Matrix metalloproteinase-7-dependent release of tumor necrosis factor-alpha in a model of herniated disc resorption

Herniated disc (HD), one of the major causes of low back pain, is often resolved spontaneously without surgical intervention. Resorption is associated with a marked increase in infiltrating macrophages, and the matrix metalloproteinases (MMP) MMP-3 and MMP-7 have been implicated in this phenomenon. We developed a murine organ culture model in which intact intervertebral discs were cocultured with peritoneal macrophages to investigate the role of MMPs in HD resorption. Using macrophages isolated from MMP-null mice, we report that macrophage-produced MMP-7 was required for proteoglycan degradation, loss of wet weight, and macrophage infiltration of cocultured discs. The inability of MMP-7-deficient macrophages to infiltrate discs could not be attributed to a defect in macrophage migration. MMP-7 was required for the release of the cytokine TNF-alpha from peritoneal macrophages. The generation of soluble TNF-alpha was essential for the induction of MMP-3 in disc cocultures, which in turn is required for the generation of a macrophage chemoattractant and subsequent macrophage infiltration. TNF-alpha release from macrophages was necessary but insufficient for disc resorption, which required macrophage infiltration. We conclude that there is extensive communication between macrophages and chondrocytes in HD resorption and that an essential component of this communication is the requirement for MMPs to release soluble bioactive factors.

Drug sensitivities of the primary afferents and their changes after inflammation

This study explored the possibility that altered sensitivities of the dorsal root and dorsal root ganglion to neuroactive substances released in inflamed tissue may be involved in radicular pain. The chemical sensitivities of the dorsal root and ganglion of rats were examined by monitoring nerve membrane potential. Endogenous pain inducing substances such as bradykinin, serotonin, acetylcholine, and histamine caused depolarizations of the dorsal root and the ganglion. Application of bradykinin or capsaicin to the dorsal root and ganglion on the isolated spinal cord preparation evoked spinal reflex activities in the lumbar ventral root. These results suggest that, when pain inducing substances are released at the dorsal root or its ganglion, they may initiate action potentials and cause pain. As an inflammation model, chromic gut was tied loosely around the lower lumbar nerve root. The dorsal root of the surgically treated rats showed an increased sensitivity to bradykinin when compared with sham operated rats. In contrast, the sensitivity of the dorsal root to gamma-aminobutyric acid, a major inhibitory transmitter in the spinal cord, was decreased. This result suggests that these reciprocal changes in the sensitivities of the dorsal root may play an important role in the pathogenesis of chemical radiculitis.

Total hip arthroplasty using bone cement containing tri-n-butylborane as the initiator

We performed total hip arthroplasty (THA) using a special acrylic self-curing bone cement (Bonemite), which contains tri-n-butylborane as the initiator. Its maximum temperature at curing is lower than that of a conventional bone cement (CMW). Fifty-eight THAs using Bonemite and 35 THAs using CMW were followed up for more than 8 years (12.5 years on average). At the 10-year follow-up, the survival rates, using revision surgery or aseptic loosening impending revision as the endpoint for failure, were 92.2% for the patients in the Bonemite group and 91.0% for those in the CMW group. No statistical differences were observed between the patients in these two groups with regard to survival rate (p = 0.39). Bonemite showed no clear superiority compared with CMW, although the results suggest that Bonemite is safe and reliable for clinical use and stable in situ for long time.

Two-bundle reconstruction of the anterior cruciate ligament using semitendinosus tendon with endobuttons: operative technique and preliminary results

We carried out two-bundle reconstruction of the anterior cruciate ligament (ACL) using multi-strand semitendinosus tendon for the purpose of getting better stability under aggressive rehabilitation by putting the graft in the normal anatomy with minimized notch-plasty. The drill guide position was determined using two-directional radiography in hyperextension. The two-bundle procedure was performed using the inside-out technique for grafting and two Endobuttons (Acufex Microsurgical, Mansfield, MA) for femoral graft fixation. The clinical outcomes 2 years postoperatively of 54 of 62 consecutive patients were reported. The preliminary results suggested that the two-bundle procedure showed a better trend with respect to anterior stability compared with those of our previous experience using the single-bundle technique under the same aggressive rehabilitation. The two-bundle procedures have several theoretical advantages over single-bundle with multi-strand tendon graft. The present two-bundle reconstruction is recommended to result in better anterior stability with minimized notch-plasty and with no serious complications.

Relation between the painful shoulder and the cervical spine with narrow canal in patients without obvious radiculopathy

It is well known that cervical radiculopathy sometimes causes shoulder pain. Hypothesizing that the cause of painful shoulder is related to the cervical spine in the absence of obvious radiculopathy, we measured the anteroposterior diameter of the spinal canal and the range of motion of the cervical spine in patients with painful shoulder on lateral cervical radiographs of the spine. Painful shoulder was diagnosed in 76 patients (24 men and 52 women; mean age 57.6 years). Patients who reported neck pain or numbness of the upper limbs and patients with neurologic abnormalities were excluded from this study. A control group of 54 asymptomatic volunteers (27 men and 27 women; mean age 55.5 years) was formed. The difference in age between the patient group and the control group was not significant. The anteroposterior diameter of the spinal canal at C5 and C6 in the painful-shoulder group (C5: 12.74 mm; C6: 12.76 mm) was significantly narrower than in the control group (C5: 13.60 mm; C6: 13.79 mm). The range of motion was greatest at C4-5 and smallest at C2-3 in both groups; and there was no significant difference in the range of motion between the painful-shoulder group and the control group. When women only or men only were assessed, the results were nearly the same between groups. The cervical spine without obvious radiculopathy appears to be involved in patients with a painful shoulder. We speculate that the shoulder is affected by irritation of a cervical nerve root or referred pain.

Bone mineral density in the distal radius in a healthy Japanese population and in relation to fractures of the distal radius

Changes in bone mineral density with age were measured in the distal radius of healthy adults using dual energy X-ray absorptiometry. A total of 2789 healthy women (20-95 years old) and 1255 healthy men (20-87 years old), and 72 women (52-94 years old) and 23 men (51-79 years old) with fractures of the distal radius were assessed. Bone mineral density remains relatively stable in men despite aging, and was significantly higher than in women in every decade. In women aged 70 years and more, the bone mineral density was significantly lower in the fracture group than the non-fracture group. In men with fractures of the distal radius, there were no significant differences between bone mineral density and age. In the fracture groups loss of radial inclination after reduction correlated with decreased bone mineral density, but there was no significant regression between bone mineral density and the decrease in radial length or palmar tilt.

Up-regulated expression of matrilysin and neutrophil collagenase in human herniated discs

Spontaneous resorption of herniated nucleus pulposus (HNP) is commonly observed when there is substantial contact of the disc with the spinal canal. We already demonstrated the expression of matrix metalloproteinase (MMP)-3 (stromelysin-1) in the granulation tissues of HNP, suggesting its role in the resorption process of HNP. Recent studies of osteoarthritic cartilages reported an up-regulated expression of metalloproteinases including MMP-7 (matrilysin) and MMP-8 (neutrophil collagenase), suggesting their roles in the matrix degradation. To clarify the expression of MMP-7 and MMP-8 in HNP, immunohistological analysis of various types of HNP was performed. We found MMP-7 was expressed in infiltrated mononuclear cells and chondrocytes, whereas MMP-8 was specifically expressed in chondrocytes. The positive rate for both MMP-7 and MMP-8 significantly increased when HNP was exposed to the epidural space (p < 0.01). Our data suggest that not only MMP-3 but also MMP-7 and MMP-8 may play a role in the resorption process of HNP.

Effect of elution modes on protein separation by cross-axis coil planet centrifuge with two different types of coiled columns

Effect of elution modes on protein separation was investigated using cross-axis coil planet centrifuge (cross-axis CPC) with two different types of coiled columns, i.e., eccentric coil and toroidal coil assemblies. Myoglobin and lysozyme were separated with an aqueous two-phase solvent system composed of 12.5% (w/w) polyethylene glycol 1000 and 12.5% (w/w) dibasic potassium phosphate. The substantial effect of elution modes was observed by the toroidal coil, while the negative result was given at the eccentric coil. Using the toroidal coil, higher peak resolution of proteins was attained at the tail to head elution mode. In the outward lower phase mobile elution mode, the satisfactory separation was obtained by both eccentric coil and toroidal coil assemblies. However, in the inward upper phase mobile elution mode, the toroidal coil produced a broad and asymmetric myoglobin peak. The analysis using polyacrylamide gel electrophoresis revealed that the toroidal coil partially separated the components originally present in the myoglobin sample. As the result, a modified equation was devised to express the peak resolution (Rs) using the lysozyme peak. The overall results indicated that the toroidal coil produced better partition efficiency than the eccentric coil under the optimized experimental condition including the direction of the Coriolis force acting on the mobile phase in the toroidal coil.

A new pain provocation test for superior labral tears of the shoulder

We prospectively evaluated the usefulness of a new pain provocation test to diagnose superior labral tears in 32 patients with diagnosed throwing injuries of the shoulder. Results of the pain provocation test were compared with findings on magnetic resonance arthrography (all 32 patients) and arthroscopic examination (15 patients). In 22 patients, detachment of the superior labrum was observed on arthrograms, and all of them had positive results on the new pain provocation test. Nine of the other 10 patients had negative results on the new pain provocation test. However, 1 of the 10 patients had a positive result. Eleven of 15 patients were found to have superior labral lesions arthroscopically, and all of them were classified as type II superior labral anterior posterior lesions. All the 11 patients had positive pain provocation tests. The other four patients without superior labral tears on arthroscopic findings had negative results on the new pain provocation test. The new pain provocation test identified all patients with detachment of the superior labrum confirmed by magnetic resonance arthrography, for a sensitivity of 100%, a specificity of 90%, and an accuracy of 97%. Results of the new pain provocation test were in accord with arthroscopic findings in the 15 patients who underwent arthroscopic examination.

[Induction of genes into the rabbit eye by iontophoresis]

PURPOSE

After inducing 6-carboxyfluorescein (6-FAM)-labeled phosphorothioate oligonucleotides (S-ODNs) noninvasively into albino rabbit eyes by iontophoresis, we assessed the transfer of S-ODNs into the ocular tissues, their stability, and the possible presence of injury to the ocular tissues.

METHODS

The iontophoresis group consisted of 12 eyes of 6 rabbits and the control group consisted of 4 eyes of 2 rabbits given eye drops containing S-ODNs. Aqueous humor and vitreous humor were collected after iontophoresis, subjected to electrophoresis with a fluorescent DNA sequencer and analyzed by the Gene Scan program. Frozen sections at 10 microns were prepared for observations under a fluorescent microscope. A plasmid 4.7 kbp in size that expresses green fluorescent protein (GFP) was induced into 18 eyes of 9 rabbits by the same procedure.

RESULTS

In the iontophoresis group, S-ODNs were detected in the anterior chamber 5 minutes after electrophoresis and in the vitreous 10 minutes after. These S-ODNs maintained the same length as at the initial synthesis. S-ODNs could also be detected in the posterior retina 20 minutes after electrophoresis. No evidence of degeneration or inflammation due to the above procedure was found in the ocular tissues. Fluorescence showing GFP gene expressions were found in the cornea, the anterior chamber angle, and the ciliary subepithelial tissues.

CONCLUSIONS

These findings show that iontophoresis is an effective method to induce gene into rabbit eyes.

Synthetic collagen fibers coated with a synthetic peptide containing the YIGSR sequence of laminin to promote peripheral nerve regeneration in vivo

The usefulness of collagen fibers and the YIGSR sequence (Tyr-lle-Gly-Ser-Arg) of laminin for nerve regeneration were examined in vivo. Type I collagen gel (G-group), Type I collagen fibers (F-group), Type I collagen fibers coated with laminin (L-group) or the YIGSR sequence (Y-group) were packed into silicone tubes, 15 mm long, and transplanted to the sciatic nerves of Wistar rats. Empty silicone tubes were used as the control. The animals were sacrificed 8 weeks after transplantation. Bridging of the nerve was confirmed in the F-(7/12), Y-(7/10) and L-group (6/10), but no bridging was observed in any of the animals of the G- and control group. Nerve regeneration among the space of collagen fibers was observed, and it was suggested that fibroblasts infiltrated the gap in the substance of the degenerated collagen fibers were followed by Schwann cells on the basis of immunocytochemistry. The number of myelinated axons per regenerated tissue in the tube (density), and total area of myelinated axons per measured regenerated tissue in the tube (% axon area) in each the L- and Y-group were significantly higher than that in the F-group (P < 0.05). These results suggest the possibility of obtaining adequate nerve regeneration with new artificial materials only.

Electron microscopic evaluation of the effects of stress-shielding on maturation of the mid-substance and ligament-bone junction of the reconstructed anterior cruciate ligament in rabbits

To analyze the effects of stress-shielding on graft maturation after the anterior cruciate ligament (ACL) reconstruction, autogenous ACL reconstruction using Achilles tendon was performed in rabbits. Two-end fixation with a ligament augmentation device (LAD), as a stress-shielding model (SS group), and pull-out fixation with Leeds-Keio artificial ligaments (L-K ligament), as a non-stress-shielding model (non-SS group), were investigated. Intact ACL was used as the control. Specimens were harvested 6 mon postoperatively, and the analysis was focused on collagen fibril maturation in the mid-substance and bone-anchoring pattern in the bone tunnel, under light and transmission electron microscopy. The density of collagen fibrils in the control was lower than that in both experimental groups (p<0.01). The per cent collagen area in the control was higher than that in the SS (p<0.01) and the non-SS group (p< 0.05). The per cent collagen area in the non-SS group was higher than that in the SS group (p<0.05). At the ligament-bone interface, intracellular calcification of the degenerated chondrocytes occurred in the non-SS group, while in the SS group hydroxyapatite deposits were observed only in the extracellular matrix. These results show unfavorable influence of stress-shielding on graft maturation not only in the mid-substance but also at the ligament-bone junction.

A technique for reconstruction of the medial patellofemoral ligament

Additional medial patellofemoral ligament reconstruction was performed successfully on six consecutive patients with recurrent dislocation of the patella because of residual patellar instability after medial transfer of the tibial tubercle. A technique for medial patellofemoral ligament reconstruction is described, and complications and postoperative management are discussed. The reconstruction was performed using a double strand hamstring tendon graft in five patients and iliotibial allograft in one. Good stabilization of the patella was achieved in all six patients, resulting in improved confidence in higher levels of activity. The satisfactory outcome of additional medial patellofemoral ligament reconstruction suggests the possibility that the procedure may be part of the optional procedure in proximal realignment for recurrent dislocation of the patella.

Effects of aggressive early rehabilitation on the outcome of anterior cruciate ligament reconstruction with multi-strand semitendinosus tendon

To evaluate the effects of aggressive early rehabilitation on the clinical outcome of anterior cruciate ligament reconstruction using semitendinosus (and gracilis) tendon, 103 of 110 consecutive patients who underwent ACL reconstruction using multistrand semitendinosus tendon (ST) or the central one-third of patellar tendon with bony attachments (BTB) were analyzed prospectively. Subjectively, the Lysholm score was not different among the groups. The Lachman test indicated a trend of less negative grade in the ST men's group than that in the BTB men's group. On the patellofemoral grinding test, only women patients of both groups showed pain, with less positive crepitation in the ST group than in the BTB group. KT measurements at manual maximum showed more patients with more than 5 mm differences in the ST group than in the BTB group. The results of this study suggest that aggressive early rehabilitation after the ACL reconstruction using the semitendinosus (and gracilis) tendon has more risk of residual laxity than with the BTB.

In- and out-flows of elements in bones embedded in reference soils

Possible exchanges of elements between bone and the surrounding soil after being embedded underground for 2 years were estimated. Bone pieces were samples from human vertebrae without any treatments after resection. Sixteen elements were determined by atomic emission mass spectrometry. These were divided into three types; Type I, an in-flow in which elements increased, as in Fe, Al and Ba; type II, a balanced decrease in which changes were found in S, Mg and Zn; and type III, an out-flow in which elements, such as Ca and P, entered into bones from embedded soils. These exchanges depended on the varying nature of soils and also on the time underground. The exchanges were progressed in duration of the time after burial. Data obtained are possible references to judge the time-lapse after burial of bones in relating to characters of soils embedded, and to identify proper bone elements from containment elements.

Objective factors affecting overall subjective evaluation of recovery after anterior cruciate ligament reconstruction

The goal of this prospective study was to determine how objective measurements affect the overall subjective evaluation of recovery after anterior cruciate ligament (ACL) reconstruction and to evaluate the effects of graft material, residual instability and sporting activity on patient satisfaction. Ninety-seven patients with unilateral ACL injuries whose ACL was reconstructed using either a multi-strand semitendinosus (ST) graft or a central-third bone-patellar tendon-bone (BTB) graft were followed for an average of 30 months. An "overall subjective recovery score" was derived from the patients' evaluation of function of the operated knee as a percentage of the unoperated knee. The mean overall subjective recovery score at follow-up was 80% (range, 20% to 100%). This study strongly suggested that integrity of the knee extension mechanism, that is, good recovery of knee extension strength with achievement of full extension and no problems in the patellofemoral joint, is the most important factor in patient satisfaction after ACL reconstruction.

Fibroblast growth factor downregulates expression of a basic helix-loop-helix-type transcription factor, scleraxis, in a chondrocyte-like cell line, TC6

Scleraxis is a basic helix-loop-helix-type transcription factor that is expressed in sclerotome. Fibroblast growth factor (FGF) is one of the cytokines produced by the cells in skeletal tissues and is a potent modulator of skeletogenesis. The aim of this study was to examine the effects of FGF on the expression of scleraxis in chondrocyte-like cells, TC6. In these cells, scleraxis mRNA was constitutively expressed as a 1 .2 kb message at a high level in contrast to its low levels of expression in fibroblast-like cells or osteoblast-like cells. Upon treatment with FGF, scleraxis mRNA level was decreased within 12 h. This effect was at its nadir at 24 h and the scleraxis mRNA level returned to its base line level by 48 h. The FGF effect was maximal at 1 ng/ml. FGF effects on scleraxis were blocked by actinomycin D but not by cycloheximide, suggesting the involvement of transcriptional events that do not require new protein synthesis. The FGF effects on scleraxis were blocked by genistein, suggesting the involvement of tyrosine kinase in the post-receptor signaling. TGFbeta treatment of TC6 cells enhanced scleraxis mRNA expression; however, combination of the saturation doses of FGF and TGFbeta resulted in suppression of scleraxis mRNA level. BMP2 also suppressed scleraxis mRNA expression in TC6 cells and no further suppression was observed in combination with FGF. These results indicate that scleraxis is expressed in chondrocyte-like TC6 cells and it is one of the targets of FGF action in these cells.

Dynamic motion study of the whole lumbar spine by videofluoroscopy

STUDY DESIGN

Dynamic lumbar flexion-extension motion was assessed by videofluoroscopy.

OBJECTIVES

To identify the motion patterns of the whole lumbar spine in normal subjects and in patients with low back pain or spondylolisthesis during actual movement.

SUMMARY OF BACKGROUND DATA

Assessment of lumbar instability on terminal radiographs is controversial. Information regarding spinal kinematics during actual movement in vivo is scarce.

METHODS

Fluoroscopic lumbar sagittal motion videos were recorded in volunteers (n = 13; mean age, 22.3) and in patients with chronic low back pain (n = 8; mean age, 43.5) and degenerative spondylolisthesis (n = 8; mean age, 63.1) while the subjects bent forward from a standing neutral position (eccentric motion) and then returned to the original position (concentric motion). The videos recorded approximately 8 seconds of motion and were converted to still images at 5 frames per second. Disc angles from the horizontal line were measured to estimate sagittal rotation of each segment. Disc degeneration was evaluated on T2-weighted midsagittal magnetic resonance image.

RESULTS

In the volunteer group, six exhibited sequentially spreading motion, four exhibited simultaneous motion, and three showed an altered motion-spreading pattern in the eccentric phase. The first two patterns were considered normal. Six (67%) of the patients with chronic low back pain also showed normal patterns, but seven (88%) of the patients with degenerative spondylolisthesis showed disordered patterns. The order of motion in the concentric phase was also different among the three groups. Prolonged deflection of the slipped segment was observed more frequently in the patients with degenerative spondylolisthesis. Disc degeneration was not always associated with motion-spreading order and the motion patterns.

CONCLUSION

Segmental instability influences the whole lumbar motion in patients with degenerative spondylolisthesis. The patients with chronic low back pain did not show a significant difference when compared with the volunteers.

[Reproductive and developmental toxicity study of sodium N-[2-[4-(2,2-dimethylpropionyloxy) phenylsulfonylamino] benzoyl] aminoacetate tetrahydrate (ONO-5046.Na (1). Fertility study in rats]

Fertility study of sodium N-[2-[4-(2,2-dimethylpropionyloxy) phenylsulfonylamino] benzoyl] aminoacetate tetrahydrate (ONO-5046.Na), a novel neutrophil elastase inhibitor, was conducted in Sprague-Dawley (SD) rats. ONO-5046.Na was administered intravenously at doses of 18.75, 37.5 and 75 mg/kg/day to male rats from 64 prior to mating, through the mating period and until necropsy, and to female rats from 15 days prior to mating until Day 7 of gestation, in order to examine its effects on fertility and reproductive performance of males and females and the development of their fetuses. There were no changes attributable to ONO-5046.Na in general signs, body weight, food consumption or autopsy findings in males and females. No drug-related changes were observed in estrous cycles, copulation and fertility indices in males and females. Pituitary weight of dams was decreased in each of the ONO-5046.Na treated groups, but no histopathological changes were observed in the pituitary. In the cesarean section findings in dams, ONO-5046.Na had no effects on the number of corpola lutea, the number of live fetuses, the implantation ratio, the resorbed and dead fetus ratio, fetal or placental weight, or the incidences of external, skeletal or visceral anomalies of the fetuses. From these results, it is considered that the NOAEL of ONO-5046.Na is 75 mg/kg/day for general and reproductive toxicity in males and females and for developmental toxicity in their fetuses.

[Toxicity study of sodium N-[2-[4-(2,2-dimethylpropionyloxy) phenylsulfonylamino] benzoyl] aminoacetate tetrahydrate (ONO-5046.Na) (4). 6-month repeated dose intravenous toxicity study in rats with 1-month recovery test]

A 6-month repeated dose toxicity study with 1-month recovery test of sodium N-[2-[4-(2,2-dimethylpropionyloxy) phenylsulfonylamino] benzoyl] aminoacetate tetrahydrate (ONO-5046.Na), a novel neutrophil elastase inhibitor, was conducted in Sprague-Dawley (SD) rats. The rats of both sexes were administered ONO-5046.Na intravenously at a daily dose of 0 (vehicle control), 18.75, 37.5 or 75 mg/kg. ONO-5046.Na did not affect clinical signs, body weight, food consumption, opthalmology, urinalysis, hematology, blood chemistry, organ weight, necropsy or histopathology at any dose. These results indicate that the NOAEL of ONO-5046.Na in rats is 75 mg/kg/day for both sexes in this study.

[Reproductive and developmental toxicity study of sodium N-[2-[4-(2,2-dimethylpropionyloxy) phenylsulfonylamino] benzoyl] aminoacetate tetrahydrate (ONO-5046.Na) (3). Teratogenicity study in rabbits]

Teratogenicity of sodium N[2-[4-(2,2-dimethylpropionyloxy) phenylsulfonylamino]benzoyl] aminoacetate tetrahydrate (ONO-5046.Na), a novel inhibitor of human neutrophil elastase, was studied. ONO-5046.Na was injected intravenously at doses of 0, 7.5, 15 and 30 mg/kg/day to pregnant Kbl: NZW rabbits from day 6 to day 18 of pregnancy. All female rabbits were sacrificed on day 29 of pregnancy and their fetuses were examined. There were no clinical signs or death attributable to ONO-5046.Na. One dam in the control group and 3 dams in the 30 mg/kg/day group aborted. Body weight gain in the 15 and 20 mg/kg/day groups and food intake in the 30 mg/kg/day group were decreased during the administration period. These changes had recovered by the end of the study. Kidney weight was increased in the 30 mg/kg/day group. There were no effects of ONO-5046.Na in necropsy findings at cesarean section in dams at any dose levels. Developmental toxicity of ONO-5046.Na was not found at any dose levels. From these results, it is considered that the NOAEL of ONO-5046.Na is 7.5 mg/kg/day for pregnant animals and 30 mg/kg/day for fetuses.

[Chlamydia pneumoniae infection in children with asthma exacerbation]

Little is known about the significance of C. pneumoniae in wheezing state in children. In this study, a total of 33 children with exacerbation of bronchial asthma were serologically and bacteriologically analyzed to investigate whether C. pneumoniae infection is associated with wheezing in children with bronchial asthma. 1) Of the 33 patients 12 (39%) had an acute antibody rise against C. pneumoniae. C. pneumoniae was isolated from 8 patients (24%) by culture. Based on these findings, 15 cases (45%) were diagnosed as C. pneumoniae infection. 2) There were no significant difference in clinical signs, symptoms and laboratory studies between with and without C. pneumoniae infection. The high incidence of C. pneumoniae infection in children with exacerbation of bronchial asthma suggests its significance as a cause of wheezing. Although there was no specific symptom in C. pneumoniae infection, this infection should be suspected in wheezing children for diagnosis and proper treatment.

[Toxicity study of sodium N-[2-[4-(2,2-dimethylpropionyloxy) phenylsulfonylamino] benzoyl] aminoacetate tetrahydrate (ONO-5046.Na) (2). 4-week repeated dose intravenous toxicity study in rats with 4-week recovery test]

A 4-week repeated dose toxicity study with 4-week recovery test of sodium N-[2-[4-(2,2-dimethylpropionyloxy) phenylsulfonylamino] benzoyl] aminoacetate tetrahydrate (ONO-5046.Na), a novel neutrophil elastase inhibitor, was conducted in Sprague-Dawley (SD) rats. The rats of both sexes were administered ONO-5046.Na intravenously at a daily dose of 0 (vehicle control and saline control), 18.75, 37.5, 75 or 150 mg/kg. ONO-5046.Na did not affect signs, body weight, food consumption, ophthalmology, urinalysis, hematology, blood chemistry, organ weights, necropsy or histopathology at any dose. These results indicate that the NOAEL of (ONO-5046.Na in rats is 150 mg/kg/day for both sexes in this study.

[Reproductive and developmental toxicity study of sodium N-[2-[4-(2,2-dimethylpropionyloxy) phenylsulfonylamino] benzoyl] aminoacetate tetrahydrate (ONO-5046.Na) (2). Study for effects on pre- and postnatal development in rats, including maternal function]

Prenatal and postnatal toxicity of sodium N-[2-[4-(2,2-dimethylpropionyloxy) phenylsulfonylamino] benzoyl] aminoacetate tetrahydrate (ONO-5046.Na), a novel inhibitor of human neutrophil elastase, was studied in Sprague-Dawley (SD) rats. ONO-5046.Na was injected intravenously at doses of 0, 18.75, 37.5 and 75 mg/kg/day to pregnant rats from day 7 of pregnancy to day 20 after delivery. All pregnant rats were allowed to deliver naturally for postnatal examination of their offspring. No adverse effects on dams were observed in clinical signs, body weight change, food consumption, pregnant, delivery or lactating performances. ONO-5046.Na did not affect the postnatal development of offspring, including birth index, survival index, physical and functional development, motor activity, emotionality, learning ability and reproductive performance. From these results, it is considered that the NOAEL of ONO-5046.Na is 75 mg/kg/day for dams and their offspring.

[Toxicity study of sodium N-[2-[4-(2,2-dimethylpropionyloxy) phenylsulfonylamino] benzoyl] aminoacetate tetrahydrate (ONO-5046.Na) (1). Single-dose intravenous toxicity studies in rats and dogs]

Single-dose toxicity studies of sodium N-[2-[4-(2,2-dimethylpropionyloxy) phenylsulfonylamino] benzoyl] aminoacetate tetrahydrate (ONO-5046.Na), a novel neutrophil elastase inhibitor, were conducted in Sprague-Dawley (SD) rats and beagle dogs. The rats of both sexes were administered ONO-5046.Na intravenously at a single dose of 150, 300 or 450 mg/kg. The male dogs were also given ONO-5046.Na at a single dose of 75 or 150 mg/kg. In the rat study, hypoactivity, bradypnea and paleness of limbs and pinna were observed at doses of 300 mg/kg and above. In particular, one of six female rats in the 450 mg/kg group showed clonic convulsion and died. In surviving animals, those signs disappeared within 3 hr after administration. No effect on body weight gain was seen in either group. Necropsy findings showed a slight foamy fluid in the bronchus, hemorrhage at the right knee joint muscle, tendon and lung in a dead animal. In the dog study, no effects on clinical signs, body weight, food consumption and blood biochemistry were seen in any animals of the 75 and 150 mg/kg groups. It is concluded that the approximate lethal doses are 450 mg/kg in rats and 150 mg/kg and above in dogs.