulation of connexin43 expression in the arterial smooth muscle cell.

The Gln-Arg 191 polymorphism of the human paraoxonase gene is not associated with the risk of coronary artery disease among Chinese in Taiwan.

Paraoxonase (PON1) is a high density lipoprotein-associated enzyme capable of hydrolyzing lipid peroxides, and thus, might protect lipoproteins from oxidation. A common polymorphism due to an amino acid substitution (Gln-Arg) at codon 191 is considered to be a major determinant of variation in serum PON1 activity. Recent studies have suggested that the PON1-191 polymorphism is an independent risk factor for coronary atherosclerosis in patients with or without diabetes mellitus. The association of PON1-191 polymorphism genotypes and coronary artery disease (CAD) among Chinese subjects in Taiwan was examined. The genotype of 218 angiographically documented CAD patients and the same number of age- and sex-matched control subjects was determined. Genotypes AA, AB and BB were present in 25 (11%), 102 (47%) and 91 (42%) of control subjects, respectively, and in 30 (14%), 96 (44%) and 92 (42%) of CAD patients, respectively (chi2 = 0.57, P = 0.75 between groups). The frequency of the A allele was 0.36 for the control group and 0.35 for CAD patients (P = 0.94). No significant differences in the PON1-191 genotype frequencies could be found between groups when multivariate logistic regression analysis was performed, or different subgroups of age, sex or risk factors were analyzed. Among control subjects, there was also no significant difference between genotypes of the PON1-191 polymorphism and various clinical and lipid variables. In conclusion, our data suggest that there is no association between the Gln-Arg 191 polymorphism of the human PON1 gene and CAD among Chinese subjects in Taiwan.

Design and pharmacological activity of phosphinic acid based NAALADase inhibitors.

A novel series of phosphinic acid based inhibitors of the neuropeptidase NAALADase are described in this work. This series of compounds is the most potent series of inhibitors of the enzyme described to date. In addition, we have shown that these compounds are protective in animal models of neurodegeneration. Compound 34 significantly prevented neurodegeneration in a middle cerebral artery occlusion model of cerebral ischemia. In addition, in the chronic constrictive model of neuropathic pain, compound 34 significantly attenuated the hypersensitivity observed with saline-treated animals. These data suggest that NAALADase inhibition may provide a new approach for the treatment of both neurodegenerative disorders and peripheral neuropathies.

Connexin make-up of endothelial gap junctions in the rat pulmonary artery as revealed by immunoconfocal microscopy and triple-label immunogold electron microscopy.

Integration of vascular endothelial function relies on multiple signaling mechanisms, including direct cell-cell communication through gap junctions. Gap junction proteins expressed in the endothelium include connexin37, connexin40, and connexin43. To investigate whether individual endothelial cells in vivo express all three connexin types and, if so, whether multiple connexins are assembled into the same gap junction plaque, we used affinity-purified connexin-specific antibodies raised in three different species to permit multiple-label immunoconfocal and immunoelectron microscopy in the rat main pulmonary artery. Immunoconfocal microscopy showed a high incidence of co-localization between connexin43 and connexin40, but lower incidences of co-localization between connexin37 and connexin40 or connexin43. Immunoelectron microscopy revealed that 83% of gap junction profiles contained all three connexins, with the proportion of connexin40 labeling being significantly higher than that of connexin37 or connexin43. The presence of three different connexin types of distinct properties in vitro provides potential for complex regulation and functional differentiation of endothelial intercellular communication properties in vivo.

Age-related alteration of gap junction distribution and connexin expression in rat aortic endothelium.

We investigated endothelial gap junctions and their three component connexins, connexin37 (Cx37), Cx40, and Cx43, during growth and senescence in rat aorta by en face immunoconfocal microscopy and electron microscopy. Gap junction spots labeled by specific antisera against Cx37, Cx40, and Cx43 were quantified at 1 day, 7 days, 28 days, 16 months, and > or =20 months of age, and the relationship between the connexins was examined by co-localization analysis. At birth, all three connexins were abundantly expressed; the number and total area of connexin spots then declined within 1 week (p<0.05 for each connexin). From 1 week, each connexin showed a distinct temporal expression pattern. Whereas Cx43 signal decreased progressively, Cx37 signal fluctuated in a downward trend. By contrast, Cx40 maintained an abundant level until > or =20 months of age (> or =20 months vs. 28 days, p<0.05 for number and total connexin signal area). These patterns were associated with changes in endothelial cell morphology. Double-label analysis showed that the extent of co-localization of connexins to the same gap junctional spot was age-dependent [>70% at birth and 28 days old; <70% at later stages (p<0.05)]. We conclude that expression of the three connexins in aortic endothelium is age-related, implying specific intercellular communication requirements during different stages after birth.

On-line multiplane transesophageal echocardiography for balloon mitral commissurotomy.

This study describes in detail the technique and results of on-line multiplane transesophageal echocardiographic guidance of balloon mitral commissurotomy in 150 consecutive patients with symptomatic mitral stenosis. The mitral valve area improved significantly and there were no in-hospital deaths, strokes, or emergency valve operations.

Immunocytochemical analysis of connexin expression in the healthy and diseased cardiovascular system.

Gap junctions play essential roles in the normal function of the heart and arteries, mediating the spread of the electrical impulse that stimulates synchronized contraction of the cardiac chambers, and contributing to co-ordination of activities between cells of the arterial wall. In common with other multicellular systems, cardiovascular tissues express multiple connexin isotypes that confer distinctive channel properties. This review highlights how state-of-the-art immunocytochemical and cellular imaging techniques, as part of a multidisciplinary approach in gap junction research, have advanced our understanding of connexin diversity in cardiovascular cell function in health and disease. In the heart, spatially defined patterns of expression of three connexin isotypes-connexin43, connexin40, and connexin45-underlie the precisely orchestrated patterns of current flow governing the normal cardiac rhythm. Derangement of gap junction organization and/or reduced expression of connexin43 are associated with arrhythmic tendency in the diseased human ventricle, and high levels of connexin40 in the atrium are associated with increased risk of developing atrial fibrillation after coronary by-pass surgery. In the major arteries, endothelial gap junctions may simultaneously express three connexin isotypes, connexin40, connexin37, and connexin43; underlying medial smooth muscle, by contrast, predominantly expresses connexin43, with connexin45 additionally expressed at restricted sites. In normal arterial smooth muscle, the abundance of connexin43 gap junctions varies according to vascular site, and shows an inverse relationship with desmin expression and positive correlation with the quantity of extracellular matrix. Increased connexin43 expression between smooth muscle cells is closely linked to phenotypic transformation in early human coronary atherosclerosis and in the response of the arterial wall to injury. Current evidence thus suggests that gap junctions in both their guises, as pathways for cell-to-cell signaling in the vessel wall and as pathways for impulse conduction in the heart, contribute to the initial pathogenesis and eventual clinical manifestation of human cardiovascular disease.

Effects of ginsenosides on vanilloid receptor (VR1) channels expressed in Xenopus oocytes.

Ginsenosides, or ginseng saponins, are biologically active ingredients of Panax ginseng. Accumulating evidence suggests that ginsenosides can alleviate pain from injections of noxious chemicals, such as capsaicin [Nah et al. (2000)]. In this study we examined the effects of ginsenoside Rc on the capsaicin-induced inward current in Xenopus oocytes that expresses the vanilloid receptor 1 (VR1). Ginsenoside Rc enhanced the capsaicin-induced inward current in a concentration-dependent and reversible manner, but ginsenoside Rc itself elicited no membrane currents. The VR1 antagonist capsazepine almost completely blocked the inward current that was elicited by capsaicin plus ginsenoside Rc. We also tested the effect of seven other fractionated ginsenosides (i.e., Rb1, Rb2, Rd, Re, Rf, Rg1, and Rg2) in addition to ginsenoside Rc. We found that six of them significantly enhanced the inward current that is induced by capsaicin with the following order of potency: Rc > Rf > Rg1 approximately Rd > Rb2 > Rb1. These results show the possibility that the in vivo effect of ginsenosides against capsaicin-induced pain is derived from their modulation of the VR1 channel function.

Dietary taurine intake and serum taurine levels of women on Jeju Island.

The purpose of this study was to investigate the dietary taurine intake and serum taurine levels of women on Jeju Island in Korea. Sixty six married women aged 43.5 +/- 7.1 volunteered for this study: 34 from the city area and 32 from two fishing-farming areas. Diet samples were collected from the participants; the samples included three meals (breakfast, lunch and supper), including snacks, drinks and whatever else the participants had eaten for 24 hours. Taurine levels in the diet and serum were determined as the dabsyl derivative by HPLC with a Rf-detector. The intake of taurine ranged from 8.4 to 767.6 mg/day and its mean value was 163.9 +/- 150.2 mg/day (mean +/- SD). There was a significant difference between the two groups: 114.9 +/- 78.7 for the women from the city area and 215.9 +/- 187.9 mg/day for the women from the fishing-farming areas (p<0.001). The taurine intake of the total diet, including all snacks and drinks, was 2300 +/- 584 g/day for the city area and 2342 +/- 528 g/day for the fishing-farming areas. The daily protein intake was 58.8 +/- 16.4 g for the women of the city area and 65.5 +/- 17.1 g for the women of the fishing-farming areas. There was a significant correlation between the intake of fish/shellfish and taurine (p=0.001) while there was no correlation between the intake of protein and taurine (p=0.057). The taurine levels in serum ranged from 68.6 to 261.6 micromol/L and the mean value was 169.7 +/- 41.5 micromol/L. There was no significant difference between the women from the city area and the women from the fishing-farming areas in serum taurine levels. The correlations of serum taurine levels with serum retinol levels (p=0.016) and alpha-tocopherol (p=0.014) levels were significant. These results suggest that taurine intake is dependent on the fish/shellfish intake and that taurine may play an important role in the retention of antioxidative nutrients.

Lack of association between the Glu298Asp variant of the endothelial nitric oxide synthase gene and the risk of coronary artery disease among Taiwanese.

BACKGROUND AND PURPOSE: Endothelial nitric oxide synthase (eNOS) plays a key role in atherosclerosis, because its product, nitric oxide, possesses antiatherogenic properties. Recent reports of molecular genetic analysis have suggested that genetic polymorphisms of the eNOS gene may be associated with coronary artery disease (CAD) or myocardial infarction (MI). However, some studies have reported discrepant results. The aims of this study were to assess whether any association exists between the Glu298Asp variant of the eNOS gene and the risk of CAD and/or MI among Taiwanese. METHODS: The subjects included 218 CAD patients and the same number of age- and sex-matched control subjects from Taiwan. Subjects' DNA was extracted from their blood and genotypes were determined by polymerase chain reaction and restriction mapping using the restriction enzyme MboI. The alleleic and genotypic frequencies were analyzed. RESULTS: The frequencies of the eNOS genotypes were similar for CAD patients (GG:GT:TT = 81.7%:17.4%:0.9%) and controls (81.2%:17.4%:1.4%; p = 0.904). No evidence of difference was found in the frequency of the T allele between CAD patients (9.6%) and controls (10.1%; p = 0.822), or between MI patients (7.5%) and controls (p = 0.322). Subjects with the GT or TT genotype did not demonstrate an increased risk of CAD compared with those with a GG genotype (p = 0.89; OR = 0.98; 95% confidence interval, CI, 0.76-1.27) in multivariate logistic regression, or when different subgroups of age, sex, or risk factors were analyzed. CONCLUSIONS: In the present case-control study, we found no evidence of an association between the Glu298Asp variant of the eNOS gene and CAD/MI among Taiwanese.

Prevalence of hepatitis B and C virus infection among women in Jeju Island, Republic of Korea.

Hepatitis B and C virus infection prevalence was investigated in the Island of Jeju (formerly Cheju), the Republic of Korea, by means of a small-scale sero-epidemiological survey in 2000. Adult women in the city of Jeju (the provincial capital) and two fishing-farming villages A and B were invited to offer venous blood samples for immunological examination for infection markers of two virus and serum biochemistry for liver function. In practice, 66 married women (33, 16 and 17 women from the city, Village A and Village B, respectively) volunteered. Sera were separated on site and were assayed for HBsAg, anti-HBs, anti-HBc, and anti-HCV positivities and liver function markers including AST, ALT and gamma-GTP. The serum assay showed that the prevalence of HbsAg+ or anti-HCV+ cases was low (5 and 2%, respectively), whereas that of anti-HBs+ and anti-HBc+ cases were high (71 and 62%) so that the over-all HBV positivity was 82%. There were essentially no urban-rural difference or age-dependent changes in the positivity. Comparison with the prevalence reported in literature shows that prevalence of HBsAg+ and anti-HCV+ is in general agreement with the values reported for the populations in general, but HBV+ prevalence might be somewhat higher than the levels reported for the general populations.

[Clinical significance of changes in the serum level of endogenous digitalis-like factor in patients with chronic congestive heart failure].

Determination of serum endogenous digitalis-like factor (EDF) concentration was carried out in 52 patients with chronic congestive heart failure with radioimmunoassay. The results showed that concentration of serum EDF in patients with chronic congestive heart failure was significantly lower than that in normal subjects (P less than 0.001). The lowering of serum EDF concentration was significantly negatively correlated with the severity of heart failure, r = 0.6475, P less than 0.001. Age had no significant effect on serum EDF concentration (P greater than 0.05). Serum EDF concentration rose after the heart failure was treated, but was still lower than that in normal subjects (P less than 0.01). Serum EDF concentration in patients with coronary heart disease was the lowest and in patients with hypertension the highest.

QT interval is prolonged but QT dispersion is maintained in patients with primary aldosteronism.

The relationship between QT duration and its dispersion in patients with primary hyperaldosteronism is not clearly known. We studied 26 patients (nine males and 17 females) with primary hyperaldosteronism. The serum potassium levels were low (2.32 +/- 0.52 mmol/l), did not correlate with serum renin or aldosterone levels, or aldosterone/renin ratio (ARR). The maximum QT intervals (QTmax) were prolonged (502 +/- 62 ms), correlated well with ARRs (p = 0.005) and aldosterone levels (p = 0.019), but not to renin (p = 0.517) or potassium levels (p = 0.196). The QT dispersions (QTd) were small (60 +/- 28.8 ms) and did not correlate with potassium, renin or aldosterone levels. QTmax but not QTd correlate with aldosterone levels in patients with primary aldosteronism. The maintenance of repolarisation homogeneity with relatively unchanged QT dispersion may contribute to our understanding of the clinical observation that ventricular tachydysrhythmia is rare among patients with primary aldosteronism.

Carcinoma of the colon in a child.

A 13-year-old boy presented with carcinoma of the ascending colon. He had had intermittent abdominal pain for about one year, with body weight loss, prior to admission. Physical examination showed diffuse abdominal tenderness, but no palpable mass. Lower GI barium study and colonofibroscopic examination showed a protruding mass over the proximal ascending colon. At operation, right hemicolectomy with ileotransversecolostomy was performed, the pathologic finding was adenocarcinoma, signet-ring cell type. Although chemotherapy with 5-fluorouracil, mitomycin, and levamisole were given subsequently, the patient expired one year after surgery because of multiple metastasis. Carcinoma of the colon is extremely rare in the young. Mucin-producing adenocarcinoma is the most predominant type of colon cancer, and most are of signet-ring cell carcinoma. While prognosis is relatively bright in adult, the prognosis is quite unfavorable in children because of the preponderance of the poor histological characteristics and the difficulty of diagnosis.