Human intestinal mucosa contains acyl-CoA:cholesterol acyltransferase activity. The enzyme has been studied by using oleylcarnitine, CoA and carnitine palmitoyltransferase as an oleyl-CoA regenerating system. The enzyme was found in the particulate fraction of the cells, it had a pH optimum between 7.2 and 8.2, and was inhibited by taurocholate. The specific enzymic activity in biopsies from intestinal mucosa of normal men was found to be 3.6 +/- 1.37 nmol cholesteryl ester formed mg protein-1 h-1, an activity which can account for all cholesteryl esters in intestinal lymph. Low enzymic activity was found in biopsies from patients with small intestinal disorders. Two pancreatectomized patients had values within the normal range.
The finding of reduced regional cerebral blood flow in patients with primary hyperparathyroidism followed by significant improvement after operation might influence the case for surgical treatment.
Nine patients with malignant pleural mesothelioma underwent extensive surgery followed by intra-operative photodynamic therapy. 2 mg/kg Photofrmn was given 48 hours prior to surgery. The thoracic cavity and eventual remaining lung were exposed to 15-30 Joules/cm2 of 630 nm laser light. Tumour tissue was analysed by microscopic photometrical techniques. Five patients with mixed or epitheloid tumours with fluorescence intensity >100 grey level/pixel seemed to benefit from the given therapy. One patient was free of disease 18 months after treatment. Two patients were treated for metastasis after 12 months with no sign of intrathoracic recurrency. Both are still alive, one without further sign of disease 32 months after initial treatment. Two patients presented generalized disease after 9 and 13 months and inirathoracic recurrency several months later. Two patients with poorly differentiated tumours and 2 patients with moderate to highly differentiated tumours, but with fluorescence intensity <100 grey level/pixel, presented recurrencies after 4 months. PDT-efficiency seems to be predicted by the intensity and distribution of drug-induced fluorescence in tumour tissue. PDT may enhance the possibility to achieve complete local tumour control after excision. Multimodal therapeutic approach of local and systemic disease seems mandatory to further improve survival.
In a 50-year-old man (case 1) and a 17-year-old girl (case 2) stones developed in a functioning renal transplant. The respective intervals from transplantation to appearance of stone were seven years and six months. The serum calcium was elevated to approximately 3.00 mmol/l in case 1 and 2.65 mmol/l in case 2. The concentration of parathyroid hormone in serum was increased in case 1. Subtotal parathyroidectomy was performed in both patients, with removal of 2550 mg (case 1) and 150-160 mg (case 2) parathyroid tissue. In case 2 slight hypercalcaemia reappeared two months later. When stones in a transplanted kidney are associated with only slight hypercalcaemia and there is no deterioration of the renal function, conservative measures to reduce the serum calcium should be tried before subtotal parathyroidectomy is undertaken.
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