[Metabolic fate of 14C-isepamicin sulfate (14C-HAPA-B) in rats. I. Absorption, distribution, metabolism and excretion after a single intramuscular and intravenous administration]

Absorption, distribution, metabolism and excretion of 14C-isepamicin sulfate (14C-HAPA-B) following a single intramuscular and intravenous administration of 25 mg/kg were studied in male rats. After an intramuscular administration, the drug was rapidly absorbed and the maximum plasma level of about 75 micrograms/ml was obtained at 10 minutes after the administration. The plasma levels rapidly decreased following either intramuscular or intravenous route. The HAPA-B was rapidly distributed into tissues except the central nervous system and the eye ball. Especially high concentrations were attained in kidney and cartilage tissues, concentrations in lung followed these tissues. Radioactivity remained in kidney for a long period, but it disappeared from cartilage and other tissues rapidly. The radioactivity in kidney was located in the cortex at 24 hours after administration. There was no difference in the distribution of radioactivity with different administration routes. The HAPA-B was mainly excreted in the urine following either intramuscular or intravenous administration. Approximately 80% of the dose by intramuscular and 92% by intravenous administrations were excreted during the first 4 hours. Within 24 hours, over 95% was recovered in either routes. The radioautogram of the thin-layer chromatography of the 0 approximately 16-hour urine showed a single radioactive zone with an identical Rf value to HAPA-B. Binding ratios of 14C-HAPA-B to plasma protein were less than 10% both in vitro and in vivo and to erythrocytes less than 9% in vitro.

[Reduction of myocardial segment shortening during angina-free period in patients with angina pectoris]

In 16 patients with angina pectoris who had no histories of myocardial infarction, myocardial segment shortening was studied during angina-free periods. Myocardial segment length in the anterior wall of the left ventricle was calculated by measuring the spatial length between two points identified as junctions of ramifying branches of the left coronary arteries using biplane coronary cineangiography. Segment shortening was classified according to the severity of coronary arterial stenosis. The patients were categorized according to the severity of coronary arterial stenosis: as 1) the 0% stenosis (normal); 2) the 50% stenosis group; and 3) the 75-90% stenosis group. Total segment shortening in the normal group was the same as that in the 50% stenosis group (10.4 +/- 2.5%). However, in the 75-90% stenosis group, segment shortening was reduced to 7.3 +/- 2.5%. Effective segment shortening during the ejection period was reduced (5.0 +/- 1.8%) in the 75-90% stenosis group, as compared with the normal group (8.4 +/- 2.4%) and the 50% stenosis group (7.2 +/- 3.6%). This study demonstrated that segment shortening was reduced at rest in patients with angina pectoris who had had no previous infarction. A possible mechanism of this reduced segment shortening during angina-free periods may be irreversible myocardial alteration from recurrent ischemic attacks.

Combined mutagenicity of cobalt(II) salt and heteroaromatic compounds in Salmonella typhimurium

Mutagenic activities of 4-aminopyridine (4AP), 4-aminoquinoline (4AQ), 9-aminoacridine (9AA) and harman (HM) were examined by the Salmonella test system in the presence of cobalt(II) chloride (CoCl2), which itself is non-mutagenic in this system. Mutagenic activity of the mixture of 9AA and CoCl2 was found to be much higher than that of 9AA alone in strains TA1537 and TA2637. A similar enhancing phenomenon was observed in 4AQ-CoCl2 and HM-CoCl2 mixtures but not in that of 4AP-CoCl2. Judging from visible and nuclear magnetic resonance spectral data, this increased mutagenicity may be attributable to the formation of moderate to weak complexes between these chemicals and the Co(II) cation. A survey of the mutagenicity of several Co(II) complexes supported this interpretation.

[Evaluation of T-2588 in the treatment of respiratory tract infection]

T-2588 was used on 55 patients with respiratory tract infections and 44 cases were evaluated; 23 patients with pneumonia, 12 patients with acute bronchitis, 2 patients with chronic bronchitis, 1 patient with diffuse panbronchiolitis and 6 patients with bronchiectasis with infection. Clinical effects of T-2588 were as follows; excellent in 6 and good in 28 patients. The efficacy rate was 77.3% (34/44). Bacteriological effects of T-2588 were prominent in 8 patients infected with B. catarrhalis, H. influenzae, K. pneumoniae and E. coli, but not in a patient infected with P. putida. The elimination rate was 90.0% (9/10 strains). As side effects, stomatitis, anorexia, diarrhea X vomiting and pruritus were observed in one patient each. Abnormal laboratory findings were observed in 4 patients with elevated GOT and/or GPT. These side effects and abnormal laboratory findings were not serious. The usefulness of T-2588 was 68.2% (30/44). Therefore, T-2588 is a useful drug and its effects are promising in clinical management of respiratory tract infections.

Effect of a protease derived from the oral bacterium Bacteroides loescheii on the inhibition of calcium-phosphate precipitation by human parotid saliva

A protease from the culture fluid of this microorganism was purified and characterized using DEAE-Sephadex and chromatofocusing and classified as a thiol protease with a mol. wt estimated as 27,500. It abolished the inhibitory activity of parotid saliva on the precipitation of calcium phosphate from supersaturated solutions. Such proteases may contribute to dental calculus formation.

[Clinical study of aztreonam on respiratory tract infections caused by gram-negative pathogens]

Aztreonam (E-0734, AZT) was administered to pneumonia and chronic respiratory tract infections. The results were as follows: AZT was administered to 29 patients. Twenty-six cases were evaluable and 3 cases were excluded from evaluation of efficacy because 1 was Gram-positive infection, 2 were unclear symptom of infection. Pneumonia was 4 cases. Chronic respiratory tract infections were 22 cases. Clinical efficacy was judged as follows; excellent in 7 cases, good in 10 cases, fair in 5 cases and poor in 4 cases, then the efficacy rate was 65.4%. Efficacy rate in pneumonia, acute aggravation of diffuse panbronchiolitis and bronchiectasis with infection was 50%, 67% and 83%, respectively. Bacteriological response was judged on 21 cases with eradication rate was 66.7%. Bacteriological response classified by pathogen was as follows: All 6 isolates of H. influenzae, 2 in 6 isolates of P. aeruginosa, 4 in 5 isolates of H. parainfluenzae and all 3 isolates of K. pneumoniae were cleared. Total eradicated rate was 74.1%. Eruption was observed in 1 case as side effect. Abnormal laboratory findings were observed in 4 cases. Elevation of GOT and GPT was in 3 cases. Increase of eosinophil and basophil was in 1 case. AZT was considered to be a useful antibiotic for the treatment of respiratory tract infections, especially chronic respiratory tract infections, caused by Gram-negative pathogens.

Biochemical rationale and the cardiac response of patients with muscle disease to therapy with coenzyme Q10

Cardiac disease is commonly associated with virtually every form of muscular dystrophy and myopathy. A double-blind and open crossover trial on the oral administration of coenzyme Q10 (CoQ10) to 12 patients with progressive muscular dystrophies and neurogenic atrophies was conducted. These diseases included the Duchenne, Becker, and limb-girdle dystrophies, myotonic dystrophy, Charcot-Marie-Tooth disease, and Welander disease. The impaired cardiac function was noninvasively and extensively monitored by impedance cardiography. Solely by significant change or no change in stroke volume and cardiac output, all 8 patients on blind CoQ10 and all 4 on blind placebo were correctly assigned (P less than 0.003). After the limited 3-month trial, improved physical well-being was observed for 4/8 treated patients and for 0/4 placebo patients; of the latter, 3/4 improved on CoQ10; 2/8 patients resigned before crossover; 5/6 on CoQ10 in crossover maintained improved cardiac function; 1/6 crossed over from CoQ10 to placebo relapsed. The rationale of this trial was based on known mitochondrial myopathies, which involve respiratory enzymes, the known presence of CoQ10 in respiration, and prior clinical data on CoQ10 and dystrophy. These results indicate that the impaired myocardial function of such patients with muscular disease may have some association with impaired function of skeletal muscle, both of which may be improved by CoQ10 therapy. The cardiac improvement was definitely positive. The improvement in well-being was subjective, but probably real. Likely, CoQ10 does not alter genetic defects but can benefit the sequelae of mitochondrial impairment from such defects. CoQ10 is the only known substance that offers a safe and improved quality of life for such patients having muscle disease, and it is based on intrinsic bioenergetics.

Enzyme immunoassay for elcatonin, a synthetic analogue of eel calcitonin, in plasma

An enzyme immunoassay for the direct measurement of elcatonin, a synthetic analogue of eel calcitonin with hypocalcemic activity, in rat and dog plasma was developed. Elcatonin was conjugated to beta-galactosidase using an N-succinimidyl ester, and the product was used as the tracer. The antibody-bound tracer was precipitated using a second antibody. The nonequilibrated procedure gave better sensitivity and precision than the equilibrated procedure. The nonequilibrated method was sensitive at quantifiable concentrations as low as 0.2 ng/mL using 0.1 mL of plasma and was also reproducible, with RSD values generally less than +/- 10%. Plasma levels in rats and dogs were determined by this competitive enzyme immunoassay after intramuscular or intravenous injection of 40 U/kg (8 micrograms/kg) of elcatonin.

Myasthenia gravis associated with lipodystrophy

Patients with partial lipodystrophy frequently show hypocomplementemia but rarely have associated autoimmune diseases. We report here a patient of myasthenia gravis associated with limb lipodystrophy, a variant form of partial lipodystrophy, and hypocomplementemia.

Effects of long use of a beta-blocker, carteolol, on exercise hemodynamics in hypertensives

The symptom limited maximal exercise was performed by a supine bicycle ergometer before and 12 weeks after oral carteolol therapy in 10 patients with essential hypertension of WHO Stage 1 and 2. At rest, arterial blood pressure (BP) and venous pressure (VP) significantly declined after therapy, while heart rate (HR), cardiac index (CI), stroke index (SI) and systemic vascular resistance (SVR) were not significantly changed. The maximal exercise work of post-therapy was similar to that of pre-therapy in 9 patients and increased in one. When compared with the pre-therapy values at each work load of exercise, carteolol caused significant decreases in systolic BP, mean BP, HR and CI, and a significant increase in SVR, while SI and VP were not significantly changed. Plasma levels of renin activity, aldosterone, and catecholamines were not altered by carteolol throughout the study at rest and with exercise. It may be concluded that the inhibition of HR increase by carteolol results in a reduced cardiac output during moderate and severe exercise and then suppresses the elevation of BP, so that carteolol makes it possible to achieve more exercise with less cardiac work.

Enhanced rectal absorption of [Asu1,7]-eel calcitonin in rats using polyacrylic acid aqueous gel base

The effects of polyacrylic acid aqueous gel on the absorption of rectally administered [Asu1,7]-eel calcitonin, a calcitonin analogue, were investigated in rats. The [Asu1,7]-eel calcitonin (1 U/kg) was given into the rectal loop in gel bases at various pH (5.5-8.5) and polyacrylic acid concentrations (0.01-1.0% w/v). The maximum hypocalcemic effect was obtained in approximately 30 min after administration of the analogue in a 0.1% w/v polyacrylic acid gel base at pH 5.5. The plasma calcium level decreased by approximately 18% from the initial level. Rectal administration in vehicles such as polyethylene glycol 1000, triglyceride fatty acid mixture base, or saline solution had little or no hypocalcemic effect at a dose of 5 U/kg. The results indicated that a polyacrylic acid aqueous gel base significantly improved the absorption of this analogue. Furthermore, rectal administration in a polyacrylic acid gel base (0.1% w/v; pH 5.5) required a dose 35 times greater than an intravenously administered dose to achieve an equivalent hypocalcemic effect.

Micro-analysis for coenzyme Q10 in endomyocardial biopsies of cardiac patients and data on bovine and canine hearts

A micro-analysis was designed for determining the levels of coenzyme Q10 (CoQ10) in specimens of ca. 500 nanograms of myocardial tissues. The prime steps included acetone extraction, purification by thin-layer chromatography, and HPLC. CoQ11 was the internal standard. This methodology was successful for human endomyocardial biopsies from cardiac patients before and after therapy with CoQ10 and has now been used for canine and bovine tissues. The mean canine CoQ10 level from six specimens from the left ventricle (l.v.) of a single animal is 0.99 +/- 0.06 micrograms/mg/d.w. The mean levels of the tissues from nine animals is 1.04 +/- 0.17 (l.v.) and 1.11 +/- 0.16 (r.v.). The mean bovine level from seven animals was 0.48 +/- 0.12 (l.v.) and 0.68 +/- 0.06 (r.v.).

Development and evaluation of a new peroral test agent GA-test for assessment of gastric acidity

A new peroral test capsule, GA-Test, containing riboflavin (5 mg) granules coated with polyvinylacetal diethylaminoacetate (AEA) for assessing gastric acidity without intubation was developed and evaluated for usefulness. GA-Test is based on the tracing in the urine of riboflavin, which is released in the stomach only in the presence of acidic fluid and is absorbed. Due to the film coating, riboflavin released very quickly at a pH of less than 5, and not at all at a pH of greater than 6. GA-Test gave a significant correlation, quantitatively, with peroral Gastrotest in assessing acidity, a non-intubation method which had been marketed in Japan prior to 1980. GA-Test results allowed division of the subjects into two groups i.e., subjects having low (hypo- or anacidity) gastric acidity and those having high (normal or hyperacidity) gastric acidity, GA-Test results agreed well with results of intubation (around 91.4%; 32 out of 35 cases) and were easily reproduced during the evaluation.

Synchronous bilateral double primary lung cancer associated with diffuse interstitial fibrosing pneumonitis (DIFP)

Double primary lung cancer with diffuse interstitial fibrosing pneumonitis (DIFP) was detected in a 61 year-old man at autopsy. Histologically, alveolar septa in whole lobes of right and left lungs were thickened diffusely with fibrosis, edema, and inflammatory cell infiltration. Alveolar cavities contained fibrinous exudate. A tumor mass measuring 8 X 5 X 5 cm occupying the right hilar portion was epidermoid carcinoma involving the right superior lobar bronchus and hilar lymph nodes. There were no metastatic foci in the right middle and lower lobes. In the lower lobe of the left lung, scattered foci of bronchiolo-alveolar carcinoma and those of epidermoid carcinoma coexisted. There were no metastatic foci in the left upper, lower lobes, and hilar lymph nodes. Both atypical bronchiolar epithelial proliferation associated with bronchiolo-alveolar carcinoma and squamous metaplasia associated with epidermoid carcinoma were detected at the same time. The clinical and pathological characteristics among 81 reported cases of lung cancer associated with DIFP are reviewed.

The oral manifestations of 4p- syndrome

The oral manifestations of 80 reported cases of 4p- syndrome are analyzed and a new case is reported. Results indicate that the common pattern of cheilognathopharyngeal disorders in 4p- syndrome is an isolated cleft palate or a high-arched palate with micrognathia. Cases of cleft lip are only about 10% of the total. The significance of other reported aberrant phenomena cannot yet be estimated.

[Complement components, whole complement activity, and circulating immune complexes in neoplastic diseases]

Serum levels of complement components(cc), whole complement activity (CH 50), and circulating immune complexes (IC) were measured in 41 patients with neoplastic diseases. The level of cc was higher than in healthy controls; the levels of C1q, C1INA, C4, C3c, C3ACT, C5, and C9 were statistically higher. In patients with lung cancer, the levels of cc were correlated with the clinical stage as well as the performance status. Both the IC serum level and the incidence of high serum IC levels in lung cancer were higher in stage III and IV than in stage I and II. Serum CH 50 was higher than in healthy controls, but not correlated with the clinical stage.

[The effect of levamisole on non-resected lung cancer--the results of randomized controlled study]

The effect of levamisole in the treatment of 61 non-resected lung cancer-26 squamous cell ca., 8 adenocarcinoma, 13 large cell ca. and 14 small cell ca- was studied by a randomized controlled trial. Levamisole was given at a daily dose of 150 mg per body weight for 3 consecutive days every 2 weeks. The main therapy, combining polychemotherapy and radiotherapy of standard dose or low dose, was given to both levamisole and control groups. The survival rate of the levamisole group was superior to that of the control group, with median survival time of 52 weeks in the former and 36 weeks in the latter, and with significant difference (p less than 0.05) during 46th to 52nd weeks. Comparing between the selected cases, the levamisole group was significantly superior (p less than 0.05) to the control group in all course examined, with median survival time of 64 weeks in the former and 36 weeks in the latter. Levamisole was more effective in the group of squamous and adenocarcinoma than large and small cell carcinoma. In the group where PPD reaction was negative at the time of initiation of the treatment levamisole was more effective than in the group of PPD positive, and also more effective in non-responders to the main therapy than responders. No side effect such as agranulocytosis was observed. Summarizing the present study, an immunotherapy employing levamisole combined with chemo-radiotherapy for non-resected lung cancer could be said to be effective in prolongation of survival time.

Correlations between salivary protease and supragingival or subgingival calculus index

Significant positive correlations between protease activities in saliva and supragingival/subgingival calculus indices, periodontal pocket depth, or P-M-A index were confirmed. When the partial correlation was calculated, the subgingival calculus index correlated well with the sediment protease at pH 8.5, and the supragingival calculus index showed a significant correlation with the supernate protease at pH 4.5.