Appearance of fluid content in Rathke's cleft cyst is associated with clinical features and postoperative recurrence rates

PURPOSE

The contents of Rathke's cleft cysts (RCCs) vary from clear and slightly viscous to purulent. Surgical treatment of symptomatic RCCs involves removing the cyst contents, whereas additional cyst-wall opening to prevent reaccumulation is at the surgeon's discretion. The macroscopic findings of the cyst content can reflect the nature of RCCs and would aid in surgical method selection.

METHODS

We retrospectively reviewed the records of 42 patients with symptomatic RCCs who underwent transsphenoidal surgery at our institute between January 2010 and March 2022. According to the intraoperative findings, cyst contents were classified into type A (purulent), type B (turbid white with mixed semisolids), or type C (clear and slightly viscous). Clinical and imaging findings and early recurrence rate (within two years) were compared according to the cyst content type.

RESULTS

There were 42 patients classified into three types. Patients with type C were the oldest (65.4 ± 10.4 years), and type A included more females (92.9%). For magnetic resonance imaging, type-A patients showed contrast-enhanced cyst wall (92.9%), type-B patients had intracystic nodules (57.1%), and all type-C patients showed low T1 and high T2 intensities with larger cyst volumes. Fewer asymptomatic patients had type C. Preoperative pituitary dysfunction was most common in type A (71.4%). Early recurrence was observed in types A and C, which were considered candidates for cyst-wall opening.

CONCLUSION

The clinical characteristics and surgical prognosis of RCCs depend on the nature of their contents.

Characteristics of Changes in Intrathecal Baclofen Dosage over Time due to Causative Disease

Intrathecal baclofen (ITB) therapy effectively treats spasticity caused by brain or spinal cord lesions. However, only a few studies compare the course of treatment for different diseases. We investigated the change in daily dose of baclofen per year and its associated adverse events in patients presenting with the three most common etiologies at our institute: hereditary spastic paraplegia, cerebral palsy, and spinal cord injury. The ITB pumps were implanted from July 2007 to August 2019, with a mean follow-up period of 70 months. In patients with hereditary spastic paraplegia, baclofen dosage was reduced after eight years following ITB introduction, and the treatment was terminated in one patient owing to disease progression. In patients with cerebral palsy, the dosage increased gradually, and became constant in the 11th year. Patients with spinal cord injury gradually increased their baclofen dosage throughout the entire observation period. Severity and adverse event rates were higher in patients with cerebral palsy than in others. The degree and progression of spasticity varied depending on the causative disease. Understanding the characteristics and natural history of each disease is important when continuing ITB treatment.

Efficacy and Safety of Ramucirumab/nab-paclitaxel for Previously Treated Advanced Gastric Cancer in Community Hospitals

As the nanoparticle albumin-bound paclitaxel (nab-PTX) is free of ethanol and premedication, the duration of administration is shorter and patients can drive themselves to and from the hospital. In the 2018 Japanese gastric cancer treatment guidelines, ramucirumab (RAM) plus weekly nab-PTX is conditionally recommended for previously treated patients with advanced gastric cancer. Here, we retrospectively analysed the efficacy and safety of RAM+nab-PTX for such patients in community hospitals. From January 2018 to December 2019, 43 patients with metastatic and recurrent gastric cancer received RAM+nab-PTX treatment. Six patients (13.9%) were older than 80 years and 9 patients (20.9%) showed ECOG-PS 2. Progression-free survival (PFS), overall survival (OS), overall response rate (ORR), disease control rate (DCR), and adverse events (AEs) were reviewed retrospectively. Median PFS was 114 days (95% confidence interval [CI]: 84-190) and median OS was 297 days (95% CI: 180-398). ORR and DCR were 32.4% and 72.2%, respectively. The incidence rates of ≥grade 3 neutropenia and febrile neutropenia were 53.5% and 2.3%, respectively. No treatment-related deaths occurred. RAM plus nab-PTX combination therapy demonstrated manageable toxicity even patients who were elderly or had an ECOG-PS 2. This treatment is useful in community hospital settings.

Global plant trait relationships extend to the climatic extremes of the tundra biome

The majority of variation in six traits critical to the growth, survival and reproduction of plant species is thought to be organised along just two dimensions, corresponding to strategies of plant size and resource acquisition. However, it is unknown whether global plant trait relationships extend to climatic extremes, and if these interspecific relationships are confounded by trait variation within species. We test whether trait relationships extend to the cold extremes of life on Earth using the largest database of tundra plant traits yet compiled. We show that tundra plants demonstrate remarkably similar resource economic traits, but not size traits, compared to global distributions, and exhibit the same two dimensions of trait variation. Three quarters of trait variation occurs among species, mirroring global estimates of interspecific trait variation. Plant trait relationships are thus generalizable to the edge of global trait-space, informing prediction of plant community change in a warming world.

Large-cell neuroendocrine carcinoma arising from a gastritis cystica polyposa

Gastritis cystica polyposa is a polypoid lesion that arises from the gastric mucosa at the gastrojejunal anastomotic site and is characterized by cystic dilation of the gastric glands. A 78-year-old man who underwent distal gastrectomy for a gastric ulcer with Billroth II reconstruction approximately 40 years previously, exhibited a gastritis cystica polyposa at the anastomotic site. Ulceration was observed on an annual endoscopic examination. Endoscopic ultrasonography revealed a submucosal hypoechoic mass with multiple cystic lesions. Gastrectomy was performed and histological examination revealed a large-cell neuroendocrine carcinoma with cystic dilation of the gastric glands. Here, we report the first case of a large-cell neuroendocrine carcinoma arising from a gastritis cystica polyposa. Endoscopic ultrasonography was effective at diagnosing a submucosal hypoechoic mass with cystic dilation of the gastric glands.

Well-differentiated pancreatic ductal adenocarcinomas measuring ≤ 1 cm exhibit early features of tumor progression: a report of five lesions and a comparative study with advanced lesions

PURPOSE

The purpose of this study was to clarify whether the features of well-differentiated pancreatic ductal adenocarcinomas (PDACs) measuring ≤ 1 cm are the same as those of early PDACs.

METHODS

Five well-differentiated PDACs measuring ≤ 1 cm were clinicopathologically compared with 19 ≥ 2 cm PDACs. Additionally, an immunohistochemical analysis for abnormalities in the expression of five molecular parameters: MUC1, p16, p53, Smad4 and sonic hedgehog, which are associated with tumor progression, was performed.

RESULTS

The clinicopathological comparison revealed that well-differentiated PDACs measuring ≤ 1 cm were detected significantly more often without angiolymphatic invasion and with a sparse presence of cancer cells than were the ≥ 2 cm PDACs. On the other hand, in well-differentiated PDACs measuring ≤ 1 cm, the incidence of abnormal immunolabeling for MUC1, p16, p53 and sonic hedgehog was similar to that in ≥ 2 cm PDACs. However, the incidence of diffusely positive immunolabeling for MUC1 and the mean number of abnormally immunolabeled samples for the five parameters were significantly lower in well-differentiated ≤ 1 cm PDACs (20 % and 3 ± 1) than in ≥ 2 cm PDACs (90 % and 4 ± 1).

CONCLUSION

The current study revealed that as the tumor size increases, molecular abnormalities are accumulated, suggesting that well-differentiated PDACs measuring ≤ 1 cm are in an earlier stage of genetic progression than are ≥ 2 cm PDACs, and these lesions may exhibit early features of invasive PDACs.

[Long survival of a colon cancer case with synchronous multiple liver metastases responding to S-1]

In May 2005, a 79-year-old woman was referred to our hospital with complaints of right lower quadrant mass and feces mixed with blood. After examination, she was diagnosed with ascending colon cancer and synchronous multiple liver metastases. Postoperative diagnosis after right hemicolectomy and D3 lymph node dissection was T2, N1, H2, P0, M0, and Stage IV. One month after the operation, we started a combination chemotherapy using 5-FU plus UFT as pharmacokinetic modulating chemotherapy with hepatic arterial infusion (HAI-PMC). But abdominal CT scan revealed the increase of multiple liver metastases, PD, after 4 courses of treatment. We then changed to modified HAI-PMC (additional CPT-11, once every four weeks), but had to cancel it due to her exhaustion and inappetence. Therefore, S-1 was started from October, 2005. Each course consisted of daily oral administration of 80 mg S-1 for 4 weeks and withdrawal for 2 weeks. After 4 courses, abdominal CT scan revealed a reduction in the number of multiple liver metastases, PR. PR has continued for a long term to date. As an adverse event, we had grade 3 neutropenia and grade 2 diarrhea in January 2009, and we changed the administration method (80 mg S-1 for 2 weeks and withdrawal for 1 week). She continues to undergo outpatient treatment with good QOL without a lesion for 4 years and 6 months. S-1 is expected to be an effective agent for the treatment of advanced colon cancer.

[A case of synchronous hepatocellular carcinoma successfully treated by S-1 and cisplatin (CDDP) as neoadjuvant chemotherapy for gastric cancer]

Combination chemotherapy with S-1 and cisplatin(S-1/CDDP)has become the standard treatment for gastric cancer, but the effect for hepatocellular carcinoma has not become clear. We experienced a case with advanced gastric cancer and hepatocellular carcinoma at the same time. We used S-1/CDDP as neoadjuvant chemotherapy for the case and performed surgical resection of the gastric cancer and hepatocellular carcinoma. From histological examination of the resected specimen, we may be able to prove that the S-1/CDDP chemotherapy for the hepatocellular carcinoma was also effective. A 57-year-old man visited our hospital with epigastralgia. Further examinations revealed a type-3 advanced gastric cancer with bulky N2 and hepatocellular carcinoma at segment 5. The gastric cancer was thought to be too advanced for initial surgery, so we performed S-1/CDDP chemotherapy(S-1 100 mg/body/day, CDDP 20 mg/body twice/week for 2 weeks)as preoperative therapy. After remarkable shrinkage of the gastric cancer was obtained, we performed distal gastrectomy, D2+a lymph node excision, liver S5 segmentectomy and cholecystectomy. The histological examination showed remarkable denaturation and necrosis as grade 2 effectiveness in over two-thirds of the hepatocellular carcinoma area and grade 1b in gastric cancer according to the Japanese classification of gastric carcinoma. This result suggests that S-1/CDDP chemotherapy might therefore be effective as systemic therapy for patients with hepatocellular carcinoma. However, further clinical trials are required.

Elevated CO2 and nitrogen availability have interactive effects on canopy carbon gain in rice

•  Here we analysed the effects of CO₂ (C_a ) elevation and nitrogen availability on canopy structure, leaf area index (LAI) and canopy photosynthesis of rice (Oryza sativa). •  Rice was grown at ambient and elevated C_a (c. 200 µmol mol^-1 above ambient, using the free-air CO₂ enrichment, FACE) and at two N availabilities. We measured leaf area, area-based leaf N contents and leaf photosynthesis, and calculated net daily canopy photosynthesis. •  FACE plants had higher light-saturated rates of photosynthesis (P_max ) and apparent quantum yields than ambient plants, when measured at their own growth CO₂ . C_a elevation reduced the total leaf N in the canopy (N_leaf ) but had no effect on LAI, and the average leaf N content (N_leaf /LAI) was therefore reduced by 8%. This reduction corresponded well with our model predictions. Leaf area index increased strongly with N availability, which was also consistent with our model. •  Calculated canopy photosynthesis increased more strongly with N_leaf under elevated than under ambient C_a . This indicates that there is an N × C_a interactive effect on canopy carbon gain. This interaction was caused by the increase in LAI with N availability, which enhanced the positive effect of the higher quantum yield under C_a elevation.

Synthesis of optically active TAN-67, a highly selective delta opioid receptor agonist, and investigation of its pharmacological properties

We have synthesized the nonpeptidic highly selective delta opioid receptor agonist, (+/-)-TAN-67, (4aS*, 12aR*)-4a-(3-hydroxyphenyl)-2-methyl-1,2,3,4,4a,5,12,12a-octahydropyrido [3,4-b] acridine. In spite of high potent agonist activity for the delta opioid receptor in in vitro assay, (+/-)-TAN-67 afforded no analgesic activity in the mouse warm-plate test. This result led us to separate (+/-)-TAN-67 into optically pure compounds. Each enantiomer of racemic TAN-67 was synthesized from the corresponding optically active 6-oxodecahydroisoquinoline which was obtained by fractional recrystallization of its optically pure di-p-toluoyl tartaric acid salt. In bioassay using mouse vas deferens, (-)-TAN-67 showed full agonist activity (IC50 = 3.65 nM). On the other hand, (+)-TAN-67 showed almost no agonist activity, but interestingly afforded hyperalgesic activity in vivo (i.t. injection).

KF31327, a new potent and selective inhibitor of cyclic nucleotide phosphodiesterase 5

The effects of KF31327 (3-ethyl-8-[2-(4-hydroxymethylpiperidino)benzylamino]-2,3-dihydro-1H-imidazo[4,5-g]quinazoline-2-thione dihydrochloride) on phosphodiesterase 5 (cyclic GMP-specific phosphodiesterase) activity and platelet aggregation were investigated and compared with those of sildenafil, a well-known phosphodiesterase 5 inhibitor. KF31327 inhibited phosphodiesterase 5 from canine trachea (K(i)=0.16 nM) more potently than sildenafil (K(i)=7.2 nM). The kinetic analysis revealed that KF31327 was a non-competitive inhibitor. In the presence of nitroglycerin (nitric oxide generator), both compounds inhibited the collagen-induced aggregation of rabbit platelets at less than 0.1 microM, augmenting intracellular cyclic GMP level without affecting cyclic AMP. In contrast, in the absence of nitroglycerin, a higher concentration (10 microM) of KF31327 was required to inhibit platelet aggregation and increased both cyclic nucleotide levels. However, 10 microM sildenafil did not affect aggregation despite elevation of cyclic GMP comparable to that in the presence of nitroglycerin. These results indicate that in the presence of nitroglycerin, the inhibition of platelet aggregation by KF31327 is due to the elevation of cyclic GMP, whereas the mechanism underlying the inhibition without nitroglycerin might be related to a rise in intracellular cyclic AMP.

Duodenogastric reflux following cholecystectomy in the dog: role of antroduodenal motor function

BACKGROUND

Duodenogastric reflux has been implicated in the pathogenesis of gastric ulcer and gastritis. Duodenogastric reflux after cholecystectomy is also a possible cause of post-cholecystectomy syndrome.

AIM

To investigate the role of antroduodenal motor function in increased duodenogastric reflux following cholecystectomy and the effect of trimebutine maleate (trimebutine) on the duodenogastric reflux in conscious dogs.

METHODS

Antropyloric and duodenal motility and bile acids content in the gastric juice were measured for 3 h during the inter-digestive state in dogs with or without cholecystectomy.

RESULTS

Bile acids content in the gastric juice of cholecystectomized dogs was significantly higher than that of non-cholecystectomized dogs. The frequency of pyloric relaxation during phase II of the migrating motor complex was significantly increased following cholecystectomy. Intravenous infusion of trimebutine inhibited both the increased duodenogastric reflux and the frequency of pyloric relaxation in the cholecystectomized dog.

CONCLUSION

Duodenogastric reflux and frequency of pyloric relaxations were increased in cholecystectomized dogs and trimebutine suppressed both of them. These findings suggest that the increased frequency of pyloric relaxation contributes to the duodenogastric reflux following cholecystectomy.

[Usefulness of pharmacokinetic modulating chemotherapy (PMC) for the postoperative adjuvant therapy of colorectal carcinoma: a preliminary report]

Pharmacokinetic modulating chemotherapy (PMC) using oral UFT and continuous venous 5-FU infusion was administered to 22 resectable patients with Dukes' B2-D colorectal carcinomas. The regimen was arranged as follows: Group A (n = 12) UFT 300-450 mg/day, 5 days a week and 5-FU 440-600 mg/m2/24 hr (750-1,000 mg/body/24 hr) once a week, Group B (n = 10), UFT less than 300 mg/day, 5 days a week, and/ or 5-FU less than 440 mg/m2/24 hr (750 mg/body/ 24 hr) once a week. The control group (Group C, n = 26) was selected at random from among non-PMC cases matched for other background factors and in which surgery had been performed during the past 4 years. Fifteen out of 26 patients in Group C were treated with 5-FU masked compounds orally. The cumulative 2 year recurrent rates of Groups A, B and C were 8.3%, 52.0% and 50.0%, respectively; the rate of Group A was significantly lower than that of Group B (p < 0.05). Four patients who suffered from PMC-related side effects of grade 1-2 wanted to decrease their dosage of UFT and/or 5-FU. They were registered in Group B. These results suggest that the regimen of Group A was advantageous in improving the prognosis after resection of Dukes' B2-D colorectal carcinoma.

The effect of nociceptin, an endogenous ligand for the ORL1 receptor, on rat colonic contraction and transit

To assess the role of ORL1 (opioid receptor-like 1) receptor in the bowel movement, we investigated the effect of nociceptin on colonic contraction and transit in rats. Nociceptin (0.1-100 nM) concentration-dependently caused an immediate tonic contraction followed by rhythmic waves of contractions in the isolated colon. The response to nociceptin (10 nM) was not affected by the classical opioid receptor antagonists, naloxone, naltrindole and nor-binaltorphimine. Suppression of effect of inhibitory neurotransmitters using pituitary adenylate cyclase activating polypeptide(6-38) (PACAP-(6-38); 3 microM), vasoactive intestinal polypeptide(10-28) (VIP-(10-28); 3 microM) and N(omega)-nitro-L-arginine methyl ester (L-NAME; 100 microM) did not influence the nociceptin-induced contractions. In anesthetized rats, intravenous administration of nociceptin (1 microg/kg) or morphine (1 mg/kg) caused phasic contractions in the proximal colon. Pretreatment with naloxone (300 microg/kg, i.v.) abolished the contractions induced by morphine, but not by nociceptin. The rate of large intestinal transit was dose-dependently accelerated by nociceptin (0.03-3 microg/kg, s.c.), but was retarded by morphine (1.7-5 mg/kg, s.c.). These results indicate that stimulation of ORL1 receptor accelerates the colonic contraction and transit independently from opioid receptors.

A study of the internal structure of the mandibular ramus in Japanese

To clarify the internal structure of the mandibular ramus in Japanese adults, we performed bone morphometry. Specimens were obtained from four areas: the mid-area between the mandibular foramen and the lowest point of the mandibular notch, areas immediately above and below the mandibular foramen, and the mid-area between the mandibular foramen and the mandibular angle. The mandibular ramus was divided into the anterior and posterior parts, and morphometric analysis was performed on the four areas in each part. The percentage of the trabecular bone area in spongy bone was higher in the anterior part than in the posterior part. In both the anterior and posterior parts, the percentage of trabecular bone was the highest in the most inferior area. Trabecular bone was thicker in the anterior part than in the posterior part. Both in the anterior and posterior parts, trabecular bone was the thickest in the most inferior area. The arrangement of trabecular bone was more complicated in the anterior part than in the posterior part. Trabecular bone was most frequently arranged in the anteroposterior direction. In the superior area of the posterior part, much trabecular bone ran from the posterior buccal side toward the anterior lingual side. Compact bone was thicker in the anterior part than in the posterior part and on the buccal side than on the lingual side. No age-related changes were observed in any element of trabecular bone structure.

Protection by histidine against oxidative inactivation of AMP deaminase in yeast

Oxidative inactivation of AMP deaminase and its protection were analyzed under the in situ conditions of yeast cells. AMP deaminase was readily inactivated by an exposure to hydrogen peroxide plus copper in permeabilized yeast cells. Addition of ascorbic acid further enhanced the inactivation of the enzyme, suggesting the hydroxyl radical produced by the Fenton reaction is responsible for the inactivation of the enzyme. Addition of histidine caused an effective protection against the inactivation of AMP deaminase by hydrogen peroxide-induced hydroxyl radical. The concentration of histidine required for half-maximal effect was within physiological range. Cysteine showed less effective protection against oxidative inactivation. Other amino acids as potent copper-chelating agents as well as trolox and taurine showed little or no effect. Histidine can act as a physiological "antioxidant" in yeast cells.

Synthesis and structure-activity relationship of trimebutine derivatives

Trimebutine derivatives were synthesized by utilizing alkylation or acylation of isonitriles and nitrile as a key step. The colonic contractile effects of these compounds were examined, and T-1815 was found to have strong colonic propulsive activity.

Effects of the new anti-ulcer drug ecabet sodium (TA-2711) on pepsin activity. II. Interaction with substrate protein

To define the mechanism of the protection by ecabet (TA-2711) of the gastric mucosa from peptic attack, the characteristics of protein binding of this drug and its effect on peptic hydrolysis of substrate proteins were investigated in vitro. Both the binding to proteins and the hydrophobicity of ecabet were dependent on the pH; the lower the pH, the higher both parameters. The percentage of ecabet bound to proteins was nearly constant, being independent of the drug concentration at pH's below 2, indicating that this drug is bound to proteins in a non-specific manner. The activity of peptic hydrolysis of bovine serum albumin (BSA) decreased in the presence of ecabet, and this was not due to the interaction between pepsin and ecabet judging from the kinetic studies. The apparent Km values of peptic hydrolysis of BSA increased depending on the quantity of ecabet bound to BSA. These results suggest that ecabet is bound to substrate proteins by a non-specific hydrophobic interaction to form a complex that is less vulnerable to peptic hydrolysis.

Effects of the new anti-ulcer drug ecabet sodium (TA-2711) on pepsin activity. I. Inactivation of enzyme protein

To investigate the mechanism of the anti-peptic action of ecabet sodium (TA-2711) observed in pylorous-ligated rats, effects of this drug on the peptic activity of rat gastric juice, purified hog pepsin and pepsinogen were studied in vitro. After incubation with or without ecabet at acidic pH, the reaction mixture was centrifuged, and the peptic activity of the supernatant was measured. Ecabet depressed the peptic activity of pepsin and pepsinogen in parallel with a decrease in the protein concentration of the respective supernatant. Depression was greatest with pepsinogen (97% at 2.5 mg/ml of the drug) followed by gastric juice (about 60% at 10 mg/ml), and inhibition of the peptic activity of pepsin was weakest (about 10% at 10 mg/ml). When a fraction of the rat gastric juice containing substances with molecular weights below 10,000 was added to the pepsin solution, the anti-peptic activity of ecabet was potentiated. These results suggest that oral dosing of ecabet reduces the peptic activity of gastric juice by precipitating pepsin, which is facilitated by an unknown component(s) of gastric juice, and that the inactivation of pepsinogen may also contribute to the anti-peptic activity of ecabet.

Effect of a new colonic prokinetic compound, T-1815, on gastrointestinal motility in anesthetized and conscious fasted dogs

Effect of T-1815, a new colonic prokinetic compound, on gastrointestinal motility was studied in anesthetized and conscious dogs fasted for 24 hr before experiment. In anesthetized dogs, intravenous injection of T-1815 in doses of 0.3-3.0 mg/kg caused a biphasic effect on the gastric motility, a slight decrease followed by a slight increase. While the compound elicited only an increase in motility of the duodenum, jejunum and colon. In the colon, high-amplitude contractions were observed in 2 out of 5 animals at 1 mg/kg, i.v. of T-1815 and 4 out of 5 animals at 3 mg/kg. Bethanechol at 0.01 mg/kg, i.v. produced only a potentiation of the motility in all of the sites, but never induced high-amplitude contractions in the colon. During the interdigestive state in conscious dogs, intravenous T-1815 at 1 and 3 mg/kg caused contractions similar to the interdigestive phase III contractions at the stomach and duodenum in only 2 out of 7 experiments, and colonic motility was slightly depressed at 3 mg/kg. Oral administration of T-1815 at 30 and 50 mg/kg did not elicit the phase III-like contractions but produced persistent contractions at the stomach and duodenum in 2 out of 4 conscious animals during the interdigestive state. In the proximal and middle colon, high-amplitude contractions were observed in 5 out of 7 animals by 10-50 mg/kg, p.o. of T-1815. From the above results, it is concluded that the pharmacological effect of T-1815 on gastrointestinal motility is different from that of the cholinergic agonist. In addition, T-1815 seems to have a characteristic to induce high-amplitude contractions which are known to be closely related to defecation.

Comparison of the effects of T-1815, yohimbine and naloxone on mouse colonic propulsion

The colonic prokinetic activity of a newly synthesized compound, T-1815, administered orally, was compared with that of yohimbine and naloxone in mice. The time required to evacuate a glass bead inserted into the distal colon was taken as an index of prokinetic activity. Clonidine (3-30 micrograms/kg s.c.), and loperamide (0.3-3.0 mg/kg s.c.) delayed bead expulsion in a dose-dependent manner. Yohimbine (0.3-10 mg/kg) and T-1815 (0.1-10 mg/kg) showed a dose-dependent reduction of the delay in evacuation induced by clonidine, but naloxone had no effect. The loperamide-induced retardation of colonic propulsion was reduced by naloxone (0.3-10 mg/kg) and T-1815 (0.1-10 mg/kg) in a dose-dependent manner, but yohimbine had no effect. In normal animals, yohimbine and naloxone had no significant effect on evacuation, while a slight acceleration was observed with T-1815 at 10 mg/kg. No soft feces and/or diarrhea were observed with any of the three test drugs. These results indicate that T-1815 appears to be a unique colonic prokinetic compound, the action of which may be mediated through mechanisms other than antagonism for alpha 2-adrenoceptors or opioid receptors.

Evidence that the enzyme catalyzing the conversion of guanosine diphosphate D-mannose to a 4-keto sugar nucleotide intermediate requires nicotinamide adenine dinucleotide phosphate

The first enzyme in the formation of GDP-L-fucose from GDP-D-mannose, which forms a GDP-4-keto sugar intermediate, was purified to homogeneity from cell extracts of Klebsiella pneumoniae. During purification, the enzyme was found to be highly activated by NADP. It was proven that the pyridine nucleotide coenzyme of the enzyme was NADP, not NAD, which differs from previously accepted information. NAD had no effect on enzyme activity. The product of the enzyme reaction with NADP as coenzyme was separated from other nucleotides by high-performance liquid chromatography, and using ion spray liquid chromatography/mass spectrometry the mass was determined for the first time, as 587, which is same as the calculated mass of GDP-4-keto-6-deoxy-D-mannose.

A study of the internal structure of the Japanese mandible

The thickness of the substantia compacta and the volume and width of the trabecular bone of the substantia spongiosa were investigated by soft X-ray photographs made of thin sections of many kinds of dentulous and edentulous mandibles. The results were: 1) The thickness of substantia compacta is especially thick on the lingual side in the incisor region and thickest in the molar region in all materials. At the base of mandible, the thickness is essentially the same in all regions, but, the thickness of dentulous materials is greater than of edentulous ones. 2) On the upper part, the volume of trabecular bone is less in the premolar region in both edentulous and dentulous material than in other regions, however, there is relative more in edentulous than in dentulous. In the central part, there is almost the same amount of trabecular bone in the dentulous and edentulous material. 3) The width of the trabecular bone in the substantia spongiosa is greater in the incisor region than in other regions in all materials. In the upper and central part, it is smaller in the premolar region in both edentulous and dentulous material but, it increases in the molar region in the edentulous materials.

[Effects of trimebutine on colonic propulsion in mice]

Effects of oral administration of trimebutine on colonic propulsion in conscious mice were studied by measuring the time required to evacuate a bead which had been inserted into the colon, and compared with those of metoclopramide and domperidone. In normal animals, trimebutine (10 and 50 mg/kg), metoclopramide (50 mg/kg) and domperidone (50 mg/kg) had no effect on the bead evacuation. Metoclopramide and domperidone at 30 mg/kg showed no effect on the delay of colonic propulsion induced by clonidine, while trimebutine (10 and 30 mg/kg) restored the delay significantly. Trimebutine also showed restoration of the delay induced by loperamide. On the acceleration of the propulsion induced by neostigmine, trimebutine (10 and 30 mg/kg) showed an inhibition. In addition, trimebutine (3-30 mg/kg) dose-dependently suppressed the development of soft feces and/or diarrhea induced by neostigmine. According to the results, it is concluded that trimebutine produces both acceleration and inhibition on the colonic propulsion in mice.

Effects of the new anti-ulcer agent 12-sulfodehydroabietic acid monosodium salt on healing of acetic acid-induced gastric ulcers in rats

The macroscopic and microscopic effects of 12-sulfodehydroabietic acid monosodium salt (TA-2711, CAS 86408-72-2) on the healing of acetic acid-induced gastric ulcers in rats were compared with those of sucralfate and carbenoxolone. Test compounds were given orally twice a day for 10 consecutive days from the day after the injury with glacial acetic acid. TA-2711 (50 and 100 mg/kg) dose-dependently decreased the macroscopic ulcer index (mm2). In addition, at a dose of 100 mg/kg, this drug decreased the length of mucosal defect in the ulcerated region and increased the mucosal regeneration index estimated by microscopic observation. Furthermore, the mucosa surrounding the ulcerated area and the regenerated epithelium in the TA-2711 administered group contained more PAS (periodic acid-Schiff)-positive material than those in the control group. On the other hand, neither sucralfate nor carbenoxolone (100 mg/kg) showed any significant effects on ulcer healing.

Effects of the new anti-ulcer agent 12-sulfodehydroabietic acid monosodium salt on duodenal alkaline secretion in rats

Alkaline secretion was measured by pH-stat titration (pH 7.4) during circulation of 0.15 mol/l NaCl through the duodenal lumen in urethane-anesthetized rats. 12-Sulfodehydroabietic acid monosodium salt (TA-2711), at concentrations of 5 and 10 mg/ml, instilled into the circulating fluid at pH 7.4 caused a slight increase in alkaline secretion. When the duodenal lumen was acidified to pH 2.0 for 5 min by instillation of HCl into the circulating fluid, a remarkable increase in alkaline secretion occurred. Addition of TA-2711 (5 and 10 mg/ml) to the circulating fluid considerably enhanced the acid-induced alkaline secretion, with a concurrent increase in prostaglandin E2 release into the circulating fluid. These effects of TA-2711 were inhibited by the pretreatment with indometacin (10 mg/kg s.c.). The results indicate that TA-2711 has an enhancing effect on acid-induced alkaline secretion and endogenous prostaglandins may be involved in the alkaline secretion enhanced by TA-2711.

Effects of 12-sulfodehydroabietic acid monosodium salt (TA-2711), a new anti-ulcer agent, on gastric mucosal lesions induced by necrotizing agents and gastric mucosal defensive factors in rats

Effects of TA-2711 on gastric mucosal lesions induced by various necrotizing agents and several defensive factors of gastric mucosa were investigated in rats. Oral administration of TA-2711 at 12.5 to 200 mg/kg prevented the formation of gastric mucosal lesions induced by 99.5% ethanol, 0.6 N HCl, 0.2 N NaOH and boiling water with ED50 values of 24, 58, 16 and 101 mg/kg, respectively. Oral TA-2711 at 100 mg/kg increased the gastric mucosal prostaglandin E2 (PGE2) level without any change in transmucosal potential difference. A sustained decrease in gastric mucosal blood flow produced by intragastric administration of 99.5% ethanol was inhibited by oral TA-2711 (50, 100 mg/kg) and 16,16-dimethyl PGE2 (10 micrograms/kg). The effect of TA-2711 on ethanol-induced decrease in blood flow was suppressed by indomethacin (10 mg/kg, s.c.). Oral TA-2711 (25-100 mg/kg) dose-dependently increased the amount of mucus adherent to the gastric mucosa. In addition, gastric HCO3- secretion was increased by intragastric TA-2711 at 2.5 and 5.0 mg/ml. These results suggest that TA-2711 enhances gastric mucosal resistance by increasing mucus and HCO3- secretion and by maintaining mucosal blood flow, and protects the gastric mucosa against various irritants. The effects of TA-2711 appear to be mediated by mucosal prostaglandins such as PGE2.

Effects of 12-sulfodehydroabietic acid monosodium salt (TA-2711), a new anti-ulcer agent, on gastric secretion and experimental ulcers in rats

Effects of 12-sulfodehydroabietic acid monosodium salt (TA-2711), a new anti-ulcer agent, on gastric secretion and experimental ulcers were investigated in rats. Oral administration of TA-2711 at doses of 25 to 100 mg/kg immediately after pyloric ligation markedly reduced pepsin activity and slightly lowered acid concentration without affecting the volume of gastric juice. Addition of TA-2711 (0.25-16 mg/ml) directly to gastric juice also reduced pepsin activity in vitro. Oral TA-2711 dose-relatedly inhibited the formation of pylorus-ligated ulcers (50-200 mg/kg), aspirin-induced gastric erosions (25-100 mg/kg) and cysteamine-induced duodenal ulcers (100-800 mg/kg). In addition, this drug prevented both the formation of gastric lesions (6.3-100 mg/kg, p.o.) and the fall in gastric potential difference (100 mg/kg, p.o.) induced by ethanol. The preventive effect against ethanol-induced lesions was suppressed by pretreatment with indomethacin (10 mg/kg, s.c.). Intravenous dosing of TA-2711 (10-100 mg/kg) never produced such effects on ethanol-induced lesions and pepsin activity as observed by oral administration. These results indicate that TA-2711 exerts its anti-ulcer effect by a local action, and it is suggested that both reduction of pepsin activity and a mucosal prostaglandin-mediated process are involved in the anti-ulcer action of TA-2711.

Quantitative and morphological studies of the trabecular bones in the condyloid processes of the Japanese mandibles; changes due to aging

The structure of bone changes with advancing age. In order to observe changes in the trabecular bone structure of the mandibular condyloid process and their relationship to age, the mandibular condyloid process and third lumbar vertebra were extracted from cadavers from several age groups, and changes in trabecular bone structure due to age were compared. Comparison of the trabecular bones of the lumbar vertebra and condyloid processes from single cadavers by age revealed a clear reduction in trabecular bone density and width in the lumbar vertebra accompanying advancing age. In the condyloid process in contrast no major changes were observed; it appears that the effects of aging are slight.

A finger volume-oscillometric device for monitoring ambulatory blood pressure: laboratory and clinical evaluations

A new portable device for the indirect measurement of ambulatory blood pressure in the finger was successfully applied to normotensive and hypertensive subjects in and outside a ward setting. The device uses the volume-oscillometric technique and, equipped with a microprocessor, permits long-term ambulatory monitoring of indirect systolic and mean blood pressure at desired intervals (once every 1-10 min). Systolic and mean blood pressures obtained by this method were well correlated with those measured by the direct (Oxford) and arm-cuff methods. Systolic and diastolic blood pressure obtained by the volume-oscillometric device were almost identical with those recorded by an arm-cuff. Systolic blood pressure obtained by the volume oscillometric method was, however, significantly lower than that measured by the direct method. The new device has also been used to measure blood pressure during treadmill exercise and ice-water immersion. Mean values of blood pressure and the SD of these averaged for 24 hours, or for every hour, were reproducible when the measurements were repeated under the same condition. The present device is portable, causes minimal noise, can detect rapid change in blood pressure and causes less discomfort when compared to the conventional arm-cuff method. Regular measurements can be made with minimal sleep disturbance. This fully automatic volume-oscillometric device allows reliable 24-hour monitoring of ambulatory blood pressure not only in but also outside a ward setting, and as such is useful for studies of hypertension.

[Laboratory and clinical studies of cefmetazole in serious infection by Staphylococcus (author's transl)]

Cefmetazole (CMZ) is an antibiotic agent belonging to the cephamycin group, which is resistant to beta-lactamase and has a broad antibacterial spectrum covering from Gram-negative to -positive organisms. Although this agent has been proved to have an antibacterial activity against Staphylococcus spp., it has not been used for treatment of the infections caused by the organism. Thus, 62 strains of S. aureus isolated clinically were compared for their sensitivity to CMZ, cefoxitin (CFX), cefuroxime (CXM), cefazolin (CEZ), and ampicillin (ABPC). In addition, 5 children suffering from septicemia due to S. aureus were treated with CMZ 158 mg/kg at a mean daily dose for a mean period of 14 days. The dose was used after dividing into 3 and 4 equal parts in 1 and 4 children, respectively. One old patient with septicemia was given 2,000 mg of CMZ twice daily for 4 days and once daily for subsequent 3 days. Another child with bacterial meningitis was treated with 50 mg/kg of CMZ 4 times daily for 63 days. The drug was given intravenous injection by one-shot or drip infusion in all cases under observation of clinical effects, bacteriological effects and side effects. The MIC of CMZ against S. aureus at inoculum sizes of 10(6) and 10(8) cells/ml was 1.56 mcg/ml in 72.6 and 56.5% of the strains, respectively. When 5 drugs were compared on the basis of the MIC to which the largest number of strains were sensitive, CEZ was most active, and CMZ was ranked in the next place and similar to CXM in activity. However, when the whole range of the MIC was considered, CMZ was more excellent than CXM, its MIC was lower than those of CEZ, CFX and ABPC in a greater number of strains. It was considered from the results that the serum level of CMZ was effective against 100 and 93.5% of strains at an inoculum size of 10(6) cells/ml and against 100 and 83.9% of strains at an inoculum size of 10(8) cells/ml until 4 and 6 hours after a one-shot intravenous injection of 50 mg/kg of Moni-trol I standard, respectively in the children. Thus, CMZ is expected to manifest a sufficient effect on septicemia caused by S. aureus in children who receive a one-shot intravenous injection of 50 mg/kg of it 4 times daily. Treatment with CMZ was clinically evaluated to be excellent in 3, good in 3 and poor in none of 6 patients with septicemia due to S. aureus, and fair in the 1 with Staphylococcal meningitis. The bacteriological result was excellent, since the causal organisms were eradicated in all cases. With regard to side effects, abnormal eosinophilia was found in 2 cases, but it was no ascribable to this drug in 1 of them. GOT showed an abnormal rise in 1 case and both GOT and GPT in 1, although they were considered not to be related to this drug in either case. It is considered from these results that CMZ is a valuable drug in treatment of septicemia due to S. aureus.

Barium and strontium can substitute for calcium in noradrenaline output induced by excess potassium in the guinea-pig

1. The ability of Ba2+ and Sr2+ to substitute for Ca2+ in the noradrenaline output induced by excess K+ was examined using isolated guinea-pig vas deferens. 2. When the vas deferens was repeatedly exposed to excess K+ (60 mM) at 40 min intervals, the noradrenaline output increased at least three-fold in incubation medium which contained either Ca2+, Ba2+ or Sr2+. The response decreased on repetition. The order of effectiveness was roughly Ba2+ > Ca2+ > Sr2+. 3. In the absence of excess K+, these cations had no significant stimulating effect on the noradrenaline output even when added after exposure to Ca2+-free solution. 4. As the concentration of divalent cation was increased from 0.2 to 2.5 mM the noradrenaline output induced by excess K+ increased. The maximum noradrenaline output was achieved at a divalent cation concentration of 2.5 mM and was 29.56 +/- 3.52, 15.02 +/- 1.12 and 7.45 +/- 0.84 (mean +/- S.E. of mean) n-mole/g per hr in the presence of either Ba2+, Ca2+ or Sr2+, respectively. Further increase in the concentration of the cations reduced the response. 5. The addition of either Sr2+ (2 mM) or Ca2+ (1 mM) to a solution containing various concentrations of Ba2+ facilitated the K+-induced increase in the noradrenaline output when the Ba2+ concentration was low, but inhibited release of noradrenaline when higher concentrations of Ba2+ were used. The addition of Sr2+ (1 mM) to Ca2+-containing solutions had a similar effect. 6. Mg2+ competitively inhibited the K+-induced increase in the noradrenaline output in the presence of either Ba2+ or Sr2+ and blocked that in the presence of CA2+. 7. The results indicate that both Ba2+ and Sr2+ can substitute for Ca2+ in the cations act though the same site at some stage in the process of K+-induced transmitter release.

[Therapeutic effect of oral doxycycline on syphilis (author's transl]

Eighty-one patients with syphilis were treated with oral doxycycline. A course of the antibiotic treatment consisted of 200 mg of doxycycline daily in two divided doses for 28 days. The course was repeated three to four times a year with an interval of several months. Quantitative Venereal Disease Research Laboratory (VDRL), Wassermann reaction (WR), and Treponema pallidum hemagglutination assay (TPHA) tests were performed monthly to evaluate the therapeutic effect of doxycycline treatment. The response rate was 100% for primary, 91.7% for early, 63.0% for late, and 61.8% for congenital syphilis in adults. No notable side effects were encountered except for epigastric fullness in four patients, which did not require the treatment to be discontinued. No abnormalities were detected in the results of laboratory tests.

Clinical evaluation of amoxycillin in the treatment of syphilis

Following demonstration of in vitro activity of amoxycillin against Treponema pallidum, a clinical research group was set up to study the effects of amoxycillin against various stages of syphilitic infection in men. A total of eighty-nine cases, fifteen primary, twenty-nine secondary, thirty late and fifteen adult congenital patients have been investigated. One hundred per cent effectiveness was recorded for primary and secondary syphilis; 66.7% for late syphilis and 60% success for adult congenital syphilis. In 10.4% of cases there was a transient elevation of SGOT and SGPT although it is not certain whether this was a reaction to the drug itself. There were three incidences of drug-related rash and two other minor side-effects. Amoxycillin is thus a safe and effective oral agent for the treatment of all stages of syphilis in man.

Therapeutic effect of oral doxycycline on syphilis

Fifty-one patients with syphilis were treated with oral doxycycline. A course of the antibiotic treatment consisted of 200 mg of doxycycline daily in two divided doses for 28 days. The courses were repeated three to four times a year with an interval of several months. Quantitative Venereal Disease Research Laboratory (VDRL), Wassermann reaction (WR), and Treponema pallidum haemagglutination assay (TPHA) tests were performed monthly to evaluate the therapeutic effect of doxycycline treatment. The response rate was 100% for primary, 90% for early, 68% for late, and 90% for congenital syphilis in adults. No notable side effects were encountered except for epigastric fullness in one patient, which did not require the treatment to be discontinued. No abnormalities were detected in the results of laboratory tests.

The effect of ouabain on noradrenaline output from peripheral adrenergic neurones of isolated guinea-pig vas deferens

1. The effect of ouabain on the noradrenaline output from peripheral adrenergic neurones has been studied using isolated guinea-pig vasa deferentia.2. Exposure to ouabain (10(-4)M) causes a gradual increase in the noradrenaline output. The effect occurs after a delay of 20 min and reaches a maximum during the period from 40-60 min.3. In the absence of external Ca, exposure to ouabain fails to produce an increase in the noradrenaline output. However, the reintroduction of Ca (2.5 mM) after a 1 hr exposure to ouabain in Ca-free media causes a rapid rise in noradrenaline output which reaches a maximum within the first 20 min.4. After a 1 hr exposure to a low concentration of ouabain (10(-5)M) the reintroduction of Ca is almost ineffective in increasing the noradrenaline output. When the concentration of ouabain is increased, the reintroduction of Ca becomes effective and causes a maximum effect with 10(-4)M ouabain. In the presence of a constant amount of ouabain (10(-4)M) the noradrenaline output induced by the reintroduction of Ca increases over the range 0.2-2.5 mM.5. In the presence of ouabain (10(-4)M) the Ca-induced noradrenaline output increases in a linear fashion with increasing Na concentrations from 25 to 143 mM, as long as NaCl is replaced with equimolar choline chloride or isotonic sucrose.6. In the presence of the lowest effective concentration of sodium (25 mM) the noradrenaline output induced by the reintroduction of Ca after a 1 hr exposure to ouabain is potentiated by LiCl. However, in the complete absence of Na(+) ions, there is no Li-dependent increase in the Ca-induced noradrenaline output.7. It is suggested that ouabain may cause an increase in noradrenaline output by an effect on the Na-dependent Ca influx system.

Role of calcium in the release of noradrenaline induced by sodium deprivation from the guinea-pig vas deferens

The ability of Na-free media containing isotonic sucrose or equimolar choline chloride to increase the spontaneous release of noradrenaline from adrenergic nerve terminals and the dependence of the increase on extracellular calcium have been examined in the isolated guinea-pig vas deferens. The increase in noradrenaline output induced by the Na deprivation was gradual in contrast to the rapid response produced by excess potassium. The release of noradrenaline induced by the Na-free solution containing sucrose was not significantly reduced by the removal of calcium with or without EGTA in the first 1 h period, but was reversibly inhibited in the second 1 h period. On the other hand, the effect of the Na-free solution containing choline was significantly but reversibly decreased by exposure to the Ca-free media without any chelating agent in both periods of incubation. Lanthanum (0.25 mM) moderately inhibited the response induced by calcium reintroduction following exposure to the Ca-free, Na-free choline medium, but magnesium (10 or 20 mM) did not. It is suggested that Na deprivation may cause an increase in Ca efflux, a decrease in Ca efflux or a release of intracellulary stored calcium resulting in an increase in the level of intracellular free calcium which then stimulates the output of noradrenaline.