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We examined changes in the enzyme activities and metabolites related to hepatic fatty acid synthesis in fasted rats with sepsis produced by cecal ligation and puncture. Sepsis stimulated the in vivo incorporation of tritiated water into hepatic fatty acids and nonsaponifiable lipids. The activities of acetyl-CoA carboxylase, ATP-citrate lyase, and NADPH-generating enzymes (glucose-6-phosphate dehydrogenase and malic enzyme), the tissue levels of citrate and malonyl-CoA, and the dephosphorylation of carboxylase were increased in the livers of fasted septic rats compared with fasted sham-operated control rats. These results indicate that sepsis stimulated hepatic lipogenesis and sterologenesis in fasting rats. Furthermore, sepsis reduced the specific activity of hepatic mitochondrial carnitine palmitoyltransferase and raised that of glycerophos-phate acyltransferase, suggesting an increased diversion of cytosolic acyl-CoA towards esterification. These intrahepatic metabolic changes strongly suggest that sepsis causes anabolic action on hepatic lipid metabolism.

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We report a case of amebic liver abscess in a patient on chronic hemodialysis as well as its drug regimen. A 42-year-old single man who was undergoing long-term dialysis complained of fever and right hypochondralgia and was admitted to our hospital. A space-occupying lesion (10cm in diameter) was found on abdominal CT in the right lobe of the liver. He was diagnosed as having hepatic amebiasis because of a positive serologic test. Patients with amebic liver abscess were formerly more likely to have had recent travels to endemic areas, but recently this disease had become predominant among patients with depressed immune response. The immunological mechanism of resistance to infection is disturbed in patients on regular dialysis treatment and this disturbance interferes with the host-parasite equilibrium. Recently metronidazole or tinidazole is employed in the initial treatment of this disease. The metabolites of metronidazole, however, are slowly excreated and possibly accumulated in the patients with chronic renal failure, for which hemodialysis can efficiently remove. We successfully treated this patient with metronidazole 500mg daily, which corresponded to about one third of the usual dosage, without any toxic side effects.

The epidemiological study on registered cases of sudden infant death syndrome (SIDS) in Tokyo: examination of the effect of autopsy on diagnosis of SIDS and the mortality statistics in Ja