Syntheses, Structures, and Reactivity of Low Spin Iron(III) Complexes Containing a Single Carboxamido Nitrogen in a [FeN5L] Chromophore

A new pentacoordinate ligand based on TPA (tris-(2-pyridylmethyl)amine), namely, N,N-bis(2-pyridylmethyl)amine-N-ethyl-2-pyridine-2-carboxamide (PaPy(3)H), has been synthesized. The iron(III) complexes of this ligand, namely, [Fe(PaPy(3))(CH(3)CN)](ClO(4))(2) (1), [Fe(PaPy(3))(Cl)]ClO(4) (2), [Fe(PaPy(3))(CN)]ClO(4) (3), and [Fe(PaPy(3))(N(3))]ClO(4) (4), have been isolated and complexes 1-3 have been structurally characterized. These complexes are the first examples of monomeric iron(III) complexes with one carboxamido nitrogen in the first coordination sphere. All four complexes are low spin and exhibit rhombic EPR signals around g = 2. The solvent bound species [Fe(PaPy(3))(CH(3)CN)](ClO(4))(2) reacts with H(2)O(2) in acetonitrile at low temperature to afford [Fe(PaPy(3))(OOH)](+) (g = 2.24, 2.14, 1.96). When cyclohexene is allowed to react with 1/H(2)O(2) at room temperature, a significant amount of cyclohexene oxide is produced along with the allylic oxidation products. Analysis of the oxidation products indicates that the allylic oxidation products arise from a radical-driven autoxidation process while the epoxidation is carried out by a distinctly different oxidant. No epoxidation of cyclohexene is observed with 1/TBHP.

Rhabdomyomatous mesenchymal hamartoma of the eyelid: report of a case and literature review

PURPOSE

To report a rare case of rhabdomyomatous mesenchymal hamartoma and to compare its features with those cases previously reported.

DESIGN

Interventional case report and literature review.

INTERVENTION

Complete ophthalmologic and systemic examinations followed by excisional biopsy and histopathologic examination.

MAIN OUTCOME MEASURES

Clinical examination features and histopathologic findings.

RESULTS

A 6-month-old Latino male presented with a congenital, elevated, smooth, flesh-colored right lower eyelid lesion. An ipsilateral right limbal dermoid and an upper eyelid coloboma were also present. Excisional biopsy of the eyelid lesion revealed randomly oriented mature striated muscle tissue with associated adipose tissue, blood vessels, pilosebaceous units, and peripheral nerves, findings consistent with rhabdomyomatous mesenchymal hamartoma. Of the 24 reported cases (including the current case), eight had associated congenital anomalies.

CONCLUSIONS

Although rhabdomyomatous mesenchymal hamartomas are rare and benign, they may be associated with other congenital anomalies and anomaly syndromes. As a result, we recommend systemic evaluation of patients diagnosed with this entity.

Monomeric and dimeric copper(II) complexes of a novel tripodal peptide ligand: structures stabilized via hydrogen bonding or ligand sharing

The novel tripodal ligand N-(bis(2-pyridyl)methyl)-2-pyridinecarboxamide (Py3AH) affords monomeric and dimeric copper(II) complexes with coordinated carboxamido nitrogens. Although many chloro-bridged dimeric copper(II) complexes are known, [Cu(Py3A)(Cl)] (1) remains monomeric and planar with a pendant pyridine and does not form either a chloro-bridged dimer or the ligand-shared dimeric complex [Cu(Py3A)(Cl)]2 (4) in solvents such as CH3CN. When 1 is dissolved in alcohols, square pyramidal alcohol adducts [Cu(Py3A)(Cl)(CH3OH)] (2) and [Cu(Py3A)(Cl)(C2H5OH)] (3) are readily formed. In 2 and 3, the ROH molecules are bound at axial site of copper(II) and the weak axial binding of the ROH molecule is strengthened by intramolecular hydrogen bonding between ROH and the pendant pyridine nitrogen. Two ligand-shared dimeric species [Cu(Py3A)(Cl)]2 (4) and [Cu(Py3A)]2(ClO4)2 (5) have also been synthesized in which the pendant pyridine of one [Cu(Py3A)] unit completes the coordination sphere of the other [Cu(Py3A)] neighbor. These ligand-shared dimers are obtained in aqueous solutions or in complete absence of chloride in the reaction mixtures.

Comparison of outcomes between living donor and cadaveric lung transplantation in children

BACKGROUND

Long-term survival in lung transplant is limited by bronchiolitis obliterans (BOS). We compared outcomes in pediatric living donor bilateral lobar (LL) vs cadaveric lung transplant (CL).

METHODS

Children were studied who had LL or CL with at least 1 year follow-up. Data collected included acute rejection episodes, pulmonary function tests (PFT), BOS, and survival. Mean age was 13.36+/-3.16 years in LL and 12.00+/-4.19 years in CL patients (p = 0.37, ns).

RESULTS

There was no difference in rejection (p = 0.41, ns). CL had rejection earlier (2.48+/-3.84 months) than LL (13.60+/-10.74 months; p = 0.02). There was no difference in 12 month PFT. But at 24 months, LL had greater forced expiratory volume in 1 second (FEV1) (p = 0.001) and FEF25-71% (p = 0.01) than CL. BOS was found in 0/14 LL vs 9/11 (82%) CL after 1 year (p = 0.04). After 2 years, 0/8 LL and 6/7 (86%) CL had BOS (p < 0.05). LL had 85% survival vs 79% for CL at 12 months. At 24 months, LL survival was 77% vs 67% for CL.

CONCLUSIONS

Pediatric LL had less BOS and better pulmonary function than CL. As BOS is a determinant of long-term outcome, we believe LL is the preferred lung transplant method for children.

Coexistent neurenteric cyst and enterogenous cyst. Further support for a common embryologic error

The authors describe common embryological pathways responsible for coexistent neurenteric and enterogenous cysts in a patient with spinal dysraphism.

Documentation of EWS gene rearrangements by fluorescence in-situ hybridization (FISH) in frozen sections of Ewing's sarcoma-peripheral primitive neuroectodermal tumor

Prompt and accurate diagnosis of small round cell tumors warrants ancillary studies. Recently, two-color fluorescence in-situ hybridization (FISH) using probes for specific gene rearrangements has gained wide acceptance. EWS gene rearrangements, present in essentially 100% of Ewing's Sarcoma/peripheral primitive neuroectodermal tumor, were evaluated by FISH on frozen sections (FS) of tumor biopsies from 10 patients, plus a negative control, and in seven other malignant neoplasms of childhood. 4mu FS were hybridized overnight, using a single EWS gene-specific probe spanning the EWS breakpoint. We identified EWS rearrangements in 8 of 10 cases (80%) of Ewing's Sarcoma/pPNET. There are no known false positives in diploid or near-diploid tumors, or in any of the non-EWS tumors tested; the uncommon false negative can be confirmed by RT-PCR. Hyperdiploid cases with multiple copies of chromosome 22 may be better evaluated by two-color FISH. This is the first use on FS biopsy material of a single probe for EWS, capable of detecting all known EWS rearrangements, in ES and other tumors. Utilization of this ancillary technique on FS for ES/pPNET and other tumors with distinctive chromosomal translocation is highly specific, reliable, expeditious (24-36 hours) and cost-effective.

Gastric duplication-colonic fistula with colonic ulceration and bleeding

An 11-month-old girl had massive rectal bleeding. A midabdominal mass was palpated. Ultrasound scan showed a large cystic mass with diffusely echogenic contents; Tc-99M radionuclide scan confirmed a duplication. Exploratory surgery and pathology examination showed a gastric duplication with formation of a fistula into the transverse colon with a colonic ulcer and hemorrhage. This combination of findings is presented as a rare cause of lower gastrointestinal hemorrhage in infancy.

Systemic mast cell disease associated with primary ovarian mixed malignant germ cell tumor

A 12-year-old girl with a mixed malignant germ cell tumor of the ovary, treated by surgery and chemotherapy, developed systemic mast cell disease (SMCD) approximately 3 months after chemotherapy. Hematologic malignancies have previously been noted in patients with mediastinal germ cell tumors but this is the first report of a primary ovarian germ cell neoplasm associated with SMCD.

Increased submucosal nerve trunk caliber in aganglionosis: a "positive" and objective finding in suction biopsies and segmental resections in Hirschsprung's disease

OBJECTIVE

To establish the diagnostic usefulness of submucosal hypertrophic nerve trunk morphology in Hirschsprung's disease as a quantifiable parameter supportive of aganglionosis on hematoxylin-eosin-stained sections.

DESIGN

We retrospectively evaluated size and density of submucosal nerves on hematoxylin-eosin-stained sections and S100 protein-stained sections of resected segments from 13 patients with Hirschsprung's disease, and in sections of 20 aganglionic and 50 ganglionic rectal suction biopsies.

SETTING

All patients were seen at Childrens Hospital Los Angeles (Calif), a tertiary-care pediatric center; the age of patients at diagnosis or resection ranged between 2 days and 3 years.

RESULTS

Aganglionic segments contain many distinct nerve trunks greater than 40 microm in diameter. Ganglionic segments/biopsies showed no nerve trunk larger than this threshold value (P approximately .0000). Nerve trunks of such caliber are rarely encountered in pathologic transition zones and sites of colostomy.

CONCLUSIONS

Submucosal nerve trunks that are 40 microm or greater in diameter strongly correlate with abnormal innervation/aganglionosis. Use of this objective parameter in evaluating suction biopsies should be helpful in the morphologic diagnosis of Hirschsprung's disease in infancy and early childhood.

Living donor lobar lung transplantation: the pediatric experience

Living donor (LD) lobar lung transplantation is now an accepted alternative to cadaveric lung transplantation in selected patients with end-stage lung disease. This study reviews the Childrens Hospital Los Angeles LD experience of 17 patients (mean 13.2 +/- 2.7 yrs; range 9.3-18.5 yrs). 12 LD patients had end-stage cystic fibrosis, 4 had primary pulmonary hypertension, and 1 child had bronchiolitis obliterans. LD candidates must meet the same criteria as for cadaveric lung transplant candidates. Donor candidates are rigorously screened (physically and psychologically) prior to acceptance for lobectomy. LD patients receive the same triple immunosuppression regimen as our cadaveric recipients (prednisone, cyclosporine/FK506, and azathioprine/mycophenolate). Comparison of rejection episodes, incidence of bronchiolitis obliterans, pulmonary function tests, exercise stress tests, and cardiac catheterization data was made between LD and cadaveric lung transplantation (CL) pediatric recipients. Donor outcomes were also reviewed. In our pediatric program, the 1-year survival rate for LD recipients is currently 81%, which compares favorably with the ISHLT average of 70% for pediatric transplant patients. The incidence of rejection is about the same for LD and CL recipients, but the episodes are less severe for pediatric LD patients. There have been no histological cases of bronchiolitis obliterans syndrome in our LD recipients. Although there have been questions as to whether transplanted lobes can supply comparable pulmonary reserve to whole cadaveric lungs, the lung volumes (TLC and VC), expiratory flow rates, maximal exercise stress tests, and pulmonary artery pressures (no evidence of pulmonary hypertension) in LD patients are not significantly different to CL recipients in our institution. Besides pain from the thoracotomy, the donors have a decrease of 16% (right lower lobe donor) and 18% (left lower lobe donor) in their vital capacity. Otherwise, there have been no major complications to the donors and most have resumed their usual activities. Based on outcomes, pulmonary function tests, exercise stress tests, and hemodynamic studies as well as low donor morbidity, living donor double lobar lung transplantation is a viable alternative to cadaveric lung transplantation in selected pediatric patients with end-stage lung disease.

Distinct pattern of ret oncogene rearrangements in morphological variants of radiation-induced and sporadic thyroid papillary carcinomas in children

In this study, we compare the morphological and genetic characteristics of 38 post-Chernobyl thyroid papillary carcinomas from Belarussian children 5-18 years old with those of 23 sporadic papillary carcinomas from the same age children without history of radiation exposure from Los Angeles and Cincinnati. Among radiation-induced tumors, solid variant of papillary carcinoma was found in 37%, follicular in 29%, typical papillary in 18%, and mixed and diffuse sclerosing variants in 8% each. In the sporadic group, a typical papillary pattern was prevalent in 70%, follicular in 17%, diffuse sclerosing variant in 9%, and solid in 4%. In both groups, the prevalence of ret rearrangements was high, but the frequency of specific types of rearrangement was significantly different. Among radiation-induced tumors, ret/PTC3 was found in 58%, ret/PTC1 in 16%, and ret/PTC2 in 3%, whereas among sporadic tumors, ret/PTC1 was found in 47% (P < 0.05), and ret/PTC3 was found in 18% (P = 0.01). The morphological variants of papillary carcinoma showed different prevalence of the specific types of ret rearrangement. Seventy-nine % of solid variant tumors had ret/PTC3, whereas only 7% had ret/PTC1 (P = 0.0007). Among typical papillary tumors, ret/PTC1 was found in 38%, ret/PTC3 in 19%, and ret/PTC2 in 5%. Thus, ret rearrangements are highly prevalent in pediatric papillary carcinomas from children exposed to radiation and in those occurring sporadically. However, the types of ret/PTC vary between these two populations, with ret/PTC3 present more commonly in post-Chernobyl tumors. Furthermore, solid variants have a high prevalence of ret/PTC3, whereas typical papillary carcinomas do not, suggesting that the different types of ret rearrangement confer neoplastic thyroid cells with distinct phenotypic properties.

Prolonged course of illness in a child with malignant lymphoma mimicking sarcoidosis

We describe a case of malignant lymphoma mimicking the rheumatic presentation of sarcoidosis in an adolescent with a 3-year history of febrile illness. Final diagnosis was established by tissue biopsy after multiple studies failed to provide histological evidence of granulomas consistent with sarcoidosis. We discuss the limited diagnostic specificity of serum angiotensin converting enzyme in sarcoidosis and emphasize the need for aggressive diagnostic evaluation of a patient whose clinical presentation is not fully explained by a known rheumatologic illness.

Reverse transcriptase PCR amplification of EWS/FLI-1 fusion transcripts as a diagnostic test for peripheral primitive neuroectodermal tumors of childhood

The peripheral primitive neuroectodermal tumors (pPNETs) of childhood, including Ewing's sarcoma, peripheral neuroepithelioma, and Askin's tumor, often present significant diagnostic challenges for the anatomic pathologist. One consistent feature of these tumors is the presence of the t(11;22)(q24;q12) in tumor cells, and this translocation has been useful as a marker for this group of tumors. The recent cloning of the t(11;22) breakpoint has revealed the fusion of the human FLI-1 gene on chromosome 11q24 with a gene of unknown function called EWS on 22q12, and fusion transcripts have been detected. These findings have raised the possibility of using molecular genetic analysis as a tool to diagnose pPNETs. To this end, we have tested pPNETs for the presence of EWS/FLI-1 fusion transcripts by reverse transcriptase-polymerase chain reaction (RT-PCR) using EWS and FLI-1 specific primers. Eight (80%) of 10 pPNET cell lines were positive for amplified products using this technique. These results were confirmed by Southern analysis, which revealed rearrangements of EWS using genomic EWS probes in all eight positive cell lines. We then tested 20 primary pPNET tumors, and identified fusion transcripts by RT-PCR in 18 (90%) of these cases. Cloning and sequencing of PCR products confirmed the presence of EWS and FLI-1 sequences in these products. Furthermore, fusion transcripts were not detected by this technique in a series of non-pPNET pediatric solid tumors. Detection of EWS/FLI-1 fusion transcripts by RT-PCR therefore provides a novel adjunctive tool in the diagnosis of pPNETs.

Antibody to capsular polysaccharides of Streptococcus pneumoniae: prevalence, persistence, and response to revaccination

The prevalence of immunity to Streptococcus pneumoniae in the adult population of the United States is unknown. In the study described herein, military recruits had anticapsular IgG antibody to only 15% of common pneumococcal serotypes, whereas working men and elderly men had IgG antibody to 33% and 34% of the common serotypes, respectively (P < .001). Among eight elderly subjects, the prevalence of IgG antibody to capsular polysaccharides increased from 30% to 78% after pneumococcal vaccination; 6 years thereafter, the rate of positive reactions had declined to 58% and IgG levels had declined substantially. With revaccination, IgG levels returned to within (+/-) 40% of the original postvaccination levels. IgM and IgG antibody appeared or began to increase in titer 6 days after vaccination; the rate and degree of response were the same after the first and second exposures. Since most individuals rapidly develop IgG antibody after colonization by S. pneumoniae and since IgG confers immunity, these data suggest that pneumonia is infrequent among healthy adults not because preexisting immunity is widespread but because--with colonization--an immune response develops rapidly, preceding specific events that might lead to infection. Our findings support recommended vaccination procedures and suggest that wider application in subsets of healthy younger adults should be considered.

Age-related marrow changes in the pelvis: MR and anatomic findings

Short repetition time magnetic resonance images of the pelvis in 70 subjects (aged 1 day to 24 years) without history of bone marrow disease were retrospectively analyzed for the distribution and appearance of red and yellow marrow. The signal intensity and degree of mottling of marrow in six anatomic regions of the pelvis were observed and were assigned a grade. Anatomic correlation was provided with gross and microscopic examination of bone marrow biopsy specimens taken from selected pelvic sites in cadavers of children. Marrow signal intensity increased in all pelvic regions except the acetabulum from birth to age 24 years. Marrow heterogeneity was most prominent in the acetabulum at all ages. Patterns of bone marrow signal intensity and heterogeneity are recognized for four age groups: the infant, child, adolescent, and young adult. Regional and age-related differences in the signal intensity of pelvic marrow correlate with the percentage of fat seen microscopically in marrow.

Antifusion activity in sera from persons infected with human immunodeficiency virus type 1

Cell-to-cell fusion plays an important role in the pathogenesis of human immunodeficiency virus type 1 (HIV-1) infections. An assay to measure the antifusion activity of serum has been developed by using the fusion event that occurs between H9 cells chronically infected with HIV-1 (H9IIIB) and fusion-susceptible MT-2 cells. The endpoint is determined by measuring neutral red uptake in cells after syncytium formation is allowed to occur in the presence of various serum dilutions. The assessment of antifusion activity in serum by neutral red uptake has been shown to correlate with syncytium reduction as determined by direct counting. The optimal number and ratio of cells in the suspension for efficiency and speed of the assay have been determined. With this assay it was shown that 50% of 36 serum specimens capable of neutralizing cell-free virions failed to inhibit syncytium formation. The assay can thus measure a distinct activity in HIV-1-immune human sera which is a subset of neutralization activity. Because of the potential role of this activity in the rate of disease progression and protective immune responses, the antifusion assay will be an important tool for the investigation of disease pathogenesis and for acquired immunodeficiency syndrome vaccine development. The assay can also be applied to the investigation of the pathogenesis of the fusion event at the cellular level. The ability to use absorbance measurements rather than syncytium counts as the endpoint facilitates direct computer-assisted data analysis, which expedites the performance of the assay.

Differential inhibition of HIV-1 cell binding and HIV-1-induced syncytium formation by low molecular weight sulphated polysaccharides

Dextran sulphate (MW 5000 and 8000) and a polysulphated glycosaminoglycan (MW 10,000), at concentrations that provided complete protection in a homologous infection assay, failed to block syncytium formation and the resulting cytopathic effect when MT-2 cells were mixed with H9/HIV-1 cells. These substances also had no antiviral activity when added to cells, after virus challenge, at a time when binding and entry were complete. However, a high molecular weight (500,000) dextran sulphate blocked HIV-1 infection at both stages. Thus, the gp120-CD4 interactions mediating HIV-1 binding and HIV-1-induced syncytium formation are differentially affected by this class of polyanionic substances. Furthermore, size may be a determining factor in their potential application as anti-HIV treatment.

Pharmacokinetics of doxylamine given as Bendectin in the pregnant monkey and baboon

The object of the present study was to determine the maternal plasma pharmacokinetics of doxylamine (the antihistamine component of Bendectin) following Bendectin administration. Bendectin was administered daily, po, at a dosage approximately 10 times the maximum human therapeutic dosage (7 mg/kg/day) throughout organogenesis (approximately days 22 through 50 of gestation) to three cynomolgus monkeys, four rhesus monkeys, and five baboons. Two pharmacokinetic experiments were performed in each animal, one on the first day of treatment and one on the last day of treatment. Although this study was not designed specifically as a teratologic examination, no morphologic abnormalities were observed when the fetuses were examined on approximately day 100 of gestation. A single-compartment, parallel first- and second-order elimination model was used to analyze the data. Although considerable interindividual variation was evident, no significant differences between species were observed when the half-life for the absorption of doxylamine from the gut or the elimination of doxylamine and metabolites from the plasma were compared. The plasma elimination half-lives and the clearance values were not altered by the 29 days of Bendectin treatment for any of the species. Only the half-life for the absorption of doxylamine in the baboon was reduced by daily dosing with Bendectin, but this did not alter doxylamine elimination. Thus, the pharmacokinetics of doxylamine administered as Bendectin were similar in the three nonhuman primate species examined and were not altered by repeated daily administration.

Valproic acid developmental toxicity and pharmacokinetics in the rhesus monkey: an interspecies comparison

This study was undertaken to assess the developmental toxicity and drug distributional and metabolic characteristics of prenatal valproic acid (VPA) exposure in rhesus monkeys. Oral administration of 20-600 mg/kg/day VPA (approximately 1-15 X human therapeutic dose) to 33 animals on variable gestational days (GD) during organogenesis resulted in dose-dependent developmental toxicity manifested as increased embryo/fetal mortality, intrauterine growth retardation, and craniofacial and skeletal defects. Biphasic plasma elimination curves were observed for total and free VPA on the first (GD 21) and last (GD 50) days of treatment in the 100- and 200-mg/kg/day dose groups. VPA exhibited dose-independent elimination kinetics at the plasma concentrations observed in this study. There was no significant change in pharmacokinetic parameters (maternal plasma elimination rate, area under the curve, peak plasma concentration) between the first and last days of treatment at either dose level. Placental transfer studies indicated that embryos were exposed to half the free VPA concentrations present in maternal plasma on GD 37. Comparisons of interspecies sensitivity to VPA-induced developmental toxicity in the mouse, rat, monkey, and man are made.

Evaluation of valproic acid (VPA) developmental toxicity and pharmacokinetics in Sprague-Dawley rats

This study was undertaken to assess the pharmacokinetics and developmental toxicity of the anticonvulsant, valproic acid (VPA), a human teratogen, in Sprague-Dawley rats. Oral administration of 200-800 mg/kg VPA (5-20x human therapeutic dose) from Gestational Days (GD) 8 to 17 resulted in increasing maternal toxicity at the higher doses with 100% maternal lethality at 800 mg/kg. Although there was an increased incidence of resorptions at 600 mg/kg (48 +/- 43%) compared to controls (18 +/- 24%), it was not statistically significant. Fetal examination on GD 20 revealed dose-dependent fetal growth retardation (p less than or equal to 0.05) as evidenced by decreased fetal weight and length in addition to underossification of both the axial and appendicular skeleton. The incidence of skeletal defects, including abnormal vertebrae, ribs, and craniofacial dysmorphia, also increased with higher doses of VPA. Cardiac anomalies observed in the two highest treatment groups consisted of great vessel malformations with or without associated ventricular septal defects (VSDs). Urogenital defects were also noted in the 600 mg/kg group. The plasma elimination half-life on GD 8 was 1.0 +/- 0.3 hr at 200 mg/kg and 2.3 +/- 0.7 hr at 600 mg/kg. Maximal concentrations of total and free drug were 341 +/- 18 micrograms/ml and 181 +/- 11 micrograms/ml, respectively, in the low-dose group and 911 +/- 379 micrograms/ml and 542 +/- 224 micrograms/ml in the high-dose group. No significant changes in any pharmacokinetic parameters (t1/2, AUC, Cmax, tmax) were observed over the 10-day treatment period at either dose level.

Evaluation of the teratogenicity and pharmacokinetics of diflunisal in cynomolgus monkeys

This study examined the pharmacokinetics and potential teratogenicity of the nonsteroidal antiinflammatory drug, diflunisal, in cynomolgus monkeys. Pregnant cynomolgus monkeys were administered 0.5% methyl cellulose, 20 mg/kg/day diflunisal, or 80 mg/kg/day diflunisal on Days 25 to 48 of gestation. There was no evidence of maternal toxicity, increased abortion rate, fetal growth retardation, or malformation. These data demonstrate that diflunisal is not teratogenic in cynomolgus monkeys over a dosage range of 20 to 80 mg/kg/day. Peak plasma levels of diflunisal were found 1 hr after oral administration of [14C]diflunisal at a dosage of 60 mg/kg and declined to low levels by 24 hr. The plasma elimination half-life was calculated to be 10.2 hr over the period of 1 to 8 hr postadministration. Intact diflunisal accounted for 96.4% of total plasma radioactivity at 0.5 hr and declined to a value of 74% at 8 hr. Plasma protein binding averaged greater than 99% over a concentration range of 62.5 to 250 micrograms/ml. Urinary excretion of diflunisal and metabolites averaged 66.5% of the dosage over the first 4 days postadministration, compared with 0.8% in the feces. The majority of activity represented conjugates of diflunisal. Embryo concentrations of diflunisal on Days 35 to 37 of gestation were 0.7 and 1.1% of maternal plasma level at 4 hr postadministration of 20 or 60 mg/kg, respectively.

Studies on the circadian rhythm of IOP in rabbits: correlation with aqueous inflow and cAMP content

We investigated the relationship of aqueous humor inflow rate and cyclic AMP concentrations to the spontaneous and dramatic changes in IOP associated with onset of darkness in our previously described model of circadian rhythm of intraocular pressure. After onset of darkness, rabbits entrained in an environment with a daily alternating cycle of 12 hours light and 12 hours darkness (12L:12D) showed an 85% increase in outflow pressure, a nearly 60% increase in aqueous inflow rate and an 80% increase in aqueous cAMP. Animals desynchronized by an unpredictable light cycle showed no increase in IOP or inflow rate when measured at the same time intervals as were the entrained animals. Thus, the IOP, aqueous inflow rate and aqueous cAMP are all seen to change in the same direction in a pharmacologically unperturbed rabbit eye. Previous pharmacological studies in rabbits have correlated an increase in cAMP with a decrease in IOP and aqueous inflow.

Effects of ibuterol, a beta-2 adrenergic prodrug, on intraocular pressure

Ibuterol, a prodrug of terbutaline, was approximately 100 times more potent than terbutaline in producing ocular hypotension in the treated eye of normal and sympathectomized (SX) rabbits. In normal rabbits, ibuterol produced no change in IOP of the contralateral eye whereas in unilaterally SX rabbits a rise in IOP occurred in the SX (contralateral) eye when the normal eye was treated with ibuterol. Ibuterol also suppressed ocular hypertension induced by water loading and delayed the IOP recovery rate although its onset of action was delayed. Aqueous flow was increased significantly at 1 hr after ibuterol in fluorophotometric studies in normal rabbits. Pretreatment with forskolin antagonized rather than enhanced ibuterol-induced ocular hypotension. Pretreatment with diclofenac failed to suppress the development of tachyphylaxis to the ocular hypotensive effect of ibuterol. Although ibuterol is an effective ocular hypotensive agent in rabbits, the effects of this agent on aqueous flow are complex and tachyphylaxis to the ocular hypotensive effect develops fairly rapidly.

Effects of topical diclofenac sodium in a rabbit model of ocular inflammation and leukotaxis

A useful model that combines paracentesis with administration of a leukotactic factor was developed in order to study the effects of topical diclofenac sodium on various aspects of ocular inflammation. The increases in intraocular pressure (IOP) and secondary aqueous humor protein concentration induced in rabbits by anterior chamber paracentesis, as well as leukocyte accumulation in the anterior chamber induced by formyl-methionyl-leucyl-phenylalanine, were significantly reduced by topical application of diclofenac sodium at concentrations of 2 mM (0.064%, w/v) and higher. Lower doses consistently affected only IOP and secondary protein concentrations. A slight paracentesis-induced miosis was refractory to diclofenac sodium. That this potent inhibitor of prostaglandin synthesis can reduce important signs of ocular inflammation is well supported in this model.

Comparison of the metabolism of cortisol and triamcinolone acetonide in the early, mid, and late gestational age rhesus monkey (Macaca mulatta)

The metabolism of radiolabeled cortisol and triamcinolone acetonide (TAC) was compared in the early, middle, and late gestational age rhesus monkeys. Trace amounts of 14C-cortisol and 10 mg/kg 3H-TAC (Kenalog) were simultaneously administered i.m. to the maternal animal. Whole 30-day embryos or 61- to 137-day fetal organs, amniotic fluid, and placenta were collected from 0.5 to 24 h after dose administration and analyzed by high-performance liquid chromatography (HPLC). Serial blood samples collected from all maternal animals and the late gestational age fetuses were similarly processed. The maternal plasma concentration of total radioactivity derived from TAC 1-60 min after dose administration was significantly less on day 30 of gestation as compared to day 60 at the 5-, 10-, and 60-min time points. At 60 and 130 days of gestation, however, the maternal plasma concentrations of total radioactivity were similar. Concentrations of cortisol-derived radioactivity in the maternal plasma were the same across gestational age. The plasma TAC and cortisol metabolic profiles, as determined by HPLC, were not significantly different throughout pregnancy. In late pregnancy 30 min after dose administration, the fetal to maternal plasma cortisol ratio was 0.34, whereas the same ratio for TAC was 0.96. By 1 h after dose administration, less than 8% of the total 14C radioactivity in fetal tissues was cortisol and over 92% of the 3H was TAC. The extensive fetoplacental metabolism of cortisol to inactive metabolites and the resistance of TAC to metabolic conversion results in greater TAC than cortisol exposure of the developing rhesus monkey conceptus.

Comparative distribution and metabolism of triamcinolone acetonide and cortisol in the rat embryomaternal unit

Triamcinolone acetonide (TAC) is teratogenic in rats while cortisol has been reported as not teratogenic. The objective of this investigation was to determine whether this difference in teratogenicity could be due to a difference in the metabolism and distribution of the parent compound in the embryomaternal unit. 3H-TAC and 14C-cortisol were administered intramuscularly to pregnant rats on day 12 of gestation. These dams were killed at each of the following time points after injection: 0.5, 1, 3, 6 and 24 hr. Maternal plasma and embryos were analyzed by high performance liquid chromatography (HPLC) and liquid scintillation counting. The plasma concentration of parent TAC was significantly greater than that for parent cortisol at all time points. The plasma elimination half-life for TAC, 86 min, was also calculated to be significantly longer than that for cortisol, 8 min. Furthermore, the percentage of total plasma radioactivity representing HPLC resolved TAC was much higher than that representing cortisol at all time points. The concentration of TAC in the embryos was significantly greater than for cortisol at all time points. The elimination half-life for unchanged TAC in the embryos was 142 min compared to 22 min for cortisol. The percentage of total radioactivity in the embryos representing unchanged TAC was similar to that found in maternal plasma while the percentage of total radioactivity representing unchanged cortisol was much lower than that found in maternal plasma. These findings support the hypothesis that differences in the distribution and metabolism of the parent compound are a critical factor in determining the teratogenicity of that compound.

Comparative teratogenicity of triamcinolone acetonide, triamcinolone, and cortisol in the rat

Pregnant rats were injected im with 0.5 mg/kg triamcinolone acetonide (TAC) on day 12, 13, or 14 of gestation and the fetuses were examined for cleft palate on day 20. All three TAC-treated groups showed an increased proportion of fetuses with cleft palate compared to an untreated control group. Only the group treated on day 13 showed a significant increase in the proportion of litters affected. This indicates that day 13 of gestation is the most sensitive day for cleft palate induction by TAC in the rat. Pregnant rats were then treated on day 13 of gestation with either TAC, triamcinolone (TA), or cortisol. TAC was 59 times as potent as TA in inducing cleft palate, with ED50 values of 1.1 mg/kg and 65 mg/kg respectively. Cortisol induced a significant increase in cleft palates at 500 mg/kg, but the efficacy of this compound was too low to calculate an ED50 and relative teratogenic potency value. Other developmental abnormalities including umbilical hernias, resorption, and fetal death resulted from TAC treatment. Fetal growth retardation was produced by all three compounds. The rank order of teratogenic potency was determined to be TAC greater than TA greater than cortisol.

Distribution and metabolism of triamcinolone acetonide in the rat embryomaternal unit during a teratogenically sensitive period

The distribution and metabolism of triamcinolone acetonide (TAC) in the rat embryomaternal unit were investigated during a teratogenically sensitive period. Pregnant rats (Day 12 of gestation) were injected im with 0.125 or 0.5 mg/kg [3H]TAC. Maternal plasma and embryos were collected at selected time points and analyzed by HPLC and liquid scintillation counting. No significant differences in the percentage of total radioactivity representing unchanged TAC, concentration of TAC, or its elimination half-life were detected in either plasma or embryos of the two dose groups. These results provide evidence that the metabolism and distribution of TAC in the rat embryomaternal unit are dose independent over this known teratogenic dose range. To determine whether multiple administration of TAC resulted in any alterations in maternal or embryonal exposure, the same parameters were evaluated following one (Day 12), two (Days 12 and 13), or three (Days 12, 13, and 14) injections of [3H]TAC (0.5 mg/kg, im). The only alterations detected were an increase in the percentage of total radioactivity in maternal plasma representing unchanged TAC at 1 hr following the second or third injection and an increase in the embryonal concentration of TAC at the same time points.

Comparison of the transplacental pharmacokinetics of cortisol and triamcinolone acetonide in the rhesus monkey

The late gestational age rhesus monkey was used to study the transplacental pharmacokinetics of radiolabeled triamcinolone acetonide (TAC) and cortisol. Tritiated-TAC and [14C]cortisol were administered simultaneously via the maternal radial vein were administered simultaneously via the maternal radial vein and blood samples were serially drawn from catheters implanted in both the maternal femoral artery and fetal umbilical vein and artery. High-performance liquid chromatography of the processed blood samples revealed that from 93 to 100% of the 3H in the fetal circulation was parent TAC, whereas only 14 to 49% of the 14C was cortisol during the 40-min period after dose administration. Fetal tissue samples taken at 3 hr after dose administration showed that 75 to 96% of the 3H present was TAC, whereas no cortisol was observed. TAC demonstrated dose-independent kinetics. Samples collected from the umbilical vein of the in situ placenta after fetectomy revealed that cortisol was extensively converted to cortisone by the placenta, whereas TAC was refractory to placental metabolism. This placental conversion of cortisol to cortisone and the further metabolism and conjugation of cortisol by the fetoplacental unit resulted in a fetal to maternal plasma cortisol ratio of 0.2. In contrast, the lack of placental or fetoplacental metabolism of TAC resulted in a fetal to maternal plasma TAC ratio of 0.6.

Separation of some natural and synthetic corticosteroids in biological fluids and tissues by high-performance liquid chromatography

A high-performance liquid chromatography (HPLC) technique was developed for the determination of radiolabeled triamcinolone acetonide (TAC), cortisol and their metabolites in rhesus monkey plasma, urine and tissue samples. After protein precipitation, the parent compounds and metabolites were simultaneously resolved using a single-column reversed-phase HPLC system. TAC was subsequently verified by mass spectrometry and TAC glucuronide was tentatively identified by enzymatic hydrolysis and mass spectrometry of the hydrolysis product. The endogenous hormones, cortisol and cortisone were presumptively identified by cochromatography with authentic standards on two different HPLC systems and positively identified by reverse-isotope recrystallization. Other metabolites of both compounds were detected by selective enzymatic hydrolysis and HPLC. This method is rapid and reproducible with a total recovery greater than 80%.

Effects of ethanol, acetaldehyde and acetate on insulin release from perifused pancreatic islets

It has been postulated that ethanol-induced changes in carbohydrate hemeostasis are mediated in part by alterations in pancreatic endocrine function. In this study ethanol (40, 120 and 240 mg/dl) produced dose-related suppression of immunoreactive insulin (IRI) release from isolated rat islets perifused with glucose and theophylline. Acetaldehyde inhibited IRI release at a concentration (39 mg/dl) much higher than can be achieved in vivo. A high concentration (29 mg/dl) of acetate did not influence IRI release. These results suggest that the ability of ethanol to inhibit IRI release resides principally in the parent compound and not its metabolites.

Ocular hypertensive response to beta-adrenoceptor agonists

Acute administration of non-selective and relatively selective beta-adrenoceptor agonists elicit a monophasic fall in IOP. The present study indicates that unilateral application of certain beta-agonists on consecutive days can result in marked ocular hypertension. 1-Epinephrine, reproterol and 1-isoproterenol evoked an elevation of IOP on the second and third day after topical administration of a 2% solution in normal rabbits and in rabbits with surgically transected extraocular muscles. In contrast, the same concentration of d-isoproterenol produced hypotensive responses only when administered once daily for three consecutive days. Since d-isoproterenol did not cause a rise in IOP during chronic administration, the mechanism involved in the hypertensive response appears to be more sensitive to the levorotatory form. Administration of timolol inhibited the ocular hypertensive effect of epinephrine and reproterol. Since timolol lowers IOP by depressing formation of aqueous, it is suggested that the rise in IOP following chronic administration of beta-agonists possibly involves an increase in aqueous humor production.

Steric structure activity relationships of various adrenergic agonists: ocular and systemic effects

Dextrorotatory (d) forms of adrenergic drugs are known to be much less active than the levo (l) forms in effecting classical adrenergically mediated responses (alpha, beta 1, beta 2) in metabolic organs and cardiovascular tissues. Adrenoceptor intrinsic activity and affinity, enzymatic inactivation and neuronal uptake are all known to be relatively selective for the l-forms. It is known, however, that the d-isomers of certain agonists, such as isoproterenol, are as effective or even more effective ocular hypotensive agents than their respective l-forms or the racemates (dl) in rabbits. We tested the d- and l-isomers of epinephrine (alpha, beta 1, beta 2), norepinephrine (alpha, beta 1), phenylephrine (alpha 1), isoproterenol (beta 1, beta 2) and soterenol (alpha, beta 2) for their comparative effects after topical administration on intraocular pressure (IOP), pupil diameter (PD), arterial blood pressure (ABP) (after both topical and i.v. administration), aqueous cAMP, and aqueous and plasma lactate and glucose in the normotensive rabbit model. The results with ABP and concomitant changes in plasma biochemical correlates normally associated with adrenergic mechanisms were consistent with well established theory of stereospecificity. Data from ocular parameters, however, suggest that d-isomers of adrenergic agents evoke ocular responses that are divergent from this theory. The relation of ocular and systemic pressure responses with their respective biochemical correlates suggests that some d-isomers of adrenergic stimulants may be acting as partial agonists.

Circadian rhythm in intraocular pressure: a rabbit model

An animal model for study of the circadian rhythm in intraocular pressure (IOP) was developed using carefully maintained environmental lighting conditions. Highly predictable, precipitous increases and decreases in IOP of somewhat more than 10 mm Hg were found to be closely correlated with the onset of darkness and light, respectively. The daily spontaneous variations in IOP, once entrained, were maintained in constant darkness, but were eliminated by constant light, as is similarly seen in many mammalian systems. This model provides a novel means of investigating circadian IOP oscillation, which has been shown to be especially amplified in primary open angle glaucoma (POAG). This new rabbit model may also warrant consideration for use in screening ocular antihypertensive drugs since it could obviate the gross physiological manipulations and concomitant side effects inherent in the popular methods of inducing ocular hypertension in animal models.

Taurine concentrations in the aqueous humor and plasma of anesthetized rabbits

Aqueous humor taurine concentrations were found to be significantly higher (p < 0.01) than that of the plasma in anesthetized rabbits. Topical application of 2 mg terbutaline lowered intraocular pressure (p < 0.001), but did not alter aqueous taurine content.

The effects of topical prazosin on normal and elevated intraocular pressure and blood pressure in rabbits

A 0.1 mg (base) dose of prazosin, a postsynaptic alpha- (alpha 1) adrenoceptor antagonist, in rabbits effected an early decrease in arterial blood pressure, normal intraocular pressure (IOP) and IOP artificially elevated by water loading. The late drug effects suppressed elevated IOP, but not normal IOP. The IOP effects of prazosin seem largely independent of the effect on blood pressure.

Acute pretreatment with pyrazole and ethanol: effects on glucose-induced changes in insulin and glucagon

Ethanol suppressed, in a dose-related manner, glucose-induced insulin (IRI) release and thus delayed the disappearance of glucose from the blood of rats. Pretreatment with pyrazole, an alcohol dehydrogenase inhibitor, exacerbated the effect of ethanol on IRI release, glucose tolerance and glucagon (IRG) release. These results suggest that ethanol produces glucose intolerance by inhibiting glucose-induced IRI release and by augmenting IRG release. Moreover, these findings indicate that ethanol does not have to be metabolized completely in order to produce these effects.

Effect of beta-adrenergic drugs on plasma glucose and glucagon in Japanese quail: a preliminary report

The present study was conducted to determine the effects of beta-adrenergic stimulation on plasma glucose and glucagon (IRG) levels in Japanese quail. Isoproterenol, epinephrine and three relatively selective beta-adrenoceptor agonists (terbutaline, salbutamol and reproterol) produced dose-related hyperglycemia and hypoglucagonemia. This study demonstrates that beta-adrenoceptor agonists produce hyperglycemia in birds as they do in mammals, but that the rise in plasma glucose in birds, unlike mammals, is accompanied by a profound fall in plasma IRG levels.

Alterations in arginine-induced pancreatic hormone release: influence of acute and chronic exposure to ethanol

Acute oral administration of ethanol (150 and 750 mg/100g) to fasted rats produced dose-related inhibition of arginine-induced insulin (IRI) release, an elevation of plasma glucagon (IRG) levels and minor effects on blood glucose. In contrast, chronic consumption of ethanol for 10 weeks augmented arginine-induced hyperglycemia and hperinsulinemia. Thus, acute ethanol administration decreased plasma IRI levels at both doses, presumably by suppressing beta cell function; whereas, function of the alpha cell and plasma IRG levels were increased, but only by the high dose of ethanol. In these experiments the effects exerted by ethanol on the pancreatic endocrine responses to arginine infusion varied according to: dose of ethanol administered; duration of exposure to ethanol; and state of nourishment of the subjects.

Effects of adrenergic drugs on aqueous cAMP and cGMP and intraocular pressure

The following variously selective adrenergic agonists were tested for their effects on the concentration of adenosine 3',5' cyclic monophosphate and guanosine 3',5- cyclic monophosphate in the aqueous humor of treated and fellow eyes of rabbits one hour after topical unilateral application (2 mg, base): Epinephrine (alpha, beta 1.beta 2), phenylephrine alpha), isoproterenol (beta 1, beta 2), tazolol (beta 1) and terbutaline (beta 2). All drugs produced a significant increase in cAMP in the treated eyes and all but terbutaline produced a significant increase in the fellow eye. Terbutaline alone caused an increased in cGMP although a similar dose of pilocarpine, a cholinergic agonist, was ineffective in changing cGMP levels. We conclude that (1) diverse adrenoceptor stimulation can increase cAMP, but (2) not necessarily in direct relation to an agent's hypotension induced by pilocarpine is not accompanied by an increase in aqueous cGMP.