Effects of a thromboxane synthase inhibitor (CS-518) on the eosinophil-dependent late asthmatic response and airway hyperresponsiveness in guinea pigs

The effects of CS-518, a thromboxane A2 synthase inhibitor, on antigen-induced dual bronchial responses, airway hyperresponsiveness (AHR) and airway eosinophilia were investigated in an experimental guinea pig model of the late asthmatic response. Oral CS-518 (1 and 10 mg/kg) inhibited immediate and late asthmatic responses dose-dependently. It also inhibited AHR and eosinophil accumulation after antigen challenge. Therefore, thromboxane A2 is possibly involved in development of the late asthmatic response and AHR, and CS-518 was inferred to inhibit these via inhibition of eosinophil accumulation and thromboxane production.

Relationship between airway eosinophilia and airway hyperresponsiveness in a late asthmatic model of guinea pigs

To elucidate the mechanism of development of asthma, we tried to develop a model which elicited a late asthmatic response by a combination of systemic and inhaled sensitization with ovalbumin in guinea pigs. Eighty-seven percent of animals elicited both an immediate and late asthmatic response after the third antigen inhalation. Airway eosinophilia and airway hyperresponsiveness (AHR) induced after the third challenge were more severe than those after the first challenge. There was a good correlation between airway eosinophilia and AHR in this model under experimental modulation of the number of eosinophils, such as by interleukin 5 or antieosinophil antibody injection. These results demonstrate that eosinophils play an important role in the development of late asthmatic response and AHR.

[Basic and clinical studies of pazufloxacin on infectious enteritis research group of T-3761 on infectious enteritis]

A clinical study was carried out on pazufloxacin (PZFX) in 137 patients including shigellosis, Salmonella enteritis, enteropathogenic Esherichia coli enteritis and cholera, and carriers of these pathogens. Antibacterial activity of PZFX against clinical isolates, fecal concentration of PZFX and effects of PZFX on fecal microflora were also investigated. The overall clinical efficacy rate was 97.2%. The bacteriological efficacy rates were 98.2% against Shigella spp., 81.8% against Salmonella spp., 50% against Vibrio cholerae O1, and 100% against E. coli, V. parahaemolyticus, Aeronomas spp., Plesionomas shigelloides and V. cholerae non-O1, respectively. Side effect (epigastralgia) was observed in 1 of 130 cases (0.8%). The rate of abnormal laboratory findings was 11.2% (11/98). These were mainly elevation of GOT and/or GPT and increased eosinophils. The clinical usefulness rate was 95.2%. The MIC90 values of PZFX against Shigella spp., Salmonella spp. and E. coli were 0.025, 0.025 and 0.025 micrograms/ml, respectively. The results of fecal drug concentration and the effects on fecal microflora in one patient were compatible with those obtained in healthy volunteers.

[Diffusion MRI for evaluating cerebrovascular disease]

There are several new magnetic resonance (MR) technologies, which will provide data about the pathogenesis, circulatory state and cellular effects of ischemic stroke. Among them, diffusion MRI is the most promising one. This technology clearly reveals, within minutes of stroke onset, ischemic lesions which ultimately progress to infarct. The early ischemic lesions demonstrated by diffusion MRI represent regions with slower water diffusions perhaps due to intracellular water accumulation or shrinkage of the extracellular spaces resulting from ionic pump failure, spreading depression, or other mechanisms. The diffusion MRI can show not only irreversible but also reversible ischemic lesions, and therefore has a potential to discriminate salvageable tissues from irreversibly damaged tissues before a therapeutic intervention with thrombolytic and/or cytoprotective agents. The diffusion MRI can highlight only a fresh lesion, because water diffusion is decreased during several days after stroke onset. Diffusion MRI is extremely prone to motion artifacts, a major concern against clinical application. This problem can be solved by combination with an ultrafast technique, echo planar (EP) imaging. The EP diffusion MRI will become a rapid, reliable, objective and essential emergency diagnostic test in a clinical setting that will guide the development and application of acute therapeutic intervention.

Initial and subsequent angiographic outcome of percutaneous transluminal angioplasty performed on internal mammary artery grafts

OBJECTIVE

To estimate the initial outcome and incidence of restenosis of angioplasty of internal mammary artery grafts in a retrospective study.

METHODS

The study population consisted of 46 patients (48 lesions) who underwent first balloon angioplasty within the internal mammary artery graft. Most (37/48) were at the distal anastomosis. A few (8/48) were in the graft body. Six patients with the evidence of angiographic restenosis underwent a second angioplasty.

RESULTS

The success rate and the restenosis rate of the first angioplasty was 73% and 30% respectively. Of the 34 patients (35 lesions) with a successful first angioplasty, 30 underwent follow up angiography with a restenosis rate of 30% (9/30). A second angioplasty was performed on six of the nine restenotic lesions, with a success rate of 83% and no restenoses. The percent diameter stenosis of the recipient native coronary artery was significantly greater in the restenosis group, at 75 (SD 27)% v 89 (17)%, p < 0.05.

CONCLUSIONS

First angioplasty of 46 patients (48 lesions) within an internal mammary artery graft was performed with a success rate of 73% and a restenosis rate of 30% (follow up rate of 88%). The extent of the stenosis of the recipient native coronary artery may affect the restenosis rate.

Metabolism of sertindole: identification of the metabolites in the rat and dog, and species comparison of liver microsomal metabolism

1. The main exretion pathways of a novel antipsychotic drug, sertindole, in the rat and dog are faecal excretion via intestinal secretion and biliary excretion respectively. 2. Similar liver microsomal metabolic patterns were observed in the rat, monkey, and man, and Lu 30-131 (5-hydroxy-serindole) and Lu 30-148 (4-hydroxy-serindole) were the major metabolites, and Lu 25-073 (nor-sertindole) and Lu 28-092 (dehydro-sertindole) were minor ones. In the dog, however, Lu 31-096 (3'-fluoro-4'-hydroxy-sertindole) and Lu 30-148 (4-hydroxy-sertindole) were the major metabolites, and Lu 25-073 (nor-sertindole), Lu 28-092 (dehydro-sertindole), and Lu 30-131 (5-hydroxy-sertindole) were minor ones. These findings suggest that the metabolism of sertindole in man resembles those in the rat and monkey and is different from that in the dog. 3. Rat in vitro and in vivo liver metabolites, dog liver microsomal metabolites, and dog biliary metabolites were isolated and identified by liquid chromatography/mass spectrometry and/or 1H-nmr. 4. Two metabolites, Lu 31-096 (3'-fluoro-4'-hydroxy-sertindole) and Lu 31-154 (3'-fluoro-4'-hydroxy-dehydro-sertindole), were formed via the 'NIH shift' mechanism. 5. Sertindole is metabolized by hydroxylation at the 4- and 5-positions on the imidazolidinone ring, N-dealkylation, and an NIH shift at the fluorophenyl group. Further metabolism (dehydration, oxidation, hydroxylation, glucuronidation and sulphation) was also observed. 6. In the rat, oxidation at the imidazolidinone ring and N-dealkylation are the main metabolic reactions. On the other hand, in the dog, the NIH shift at the fluorophenyl group, followed by conjugation is the main metabolic pathway.

[Five cases of drug-induced pneumonitis due to Sho-saiko-to or interferon-alpha or both]

We encountered five cases of drug-induced pneumonitis due to Sho-saiko-to or interferon-alpha or both. In all 5 cases the underlying disease was chronic hepatitis or liver cirrhosis caused by hepatitis C virus. Interferon-alpha alone was administered in one case, Sho-saiko-to alone was administered in two cases, and both were administered in two cases. Bronchoalveolar lavage was done in 4 cases. In three cases, lymphocytosis and abnormally low CD4/8 ratios were found on examination of bronchoalveolar lavage fluid. In the only case in which interferon-alpha alone was given the percentage of neutrophils in bronchoalveolar lavage fluid was abnormally high, and the adult respiratory distress syndrome developed. Lymphocyte stimulation tests were done in four cases, and in all four cases the only positive results were against Sho-saiko-to or against interferon-alpha. The frequency of drug-induced pneumonitis among patients with chronic hepatitis or liver cirrhosis was 0.7% in those given only Sho-saiko-to, 0.5% in those given only interferon-alpha, and 4.0% in those given both interferon-alpha and Sho-saiko-to. Therefore, pneumonitis due to Sho-saiko-to and to interferon-alpha is more likely to occur if these two drugs are given simultaneously.

Realistic three-dimensional left ventricular ejection determined from computational fluid dynamics

A realistic model of the left ventricle of the human heart was constructed using a cast from a dog heart which was in diastole. A coordinate measuring machine was used to measure and digitize the coordinates of the left ventricle. From the complex measured left ventricle shape values, a three-dimensional finite volume representation was constructed using a simulation package. The left ventricular walls moved towards the centre of the aortic outlet in order to study the effects of time-varying left ventricular ejection. The left ventricular wall motion was assumed to follow the blood flow and the wall grid was reformed 25 times during the calculation. The 25.8 cm3 ventricular volume was reduced by 75% in 0.25 s. Centreline and cross-sectional velocity vectors greatly increased in magnitude at the aortic outlet, and most of the pressure occurred in the top 15% of the heart. The computational method should make it possible to compare simulation results with important measurement techniques such as ultrasound and magnetic resonance imaging, and this should allow a finer detail of flow understanding than is presently available using either a modelling or imaging method alone.

Synthetic nucleosides and nucleotides. XXXV. Synthesis and biological evaluations of 5-fluoropyrimidine nucleosides and nucleotides of 3-deoxy-beta-D-ribofuranose and related compounds

1-O-Acetyl-2,5-di-O-p-chlorobenzoyl-3-deoxy-D-ribofuranose (1), derived from the antibiotic cordycepin was coupled with trimethylsilylated derivatives (2a-c) of N4-propionylcytosine, N4-p-toluoyl-5-fluorocytosine and 5-fluorouracil in the presence of trimethylsilyl trifluoromethanesulfonate (TMS-triflate) to give fully acylated nucleosides (3a-b and 3d, respectively). Selective removal of the N4-propionyl group of 3a by treatment with hydrazine hydrate gave 2',5'-di-O-p-chlorobenzoyl-3'-deoxycytidine (4). Deamination of 4 with sodium nitrite in trifluoroacetic acid afforded 2',5'-di-O-p-chlorobenzoyluridine (3c) in good yield. Compounds 3a-d were saponified to give free 3'-deoxycytidine (5a), 5-fluoro-3'-deoxycytidine (5b), 3'-deoxyuridine (5c), and 5-fluoro-3'-deoxyuridine (5d), respectively. These 3'-deoxyribonucleosides (5a-d) were then converted to corresponding 5'-monophosphate and further phosphorylated to the 5'-triphosphates by the phosphoroimidazolidate method. The nucleosides (5a-d) were examined for growth-inhibitory effects on mouse leukemic L5178Y cells, and their IC50 values (microgram/ml) were 1.8, 33, 6.5, and 18, respectively. On the other hand, the antiviral activities of these compounds on a rhabdovirus, infectious hematopoietic necrosis virus (IHNV), were moderate (IC50 = 100-500 micrograms/ml in CHSE-214 cells). The 5'-triphosphates showed remarkable inhibitory effects on DNA polymerase beta and DNA polymerase alpha-primase purified from testes of the cherry salmon, Oncorhynchus masou, but not on common DNA polymerase alpha from same source.

Evidence that PGF2 alpha-induced contraction of isolated guinea pig bronchi is mediated in part by release of tachykinins

To investigate whether prostaglandin F2 alpha (PGF2 alpha) stimulates the release of tachykinins and whether the tachykinins play a role in the PGF2 alpha-induced bronchial contraction, we examined the contractile response to PGF2 alpha in the presence or absence of a neutral endopeptidase (NEP) inhibitor phosphoramidon in the guinea pig main bronchus in vitro. Because NEP effectively cleaves tachykinins, we hypothesized that the inhibition of NEP would enhance a PGF2 alpha-induced bronchial contraction if PGF2 alpha stimulates the release of tachykinins. Phosphoramidon significantly enhanced the concentration-response curve to PGF2 alpha. And it also significantly enhanced 10(-5) M PGF2 alpha-induced contraction. The enhancement was significantly attenuated in tissues where the tachykinins had been depleted by treatment with capsaicin. Furthermore, the enhancement of contraction was also significantly attenuated in the presence of tachykinin antagonist FK-224 (10(-5) M). Tetrodotoxin, a sodium-channel blocker that blocks nerve conduction, did not affect the enhancement. From these results we conclude that 1) PGF2 alpha causes the release of tachykinin-like substances, 2) these substances play a role in bronchial contraction in tissues where NEP activity is inhibited, and 3) nerve conduction is not necessary for the release of these substances in the guinea pig bronchus.

Effects of (-)-S-2,8-dimethyl-3-methylene-1-oxa-8-azaspiro[4,5]decane L-tartrate monohydrate (YM796), a novel muscarinic agonist, on disturbance of passive avoidance learning behavior in drug-treated and senescence-accelerated mice

Effects of YM796 (-)-S-2,8-dimethyl-3-methylene-1-oxa-8-azaspiro[4,5]decane L-tartrate monohydrate; a novel muscarinic agonist, were observed on disturbance of passive avoidance learning behavior in drug- (protein synthesis inhibitor and anticholinergic drugs) treated and senescence-accelerated mice in comparison with those of a muscarinic agonist (AF102B) and acetylcholinesterase inhibitors (E2020 (1-benzyl-4-[(5,6-dimethoxy-1-indanone-2-yl) methyl] piperidene hydrochloride), NIK247 [9-amino-2,3,5,6,7,8-hexahydro-1H-cyclopenta(b)-quinoline monohydrate hydrochloride], THA (9-amino-1,2,3,4-tetrahydroacridine) and physostigmine). All tested drugs administered before training significantly prolonged the shortened latency of step-through induced by the protein synthesis inhibitor cycloheximide (150 mg/kg s.c.). This shortened latency was also significantly prolonged when YM796 was administered immediately after training, but not when administered before the test trial. The ameliorating effect of YM796 on the impairment in learning behavior by cycloheximide was significantly suppressed by pirenzepine (0.1 micrograms/mouse i.c.v.). When administered before training, all test drugs prolonged the shortened latency of step-through induced by treatment with the anticholinergic drugs [scopolamine (1 mg/kg s.c.) and hemicholinium-3 (0.3 microgram/mouse i.c.v.)], suggesting that they ameliorated the impairment of learning behavior. This shortened latency in scopolamine-treated mice was also significantly prolonged by YM796, AF102B, E2020, NIK247 and physostigmine when administered immediately after training, but not when administered before the test trial. The pharmacological actions of YM796 administered immediately after training and before the test trial in hemicholinium-3-treated mice were similar to those in scopolamine-treated mice.(ABSTRACT TRUNCATED AT 250 WORDS)

Superficial spreading type of early gastric lymphomas

Recent advances in diagnostic techniques have increased the apparent incidence of gastric lymphomas at an early stage. However, the clinical features of the superficial spreading type of early gastric lymphoma are not well-documented. We retrospectively examined the clinicopathologic features of 5 patients with the superficial spreading type of early gastric lymphoma. These tumours were MALTomas which had a characteristically difficult diagnosis and indistinct tumour margins, and a high incidence of lymph node involvement was found. We conclude that satisfactory treatment of this neoplasm requires a wide resection of the stomach with extensive lymph node dissection.

Changes in the composition of bilirubin-IX isomers during human prenatal development

We analyzed the isomeric composition of bilirubin-IX in human fetal bile using HPLC. The approximate ratio of the bilirubin-IX isomers obtained from the fetal bile at 20 weeks of gestation was IX alpha, 6%; IX beta, 87%; IX gamma, 0.5%; and IX delta, 6%. From 15 to 22 weeks, bilirubin-IX beta was predominant and bilirubin-IX delta and bilirubin-IX alpha were also present in the bile as minor components. By 28 weeks, bilirubin-IX alpha constituted about 50% of the total bilirubin. There was a general correlation between fetal age and the proportion of bilirubin-IX alpha to bilirubin-IX beta in the bile and the small intestinal contents of fetuses. As development proceeded from mid-gestation to near term, the isomeric composition dramatically changed, with a decrease in the IX beta isomer and a subsequent increment of the IX alpha isomer. In contrast, the IX delta isomer changes little. Recently, we identified four forms of biliverdin reductase including two biliverdin-IX alpha reductases and two biliverdin-IX beta reductases in human liver cytosolic fractions [Yamaguchi, T., Komoda, Y. & Nakajima. H. (1994) J. Biol. Chem. 269, 24,343-24,348]. The proportion of the total activity of biliverdin-IX beta reductases to that of biliverdin-IX alpha reductases was considerably higher in the fetal, than in the adult liver.

Intracoronary stenting of a coronary occlusion resulting from an aortic dissection

Acute myocardial infarction secondary to aortic dissection may occur due to compression of the coronary arteries by a hematoma or extension of the dissection into the coronary arterial wall. We report a patient with this condition who was successfully treated by Palmaz-Schatz stenting, providing an alternative to thrombolysis or angioplasty.

Effect of sodium hyaluronate ophthalmic solution on peripheral staining of rigid contact lens wearers

We evaluated the efficacy of sodium hyaluronate ophthalmic solutions on 3 and 9 o'clock staining with rigid contact lens wearers in a double masked multicenter study involving four institutions and 43 patients. Both sodium hyaluronate (0.1%) and control ophthalmic solutions (artificial tears) without preservative were used. Patients were randomly divided into two groups. The test group received sodium hyaluronate ophthalmic solution, and the control group received artificial tears as a control ophthalmic solution. The agents were instilled six times per day for 2 weeks while patients wore contact lenses. Although subjective symptoms improved similarly in the two groups, slit lamp observation, corneal staining, and anterior segment photography demonstrated improved results in eyes having received sodium hyaluronate ophthalmic solutions. We conclude that sodium hyaluronate ophthalmic solution is effective and safe for treating 3 and 9 o'clock staining in rigid contact lens wearers.

Total gastrectomy for early gastric cancer

A total gastrectomy was performed in 49 patients with early gastric cancer, and the effectiveness of this procedure was evaluated by reviewing the hospital files of the patients. The reasons for this total gastrectomy were as follows: (1) lymph node dissection for 22 patients, (2) surgeon's choice in reconstruction for 10 patients, (3) modification of the surgery from subtotal to total gastrectomy for seven patients, (4) synchronous multiple cancers for seven patients, and (5) cancer in a stomach remnant for three patients. Of 49 patients, 42 had the cancerous lesions in the upper portion of their stomachs. Lymph node involvement occurred in 5 patients, but not in the supra- or infrapyloric lymph nodes. Postoperative complications such as anastomotic leakage, reflux esophagitis and pancreatic fistula occurred in five, four, and two patients, respectively. Postoperative death, including two patients who died within 30 days after the surgery, occurred in 5 patients. Our study showed that total gastrectomy resulted in excessive unnecessary surgery in 39 out of 49 patients (79.6%). We conclude that a total gastrectomy should not be performed on patients with early gastric cancer except for synchronous multiple cancers and for cancers in a stomach remnant.

Decreased plasma tissue factor pathway inhibitor activity in ischemic stroke patients

Although tissue factor pathway inhibitor (TFPI) plays an essential role in the regulation of blood coagulation, the quantitative changes in its levels in thrombotic disease are still undefined. We compared TFPI activity in ischemic stroke patients and control subjects matched for age and cholesterol level to determine whether TFPI activity is changed in the disease. TFPI activity was significantly lower in the stroke patients (1.01 +/- 0.24 U/ml) than in the control subjects (1.10 +/- 0.16 U/ml). In relation to clinical subtypes of stroke, TFPI activity in atherothrombotic infarction (0.93 +/- 0.19 U/ml) and lacunar infarction (0.99 +/- 0.23 U/ml) was significantly lower than in the control subjects, whereas the level in cardioembolic infarction (1.16 +/- 0.31 U/ml) was not. No relationship could be established between TFPI activity and other haemostatic parameters reflecting the production of thrombin/fibrin and the activation of fibrinolysis. These results may suggest that the moderately lower TFPI activity in stroke patients could be due to atherosclerotic changes rather than to consumptive coagulopathy.

Morphology and Physiology of the Thoracic and Abdominal Stretch Receptors of the Isopod Crustacean Ligia exotica

In the terrestrial isopod Ligia exotica, paired stretch receptors, each comprising a separate rapidly and slowly adapting receptor cell, were found in the third to eighth thoracic segments and first five abdominal segments. The dendritic endings of the two sensory cells in each receptor terminate on a common receptor muscle; the cross-striation of this fiber is homogeneous throughout the segments. But the dendritic endings of the receptor cells differ: the rapidly adapting cell has a club-shaped ending restricted to the middle of the receptor muscle, whereas the slowly adapting receptor cell has a bifurcating ending that extends along the entire length of the muscle. Stretch applied to the receptor muscle evokes characteristically different responses in the two sensory cells. The slowly adapting receptor cell has a lower firing threshold and fires continuously for the duration of the stretch, while the rapidly adapting receptor cell has a higher threshold and fires a brief burst at the beginning of the stimulus. However, application of an intense stimulus will evoke continuous firing of the rapidly adapting receptor, which then changes to intermittent bursts. The adaptive significance of such a response is not known, nor is it likely to occur in nature. However, this unusual response is intrinsic to the rapidly adapting cell, as it can be evoked by current injection. In the second thoracic segment, instead of rapidly and slowly adapting cells, we found a single slowly adapting cell with a long robust dendrite attached to the extensor muscle.

Effects of anion transport inhibitors on hemolysis of human erythrocytes under hydrostatic pressure

Effects of anion transport inhibitors on hemolysis of human erythrocytes at 200 mPa were examined. The degree of hemolysis was decreased by treating intact cells with 4,4'-diisothiocyanostilbene-2,2'-disulfonate (DIDS), 4,4'-dinitrostilbene-2,2'-disulfonate and pyridoxal 5'-phosphate (PLP) had little effect on the hemolysis. In contrast, the degree of hypotonic hemolysis increased upon treatment with anion transport, inhibitors. From the relationship between the hemolysis at 200 mPa and anion transport, it was found that high-pressure-induced hemolysis was suppressed by the covalent binding of anion transport inhibitors to band 3. This idea was supported by the finding that the hemolysis at 200 mPa of trypsin-treated erythrocytes was suppressed by DIDS. Furthermore, the spectrin content in vesicles which are released from erythrocyte ghost by dimyristoyl-phosphatidylcholine decreased upon DIDS labeling of band 3, but did not change upon PLP labeling. These results suggest that the interaction of the cytoplasmic domain of band 3 with spectrin, perhaps via ankyrin, is tightened by the covalent binding of bulky ligands to the exofacial domain of band 3.