Periodontal regeneration: myth or reality?

Recent scientific advances have enabled scientists to understand some of the basic biological events leading both to an accelerated and improved healing of many tissues. These advances are now being applied to periodontal wound healing. Previous studies have indicated that various oncogenes are sequences related to growth factors and, that when these sequences are altered, cellular phenotype and especially cellular proliferation is altered. Data are presented using various human cell lines, including a c-myc-transfected periodontal ligament (PDL) cell line, which delineate the relationship between oncogenes, mRNA oncogene transcripts and polypeptide growth factors as inducers of cell phenotypic alterations, including adhesion, migration and proliferation. The polypeptide growth factors are a unique class of molecules that regulate cell phenotype both in vitro and in vivo. These demonstrable phenotypic conversions have indicated that such factors will play an important role in hard-soft tissue repair. Additionally, new data suggest that older PDL cells are not responsive to polypeptide stimulation; both the migratory and proliferative responses are diminished. A unique growth factor has been isolated and sequenced, which when applied to older PDL cells will reverse this refractory phenotype. These recent studies are extensively reviewed with emphasis and conclusions based on growth factor-induced periodontal regeneration. These studies stress the undeniable role that these novel approaches will have in future chairside periodontal practice.

Controlled release microspheres based on Eudragit L100 for the oral administration of erythromycin

The use of Eudragit L100, a copolymer based on methacrylic acid and methacrylic acid methyl ester, in preparing erythromycin microspheres is described. The microspheres were simply prepared in liquid paraffin by solidifying an Eudragit L100 in ethanol solution. When gelatin was incorporated in the solidifying solution, the resultant microspheres were more spherical and had a smooth surface. The size of the microspheres could be controlled by varying the Eudragit L100 concentration in ethanol, and erythromycin was incorporated with 60-70% efficiency. The degradation of erythromycin by acid was markedly protected when the erythromycin microspheres were coated with the polymer. The in vitro release rate of erythromycin from the microspheres was also modified by the coating process. The feasibility of preparing formulations of erythromycin for oral administration, which release the drug at a controlled rate, and protect the drug from gastric acid, is thus demonstrated.

[Interleukin-2 receptor expression in pulmonary granulomatous diseases]

Interleukin-2 receptor expression (IL-2R) on monocytes and alveolar macrophages (AM) was determined in patients with sarcoidosis and pulmonary tuberculosis. In sarcoidosis and tuberculosis, IL-2R on monocytes was detectable, while it was undetectable in healthy controls. IL-2R on AM in sarcoidosis and tuberculosis was significantly increased as compared to healthy controls. IFN-gamma, which has been shown to be increased in sarcoidosis and tuberculosis as compared to healthy controls, induced IL-2R on monocytes in healthy controls, suggesting that IFN-gamma is at least in part responsible for the induction or enhancement of IL-2R on monocytes or AM in sarcoidosis and tuberculosis. Phorbol myristate acetate which is known to be protein kinase C (PKC) activator induced IL-2R on monocytes, and PKC inhibitor, H7, inhibited IFN-gamma-induced IL-2R on monocytes in healthy controls. Calcium ionophore, A23187, induced IL-2R on monocytes and calmodulin antagonist, W7, inhibited IFN-gamma-induced IL-2R on monocytes. Based on these results, it seems that not only the PKC pathway but also the calcium-calmodulin pathway is involved in IFN-gamma-induced IL-2R.

[The influence of multiple modeling and self-esteem on children's self-reinforcement]

The purpose of this study was to test the hypothesis that high (low) self-esteem children modeled after a lower (higher) SR criterion model in a multiple condition. Based on their self-esteem rating scores 48 third-graders were selected and divided randomly into two modeling conditions: a HL condition in which subjects viewed a video showing both an H model (high SR criterion) and an L model (low SR criterion), and an M condition that showed children only an M model (middle SR criterion). Both groups contained high and low self-esteem children. The number of tokens taken as self-reward in a task which was the same as that shown on the video was analysed. The following were the main results. The high self-esteem group in the HL condition took more tokens for their high score than the high one in the M condition. But the low self-esteem group in the HL condition tended to take fewer tokens for their high score than the low one in the M condition. In the HL condition, the low self-esteem group took fewer tokens than the high one. These results supported the hypothesis.

[Therapeutic efficacy of imipenem/cilastatin sodium on respiratory tract infections in lung cancer patients]

Imipenem/cilastatin sodium (IPM/CS) was used to treat respiratory tract infections (RTI) in 54 patients with lung cancer. Out of the 54 patients studied, 53 were evaluable for the utility of IPM/CS; 42 had pneumonia, 9 had obstructive pneumonia, 1 had a lung abscess and 1 had acute bronchitis. The efficacy rate was 71.7%. Seventeen causative organisms were isolated from 14 patients. They included Staphylococcus aureus 5 strains, Staphylococcus epidermidis 4 strains, Staphylococcus sp. 2 strains, Enterococcus faecalis 1 strain, Pseudomonas aeruginosa 2 strains, Pseudomonas fluorescens 2 strains, Acinetobacter sp. 1 strain, and the eradication rate was 81.8%. Clinical adverse effects (nausea and vomiting) were observed in 1 patient. Abnormalities in laboratory test results were observed in 3 patients. They disappeared or returned to normal values after completion of therapy or discontinuation of IPM/CS administration. IPM/CS appears to be a useful antibiotic for RTI in patients with lung cancer.

Clinical significance of abnormal Q wave disappearance in acute transmural myocardial infarction

The clinical features of acute myocardial infarction patients in whom abnormal Q wave disappeared were analyzed. Of 201 patients, 40 (20%) (Group A) showed disappearance of Q wave in serial electrocardiograms. Regional ejection fraction of the infarcted portion improved significantly (from 24 +/- 2 to 34 +/- 4%, p less than 0.001) during chronic phase in Group A, but no such improvement was present in Group B patients who showed no change in the Q wave. Global ejection fraction was greater and percent akinetic segment was smaller in Group A than in Group B at chronic phase. Coronary occlusion occurred more often at segment 7 in Group A; in Group B, occlusion occurred more frequently upstream at segment 6, suggesting Group A had a smaller area of risk. Spontaneous recanalization was more often (57%) and complete occlusion was less frequent in Group A. These indicate that Group A is characterized by a smaller area of risk, smaller infarct size, earlier reperfusion, and greater improvement in wall motion. Twenty-eight patients (70%) of Group A lost Q wave within one month and 12 patients (30%), after 3 months or more. Electrical stunning of the myocardium may be a possible mechanism for the early disappearance of Q waves, and anatomical healing for the late disappearance of Q waves.

Antigen-presenting capacity of alveolar macrophages and monocytes in pulmonary tuberculosis

Using purified protein derivative of tuberculin (PPD) as an antigen, antigen-presenting capacity by monocytes (Mo) and alveolar macrophages (AM) was determined in 17 patients with pulmonary tuberculosis and nine healthy controls. All of the patients and healthy controls were positive for PPD skin test. Although Mo obtained from both the control and tubercular subjects revealed antigen-presenting capacity to autologous blood T-lymphocytes, no significant difference was observed between the two groups. In contrast, AM obtained from the tubercular patients, but not from the controls, showed antigen-presenting capacity to autologous blood T-lymphocytes and to lung T-lymphocytes. No significant difference was shown in HLA-DR antigen expression on AM between the control and tubercular patients. Besides, the exogenous addition of interleukin-1 (IL-1) did not induce antigen-presenting capacity by AM obtained from the controls. These results suggest that neither increased HLA-DR antigen expression on AM nor an increased release of IL-1 from AM is responsible for the enhanced antigen-presenting capacity in tuberculosis.

Antigen-presenting capacity of alveolar macrophages and monocytes in pulmonary tuberculosis

Using purified protein derivative of tuberculin (PPD) as an antigen, antigen-presenting capacity by monocytes (Mo) and alveolar macrophages (AM) was determined in 17 patients with pulmonary tuberculosis and nine healthy controls. All of the patients and healthy controls were positive for PPD skin test. Although Mo obtained from both the control and tubercular subjects revealed antigen-presenting capacity to autologous blood T-lymphocytes, no significant difference was observed between the two groups. In contrast, AM obtained from the tubercular patients, but not from the controls, showed antigen-presenting capacity to autologous blood T-lymphocytes and to lung T-lymphocytes. No significant difference was shown in HLA-DR antigen expression on AM between the control and tubercular patients. Besides, the exogenous addition of interleukin-1 (IL-1) did not induce antigen-presenting capacity by AM obtained from the controls. These results suggest that neither increased HLA-DR antigen expression on AM nor an increased release of IL-1 from AM is responsible for the enhanced antigen-presenting capacity in tuberculosis.

Antigen-presenting capacity in patients with sarcoidosis

Antigen-presenting capacity by monocytes and AMs was determined in 13 patients with sarcoidosis and nine healthy control subjects, using PPD as the antigen. The patients and healthy control subjects all had positive PPD skin tests. Monocytes from both the control subjects and the patients with sarcoidosis exhibited antigen-presenting capacity to autologous peripheral T-lymphocytes, without any significant difference between the two groups. The AMs from patients, but not control subjects, demonstrated antigen-presenting capacity to autologous peripheral T-lymphocytes. Antigen-presenting capacity by monocytes and AMs to lung T-lymphocytes was lower than to peripheral T-lymphocytes, but not significantly. Antigen-presenting capacity was not significantly different between patients with sarcoidosis who had positive and negative PPD skin tests. The mechanism of enhanced antigen-presenting capacity by AMs in sarcoidosis is uncertain at present, but no significant difference was observed in DR antigen expression on AMs between controls and patients with sarcoidosis, and the addition of exogenous IL-1 or IFN-gamma did not induce antigen-presenting capacity by AMs in controls, suggesting that neither increased DR antigen expression on AMs nor increased release of IL-1 or IFN-gamma from AMs is responsible. Thus, these results suggest that T-lymphocyte activation in sarcoidosis may in part be attributable to an enhanced antigen-presenting capacity by AMs.

[The influence of perceived mother model attitudes on children's aggressive or prosocial behavior]

The present experiment was to examine the influence of perceived attitudes of mother models on preschool children's aggressive or prosocial behavior. Based on the score of CCP (children's cognition of parents) Test, sixty four-year-olds were selected and then modeling sessions were administered to them. Their mothers and kindergarten teachers were asked to answer a questionnaire on aggression and altruism of children in daily life situations. Mothers were also required to make self-ratings on their aggression, altruism and rearing attitudes. The following results were obtained. Boys who perceived being rejected by their mothers displayed less imitative aggressive behaviors than other boys and they showed significantly more extrapunitive responses in the P-F Study. No relationships were found between children's modeling behaviors and their aggression or altruism. Children's aggression at kindergarten correlated positively with their aggression at home and with their mother's aggression. It was noteworthy that girl's altruism at kindergarten correlated positively with their mother's rejection, control, and aggression.

Alveolar soft-part sarcoma of the tongue. Report of a case

A case of alveolar soft-part sarcoma (ASPS) of the tongue in a 19-year-old boy is presented. He underwent a hemiglossectomy and received chemotherapy and has been free of disease for 3 years. The origin of intracytoplasmic periodic acid-Shiff(PAS)-positive crystals found in the tumor and the histogenesis of ASPS are briefly discussed.

[A Japanese family with hereditary HbH disease--a case report and its gene analysis]

Hereditary HbH disease was found in a Japanese family. The propositus showed hypochromic microcytic anemia and chronic hemolysis. HbH inclusion bodies were detected in red cells, and an abnormal band corresponding HbH was found in an isoelectric focusing of the hemolysate. Gene analysis of the propositus revealed double heterozygosity for alpha + and alpha zero thalassemias. Four of six his siblings shared the alpha zero thalassemia and one the alpha + thalassemia. Another one was normal. The alpha + thalassemia was of 3.7 kb-deletion type and alpha zero was close to Southeast Asian type. This is the fourth Japanese family with hereditary HbH disease.

[The treatment, course and prognosis of sarcoidosis cases]

Sarcoidosis is a disorder with a highly variable prognosis. Although spontaneous cure is common, a small number of patients become progressively worse. In this study, we analysed 433 patients with sarcoidosis who presented to our institute. Twenty-seven patients (6.2%) of them developed serious morbidity. We studied the clinical course, prognosis and use of steroid therapy in those 27 patients. Eight (29.6%) of the 27 patients developed severe disability during their clinical course, in spite of their mild clinical symptoms and findings at first presentation. Therefore, clinical symptoms and findings, such as ocular disorders, ECG abnormalities, negative reaction to PPD, serum ACE values and lymphocyte count are not always useful markers for the prognosis of sarcoidosis. The relationship between maximum serum ACE values during the course and the duration of the active phase was investigated in 93 patients who were followed throughout their course of the disease. Improvement occurred more often within 5 years in the patients with DR5(+) HLA class II or DRw53(-) compared to patients with DR5(-) or DRw53(+). Using various combinations of specific antigens, the following 5 groups revealed good prognoses, frequently improving within 5 years, 1) DR5(+) and DR4(-), 2) DR5(+) and DRw53(-), 3) DR5(+), DR4(-) and DR8(-), 4) DR5(+), DR4(-) and DR9(-), 5) DR5(+), DR4(-), DR8(-) and DR9(-). HLA class II antigens may also play an important role in the prognosis of sarcoidosis. Since relapses almost always occurred after cessation of steroid therapy, the duration of treatment should be as long as possible and the dosage should also be tapered carefully.

[Bacteriological study of gingivitis in pubertal children. 2. Subgingival microflora cultivable on the nonselective blood agar medium]

The present study involved cultural and microscopic characterization of the subgingival microorganisms of pubertal children with gingivitis. Samples were obtained from eight children 12-14 years of age. Gram-positive organisms made up 56% of the isolates and included mainly Actinomyces israelii, Actinomyces naeslundii. Gram-negative anaerobic rods constituted 25% of the isolates and Bacteroides intermedius (9.7%) was most predominant species. The selective media permitted significantly lower recovery of Actinomyces spp. and Capnocytophaga spp. than nonselective blood agar medium. However, sixty-nine percents of isolates were cultured on the selective media employed in the present study. These results suggest that the subgingival microflora of gingivitis in pubertal children may be similar to those of adult gingivitis and that the use of these six selective media makes it possible to enumerate predominant cultivable microorganisms in subgingival area of pubertal children with gingivitis.

[A roentogenographical study on the alignment of the lower extremities in secondary coxarthrosis]

Alignment of the lower extremities in secondary coxarthrosis (273 lower extremities) and controls (240 normal lower extremities) were studied using roentogenograms of whole lower extremities including the pelvis taken in the standing position with both legs. Secondary coxarthrosis, which is caused by congenital dislocation of the hip joint, was classified into four groups: unreduced dislocation, high dislocation, incomplete dislocation, and dysplasia of the acetabulum. Comparative studies were conducted using statistical data on measured items, obtained from secondary coxarthrosis cases and controls. In controls, the femoro-tibial angle (FTA) was 175.5 +/- 2.08 degrees and the mechanical axis passed through the medial side to the middle of the knee. It has been noted that a tendency for bow-legs was seen after the age of 50. In coxarthrosis with high dislocation, the most marked knock-knees were observed (FTA of 172.5 +/- 3.88 degrees), while in coxarthrosis with incomplete dislocation and dysplasia of the acetabulum, there was a tendency to coxa valga but no tendency toward knock-knees was evident. Cases of total hip replacement revealed that it is possible to improve knock-knees by installing a socket in the primary acetabulum as much as possible, correcting the difference between the length of the legs and elimating adduction contracture. It was also possible to study factors contributing to bow-legs and knock-knees by means of multivariate analysis.

[Antigen presentation in pulmonary tuberculosis]

Antigen presenting capacity (APCC) by monocytes (Mono) and alveolar macrophages (AM), using PPD as the antigen, was determined in 15 patients with pulmonary tuberculosis and 9 healthy controls who all showed positive PPD skin tests. Results were as follows: 1) Mono from both healthy controls and tuberculosis showed APCC to autologous peripheral T lymphocytes, and no significant difference was observed between the two groups. 2) AM from tuberculosis showed APCC to autologous peripheral T lymphocytes, however AM from healthy controls did not. 3) APCC by autologous Mono or AM to lung T-lymphocytes was lower than that to peripheral T-lymphocytes, but the difference was not significant. 4) In tuberculosis, APCC, observed before chemotherapy, was remarkably weakened during the first two months of therapy, and almost recovered to the previous level thereafter. 5) The mechanism which enhances APCC by AM in tuberculosis is uncertain. But neither increased DR antigen expression on AM nor release of IL-1 from AM suggested to be be responsible for the enhanced APCC in tuberculosis.

HLA and sarcoidosis in the Japanese

One hundred fourteen patients with sarcoidosis, who were diagnosed as having sarcoidosis histologically, have been typed for HLA class 1 (A, B, and C) and class 2 (DR and DQ) antigens. Controls consisted of 478 healthy Japanese subjects. The frequencies of HLA-A1, HLA-Bw46, HLA-Cx46, HLA-DRw8, HLA-DRw9, and HLA-DRw52 were significantly increased in sarcoidosis compared to control subjects, but only four patients were positive for HLA-A1. Increased frequencies of HLA-Bw46 and HLA-Cx46 were thought to be attributable to linkage disequilibrium with HLA-DRw8. Patients with HLA-DRw52 were the most frequent (84 cases of 113). No significant differences were observed between HLA-DRw52-positive and HLA-DRw52-negative patients in their clinical features, but all of the patients with muscular involvement (six cases) were positive for HLA-DRw52. Among patients positive for HLA-DRw52, those with HLA-DR5 showed a significantly better clinical course and earlier onset of the disease than those with HLA-DRw8. These results suggest that HLA antigens may play an important role in the pathogenesis of sarcoidosis.

[The effects of coronary thrombolysis on the short- and long-term mortality in acute myocardial infarction]

Among 263 patients with acute myocardial infarction, 141 were treated with urokinase (UK group) and 122 received no urokinase (conventional group). Urokinase (UK) was administered intracoronarily in 55 cases; intravenously (mainly 1,920,000 units) in 64 cases; and intravenously and intracoronarily in 22 cases. The mortality rates were ascertained three months after admission and during the mean follow-up periods of 17.5 months for the UK group and 24.5 months for the conventional group. The three month mortality was significantly lower in the UK group (10.6%, 15 cases) than in the conventional group (23.8%, 29 cases) (p less than 0.01). The mortality during the entire follow-up period was also lower in the UK group (14.2%, 20 cases) than in the conventional group (26.2%, 32 cases) (p less than 0.05). Fatalities due to cardiac rupture, ventricular fibrillation, cardiac failure, cardiogenic shock and recurrent infarction were uniformly less in the UK group. It was concluded that coronary thrombolysis is an effective means of reducing mortality in acute myocardial infarction.

Pleural fluid neuron-specific enolase. A useful diagnostic marker for small cell lung cancer pleurisy

We studied the value of pleural fluid neuron-specific enolase as a possible diagnostic marker for pleurisy of small cell lung cancer by using enzyme immunoassay. Pleural fluid NSE levels in 12 patients with carcinomatous pleurisy due to small cell lung cancer were compared with those in 37 patients with carcinomatous pleurisy due to non-small cell lung cancer and 39 patients with tuberculous pleurisy. The pleural fluid NSE level was elevated in nine of 12 (75 percent) patients with SCLC. However, only two of 37 (5 percent) patients with NSCLC and two of 39 (5 percent) patients with tuberculous pleurisy had an elevated pleural fluid NSE level. Moreover, none of ten SCLC patients with cytology-negative pleural effusions showed elevated pleural fluid NSE level. Thus, determination of pleural fluid NSE levels seems to be an effective means to differentiate carcinomatous pleurisy due to SCLC from that due to NSCLC, tuberculous pleurisy and cytology-negative pleural effusion in SCLC.

[Effects of sex hormones on human PMN migration]

It is believed that gingivitis at puberty is exaggerated by alterations of the hormonal balance. We have suggested that estradiol promotes the gingivitis at puberty while progesterone reduces it (J. Hiroshima Univ. Dent. Soc. 19: 1987). But the mechanisms of these hormones which influence gingival inflammation are not known yet. Therefore, we hypothesized that one of the possible mechanisms of sex hormones on gingival inflammation is through their action on polymorphonuclear leucocytes (PMNs) function because PMNs play an important role in periodontal disease. The purpose of this study was to investigate the effect of sex hormones on PMNs function, especially their migration in vitro. PMNs and plasma were obtained from heparinized peripheral blood of 23 healthy adults. PMNs were preincubated at 37 degrees C for 15 minutes with progesterone or 17 beta-estradiol at designated concentrations. After preincubation, PMNs migration was measured using 48-well chemotaxis micro-chamber with N-formyl-methionyl-leucyl-phenylalanine (FMLP) as chemoattractant. The levels of estradiol and progesterone in the plasma were determined using Direct Radioimmunoassay Kits and the correlation between sex hormone levels and PMNs migration was investigated. PMNs migration to 10(-6) M FMLP was enhanced significantly by progesterone at the concentrations of 200 ng/ml while it was reduced by estradiol at 0.4 ng/ml and 2.0 ng/ml. Random migration of PMNs was enhanced significantly by progesterone at 20 ng/ml while it was reduced by estradiol at 0.4 ng/ml. Significant positive correlation was found between progesterone level in plasma and the PMNs migration in vitro. Estradiol level in plasma did not have any correlation with the PMNs migration in vitro.(ABSTRACT TRUNCATED AT 250 WORDS)

The concentration of salivary steroid hormones and the prevalence of gingivitis at puberty

Gingival conditions of 1323 junior high schoolchildren aged 12-15 were examined, and 132 children who had either healthy gingivae or severe gingivitis were called to the clinic. More precise examination of gingivitis was performed by assessment of Jackson's gingivitis index (G.I.), probing depth (P.D.), and bleeding on probing. Whole saliva was collected, and the salivary concentrations of estradiol, progesterone, and testosterone were determined by radioimmunoassay. Subgingival bacterial plaque was sampled from 36 children, and total bacterial counts and morphological differentiation were performed under a phase-contrast microscope. For statistical analysis, both males and females were divided into two groups according to the concentration of each sex hormone and subgrouped by the results of clinical examinations. Chi-square analysis using 2-by-2 tables was performed to determine the relation between salivary steroid hormone levels and gingival inflammation.

The results suggest that unbalanced secretion of certain hormones might be one of the factors promoting gingivitis at puberty.

Effects of coronary thrombolysis on left ventricular ejection fraction in patients with acute myocardial infarction

Left ventriculograms were performed on 65 patients with acute myocardial infarction, once upon admission and again 3 months later. In 29 cases urokinase was injected intravenously and/or intracoronarily. The other 17 were treated without urokinase. In 8 out of 29 patients whose infarct-related coronary arteries remained completely occluded following urokinase therapy, the global ejection fraction was reduced from 54 +/- 3% during the acute stage to 46 +/- 5% during the chronic stage (p less than 0.001). However, for the 21 patients whose coronary arteries were successfully recanalized, the 2 values were the same (52 +/- 2%). The highest global ejection fractions were seen in 19 spontaneously recanalized patients (acute: 54 +/- 2%, chronic: 55 +/- 2%). For the 8 unsuccessful patients, the regional ejection fraction for the infarcted portion was reduced from 20 +/- 5% during the acute stage to 18 +/- 6% during the chronic stage. But for the successful patients there was an improvement from 22 +/- 2% during the acute stage to 27 +/- 2% during the chronic stage. Again, the regional ejection fraction was the highest for the spontaneously recanalized group, being 31 +/- 2% and 36 +/- 3% during the acute and chronic stages, respectively. These results indicate that if the coronary artery remains occluded during the acute stage the reduced left ventricular function continues to deteriorate even more during the chronic stage. Successful coronary thrombolysis, however, might salvage the infarcted myocardium as well as preserve the function of the left ventricle.

Plasma catecholamine concentrations during a 72-hour aminophylline infusion in children with acute asthma

To explore the possibility that theophylline may act through adrenomedullary secretion of catecholamines, we examined the time courses of plasma norepinephrine (NE), epinephrine (E), and theophylline concentrations and peak expiratory flow (PEF) in nine children with an acute exacerbation of asthma receiving a 72-hour constant infusion of aminophylline. These measurements were made before (baseline) and at 2, 24, 48, and 72 hours after the infusion began. Plasma theophylline concentrations were kept constant in a near midpoint therapeutic range (mean +/- SEM, 14.1 +/- 1.3 to 16.1 +/- 1.1 micrograms/ml) during the 24- to 72-hour infusion periods. Compared with the respective baseline values (383.8 +/- 56.0 and 67.6 +/- 11.8 pg/ml for NE and E), the following postinfusion plasma catecholamines reached statistically significant difference: 664.0 +/- 125.1 pg/ml for NE at 24 hours (p less than 0.05), and 214.9 +/- 57.8, 233.7 +/- 82.2, and 137.6 +/- 39.4 pg/ml for E at 2, 24, and 48 hours (p less than 0.01). Despite the fact that similar plasma theophylline concentrations were maintained, plasma E, which peaked at 24 hours after dose, returned toward the baseline at the end of infusion (99.7 +/- 24.1 pg/ml), whereas this trend was not observed for NE. The postinfusion PEF increased (p less than 0.01) in a stepwise fashion, compared with the baseline, as the infusion progressed. The change in PEF correlated significantly (p less than 0.002) with plasma theophylline concentrations but not with the increase in plasma E from the baseline. Theophylline concentrations did not correlate with the increase in plasma NE or E from the baseline.(ABSTRACT TRUNCATED AT 250 WORDS)

[Studies on the metabolic fate of 14C-rokitamycin. Absorption, distribution, metabolism and excretion in infant rats]

14C-Rokitamycin (RKM) at the dose of 200 mg/kg was administered orally to fasted infant rats to study the absorption, distribution, metabolism and excretion in infant animals. The mean blood level of 14C-RKM reached its peak of 20.25 micrograms/ml in 30 minutes. The mean area under the curve was 93.23 micrograms.hr/ml. In vivo plasma protein binding rates of 14C-RKM were about 30% in both infant and adult rats. 14C-RKM was distributed at high concentrations into liver, kidney, lung, spleen, pancreas, bone marrow, submaxillary gland and some other tissues. Major metabolites detected in plasma, urine and bile were 10"-OH-RKM, leucomycin A7, leucomycin V and 14-OH-leucomycin V. In excretion studies, about 97% of the administered radioactivity was recovered in urine and feces within 144 hours. After intraduodenal administration to rats with cannulated bile ducts, 7.42% and 25.66% of the radioactivity were excreted within 24 hours in the urine and bile, respectively.

[Studies on the absorption and excretion of rokitamycin in infant beagle dogs. Comparison with adult beagle dogs]

Absorption and excretion of rokitamycin (RKM) were studied after oral administration of 50 mg/kg to fasted infant and adult Beagle dogs. In infant Beagle dogs, the mean plasma level of RKM reached its peak of 6.53 micrograms/ml in 15 minutes after administration. The area under the curve (AUC) value was 11.04 micrograms.hr/ml. In adult Beagle dogs, the mean plasma level of RKM reached its peak of 8.62 micrograms/ml in 30 minutes after administration. The AUC value was 18.25 micrograms.hr/ml. Ratios of Cmax and AUC value in infant Beagle dogs to those in adults were about 75% and 60%, respectively. In infant Beagle dogs, urinary excretion of RKM was 2.55% of the dose within 24 hours. In adult Beagle dogs, urinary excretion of RKM was 3.03% of the dose within the same period. The excretion ratio of RKM in infant Beagle dogs was about 85% of the adults' value.

[Acute myocarditis with localized left ventricular aneurysm: a report of three cases]

Ventricular aneurysms are rarely observed in viral myocarditis. Three cases whose left ventriculograms showed localized left ventricular aneurysms in the chronic phase of myocarditis are reported. The etiology in one case was herpes simplex virus (Case 1). Two cases (Case 2, 3) of myocarditis were admitted to our Coronary Care Unit in the acute phase, when diffuse hypokinesis of the left ventricle was demonstrated by two-dimensional (2-D) echocardiography. Hypokineses progressed to localized left ventricular aneurysm formation, demonstrated by cine angiography. In the acute phase, ST segment elevation was observed in these two cases, but it resolved. Abnormal Q waves also resolved in the chronic phase. Negative T waves were nearly normalized in one of them (Case 3). Abnormal Q waves with ST segment depression were observed in another case (Case 1). Thus, there were no characteristic or consistent findings suggesting a left ventricular aneurysm on electrocardiography. 2-D echocardiography and cine angiography proved useful for diagnosing this uncommon complication. Long-term follow-up of these cases will be important, because viral myocarditis can develop into dilated cardiomyopathy. The mechanism of left ventricular aneurysm following acute viral myocarditis included: (1) direct viral injury of the myocardium, (2) localized injury due to immunological mechanisms, and (3) coronary thrombosis due to increased platelet aggregation by viral infection.

A case-control study of lung cancer in nonsmoking women

A case-control study of Japanese women in Nagoya was conducted to investigate the significance of passive smoking and other factors in relation to the etiology of female lung cancer. A total of 90 nonsmoking patients with primary lung cancer and their age- and hospital-matched female controls were asked to fill in a questionnaire in the hospital. Elevated relative risk (RR) of lung cancer was observed for passive smoking from mother (RR = 4.0; p less than 0.05) and from husband's father (RR = 3.2; p less than 0.05). No association was observed between the risk of lung cancer and smoking of husband or passive smoke exposure at work. Occupational exposure to iron or other metals also showed high risk (RR = 4.8; p less than 0.05). No appreciable differences in food intakes were observed between cases and controls.

Improved prognosis after coronary thrombolysis with urokinase in acute myocardial infarction

The effectiveness of coronary thrombolysis with urokinase (UK) on short- and long-term outcome after acute myocardial infarction was studied by comparison of 120 patients treated with UK and 124 with conventional therapy followed up for a period of 20 months. UK was administered to patients within 6 hours of the onset of chest pain, by the intracoronary route (20,000 U/min, at a mean dose of 698,000 U) in 46 patients, intravenously (960,000 to 1,920,000 U in 15 or 30 min, at a mean dose of 1,293,000 U) in 56 patients and by the combined route (at a mean dose of 2,333,000 U) in 18 patients. Complete occlusion or 99% stenosis with severe delay of the contrast medium was found in 72.5% and recanalization by UK was achieved in 68.0%. Cumulative mortality rate was significantly reduced in the UK group (9.2% vs. 29.0%). Cardiac death from recurrent MI was also significantly reduced (2.5% vs. 10.5%). The reduction in mortality rate was demonstrated even in older patients as well as in those cases graded as severe according to the Killip and Forrester classifications. Thus, it is concluded that coronary thrombolysis with UK therapy improves the prognosis of acute myocardial infarction.

[Studies on the metabolic fate of 14C-rokitamycin. II. Accumulation of radioactivity in rats after consecutive oral administration]

After a consecutive oral administration of 200 mg/kg/day of 14C-rokitamycin (TMS-19-Q) daily for 28 days to male rats, the accumulation of radioactivity in tissues and its disappearance after the cessation of the administration was studied. Blood concentrations at peak times and 24 hours after each administration were determined daily. Both values increased gradually until the 14th day and thereafter remained roughly constant. The extent of elimination of radioactivity from the blood was practically not affected by the consecutive administration. Affinities of radioactivity to the liver, kidney, spleen, adrenal, pituitary gland, preputial gland, thyroid, intraorbital lacrimal gland and bone marrow were comparatively higher than those to other tissues. Tissue concentrations in the above mentioned tissues at the 1st day after the completion of consecutive administrations for 14 and 28 days were 2.6-6.1 and 3.2-6.8 times higher, respectively, than those at the 1st day after a single administration. The elimination of radioactivity from the tissue after the consecutive administration for 28 days was slightly slower than that after a single administration. In the consecutive daily administration for 28 days, the metabolic fate of radioactivity reached a steady state after 14 days of consecutive daily administration. Hence, the accumulation of the radioactivity did not particularly occurred. During the consecutive administration, recoveries of radioactivity in the urine and feces were almost at a constant rates, with 8.0 and 93.8% of the total radioactivity given excreted in the urine and feces, respectively, within 10 days after the last administration.

[Studies on the metabolic fate of 14C-rokitamycin. I. Absorption, distribution, metabolism and excretion in rats]

Blood concentrations of 14C-rokitamycin (14C-TMS-19-Q) reached their peaks at 1 hour after a single oral (200 mg/kg) administration to male and female rats, and they were 28.0 +/- 0.8 and 24.9 +/- 2.0 micrograms/ml, respectively. No significant differences were observed between male and female in AUC values or maximum blood concentrations. The distribution of TMS-19-Q was good, and concentrations of 14C were high in liver, kidney, spleen, pancreas, adrenal, pituitary gland, thyroid, trachea, exorbital lacrimal gland, submaxillary gland and bone marrow. During the 72 hours period after a single oral (200 mg/kg) administration of 14C-TMS-19-Q to male rats, 8.0 and 89.6% of the dose were excreted in urine and feces, respectively and a total recovery rate was 97.5% of the dose. During the 48 hours period after a single intraduodenal (200 mg/kg) administration of 14C-TMS-19-Q in male rats, 6.9 and 36.2% of the dose were excreted in urine and bile, respectively. Reabsorption of 14C excreted from the bile was negligible. Absorptions of TMS-19-Q from the duodenum, jejunum, ileum and colon were good, but absorption from the stomach was negligible. Major metabolic reactions of TMS-19-Q were deacylation and hydroxylation, and the major metabolites in rats of TMS-19-Q found in the plasma, urine and bile after oral and intraduodenal administration were 10"-OH-TMS-19-Q, leucomycin A7, leucomycin V and 14-OH-leucomycin V.

[Studies on the metabolic fate of 14C-rokitamycin. III. Transmigration to fetus or milk]

Transmigration of 14C-radioactivity to fetus or milk were studied in 17-18 day-pregnant rats and mother rats on the 14th day after parturition after a single oral administration of 14C-rokitamycin (TMS-19-Q) at a dose of 200 mg/kg. The blood concentration of the drug in the mother reached a maximum level of 22.8 micrograms/ml at 2 hours after administration. Maximum concentrations of TMS-19-Q in placenta, ovary and uterus were attained in 2 hours, and were 28.9, 26.0 and 26.2 micrograms/g, respectively. The distribution to these tissues were considered good. The maximum concentration of TMS-19-Q in the amniotic fluid was attained in 2 hours, at a level of 5.4 micrograms/ml. The transmigration to the amniotic fluid was considered poor. The maximum concentration of the drug in the fetus was achieved in 2 hours at a level of 13.7 micrograms/g. Maximum concentrations of the drug in fetal liver and brain were attained in 4 hours, and were 32.8 and 11.4 micrograms/g, respectively. Whole body autoradiography was done when the radioactivity in maternal blood reached peak concentration. It was found that radioactivities in placenta and fetal membrane were similar to the radioactivity in maternal blood, while the radioactivity in fetal brain was considerably lower than that in maternal blood. Maximum concentrations were found at 1 hour in the blood and at 4 hours in the milk, and were 14.8 and 21.5 micrograms/ml, respectively. Transmigration to the milk was good.

[Studies on the metabolic fate of 14C-rokitamycin. IV. Absorption, metabolism and excretion in dogs]

Absorption, metabolism and excretion of rokitamycin (TMS-19-Q), were studied after oral (50 mg/kg), intraduodenal (50 mg/kg) and intravenous (10 mg/kg) administrations of 14C-TMS-19-Q to male dogs. Maximum blood and plasma concentrations of the drug reached at 2 hours after oral administration, and they were 11.1 and 14.3 micrograms/ml, respectively. Maximum blood and plasma concentrations reached at 30 minutes after intraduodenal administration, and they were 10.7 and 12.0 micrograms/ml, respectively. Blood and plasma concentrations at 3 minutes after intravenous administration were 8.4 and 11.1 micrograms/ml, respectively. At 24 hours, they were 0.6 and 1.7 micrograms/ml, respectively. During the first 72 hours period after oral administration, 12.8 and 82.6% of the dose were excreted in the urine and feces, respectively. A total recovery rate was 95.4% of the dose. During the first 72 hours period after intravenous administration, 19.4 and 75.3% of the dose were excreted in the urine and feces, respectively. A total recovery rate was 94.7% of the dose. During the first 24 hours period after intraduodenal administration, 18.0 and 48.3% of the dose were excreted in the urine and bile, respectively. A total recovery rate was 66.3% of the dose. Major metabolic reactions on TMS-19-Q were deacylation and hydroxylation, and the major metabolites of TMS-19-Q found in the plasma urine and bile after intraduodenal administration to dogs were 10"-OH-TMS-19-Q, LM A7, LM V and 14-OH-LM V.

[Absorption and distribution of rokitamycin in beagle dogs]

Tissue distribution of rokitamycin (TMS-19-Q) was studied after oral administration of 50 mg/kg to fasted Beagle dogs. Tissue concentrations of TMS-19-Q reached their peaks at 1-2 hours after the administration. The order of tissue concentrations of TMS-19-Q was liver greater than kidney greater than spleen greater than lung greater than mesenteric lymph node greater than heart greater than tonsil greater than serum greater than prostate gland greater than uterus greater than skin. At the peak time, drug concentrations in tonsil and lung were about 1.1 and 1.4 times higher, respectively, than that in serum.

[Metabolic fate of 14C-isepamicin sulfate (14C-HAPA-B) in rats. II. Distribution and excretion after the successive administration]

Tissue concentrations of 14C-isepamicin (14C-HAPA-B) and its excretion were studied in male rats after 8- and 15-successive intramuscular administrations of 25 mg/kg/day. Plasma levels were hardly affected by the successive administration, and plasma concentrations as time patterns with 8- and 15-successive administrations were very similar to that with a single administration. Kidney levels of the drug increased remarkably by successive administrations. In all the organs tested except kidney, the elimination of the drug from the tissues tended to become somewhat slower with successive administrations but maximum concentrations were hardly affected by successive administrations. There was little difference between the excretion rates (urinary and fecal) after the successive doses and that after a single dose.

[Studies on the metabolic fate of isepamicin sulfate (HAPA-B). III. Intramuscular, intravenous and drip intravenous administration of HAPA-B in rabbits]

Absorption, distribution, metabolism and excretion of isepamicin sulfate (HAPA-B) were studied following intramuscular, intravenous and drip intravenous administration at doses of 6.25, 25 and 100 mg/kg to rabbits. Plasma concentrations of HAPA-B following intramuscular, intravenous and drip intravenous administration depended on dose levels. Biological half-lives (T1/2), body clearance (Clt) and areas under plasma concentration-time curves (AUC) for different routes of administration were similar in all 3 routes. A theoretical curve for drug concentrations vs. time was obtained using pharmacokinetic parameters calculated from drug concentrations in plasma following a 45-minute drip intravenous administration. From the curve, it was estimated that 60 to 90 minutes would be required to achieve a similar maximum drug concentration in plasma by drip intravenous administration to that obtained by intramuscular administration. Thus, drug concentration patterns obtained following intramuscular administration could be duplicated in drip intravenous administration by regulating the length of time for infusion. The concentration of HAPA-B in tissues obtained following a 15-minute drip intravenous administration reached maximum after 15 minutes at a level higher than that achieved by intramuscular administration, but an hour later, concentrations in tissues including the kidney decreased to similar levels obtained following intramuscular administration and patterns of concentration decrease for drip intravenous administration and intramuscular administration were quite similar to each other thereafter. The drug was rapidly excreted into the urine following any of the 3 routes, and urinary recoveries in 24 hours were 75 approximately 92% of dose amounts for all dose levels tested. Bioautograms on thin-layer chromatographs of 0 approximately 6 hours urine samples obtained following an intramuscular administration of the drug showed a single biologically active bands with similar Rf values to HAPA-B itself. No active metabolite of the drug was detected in the urine.

[Studies on the metabolic fate of isepamicin sulfate (HAPA-B). IV. Intramuscular, intravenous and drip intravenous administration of HAPA-B in dogs]

The plasma concentration and urinary excretion of isepamicin sulfate (HAPA-B) were studied following intramuscular, intravenous and drip intravenous administrations of 6.25, 25 and 100 mg/kg in dogs. Maximum plasma concentrations (Cmax) of HAPA-B after intramuscular, intravenous and drip intravenous administration depended on dosage levels. Biological half-lives (T1/2) and areas under plasma concentration-time curves (AUC) for the three different routes of administration were similar to each other. The peak plasma concentration of HAPA-B achieved with intramuscular administration was similar to that with a 1-hour drip intravenous administration at a dose level of 6.25 or 25 mg/kg. On the other hand, at a dose level of 100 mg/kg, the Cmax following intramuscular administration was similar to that following 2-hour drip intravenous administration. It was, therefore, presumed that the plasma concentration curves which are similar to that of intramuscular administration can be obtained by regulating the infusion time. The observed Cmax value for drip intravenous administration was a little higher than the theoretical Cmax value for drip intravenous administration calculated from parameters for intramuscular administration. Simulation curves obtained for extended infusion times agreed more closely with observed curves than curves simulated for shorter infusion periods. These investigations showed that plasma concentration curves for any dosage levels can be estimated from parameters calculated from experimental data obtained using intramuscular or drip intravenous administration. HAPA-B was rapidly excreted into the urine after administration through any of these 3 routes and 71 approximately 89% of the dose was excreted into the unrine in 24 hours at all dosage levels. Bioautograms of thin-layer chromatographs of the 0 approximately 6 hours urine after intramuscular administration showed single bands with a similar Rf value to that of the standard HAPA-B. No significant differences in plasma concentration and urinary excretion between HAPA-B and amikacin were observed upon intramuscular or intravenous administration of 25 mg/kg.

[Studies on the metabolic fate of isepamicin sulfate (HAPA-B). V. Plasma concentrations of HAPA-B in dogs after multiple administrations]

Plasma concentrations after a single or multiple intramuscular administrations of isepamicin sulfate (HAPA-B) at dose levels of 6.25, 25 and 100 mg/kg to male and female dogs were measured by microbiological assay, and were also compared with those of amikacin at dose levels of 25 and 100 mg/kg. Shapes of plasma concentration curves after multiple administrations of HAPA-B were very similar to those after single administrations at all dosage levels tested. On the other hand, the shape of plasma concentration curve after multiple administration of amikacin at 100 mg/kg was markedly different from that after a single administration.

[Evaluation of assay methods for isepamicin sulfate (HAPA-B) in body fluids. Bioassay, HPLC and EIA methods]

Assay methods including microbiological assay (bioassay), high performance liquid chromatography (HPLC) and enzyme immunoassay (EIA) for isepamicin sulfate (HAPA-B), a new aminoglycoside antibiotic, in body fluids were studied. The most suitable bioassay method was double layer agar-well method using Bacillus subtilis ATCC 6633 as the test organism on plate consisting of a seed-layer of nutrient agar at pH 8.0 and a base-layer of nutrient agar supplemented with 0.4% sodium chloride. Sensitivities in bioassay, HPLC and EIA methods for plasma concentration were 0.08 microgram/ml, 0.20 microgram/ml and 0.05 microgram/ml, respectively. Plasma and urinary concentrations after intramuscular administration of HAPA-B at the dose of 200 mg to healthy volunteers were measured with these 3 methods. The HPLC and the EIA methods yielded values which compared favorably to the bioassay method. Using the bioassay method, HAPA-B levels in human plasma and urine samples were found to be stable at least for 15 days at -20 degrees C.