Hepatic P450 monooxygenase activities, which strongly influence the efficacy and/or toxicity of drugs, are known to fluctuate daily. We also know that the P450 activities assessed by measurement of 7-alkoxycoumarin O-dealkylase (ACD) activities fluctuate daily, with apparently high values during the dark period in male rats. However, there is little knowledge about the factors that regulate daily fluctuation of P450 monooxygenase activities. In the present study using rats, we induced lesions in the suprachiasmatic nucleus (SCN) of the brain, the known site of the body's internal clock, and examined the effects on the daily fluctuation of the ACD activities to clarify the relationship between the SCN and the daily fluctuation of P450 monooxygenase activities. In addition, adrenalectomy was performed to re-evaluate the influence of adrenal hormones on the P450 activities. Our results indicated that daily fluctuations of the hepatic ACD activities were completely eliminated in the SCN-lesioned rats. However, the ACD activities in the adrenalectomized rats showed apparent daily fluctuations with high values during the dark period and low values during the light period. Therefore, this study demonstrated that the daily fluctuation of the hepatic P450 monooxygenase activities in male rats is controlled by the SCN but remains unaffected by the adrenal hormones.

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Successful digit replantations in aged patients are reported. Seven males and one female (eight patients with nine fingers in total), ranging in age from 65 to 74 years (71 years on average), were treated. Five fingers were replanted, and the take was very good. Although restored function in the replanted fingers was poor, the patients were satisfied with the results. There is some consensus that, since an immovable finger obstructs the function of the other normal fingers, it is better to sacrifice the digit, a solution often considered in male laborers in the prime of life who use their fingers extensively. However, in the case of aged patients, it is not as necessary to provide ingenious solutions, as it might be for young patients. Whether or not replantation is carried out should be determined after careful consideration of patient status and desire, and after extensive explanation about the postoperative condition of their fingers.

. 2003;43:715-719)