The assessment of fracture of the mandibular condyle by use of computerized tomography. Incidence of sagittal split fracture

A survey was carried out to clarify the incidence of sagittal splitting fracture of the mandibular condyle using computerized tomography. There were 33 patients, between 11 and 67 years of age, with displaced or dislocated mandibular condylar process fractures (41 cases), seen at our clinic between 1986 and 1992. The incidence of no displacement was 4.9%; deviation and displacement, 34.1%; dislocation, 46.3%; and complete avulsion, 4.9%. A sagittal splitting fracture of condyle occurred with an incidence of 9.8%. Conservative treatment was effective in the treatment of sagittal splitting fracture. Therefore, classification of fracture of mandibular condyle should include the sagittal split fracture, and investigations should include computerized tomography.

Role of proprioceptors in the mylohyoid muscle

Afferent discharges of the mylohyoid muscle branch during respiration were studied electrophysiologically in the rat. Afferent discharges from the mylohyoid muscle branch of the mylohyoid nerve were found to be synchronized with respiration. Stretching of the mylohyoid muscle elicited afferent discharges of the mylohyoid muscle branch, suggesting that lengthening of the mylohyoid muscle caused electrical activity in the proprioceptors. When the central cut end of the mylohyoid muscle branch was stimulated electrically, reflex discharges were recorded from the EMG lead at the sternohyoid muscle where it is innervated by the cervical nerve. The latency between the electrical stimulation and the action potential in the sternohyoid muscle was 3-4 ms. Therefore, the mylohyoid muscle branch may transmit information to the sternohyoid muscle regarding the stretching actions of the mylohyoid muscle resulting from movements of the hyoid bone.

Angiogenesis inhibitor TNP-470 (AGM-1470) potently inhibits the tumor growth of hormone-independent human breast and prostate carcinoma cell lines

The angiogenesis inhibitor O-(chloroacetyl-carbamoyl)fumagillol (TNP-470) showed antitumor activity in three human cancer xenograft systems. TNP-470 potently inhibited the tumor growth of hormone-independent prostate cancer PC-3 cells and breast cancer MDA-MB-231 cells dose dependently at weekly s.c. doses of 50-200 mg/kg with maximum inhibition of 96 and 88% (tumor growth, 4 and 12% of that in the respective control). In experiments of combination therapy with chemotherapeutic agents, the combination of TNP-470 (100 mg/kg) and cisplatin (5 mg/kg) showed an additive antitumor effect (from treated versus control, 38 and 22% to 5%) against PC-3 carcinoma. 5-Fluorouracil and Adriamycin alone did not significantly inhibit MDA-MB-231 tumor growth (treated versus control, 131 and 64%, respectively). TNP-470 also inhibited tumor growth of WiDr colon cancer; although the inhibition was less marked (treated versus control, 39%) than that observed with the hormone-independent cancers used in this study. In an in vitro study, all the cell lines tested were considerably insensitive to TNP-470 in monolayer cultures (50% inhibitory concentration, approximately 5 micrograms/ml), whereas TNP-470 inhibited the anchorage-independent growth of PC-3 and MDA-MB-231 cells (50% inhibitory concentration, 0.05 and 470 ng/ml, respectively). The inhibitory activity of TNP-470 against anchorage-independent growth correlated well with the in vivo antitumor activity among the cell lines tested. Thus, this inhibitory action may partly contribute to the potent antitumor activity of the angiogenesis inhibitor TNP-470, at least in the case of PC-3 and MDA-MB-231. These results suggest that hormone-independent prostate and breast cancers may be appropriate target diseases for TNP-470 clinical trials.

Inhibition of tumor growth and metastasis of rodent tumors by the angiogenesis inhibitor O-(chloroacetyl-carbamoyl)fumagillol (TNP-470; AGM-1470)

The effect of the potent angiogenesis inhibitor O-(chloroacetyl-carbamoyl)fumagillol (TNP-470), a semisynthetic analogue of fumagillin, on tumor growth and metastasis was studied using rodent tumors. Injection of TNP-470 s.c. inhibited tumor growth in a dose-dependent manner, and the tumor sizes of B16BL6 melanoma, M5076 reticulum cell sarcoma, Lewis lung carcinoma, and Walker 256 carcinoma were maximally reduced to 16, 10, 17, and 4% of that in the respective control. The activity of TNP-470 upon i.v. injection was slightly weaker than that following s.c. injection. This tendency was observed for all the tumors tested. Injection i.v. (infusion) of TNP-470 increased the life span of Walker 256 carcinoma-bearing rats by 183% over the control, while bolus i.v. injection increased the life span by only 47%. TNP-470 reduced the number of pulmonary metastatic foci of i.v. inoculated B16BL6 melanoma in a dose-dependent manner, and the number of metastatic foci was reduced to 10% of that in the control by treatment with TNP-470 at 60 mg/kg, 3 times/week. The mean survival time of B16BL6 tumor-bearing mice treated with TNP-470 using this regimen was extended by 56% over that of control mice. TNP-470 at 10 mg/kg every day also reduced the number of metastatic foci of M5076 sarcoma in the liver after resection of the tumor from the primary site. Adriamycin at the same dose only slightly reduced the number of metastatic foci, even though TNP-470 and Adriamycin showed roughly equal inhibitory activity against M5076 sarcoma growth. TNP-470 extended the mean survival time of M5076 tumor-bearing mice by more than 100% over that of control mice at 30 mg/kg every 3 days, while Adriamycin extended mean survival times by maximally 20% at 10 mg/kg. These results show that the angiogenesis inhibitor TNP-470 has strong inhibitory activities against in vivo growth and metastasis of a wide variety of tumors.

Prevalence of antibody to Toxoplasma gondii among inhabitants under different geographical and climatic conditions in Hyogo Prefecture, Japan

Sera collected from 2,564 inhabitants of different areas in Hyogo Prefecture, Japan, were examined for antibody to Toxoplasma gondii by enzyme-linked immunosorbent assay. The overall prevalence rates of male (11.6%) and female populations (7.6%) were significantly different (P < 0.001). The prevalence also depended on age of the population. Of 11 districts three, being far from the sea and occupied mainly by mountains with relatively high altitudes (95-195 m), showed a significantly lower average prevalence (5.0%) than the other districts with altitudes of 3-58 m, a part of which was adjacent to the sea (10.6%; P < 0.001). The average prevalence obtained in two districts with annual rainfall of 1,862-2,062 mm (16.8%) was significantly higher than that obtained in six districts with annual rainfall of 1,026-1,204 mm (8.6%; P < 0.001).

Masticatory function in a patient with mandibular midline cleft

Bone grafting of a midline cleft is required to allow reasonable masticatory function. However, changes in the rhythm of mastication have not been investigated before and after such bone grafting procedures. We performed bone grafting in a patient with multiple craniofacial anomalies including a midline mandibular cleft. The patient showed a marked improvement in the rhythm of mastication after repair of the midline mandibular defect. Bone grafting proved to be an effective method for securing stable occlusion with better mandibular movement.

Tactile-evoked response of sensory fibers in buccal and submandibular regions of the rat

Evoked neural responses to tactile stimulation were recorded electrophysiologically from the mechanoreceptive afferent fibers innervating the buccal and submandibular regions of Wistar rats anesthetized with sodium thiopental. Miniature probes 200 microns in diameter were used, and data analysis was performed on the mechanosensitivity of responses to tactile stimulation in the areas innervated by the mental, mylohyoid, auriculotemporal, and cervical nerves. Mechano-sensitivity of each area showed a characteristic distribution of slowly adapting (SA), rapidly adapting (RA), C-fiber (CF), and hair follicle (HF) units in individual receptive fields. The density of the SA units was high in the areas innervated by the mylohyoid and auriculotemporal nerves. The CF units were concentrated in the small dome in the area of the mylohyoid nerve and the auriculotemporal nerve, as shown by a significant response to the dynamic features of stimulation. Estimation of the current needed for tactile acuity suggests an important role of the SA fibers in the areas innervated by the auriculotemporal, mylohyoid, and cervical nerves.

Pharmacological profile of a high affinity dipeptide NK1 receptor antagonist, FK888

1. In our search for compounds that inhibit the binding of [3H]-substance P (SP) to guinea-pig lung membranes, the dipeptide SP antagonist, FK888, was developed by chemical modification of the parent compound, (D-Pro4, D-Trp7,9,10, Phe11)SP4-11. 2. In a [3H]-SP binding assay using guinea-pig lung membranes and rat brain cortical synaptic membranes, FK888 displaced [3H]-SP binding with a Ki value of 0.69 +/- 0.13 nM and 0.45 +/- 0.17 microM, respectively, in a competitive manner. 3. FK888 inhibited the contraction of guinea-pig isolated ileum induced by SP in the presence of atropine and indomethacin (a NK1 receptor bioassay) with a pA2 value of 9.29 (8.60-9.98). 4. FK888 inhibited contractions of rat vas deferens by NKA (a NK2 receptor bioassay) and of rat portal vein by NKB (a NK3 receptor bioassay) at concentrations at least 10,000 times greater than that required to inhibit contractions of guinea-pig ileum. 5. FK888 also inhibited SP-induced airway oedema in guinea-pig after both intravenous and oral administration. 6. These data demonstrate that FK888 is a potent and selective NK1 antagonist which is active both in vitro and in vivo.

Muscle spindles in the mylohyoid muscle of rats

The mylohyoid muscle has several functions in relation to respiration, deglutition, and phonation, but these functions are not fully understood. The interaction of the mylohyoid nerve and muscle in 25 rats was studied by neurophysiologic and histologic methods. Stretching of the muscle elicited electrical responses from the branch of the mylohyoid nerve innervating the mylohyoid muscle, and stretch-sensitive receptors were demonstrated histologically in the mylohyoid muscle. This study indicates that the mylohyoid muscle plays an active role in functions such as swallowing, breathing, and phonation.

Airflow receptors in the lip and buccal mucosa

Airflow receptor afferents in the oral mucosa responding to changes in intraoral air pressure during blowing were found to be innervated by the infraorbital nerve. They provided one response corresponding to the onset of blowing, a second related to an increase in air pressure, a third corresponding to the cessation of blowing, and a fourth that exhibited little change throughout sustained blowing. Intraoral air pressure in the cavity between the lips and the velopharyngeal portal may be monitored by these receptors, and the data they provide may contribute to the control of phonation.

FK 224, a novel cyclopeptide substance P antagonist with NK1 and NK2 receptor selectivity

We have discovered a novel cyclopeptide substance P (SP) antagonist, FK 224 (N-[N2-[N-[N-[N-[2,3-didehydro-N-methyl-N-[N-[3-(2-pentylphenyl )- propionyl]-L-threonyl]tyrosyl-L-leucynyl]-D-phenylalanyl]-L-allo- threonyl]-L-asparaginyl]-L-serine-nu-lactone), which inhibited [3H]SP binding to guinea pig lung membranes in a dose-dependent manner. According to Rosenthal analysis, the inhibitory effect of FK 224 on [3H]SP binding appears to be competitive. In order to clarify the receptor subtype selectivity of FK 224, we have studied the interaction of FK 224 with three tachykinin receptors (NK1, NK2 and NK3) by using receptor binding techniques and in vitro bioassays, and have also compared FK 224 with the novel nonpeptide antagonist, (+/-)-CP-96,345. In binding experiments, FK 224 dose-dependently inhibited [3H]SP binding to rat cerebral cortical membranes (NK1) and [3H]neurokinin (NK) A (NKA) binding to rat duodenum smooth muscle membranes (NK2), but did not affect [3H]eledoisin binding to rat cerebral cortical membranes (NK3). In bioassay experiments, FK 224 inhibited SP-induced contraction of guinea pig ileum (NK1) and NKA-induced contraction of rat vas deferens (NK2) in a dose-dependent manner, but did not affect NKB-induced contraction of rat portal vein (NK3). In contrast, (+/-)-CP-96,345 inhibited SP-induced contraction of guinea pig ileum, but not NKA-induced contraction of rat vas deferens or NKB-induced contraction of rat portal vein. In the presence of FK 224, SP dose-response curves and NKA dose-response curves were shifted to the right in parallel with no depression of the maximal contraction.(ABSTRACT TRUNCATED AT 250 WORDS)

Studies on condensed-heterocyclic azolium cephalosporins. IV. Synthesis and antibacterial activity of 7 beta-[2-(5-amino-1,2,4-thiadiazol-3-yl)-2(Z)- alkoxyiminoacetamido]-3-(condensed-heterocyclic azolium)methyl cephalosporins including SCE-2787

The synthesis and in vitro antibacterial activity of 7 beta-[2-(5-amino-1,2,4-thiadiazol-3-yl)-2(Z)-alkoxyiminoacetami do] cephalosporins bearing various condensed-heterocyclic azolium groups at the 3 position in the cephalosporin nucleus are described. The thiadiazolyl cephalosporins showed good antibacterial activity against both Gram-positive and Gram-negative bacteria and the MICs of the thiadiazolyl cephalosporins against Pseudomonas aeruginosa was more potent than that of the corresponding 7 beta-[2-(2-aminothiazol-4-yl)-2(Z)-alkoxyiminoacetamido]-3- (condensed-heterocyclic azolium)methyl cephalosporins. Also, the thiadiazolyl cephalosporins bearing (imidazo[1,2-b]-pyridazinium-1-yl)methyl groups at the 3 position showed antibacterial activity against methicillin-resistant Staphylococcus aureus (MRSA). Among the cephalosporins tested, 7 beta-[2-(5- amino-1,2,4-thiadiazol-3-yl)-2(Z)-methoxyiminoacetamido]-3-(imidaz o[1,2- b]pyridazinium-1-yl)methyl-3- cephem-4-carboxylate (4, SCE-2787) which exhibited the most potent antibacterial activity and the broadest antibacterial spectrum was selected as a parenteral cephalosporin candidate for further biological evaluation.

Muscle spindle distribution in the levator veli palatini muscle in the rat

We previously reported that the levator veli palatini muscle (LVP) in the rat is innervated by the glossopharyngeal nerve. The LVP positioned between the mouth and nasopharynx, has important roles in respiration, swallowing, and speech. Muscle spindles, structures scattered through skeletal muscles, appear to function like miniature strain gauges, sensing the degree of tension in the muscle. Muscle spindles were demonstrated in the rat's LVP in our neurophysiologic and histologic studies. We think the stretch of LVP modulates the rapid movements of the LVP by the proprioceptive component of the muscle spindle. Our results infer it is important to protect the innervation and the muscle spindles of the LVP from damage during any surgical dissection of the soft palate musculature.

Properties of the lingual and LVP branches of the glossopharyngeal nerve

We investigated the effects of various stimuli on the afferent and efferent branches of the glossopharyngeal nerve in the rat soft palate. One of the sensory components, the lingual branch, responded to tactile stimulation, while the LVP branch responded to stretching of the levator veli palatini muscle. We also obtained physiological and morphological evidence of the existence of muscle spindles in the levator veli palatini muscle and showed that tactile stimulation of the contralateral soft palate and stretching of the contralateral LVP modulated discharges from the motor component of the ipsilateral levator veli palatini muscle. Our results suggest that these receptor units with both sensory and motor efferents may be the main determinants of modulation of respiratory movements in the upper airway by the IXth nerve.

Studies on condensed-heterocyclic azolium cephalosporins. II. Synthesis and antibacterial activity of 7 beta-[2-(2-aminothiazol-4-yl)-2(Z)-alkoxyiminoacetamido]-3-(condensed- heterocyclic azolium)methyl-3-cephem-4-carboxylates

From our series of studies on cephalosporins bearing condensed-heterocyclic azolium methyl groups at the 3 position in the cephalosporin nucleus, we describe here the synthesis and antibacterial activity of 7 beta-[2-(2-aminothiazol-4-yl)-2(Z)-alkoxyiminoacetamido]ceph alosporins containing imidazo[1,5-a]pyridinium, imidazo[1,2-b]pyridazinium, imidazo[1,2-a]pyrimidinium, imidazo[1,2-c]pyrimidinium, and pyrazolo[1,5-a]pyridinium methyl groups at the 3 position. Among the cephalosporins tested, 7 beta-[2-(2-aminothiazol-4-yl)-2(Z)-methoxyiminoacetamido]-3- (imidazo[1,5-a]pyridinium-2-yl) (1), (imidazo[1,2-b]pyridazinium-1-yl) (2), and (pyrazolo[1,5-a]-pyridinium-1-yl) (3)methyl-3-cephem-4-carboxylates showed potent antibacterial activity and broad antibacterial spectrum. The antibacterial activity of these cephalosporins (1 approximately 3) was superior to that of ceftazidime (CAZ). These results imply that the delocalization of the positive charge of the imidazo[1,5-a]pyridinium, pyrazolo[1,5-a]pyridinium and imidazo[1,2-b]pyridazinium groups leads to an expanded antibacterial spectrum and increased activity and that these condensed-heterocyclic compounds as well as imidazo[1,2-a]pyridine are effective moieties for improving antibacterial activity and spectrum.

Studies on condensed-heterocyclic azolium cephalosporins. I. Synthesis and antibacterial activity of 7 beta-[2-(2-aminothiazol-4-yl)-2(Z)- alkoxyiminoacetamido]-3-(imidazo[1,2-a]pyridinium-1-yl)methyl-3- cephem-4-carboxylates

In our study of the structure-activity relationships of cephalosporins bearing quaternary ammonium groups at the 3 position, we postulated that delocalization of the azolium positive charge would lead to an expanded antibacterial spectrum and increased activity. Since quaternization of condensed-heterocyclic compounds such as imidazo[1,2-a]pyridine gives positive charge delocalization, 7 beta-[2-(2-aminothiazol-4-yl)-2(Z)-alkoxyiminoacetamido] cephalosporin derivatives (1-53) bearing various (imidazo[1,2-a]pyridinium-1-yl)methyl moieties at the 3 position were prepared and their antibacterial activity was determined. As expected, these cephalosporins exhibited potent activity against both Gram-positive and Gram-negative bacteria including Pseudomonas aeruginosa. These results imply that imidazo[1,2-a]pyridine is a quite useful substituent for improving antibacterial activity and spectrum. The structure-activity studies revealed that a favorable substituent on the imidazo[1,2-a]pyridine is the cyano radical at the 6 position of the ring, and ethoxyimino or 1-carboxy-1-methylethoxyimino groups are suitable for the alkoxyimino substituent. Among the cephalosporins tested, 7 beta-[2-(2-aminothiazol-4-yl)-2(Z)- ethoxyiminoacetamido]-3-(6-cyanoimidazo[1,2-a]pyridinium -1-yl)methyl-3-cephem-4-carboxylate (45) and 7 beta-[2-(2-aminothiazol-4-yl)-2(Z)-(1- carboxy-1-methylethoxyiminoacetamido]-3-(6-cyanoimidazo[1,2- a] pyridinium-1-yl)methyl-3-cephem-4-carboxylate (49) showed good antibacterial activity.

Intravenous bolus of prednisolone decreases 15-hydroxyeicosatetraenoic acid formation in the rat model of acid aspiration

BACKGROUND AND METHODS

To test the hypothesis that the effect of steroids on hydrochloric acid aspiration may be involved in the metabolism of eicosanoids, we investigated the effects of an iv bolus of prednisolone on the metabolism of 15-hydroxyeicosatetraenoic acid and 11-dehydrothromboxane B2 (11-dehydro-TxB2) in the rat model of acid aspiration. Wistar rats were randomly selected for three groups and treated with either a) an iv bolus of saline after intratracheal injection of saline (control group), b) an iv bolus of saline after intratracheal injection of acid (acid-saline group), or c) an iv bolus of prednisolone after intratracheal injection of acid (acid-prednisolone group). The concentrations of 15-hydroxyeicosatetraenoic acid and 11-dehydro-TxB2 in bronchoalveolar lavage fluid were measured by radioimmunoassay.

RESULTS

The concentration of 15-hydroxyeicosatetraenoic acid in bronchoalveolar lavage fluid of either acid-saline group (804 +/- 129 pg/mL) or acid-prednisolone group (748 +/- 112 pg/mL) was significantly greater than that of the control group (143 +/- 27 pg/mL, p less than .01) 1 hr after the administration. The iv bolus of prednisolone caused a significant decrease in 15-hydroxyeicosatetraenoic acid (acid-saline group 1027 +/- 43 pg/mL; acid-prednisolone group 514 +/- 62 pg/mL; p less than .01) and cell counts of bronchoalveolar lavage fluid 48 hrs after intratracheal injection of acid, while there was no significant change in 11-dehydro-TxB2.

CONCLUSION

These findings suggest that corticosteroid administration may contribute to the inhibition of the inflammatory process of lungs after acid aspiration by decreasing the release of 15-hydroxyeicosatetraenoic acid in the distal lung unit.

[The change in immunohistochemical localization of basic fibroblast growth factor (b-FGF) around the lens capsule after extracapsular extraction]

It has been reported that basic fibroblast growth factor (b-FGF) accelerates proliferation of mesenchymal cells and epithelial cells of cornea and crystalline lens in vitro. The immunohistochemical localization of b-FGF on guinea pig lens capsule after extracapsular extraction (ECE) of the lens was studied in order to investigate the role of b-FGF on posterior capsular opacification after ECE and neovascularization. On the 12th postoperative day, immunohistochemical staining of b-FGF was recognized along the posterior capsule on the cortical side, but not along the anterior capsule. On non-operated eyes, scanty immunoreactive materials were seen in cells at the germinative center of the equatorial region. More than two months after ECE, almost no immunoreactive staining could be recognized. In this study, immunoreactive staining of b-FGF was recognized along the posterior capsule on cortical side after operation. It has also been reported that b-FGF stimulates proliferation of the lens epithelial cells in vitro. Therefore, it is suggested that b-FGF plays an important role on posterior capsular opacification after cataract formation.

The innervation of the levator veli palatini muscle by the glossopharyngeal nerve

We developed a novel method which enables bloodless exposure of the levator veli palatini muscle in rat in order to investigate the physiological properties of this muscle. The levator veli palatini muscle which is innervated by a branch of the glossopharyngeal nerve showed rhythmic spontaneous movement in rats. Cutting the branch supplying LVP of the glossopharyngeal nerve caused cessation of the spontaneous movement of the levator veli palatini muscle. The spontaneous discharges of the glossopharyngeal nerve were synchronized with those of the phrenic nerve. A mixture of 95% oxygen and 5% room air influenced the efferent discharges from the branch of the glossopharyngeal nerve supplying the levator veli palatini muscle. These findings indicate that the motor nerve supply to the levator veli palatini muscle is the glossopharyngeal nerve, and the levator veli palatini muscle is related to the respiratory system, in particular with inspiration in rats.

Prevalence of antibody to influenza C virus among pigs in Hyogo Prefecture, Japan

The prevalence of influenza C virus among pigs in Hyogo Prefecture, Japan, was investigated by serological techniques. Out of 240 sera tested, 45 (19%) showed haemagglutination inhibition (HI) to influenza C virus. Pig sera with high HI titres also scored high in neutralization tests and ELISAs. When fractionated by sucrose density gradient ultracentrifugation, the HI/ELISA reactivities corresponded to antibodies of the IgM and IgG classes. Radioimmunoprecipitation tests revealed that some, but not all, of the pig sera with high HI activities precipitated HEF glycoprotein of influenza C virus. These results suggested that the HI activities of pig sera in Hyogo Prefecture were due to the presence of antibody to influenza C virus. Sera with IgM class antibody to influenza C virus were found throughout the year. However, the question of whether or not pigs serve as a natural reservoir for human influenza C virus still remains to be solved.

Efficacy of oral administration of ofloxacin in lower respiratory tract infections in aged patients with chronic lung disease

The efficacy of ofloxacin for the treatment of lower respiratory tract infection was evaluated in aged patients with chronic lung disease. Results are the following: improvement of leukocytosis and arterial oxygen tension was observed; peripheral blood cell analysis showed a decrease in natural killer cell counts and in helper/suppressor T cell ratio; superoxide production by peripheral blood white cells was decreased after treatment; interleukin-2 production was rather increased. We concluded that improvement in the immunological parameters indicated the efficacy of ofloxacin for lower respiratory tract infection in aged patients with chronic lung disease.

[Quantitative assessment of dyspnea by introducing new indices based on the Borg scale during exercise test and the correlation with parameters of pulmonary functions at rest]

Incremental exercise test with a bicycle ergometer was performed on thirty eight patients (11 patients with chronic obstructive pulmonary disease, 6 patients with interstitial lung disease, 21 patients with preoperative check up for respiratory disease). In 34 patients except four patients with interstitial lung disease, there was a close correlation between dyspnea expressed on the Borg scale (BS) and oxygen consumption (VO2) (r = 0.778-0.998). To evaluate dyspnea in more quantitative manner, we introduced three parameters by the BS-VO2 regression line. The Borg scale slope (BSS) represents the slope of the regression line, threshold load of dyspnea (TLD) represents the onset of dyspnea on the regression line, and the breakpoint load of dyspnea (BLD) represents the maximum oxygen consumption before the subject interrupted exercise. BSS had significant negative correlations with VC, %VC, FEV1.0, TLC, DLco, and %DLco. TLD and BLD had significant positive correlations with VC, FEV1.0, DLco, and %DLco. No correlation was found between dyspnea evaluated by the Hugh-Jones classification and the parameters of pulmonary functions (VC, FEV1.0, DLco) at rest. From these findings, we conclude that the degree of dyspnea sensation on exercise correlated with parameters of pulmonary function at rest, and that these newly introduced parameters using the Borg scale were useful for a quantitative assessment of dyspnea in health and disease.

[Cisplatin and vinca alkaloid combination chemotherapy of advanced non-small-cell lung cancer in the aged]

Fifteen patients aged over 65 years of age with advanced non-small-cl lung cancer (mean age = 70.7, stage IIIb: IV = 4:11) were treated with combination chemotherapy consisting of Cisplatin (50 or 80 mg/m2) and a vinca-alkaloid (Vindesine 3 mg/m2 or Etoposide 80 mg/m2). The effectiveness and side effects of this cisplatin therapy in different combinations of vinca-alkaloid regimens (Vindesine vs Etoposide) were examined. The mean dose of Cisplatin in the Etoposide combination group (75.2 mg/m2) was significantly higher than that in the Vindesine combination group (54.3 mg/m2) (p less than 0.01). A notable reduction the tumor size was observed in 25% of the Etoposide group, only. The 6-month survival rate and one-year survival rate were respectively 85.7%, 57.1% in the Vindesine + Cisplatin group, and 87.5%, 50% in the Etoposide + Cisplatin group. The common side effects were nausea, vomiting, anorexia, and alopecia. These symptoms were either alleviated by antiemetic drugs or followed by spontaneous recovery. Leucopenia, anemia and thrombocytopenia were found in both groups, and there was no difference in the time course of myelosuppression between the two groups. The extent of nephrotoxicity was assessed by creatinine clearance rate. Its decrease in the Vindesine group (60.1----38.9 ml/min) was higher than that in the Etoposide group (64.9----48.9 ml/min), while there was no significant change in BUN, serum creatinine and urine NAG between the two groups. There were no cases in which chemotherapy schedules had to be interrupted due to myelosuppression and nephrotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS)

Influences of inhaled tobacco smoke on the senescence accelerated mouse (SAM)

We studied the influences of inhaled tobacco smoke on lung structure, biochemical changes in bronchoalveolar lavage (BAL) fluid, and glutathione (GSH) content of the lung in the senescence accelerated mouse (SAM), using 30 female SAM-P/8 as the "senescence-prone series", compared with SAM-R/1 as the "senescence-resistant series". At 18 wks of age, half of each series were housed in Hamburg II machines and exposed to an atmosphere of tobacco smoke for 5 wks, 10 min a day, 5 days a wk. At 24 wks of age, all of the animals were sacrificed. Blood, lung, liver, kidney and eyes were removed and the contents of GSH and thiol group (-SH) were measured (n = 5). We also performed BAL, to determine its total protein, albumin, and fibronectin contents, and elastase-like activity, elastase inhibitory capacity (EIC), and trypsin inhibitory capacity (TIC) (n = 5). Histological changes of the lungs from non-lavaged animals were also examined by light microscopy (n = 5). In SAM-P/8 not exposed to tobacco smoke, the mean linear intercept was longer than that in SAM-R/1. The exposure of SAM-P/8 to tobacco smoke caused increases in its lung weight and the ratio of albumin to total protein in BAL fluid, a decrease in the EIC/TIC ratio in BAL fluid, and a decrease in the GSH content and the GSH/-SH ratio of the lung, compared with those not exposed. We also observed focal infiltration of macrophages into alveoli with hyaline membrane and thickened alveolar wall in SAM-P/8 with tobacco exposure.(ABSTRACT TRUNCATED AT 250 WORDS)

Influences of inhaled tobacco smoke on the senescence accelerated mouse (SAM)

We studied the influences of inhaled tobacco smoke on lung structure, biochemical changes in bronchoalveolar lavage (BAL) fluid, and glutathione (GSH) content of the lung in the senescence accelerated mouse (SAM), using 30 female SAM-P/8 as the "senescence-prone series", compared with SAM-R/1 as the "senescence-resistant series". At 18 wks of age, half of each series were housed in Hamburg II machines and exposed to an atmosphere of tobacco smoke for 5 wks, 10 min a day, 5 days a wk. At 24 wks of age, all of the animals were sacrificed. Blood, lung, liver, kidney and eyes were removed and the contents of GSH and thiol group (-SH) were measured (n = 5). We also performed BAL, to determine its total protein, albumin, and fibronectin contents, and elastase-like activity, elastase inhibitory capacity (EIC), and trypsin inhibitory capacity (TIC) (n = 5). Histological changes of the lungs from non-lavaged animals were also examined by light microscopy (n = 5). In SAM-P/8 not exposed to tobacco smoke, the mean linear intercept was longer than that in SAM-R/1. The exposure of SAM-P/8 to tobacco smoke caused increases in its lung weight and the ratio of albumin to total protein in BAL fluid, a decrease in the EIC/TIC ratio in BAL fluid, and a decrease in the GSH content and the GSH/-SH ratio of the lung, compared with those not exposed. We also observed focal infiltration of macrophages into alveoli with hyaline membrane and thickened alveolar wall in SAM-P/8 with tobacco exposure.(ABSTRACT TRUNCATED AT 250 WORDS)

Necrotizing buccal and cervical fasciitis

A bite wound led to necrotizing fasciitis in the temporal space, the lateral pharyngeal space and the carotid sheath, indicative of a Streptococcus and Bacteroides infection, and was successfully treated with repeated incisions, radical debridement and antibiotic therapy.

[An aged case of orthostatic hypotension possibly due to parasympathetic neurodysfunction]

94-year-old male patient, with orthostatic hypotension, possibly due to impairment of vasoconstriction and parasympathetic nervous system dysfunction was reported. This patient experienced faintness and lower muscle weakness on standing. The blood pressure was 180/90 mmHg in a supine position, while it significantly decreased to 100/58 mmHg in an upright position. There was no evidence indicating the presence of organic brain diseases, cardiovascular diseases, and endocrine diseases, plasma catecholamine, renin, aldosterone, and vasopressin levels at rest were within normal range. Thus, the cause of orthostatic hypotension of this patient was unknown. His systolic blood pressure decreased by 70 mmHg, and his diastolic blood pressure also decreased by 25 mmHg in response to a 70 degrees head-up tilting test (170/71-100/46 mmHg). Plasma vasopressin level significantly increased in response to this test (0.62-67.2 pg/ml). Plasma catecholamine levels also increased (Adr 0.01-0.10 ng/ml, Ndr 0.05-0.22 ng/ml). Other autonomic nervous system examinations revealed normal responses to mental arithmetic test, hyperventilation test, cold pressure test, and adrenalin test. However, the results of the carotid occlusion test, acetylcholine test, atropine test, phenylephrine test were considered to be abnormal. From these findings, we concluded that the functions of sympathetic nervous system were almost intact, while the parasympathetic functions were impared in this case. The orthostatic hypotension of the patient as effectively treated with fludrocortisone. This report suggests that impairment of vasoconstriction and parasympathetic neurodysfunction might be involved in the development of orthostatic hypotension in the elderly.

[An autopsied case of juvenile myocarditis which showed a remarkable cardiac enlargement during the course of six months]

A 19-year-old student was admitted for orthopnea. He had been a badminton player having no experience of serious diseases until he became aware of exertional epigastralgia ten days before admission. On examination, blood pressure was 102/70 mmHg, heart rate 148, and respiration 34. A third sound and moist rales were heard. The liver was enlarged and palpable at 8 cm below the right costal margin. The titers of the virus neutralizing antibodies determined on admission were all less than 32-fold. Chest roentgenogram as compared with that taken six months before admission showed a marked increase in the cardiothoracic ratio and pulmonary venous congestion. Echocardiogram showed a markedly dilated cavity of the left ventricule (LV) (LV diastolic diameter = 74 mm) compared with the cavity of the right ventricule (RV) (RV diastolic diameter = 20 mm) and diffusely impaired wall motion of the LV (fractional shortening = 9%). He died of intractable congestive heart failure two weeks after admission. Heart weight was 620 g. The LV cavity was markedly dilated, but the thickness of the LV free wall was within normal limits. Microscopy of the both atria, the RV, and the basal ventricular septum showed acute and chronic-staged inflammation. However, microscopy of the free wall of the LV showed only slight interstitial fibrosis without necrosis of the myocytes. The marked dilatation of the LV cavity would be due to either the same mechanism as that of dilated cardiomyopathy or excessive exercise after infection with myocarditis. This case showed that LV dilatation without myocardial necrosis/degeneration could develop among patients with myocarditis.

Inhibitory effects of mold oil including gamma-linolenate on platelet thrombus formation in mesenteric microvessels of the rat

Diet including mold oil from a lipid accumulative fungus, containing gamma-linolenic acid, showed an inhibitory effect on thrombus formation in the microvessels of rats by the light/dye method of the authors. Male Wistar rats were fed for 3 to 4 weeks with two series of experimental diets and were examined for thrombus formation. The thrombus formation times to totally occlude, ts, were 347 sec for (mold + soybean)-oil and 236 sec for (palm + soybean)-oil in the first series of diets and 1288 sec for mold oil, 538 sec for olive oil and 575 sec for safflower oil in the second series of diets. Fatty acid composition of plasma, erythrocyte and liver lipids showed an increase in arachidonate content with the diet including the mold oil. Higher arachidonate content seem favorable in inhibiting thrombus formation with increasing PGI2 formation. In terms of the level of lipid hydroperoxides, indicated as a desaturation index of constituent fatty acids, the higher desaturation index with safflower oil gave shorter ts, which suggested some oxygen derived free radicals from polyunsaturated fatty acids were involved in the mechanism of thrombogenesis study by this method.

Serum dipeptidyl peptidase activities as a possible marker of oral cancer

Serum glycyl-l-prolyl 4-methyl-coumaryl-7-amide (gly-pro-MCA) hydrolase (DPP IV) and L-lysyl-L-alanyl beta-naphthylamide (lys-ala-beta NA) hydrolase (assumed to be DPP II) activities were measured in patients with oral squamous cell carcinoma and healthy subjects. The mean serum DPP IV activity of all cancer patients was significantly (P less than 0.001) decreased, compared with that of healthy subjects. Although there was no significant difference between the stages by International Union Against Cancer (UICC) classification (1978), DPP IV levels tended to change dynamically, reflecting the clinical status during therapies. The serum DPP IV activity of patients with a fair prognosis was significantly elevated toward the normal range, whereas the activity of patients with a poor prognosis was significantly decreased (P less than 0.05). In contrast, the mean serum lys-ala-beta NA hydrolytic activity of cancer patients was significantly (P less than 0.001) increased, compared with that of healthy subjects, and was changed reciprocally to DPP IV activity. The correlation of these two serum enzyme activities with tumor weights also was observed in animal models using nude mice transplanted with human KB carcinoma cells and hamsters transplanted with BHK21 cells. These results indicate that these serum enzyme levels may become an aid for the diagnosis of malignant tumors and for estimating the prognosis of the patients.

[Immunologic evaluation in patients with lung cancer with special regard to peripheral blood natural killer cell activity and interleukin-2 productivity]

Thirteen patients with lung cancer and 62 age-matched control subjects were investigated in this study (68.5 +/- 2.7 y.o. and 70.5 +/- 1.1 y.o. respectively). The peripheral blood natural killer (NK) cell activity of patients with lung cancer and control subjects was 59.3 +/- 4.4% and 69.3 +/- 1.8%, respectively. The NK cell activity in these patients was significantly lower than the NK activity of control subjects (p less than 0.05). The Interleukin-2 (IL-2) productivity of stimulated peripheral lymphocytes from patients with lung cancer was 4.96 +/- 0.99 unit, and from control subjects was 12.31 +/- 1.51 unit. When compared with control subjects, the IL-2 productivity in the patients with lung cancer was significantly lower (p less than 0.05). There were no differences in values of OKT series or OKT4/OKT8 ratio between these patients and control subjects. Ten of the 13 patients received schizophyllan intramuscularly once a week (40 mg/week). The NK cell activity was significantly increased on the second day after the second injection of schizophyllan, but there was no change in IL-2 productivity. We conclude that the peripheral blood NK cell activity and IL-2 productivity of patients with lung cancer was decreased. The antitumor polysaccharide, schizophyllan, temporarily raised the NK cell activity of these patients.

[A study of 75 untreated lung cancers in the elderly]

The records of 1280 patients autopsied at the Yokufukai Geriatric Hospital from October 1, 1973 to August 31, 1987 were reviewed and 75 patients with untreated lung cancer, aged 70 or older, were selected. The mean age and standard deviation was 82.1 +/- 5.4 years. Male consisted of 34 subjects and 41 were female of. Histological study revealed 42 cases of adenocarcinoma, 19 cases of squamous cell carcinoma, 7 cases of small cell carcinoma, 2 cases of large cell carcinoma, 1 case of carcinoid and 4 cases of the other types. The mean survival period of 44 untreated patients diagnosed as lung cancer during life was 21.1 +/- 24.1 months. The mean survival periods for 24 patients with adenocarcinoma and 11 patients with squamous cell carcinoma were 24.0 +/- 29.3 and 12.9 +/- 11.7 months, respectively. There was no statistically significant difference in the mean survival period of adenocarcinoma and squamous cell carcinoma. 9% of 44 untreated lung cancers survived for at least 5 years, although the survival rate was slightly lower than that generally reported in the literature. On the basis of staging of TNM classification at the autopsy, the mean survival period from the diagnosis for 13 patients with stage 1 and 27 patients with stage 4 were 27.5 +/- 33.3 and 18.5 +/- 19.7 months, respectively. The incidence of brain metastasis in 75 cases was 14.7%. In this study, adenocarcinoma was more predominant in the elderly (56.0%). An inverse relationship of age to stage was partially observed.

[Cisplatin combination chemotherapy in advanced lung cancer in the aged]

Eleven aged patients over 65 years of age with advanced lung cancer (mean age = 70.8 +/- 1.4, non-small cell:small cell = 9:2, stage III:IV = 5:6) were treated with combination chemotherapy consisting of cisplatin (50 or 80 mg/m2) and vincaloids (vindesine 3 mg/m2 or etoposide 80 mg/m2). To evaluate this cisplatin combination therapy, the aged group was compared with a young group consisting of eleven patients (mean age = 53.3 +/- 1.7, non-small cell:small cell = 9:2, stage III:IV = 5:6) matched for cell type, stage and dose regimen. The mean dose of cisplatin was 58.2 mg/m2 in the aged and 63.6 mg/m2 in the younger group. A notable reduction in tumor size was observed in 9.1% of the aged and 27.3% of the young, while one-year survival rate was 63.6% in the aged and 72.7% in the young. The common side effects were nausea and vomiting, while diarrhea was seen in 18.2% of the aged. Neutropenia, anemia and thrombocytopenia were found in both groups and the time course of myelosuppression in the aged (18.2 +/- 0.8 days) was significantly shorter than that in the younger patients (22.0 +/- 1.4 days, p less than 0.05). With regard to nephrotoxicity, creatinine clearance rate in the aged decreased remarkably from 56.9 to 38.9 ml/min, while there was no significant change in BUN, serum creatinine and urine NAG between the aged and the young. Disorders of electrolytes such as hypokalemia and hyponatremia were seen in 45.5% of the aged. We conclude that advanced lung cancer in the aged was effectively treated with cisplatin combination therapy with tolerable nephrotoxicity and myelosuppression.

Studies on the biological activity of tocotrienols

Tocotrienols were evaluated for activity against transplantable murine tumors inoculated i.p. into mouse, and the activities of two tocotrienols and alpha-tocopherols were compared. When the compounds were injected i.p., alpha- and gamma-tocotrienols were effective against sarcoma 180, Ehrlich carcinoma, and IMC carcinoma, and gamma-tocotrienol showed a slight life-prolonging effect in mice with Meth A fibrosarcoma, but the tocotrienols had no antitumor activity against P388 leukemia at doses of 5-40 mg/kg/d. On the other hand alpha-tocopherol had only a slight effect against sarcoma 180 and IMC carcinoma. The antitumor activity of gamma-tocotrienol was higher than that of alpha-tocotrienol. Tocotrienols showed growth inhibition of human and mouse tumor cells when the cells were exposed to these agents for 72 h in vitro, whereas tocopherol did not show any marked cytotoxic activity. Alpha- and gamma-tocotrienols had inhibitory effects on lipid peroxidation of murine microsomes by adriamycin.

Alteration in dipeptidyl peptidase activities in cultured human carcinoma cells

For the investigation of the possibility of its being a marker enzyme for tumor cells, the activity of dipeptidyl peptidase (DPP) IV (EC 3.4.14.5), a membrane-bound enzyme, in cultured human carcinoma cells was examined. The homogenates of three carcinoma cell lines (HeLa, KB, and K-44) contained lower glycylprolyl methylcoumarinamide (Gly-Pro-MCA) hydrolase activities at pH 8.7 (assumed to be DPP IV) and higher activities of alkaline phosphatase and gamma-glutamyl transpeptidase, which are also membrane-bound enzymes, than those of normal human fibroblasts (HF). Examination of carcinoma cells for the subcellular localization and pH optimum of Gly-Pro-MCA hydrolase activity revealed that the activity of a lysosomal enzyme that hydrolyzes Gly-Pro-MCA at pH 6.4 was markedly increased in carcinoma cells, but not in normal cells. The separation and characterization of Gly-Pro-MCA hydrolases by gel filtration, affinity chromatography, and substrate specificity demonstrated that HF have three peaks indicating DPP IV, DPP II, and an unknown enzyme, whereas the three carcinoma cell lines gave a prominent peak indicating DPP II and a trace of DPP IV. The DPP II activity was 6- to 24-fold higher in carcinoma cell lines than in HF, and it also was 2.85- to 4.13-fold higher than the DPP IV activity in carcinoma cell lines but was 10-fold lower in HF. These clear enzymatic differences between carcinoma cells and normal HF may be useful as a marker of malignancy.

Orally active 1-(cyclohexyloxycarbonyloxy)alkyl ester prodrugs of cefotiam

Orally active 1-(alkyl substituted cyclohexyloxycarbonyloxy)alkyl ester prodrugs (9b-h) of 7 beta-[2-(2-aminothiazol-4-yl)acetamido]-3- [[[1-(2-dimethylaminoethyl)-1H-tetrazol-5-yl]thio]-methyl]ceph+ ++-3- em-4-carboxylic acid (cefotiam, CTM) have been studied as well as the thia (9i) and aza (9j) analogs. These represent derivatives of the 1-(cyclohexylacetoxy)ethyl ester (2) of CTM. The syntheses and oral bioavailability (BA) in mice are described. Among them, the 1-(cyclohexyloxycarbonyloxy)butyl ester (9h) gave the highest BA, 93.5%; the esters having a cyclohexyloxy group in the ester moiety gave BAs of more than 75%, although the BA of the 1-(ethoxycarbonyloxy)ethyl ester (9a) was only 23.9%. The thia analog showed a moderate BA, 46%, but the aza analog, 9j, did not show a BA of CTM. These results indicate that the 1-(substituted cyclohexyloxycarbonyloxy)alkyl group was the suitable promoiety to improve the oral BA of CTM. Chiral 1-(alkoxycarbonyloxy)alkyl groups used as the ester moiety, gave an almost 1: 1 mixture of diastereoisomeric esters. These were tested as such. However, an experiment in which the separated isomers of the 1-(cyclohexyloxycarbonyloxy)ethyl ester (9d) were administered orally confirmed that both diastereoisomers gave identical BAs.

Recent changes in prevalence pattern of Japanese encephalitis virus in Hyogo Prefecture, Japan, using a two-dimensional distribution of IgG and IgM class antibody levels in swine sera

Surveillance of antibody to Japanese encephalitis (JE) virus in swine sera was performed during the epidemic season from July to September, 1978 to 1983, in Hyogo Prefecture, Japan, using enzyme-linked immunosorbent assay (ELISA). Two-dimensional distribution analyses of ELISA values for IgG and IgM class antibodies indicated recent changes in the prevalence pattern. Time courses of antibody levels observed from 1978 to 1980 were similar to those in the 1960s of major epidemics, indicating a synchronous infection during the second wave of infection. In 1982 and 1983, however, the JE prevalence pattern implies an incessant infection cycle between vector mosquitoes and pigs during the latter half of the epidemic season. The delay of the occurrence of JE in patients confirms the longer period of exposure to infectious vectors.

The submucosal island flap in the closure of oro-antral fistula

A submucosal island palatal flap technique was used successfully in seven patients for closure of large oro-antral fistulae. The technique provides not only an island flap of submucosal connective tissue to close the fistula, but a flap of mucosa to cover the raw area of palatal bone. The advantages of the technique are that healing is satisfactory without denuded bone, the island flap has excellent mobility and does not produce bunching of the mucosa of the hard palate and recipient site, and dentures may be fitted early following the excellent healing of the wound.

Production of the modified form of human plasminogen by alpha 2-macroglobulin-plasmin complexes

It has been speculated that the modified form of plasminogen, a precursor of proteolytic enzyme plasmin in plasma, plays an important role in fibrinolysis in the blood. The present study was undertaken to examine the production by alpha 2-macroglobulin-plasmin complexes. alpha 2-Macroglobulin-plasmin complexes were purified from urokinase-activated plasma by affinity chromatography on lysine-Sepharose and gel filtration on Ultrogel AcA 22. The plasmin complex converted native plasminogen into the modified form more easily in the presence of epsilon-aminocaproic acid. The modification of native plasminogen by alpha 2-macroglobulin-bound plasmin was completely inhibited by aprotinin, and partly by soybean trypsin inhibitor. alpha 2-macroglobulin-bound plasmin produced modified plasminogen in human plasma where potent plasmin inhibitors exist, though the degree of production was small. The present results support the speculation of the important role of the modified form in vivo.

Selective induction of cytochrome b5 and NADH cytochrome b5 reductase by propylthiouracil

Both the cytochrome b5 level and NADH cytochrome b5 reductase activity in rat liver microsomes were increased 2-fold by repeated i.p. administration of 1.5 mmol/kg propylthiouracil (PTU) for 2 weeks, but neither the cytochrome P-450 level nor NADPH cytochrome P-450 reductase activity were affected by the treatment. Liver microsomes from PTU-treated rats showed a significant decrease in aminopyrine N-demethylation, but not in benzphetamine N-demethylation, aniline hydroxylation or 7-ethoxycoumarin O-deethylation. A single administration of the compound had no effect on any components of the system. In vitro, drug hydroxylation activities were not affected by PTU up to 1.0 mM. From the above evidence, repeated administration of PTU selectively induced cytochrome b5 and NADH cytochrome b5 reductase in rat liver microsomes.