Antenatal fibrinogen concentrations and postpartum haemorrhage.

BACKGROUND: It is unclear whether antenatal fibrinogen concentrations are associated with postpartum haemorrhage. METHODS: This retrospective study included 871 women with a singleton pregnancy but no known risk factors for postpartum haemorrhage, in whom fibrinogen concentration was measured within the 21 days before delivery. Correlation between antenatal fibrinogen concentrations and estimated blood loss was analysed. We tested the hypothesis that the risk of postpartum haemorrhage was higher in women with antenatal fibrinogen concentrations of <3.3 g/L. Postpartum haemorrhage was defined as an estimated blood loss ⩾700 mL following vaginal delivery and ⩾1000 mL following caesarean delivery. RESULTS: In women delivering vaginally (n=337), estimated blood loss tended to increase with decreasing antenatal fibrinogen concentration (R=-0.107, P=0.05), median fibrinogen concentration was significantly lower in 69 women with postpartum haemorrhage than in 268 women without postpartum haemorrhage (3.93 vs. 4.18 g/L, P=0.025), and postpartum haemorrhage occurred significantly more often in women with fibrinogen concentrations <3.3 g/L than in those with concentrations ⩾3.3 g/L (38% [11/29] vs. 19% [58/308], P=0.018). In women undergoing caesarean delivery (n=534), median fibrinogen concentration did not differ between those who experienced postpartum haemorrhage (n=128) and those who did not (n=406) (4.18 g/L vs. 4.07 g/L, P=0.43). Antenatal fibrinogen concentrations of <3.3g/L were not associated with higher rates of postpartum haemorrhage (26% [11/43] vs. 24% [117/491], P=0.80). CONCLUSIONS: Antenatal fibrinogen concentration <3.3g/L may be a risk factor for postpartum haemorrhage among women following vaginal delivery.

The relationship between a leaf-rolling moth (Dactylioglypha tonica) and fungi covering the cocoon.

To discover the relationship between a leaf-rolling moth and the fungi densely covering its cocoons, the rolled nest leaves were collected in two districts in Japan and antibacterial properties of the fungi were examined. Cocoons and fungi isolated from the nest were classified into 5 categories by the growth stages of the insects, and 7 categories based on taxonomic properties and pigment productivity, respectively. The dominant genus was Penicillium in each location. However, the composition of the fungal categories was different and seemed to depend on their circumstances. From all cocoons with larvae, the strains that belonged to the same fungal category and produced the same antibiotic (deoxyherqueinone) were isolated. From these results, the species-specific relationship between the insect and fungi or fungal products was considered to be not extremely tight, and it was suggested the period of the larval spinning of the cocoon is a key stage of this unique relationship.

Outbreak of Chinese herb nephropathy in Japan: are there any differences from Belgium?

OBJECTIVE: The purpose of this article was to study and clarify the features of Chinese herb nephropathy (CHN) in Japan. PATIENTS AND METHODS: The subjects consisted of patients diagnosed as having CHN in Saiseikai Nakatsu Hospital and of those reported in the literature in Japan. We investigated the clinical and histological features of CHN patients in Japan and compared them with the Belgian cases. RESULTS: The remarkable differences were as follows: (1) high prevalence in males compared with Belgian cases, (2) Fanconi syndrome was found in most cases, (3) no patients had malignant tumors in the urinary tract. In addition, the ascribed Chinese medicines in Japan were divided into three groups: 'Tenshin-toki-shigyaku-ka-gosyuyu-syokyo-to', 'Boui-ougi-to', and others. CONCLUSION: CHN in Japan has some characteristics distinguished from Belgian nephropathy. One hypothesis is a susceptibility to aristolochic acids (AAs), which is considered to be a causative agent, may be different among races. Another is that there could be some other toxic substances affecting the clinical findings although they are not identified at present. Further studies must be undertaken to clarify these differences.

(4E)-dehydrocitrals [(2E,4E)- and (2Z,4E )-3,7-dimethyl-2,4,6-octatrienals] from acarid mite Histiogaster sp. A096 (Acari: Acaridae).

A mixture of two monoterpenes was obtained as the opisthonotal gland secretion from unidentified Histiogaster sp. A096 (Acari: Acaridae), and their structures were elucidated to be (4E)-dehydrocitrals [(2E,4E)- and (2Z,4E)-3,7-dimethyl-2,4,6-octatrienals] by GC/MS, GC/FT-IR, UV and 1H-NMR spectra. Both isomers of (4E)-dehydrocitral prepared by syntheses in 4 steps from 3-methyl-2-butenal with 34.2% yields (based on the ylide) were separated by column chromatography into the (2E,4E)- and (2Z,4E)-3,7-dimethyl-2,4,6-octatrienal. Mass spectra together with GC retention times of the purified natural (4E)-dehydrocitrals were identical with those of synthetic (2E,4E)-3,7-dimethyl-2,4,6-octatrienal and (2Z,4E)-3,7-dimethyl-2,4,6-octatrienal. The geometry at the 2-C position of both synthetic (4E)-dehydrocitrals was confirmed by NOESY analyses. This is the first identification of (4E)-dehydrocitrals from the animal kingdom.

An antibiotic from Penicillium sp. covering the cocoon of the leaf-rolling moth, Dactylioglypha tonica.

An antibiotic-producing Penicillium sp. strain was isolated from cocoons of the leaf-rolling moth, Dactylioglypha tonica. An antibacterial compound was isolated from the cultured broth, and the chemical structure of the principle was determined by spectroscopic data to be a derivative of isocoumarincarboxylate.

The characteristic pattern of aminoaciduria in patients with aristolochic acid-induced Fanconi syndrome: could iminoaciduria be the hallmark of this syndrome?

BACKGROUND: In Japan the patients with Chinese herbs nephropathy (CHN), aristolochic acids-(AAs) associated renal failure, often present Fanconi syndrome. The aim of this study was to investigate the pattern of aminoaciduria in patients with AAs-induced Fanconi syndrome and to clarify whether it is different from other Fanconi syndromes reported in the literature. SUBJECTS AND METHODS: The subjects consisted of 4 patients with Fanconi syndrome due to AAs. We studied biochemical data and urinary excretion of amino acids in the 4 patients. Amino acids in their urine were analyzed by high performance liquid chromatography (HPLC). RESULTS: Three out of 4 patients showed in common very increased excretion ofproline, hydroxyproline and citruline. Last patient showed the very increased levels of proline and valine. Regarding glycine, which is considered to belong to the same group as imino acid and to be shared with high-affinity transport system ofproline, there was not very increased excretion. CONCLUSION: These findings suggest that AAs would predominantly affect the low-affinity transport system of proline in the brushborder membrane of proximal tubules because the low-affinity system is considered not to be shared with glycine transport.

A dihydroxy-gamma-lactone as an oviposition stimulant for the swallowtail butterfly, Papilio bianor, from the rutaceous plant, Orixa japonica.

The oviposition response of the Rutaceae-feeding swallowtail butterfly, Papilio bianor, was induced by a methanolic extract from leaves of its major host, Orixa japonica. Several components were responsible for this oviposition response. One of the stimulants was isolated and identified as (-)-2-C-methyl-D-erythrono-1,4-lactone. The compound was inactive alone, but elicited oviposition behavior when mixed with other fractions.

A putative binding protein for lipophilic substances related to butterfly oviposition.

A unique protein of 23 kDa (Jf23) was found in the tarsus of the female swallowtail butterfly, Atrophaneura alcinous. Jf23 has 38% identity with a bilin-binding protein, which was found in the cabbage butterfly, Pieris brassicae, and which has two consensus sequences in common with the members of the lipocalin family, suggesting that it is a binding protein for lipophilic ligands. Western blot analysis showed that Jf23 was expressed only in the female, and not in the male. Electrophysiological response of the female tarsi was stimulated by methanolic extract of their host plant, Dutchman's pipe (Aristolochia debilis). The stimulated response was depressed by the presence of Jf23 antiserum. These results suggest that Jf23 is one of the chemosensory signaling proteins, which plays one or more roles in female butterfly oviposition.

Chinese herb nephropathy in Japan presents adult-onset Fanconi syndrome: could different components of aristolochic acids cause a different type of Chinese herb nephropathy?

BACKGROUND: We encountered two cases of Chinese herb-induced Fanconi syndrome in Japan. One component of the chinese medicine was "Kan-mokutsu" (Aristolochia manshuriensis) in which aristolochic acids (AAs) were detected. METHODS: Renal biopsy showed flattening of proximal tubular epithelial cells and paucicellular interstitial fibrosis without glomerular lesions, all of which were in accordance with Chinese herb nephropathy (CHN). To date, many cases of CHN have been reported mainly as progressive renal failure in western countries. RESULTS: However, our cases were different from those in that they presented Fanconi syndrome. The detected AAs in our cases consisted of aristolochic acid (AA)-I, II and D. In contrast, in Belgium, the incriminated agent was Aristolochia fangchi which consisted of AA-I, B, C, and aristolactum. CONCLUSION: These findings could indicate that different components of AAs could cause different clinical lesions, or that the amount of ingested AAs might reflect clinical pictures, that is to say, our patients took lower volume of Chinese herbs and might be in an early stage of CHN. Furthermore, it is likely that susceptibility to this substance may be different among races. CHN would include two clinical aspects: subacute renal failure and adult-onset Fanconi syndrome. It is important to bear in mind that CHN could present Fanconi syndrome.

Clinicopathological study of mucinous gastric carcinoma.

BACKGROUND AND AIMS: Mucinous gastric carcinoma (MUC) is relatively a rare subtype of gastric carcinoma, and there has been considerable controversiy over the prognosis of this type of carcinoma. In this study we tried to analyze the clinicopathological differences between MUC and other types of gastric carcinoma (non-MUC) and determine whether MUC is associated with a worse prognosis than non-MUC. MATERIAL AND METHODS: We reviewed 645 patients with pathologically confirmed gastric cancer who underwent gastrectomy in our facility during the period from 1975 through 1997. Among them, 20 patients (3.1%) had gastric carcinoma with (MUC), and 625 patients had it without extracellular mucin (non-MUC). In addition, we classified MUC into two groups (well-differentiated type; 7 cases and poorly differentiated type; 9 cases) and analyzed the differences between them. RESULTS: The MUC tumors were more often located in the lower and the upper third of the stomach (MUC: 55% and 25%, non-mUC: 41% and 18%, respectively). The patients with MUC had more serosal invasion (t3 plus t4; MUC: 45%, non-MUC: 18%), more-invasive carcinoma (Type 3 plus 4; MUC: 60%, non-MUC: 36%) and more lymph-node involvement (MUC: 45%, non-MUC: 38%) than the patients with non-MUC. The patients with MUC were more advanced in stage at the time of diagnosis (Stage III plus IV; MUC: 50%, non-MUC: 26%) and had a higher peritoneal dissemination rate (MUC: 30%, non-MUC: 12%) and a lower curability rate (MUC: 60%, non-MUC: 78%) than the patients with non-MUC. The mean size of tumors in MUC (7.4 cm) was larger than that of non-MUC (5.5 cm). Therefore, the overall 5-year survival rate for MUC patients (33%) was lower than that for non-MUC patients (64%). There were no significant differences between well-differentiated and poorly differentiated subtypes of MUC except for the curability and peritoneal dissemination rates. CONCLUSIONS: The overall survival rate for patients with MUC was worse than that for patients with non-MUC. The poor prognosis was correlated with more advanced stage at diagnosis and more frequent serosal invasion. These results suggest the need to diagnose patients with MUC in the early stage of cancer and that in the case of the advanced stage, wide excision of the surrounding tissues and aggressive lymph-node dissection will be needed.

Glycosides of 14,15-seco- and 13,14:14,15-disecopregnanes from the roots of Tylophora tanakae.

Five new glycosides of 14,15-seco- and 13,14:15-diseco-type pregnanes, including a new pregnane, 2 alpha-hydroxyhirundigenin, were isolated, in addition to one known glycoside, cynatratoside B, from the roots of Tylophora tanakae Maxim. Their structures were elucidated by spectral and chemical means.

A sclerosant with astringent properties developed in China for oesophageal varices: comparison with ethanolamine oleate and polidocanol.

BACKGROUND: Xiao zhi ling (XZL), which consists of Chinese nutgalls and aluminium potassium sulphate, is used as a local injection for the treatment of internal haemorrhoids in China. It is also used for endoscopic sclerotherapy of oesophageal varices. To date, however, it has not been compared with other sclerosants with regard to its safety and efficacy. METHODS: In the present study, the effect on the endothelium and the haemolytic and thrombosing effects of XZL were compared with those of 5% ethanolamine oleate and 1% polidocanol, using an endothelial cell line and red blood cells taken from rats and the dorsal marginal ear vein of rabbits. In addition, XZL was injected into the area surrounding varices in rats and its efficacy was studied endoscopically and histologically. RESULTS: Xiao zhi ling reduced the size of varices in rats after causing severe damage in the injected region. Compared with the other two sclerosants, however, XZL had little effect on the endothelium and was the least haemolytic compound. Furthermore, XZL did not cause thrombosis in the injected vein of a rabbit. CONCLUSIONS: These results suggest that XZL is another type of sclerosant with astringent rather than detergent properties. This compound should be used to treat oesophageal varices by paravariceal injection in smaller doses than 5% ethanolamine oleate and 1% polidocanol.

Clerodendrin I, a New Neoclerodane Diterpenoid from Clerodendron trichotomum.

A new neoclerodane diterpenoid, clerodendrin I, was isolated from leaves of Clerodendron trichotomum as a feeding stimulant of the turnip sawfly, Athalia rosae ruficornis, and characterized as a threo epimer of clerodendrin F in the 2,3-diacetoxy-2-methylbutanoyloxy moiety at the C-3ß position.

Esophageal varices in rat models of liver cirrhosis.

Animal models resembling the human situation are very useful to investigate human disease. However, there has been no evidence of esophageal varices in rats with liver cirrhosis. In the present study, to determine whether intrahepatic portal hypertension produced by liver cirrhosis induces esophageal varices in rats, the esophagus was examined endoscopically in rat models of liver cirrhosis. All rats given carbon tetrachloride or thioacetamide and six of seven rats given a choline-deficient diet had esophageal varices or venous dilatation after 16 weeks of treatment, although the varices in one rat given carbon tetrachloride and in two rats given a choline-deficient diet were reduced from weeks 16 to 18. These findings suggest that timing is important when studying esophageal varices in rat models of liver cirrhosis. It is concluded that certain models of liver cirrhosis in rats could be used as models of esophageal varices due to intrahepatic portal hypertension.

[Chinese herbs nephropathy in the Kansai area: a warning report].

In 1993, Vanherweghem and his associates reported cases of rapidly progressive renal interstitial fibrosis in young women who were administered a slimming regimen including Chinese herbs. Subsequently, similar cases have been reported. In Japan, especially in the Kansai area, several cases of Chinese herbs nephropathy have already been reported. We experienced a patient suffering from Chinese herbs nephropathy (CHN), and further detected aristolochic acids from the Chinese herbs taken by the patient. Aristolochic acids are known to be causative agents of CHN. The danger of CHN should be noted as soon as possible and drugs containing aristolochic acids should be prohibited.

[Traditional remedy-induced Chinese herbs nephropathy showing rapid deterioration of renal function].

A 19-year-old female was referred to our hospital for azotemia and anemia. She had been taking a health food for atopic dermatitis for about three years. Urinalysis showed proteinuria, glycosuria and microscopic hematuria. Generalized aminoaciduria was observed. Moreover, severe anemia, azotemia, hypokalemia and hypophosphatemia were also observed. Renal biopsy specimen disclosed hypocellular interstitial fibrosis and degeneration of the proximal tubular epithelial cells. No remarkable changes were observed in the glomeruli. Aristolochic acid was detected in the health food. From these findings, she was diagnosed as having Chinese herbs nephropathy (CHN). Although consumption of the food intake was stopped, her renal function deteriorated rapidly. Previously, we reported that certain kinds of Chinese herbal drugs contain aristolochic acid and that the drugs should be prohibited if aristolochic acid is identified. However, we experienced a patient of CHN arising from traditional remedy, which was not proved to be safe. It should be awared that health foods may contain aristolochic acid.

Trypsin inhibitor activity in commercial soybean products in Japan.

The effect of trypsin inhibitor (TI) in soybean on the prevention of cancer has been reported in animal studies. However, the actual intake of active TI in daily life is not known. In this experiment we measured TI activity in various soybean products and the effects of some factors of processing on the TI activity. Average TI activity in whole soybean was 4,819 U/100 g, and the average percentages of remaining activity in products against that of whole soybean were momen-tofu 2.5%, yose-tofu 3.4%, kinugoshi-tofu 4.3%, jyuten-tofu 7.9%, soymilk 13.0%, natto 0.7%, soy sauce 0.8% and miso 0.3%. By heating soymilk at 100 degrees C, TI activity decreased to 11% at 10 min and 5% at 20 min. After heating soymilk in a water-bath for 15 min at 75 and 100 degrees C, TI activity decreased to 35 and 12%, respectively. The TI activity of tofu was proportional to the remaining whey. The effects of chemicals used for the coagulation of soy protein and foam-removal on TI activity were little. The results suggest that soybean products retain 2.5-12.5% TI activity of the whole soybean and that humans are consuming some active TI in their daily lives.

The pheromone system of the male danaine butterfly, Idea leuconoe.

Male Idea leuconoe butterflies release a complex mixture of volatiles from their pheromone glands (hairpencils) during courtship. The pheromone components geranyl methyl thioether (2), viridifloric beta-lactone (3) and 6-hydroxy-4-dodecanolide (10) have been synthesized for the first time. Therefore, the structural assignment of these new natural products could be proved. Related 7-hydroxy-5-alkanoides are also present in the extract. The volatiles are embedded in a lipidic, matrix with more than 150 components. This matrix consists of alkanes, alkenes, 2,5-dialkyltetrahydrofurans, secondary alkanols and alkenols as well as alkanones and alkenones. Several regioisomers of the oxidized hydrocarbons occur. The elucidation of double bond positions has been performed by MS using DMDS adducts.

Male sex pheromone of a giant danaine butterfly,Idea leuconoe.

Males of a giant danaine butterfly,Idea leuconoe, display hairpencils during courtship. The females were visually attracted to and olfactorily arrested by an artificial butterfly model to which male hairpencil extracts were added. The hairpencil extracts contained a complex mixture of volatiles, including pyrrolizidine alkaloid (PA) derivatives (danaidone, viridifloric ß-lactone), aromatics (phenol,p-cresol, benzoic acid), terpenoids (geranyl methyl thioether, (E,E)-farnesol), a series of γ-lactones (6-hydroxy-4-undecanolides and its homologs), hydrocarbons [(Z)-9-tricosene, etc.], and several compounds with higher molecular weight. A mixture of the major volatiles applied to a butterfly dummy strongly elicited an abdomen-curling acceptance posture in females. Viridifloric ß-lactone and danaidone induced significant electroantennogram responses on the female's antennae, suggesting their principal role together with other hairpencil components as a sex pheromone to seduce females.I. leuconoe males seem to acquire the precursor for both of the PA fragments from the host plant,Parsonsia laevigata (Apocynaceae), during the larval stage; thereby they do not show pharmacophagous behavior towards PA-containing plants during the adult stage. However, males are pharmacophagously attracted to and feed on a number of simple phenolic compounds in a manner similar to other danaine species towards PAs. Wild males sequester one of the phagostimulants, (-)-mellein, in the hairpencils in varying quantities. Phenolic compounds incorporated in the hairpencils may act primarily as warning odors linked with the defensive PAs present in the body tissues.

Endoscopic sclerotherapy in a rat model of esophageal varices.

BACKGROUND: Partial ligation of the portal vein has been shown to induce not only prehepatic portal hypertension but also esophageal varices in the rat. We developed an esophageal endoscopic system for endoscopic sclerotherapy of esophageal varices in rats. In the present study the efficacy of three sclerosing agents, 1% polidocanol, 5% ethanolamine oleate, and 99.5% ethanol, was compared, using this model. METHODS: Sclerosing agents were injected paravariceally in 42 rats with partial portal vein ligation. Their efficacy was compared endoscopically and histologically. RESULTS: Ethanol induced the most severe ulcers and subsequent stricture formation. The damage induced by 1% polidocanol was mild and healed quickly, whereas 5% ethanolamine oleate induced moderate damage. The varices disappeared because of fibrosis that developed after ulceration. CONCLUSIONS: The results were consistent with the known properties of these three agents, suggesting that the esophageal endoscopic system for sclerotherapy in rats provides a useful method for experimental studies of sclerotherapy.