Corneal endothelial cell loss caused by detached opacified anterior lens capsule in the anterior chamber

From 1984 to 1986, we performed cataract surgery through a 1.5 mm anterior capsule hole in 77 eyes. The hole was enlarged to 6.0 mm by a slit incision, and an intraocular lens was implanted into an almost completely intact capsular bag. Twelve (16%) eyes developed severe postoperative anterior capsule opacification. The opacified central anterior capsule, approximately 5 mm in diameter, was detached by can-opener anterior capsulotomy using a neodymium:YAG laser and fell into the inferior anterior chamber. Inferior corneal endothelial cell loss occurred in nine of the 12 eyes within 20 months after detachment; in six of the nine, inferior corneal endothelial cell density decreased 50% more than central cornea cell density. This method will be unsuitable for treating the extensive anterior capsule opacification that will occur when endocapsular cataract surgery that retains most of the lens capsule is widely performed in the future.

Estimation by radiation inactivation of the minimum functional size of acrosome-reaction-inducing substance (ARIS) in the starfish, Asterias amurensis

In the starfish Asterias amurensis, the jelly coat of the eggs contains a glycoprotein essential for the induction of the acrosome reaction in homologous spermatozoa that is termed the acrosome-reaction-inducing substance (ARIS). ARIS is a highly sulphated and fucose-rich glycoprotein of extremely high molecular mass (> 10(4) kDa). ARIS was irradiated with high-energy electrons in order to estimate the minimum size required for its biological activity. The minimum functional unit or target size of ARIS was estimated to be c. 14 kDa by target size analysis. ARIS was significantly disintegrated by the irradiation, yet the total sugar content was not apparently reduced. The binding of 125I-labelled ARIS to spermatozoa competed with that of irradiated ARIS, although the affinity of ARIS was much reduced after irradiation.

The effects of selective serotonin reuptake inhibitors and their metabolites on S-mephenytoin 4'-hydroxylase activity in human liver microsomes

The inhibitory effects of four selective serotonin reuptake inhibitors (SSRIs), fluoxetine, sertraline, paroxetine and citalopram, and three metabolites (norfluoxetine, demethylcitalopram and didemethylcitalopram), on S-mephenytoin 4'-hydroxylation activities in human liver microsomes were studied. The 4'-hydroxylation of S-mephenytoin, a representative substrate toward CYP2C19, was competitively inhibited by all the SSRIs and their metabolites studied. The mean Ki values of fluoxetine, norfluoxetine, sertraline, paroxetine, citalopram, demethylcitalopram and didemethylcitalopram were 5.2, 1.1, 2.0, 7.5, 87.3, 55.8 and 7.7 microM, respectively. The findings suggest that some SSRIs and their metabolites with a low Ki value (e.g., fluoxetine, norfluoxetine) may reduce the clearance of drugs metabolized by this isoform of P450, thereby resulting in a possible drug-drug interaction, when administered simultaneously. In addition, SSRIs and their metabolites examined herein may be substrates toward CYP2C19.

Traumatic neuroma of the common hepatic duct after laparoscopic cholecystectomy

Jaundice and stricture of the common hepatic duct were detected in a 53-yr-old woman 2 months after she had laparoscopic cholecystectomy for a gallstone. Then she underwent resection of the stricture part of the duct and hepaticojejunostomy which was effective. Pathological examination showed that traumatic neuroma, probably caused by bile leakage after cauterization, led to stricture of the common bile duct.

Dilazep inhibits binding of batrachotoxin to sodium channels in canine sarcolemmal vesicles

We studied the effect of dilazep on the binding of [3H]- batrachotoxinin A 20 alpha-benzoate ([3H]BTXB), which binds to and stabilizes the activated state of the Na+ channel, and compared it with that of lidocaine in canine cardiac sarcolemmal vesicles. Dilazep inhibited the specific [3H]BTXB binding in a dose-dependent manner with an IC50 value of 0.37 microM, while lidocaine inhibited it with an IC50 value of 92 microM. Scatchard analysis of [3H]BTXB binding demonstrated that both dilazep and lidocaine reduced the amax without a marked effect on the K(D). The inhibition of [3H]BTXB induced by dilazep was reversible. Both dilazep (4 microM) and lidocaine (100 microM) increased the dissociation rate constant of [3H]BTXB only in concentrations which are about a 10-fold greater than their IC50, indicating the low affinity of both drugs for the [3H]BTXB-bound Na+ channel. However, dilazep (0.5 microM) and lidocaine (100 microM) decreased significantly the association rate constant of the [3H]BTXB binding at concentrations near their IC50, indicating that the affinity of both drugs for the [3H]BTXB-unbound Na+ channel is relatively high. These results suggest that, in canine cardiac membrane vesicles, the effect of dilazep in inhibiting the binding of [3H]BTXB and stabilizing the Na+ channel is similar to that of lidocaine, but the potency of dilazep is greater than that of lidocaine.

Pharmacological profile of semotiadil fumarate, a novel calcium antagonist, in rat experimental angina model

1. The aim of the present study was to determine whether antianginal efficacy of semotiadil fumarate (SD-3211), a structurally novel calcium antagonist, is distinct from those of diltiazem, nifedipine and nisoldipine. 2. First, the duration of the inhibitory effects of semotiadil was compared with that of other Ca2+ antagonists in rat experimental angina evoked by vasopressin. Semotiadil (10 mg kg-1, p.o.) was effective for at least 9 h in the anginal model and those effects of semotiadil were longer-lasting than those of diltiazem (30 mg kg-1, p.o.), nifedipine (10 mg kg-1, p.o.), and nisoldipine (3 mg.kg-1, p.o.). 3. Second, the selectivity of actions of these Ca2+ antagonists for the coronary arteries and myocardium was evaluated in rat isolated perfused hearts. Diltiazem (10(-6) M) reduced cardiac contractility without inhibiting the elevation of perfusion pressure evoked by acetylcholine. Semotiadil (10(-7) M) significantly suppressed cardiac contractility and inhibited the coronary response to acetylcholine. In contrast, nifedipine (3 x 10(-9)-3 x 10(-8) M) and nisoldipine (3 x 10(-10)-10(-8) M) did not reduce cardiac contractility at concentrations which significantly inhibited the increase in perfusion pressure to acetylcholine. 4. The selectivity of semotiadil for coronary artery and myocardium is intermediate between diltiazem and dihydropyridines tested in the present study. 5. These findings suggest that semotiadil has an advantage of diltiazem, nifedipine, and nisoldipine in the treatment of angina with regard to long-lasting action and selectivity for coronary artery and myocardium.

Comparison of the interaction potential of a new proton pump inhibitor, E3810, versus omeprazole with diazepam in extensive and poor metabolizers of S-mephenytoin 4'-hydroxylation

OBJECTIVE

To compare the interaction potential of E3810, [(+/-)-sodium 2-[[4-(3-methoxpropoxy)-3-methylpyridin-2-yl]methylsulfinyl] -1H-benzimidazole] a new proton pump inhibitor, and omeprazole with diazepam in relation to S-mephenytoin 4'-hydroxylation status.

STUDY DESIGN

Fifteen healthy male volunteers consisting of six poor metabolizers and nine extensive metabolizers of S-mephenytoin 4'-hydroxylation participated in the study, where two poor and three extensive metabolizers each as a group were randomly allocated to one of the three different treatment sequences with a 3-week washout period among the three trial phases. Each volunteer received an oral once-daily dose of E3810 (20 mg), omeprazole (20 mg), or placebo for 23 days and an intravenous dose (0.1 mg/kg) of diazepam on posttreatment day 8. Plasma concentrations of diazepam and demethyldiazepam were measured up to 16 days after the administration of diazepam.

RESULTS

Diazepam was more slowly metabolized in the poor metabolizers than in the extensive metabolizers. No significant effects of E3810 and omeprazole on any kinetic parameters of diazepam were observed in the poor metabolizers. In the extensive metabolizers, omeprazole significantly decreased the mean clearance of diazepam and increased its half-life, area under the plasma concentration-time curve, and mean residence time compared with E3810 and placebo (p < 0.05 or 0.01), whereas no changes in these kinetic parameters were observed during the treatment with E3810. Omeprazole significantly increased the mean area under the plasma concentration-time curve (0-16 days) of demethyldiazepam in the extensive metabolizers compared with placebo (p < 0.01), whereas E3810 significantly increased it in the poor metabolizers compared with omeprazole or placebo (p < 0.05).

CONCLUSION

The results indicate that E3810 as a substrate goes less toward S-mephenytoin 4'-hydroxylase (CYP2C19) and has a much weaker, if any, potential to interact with diazepam compared with omeprazole.

Cortical changes in starfish (Asterina pectinifera) oocytes during 1-methyladenine-induced maturation and fertilisation/activation

Maturation of the starfish oocyte cortex to produce an effective cortical granule reaction and fertilisation envelope is believed to develop in three phases: (1) pre-methyladenine (1-MA) stimulation; (2) post-1-MA stimulation, pregerminal vesicle breakdown; and (3) post-germinal vesicle breakdown. The present study was initiated to identify what each of these phases may encompass, specifically with respect to structures associated with the oocyte cortex, including cortical granules, microvilli and vitelline layer. 1-MA treatment brought about an orientation of cortical granules such that they became positioned perpendicular to the oocyte surface, and an approximately 4-fold decrease in microvillar length. A-23187 activation of immature oocytes treated with (10 min; pregerminal vesicle breakdown) or without 1-MA resulted in a reduction in cortical granule number of 21% and 41%, respectively (mature oocytes underwent a 96% reduction in cortical granules). Elevation of the fertilisation envelope in both cases was significantly retarded compared with activated mature oocytes. In activated mature oocytes, the vitelline layer elevated 20.0 +/- 5.4 mu m from the egg's surface, whereas in immature oocytes treated with just A-23187 or with 1-MA (10 min) and A-23187, it lifted 0.35 +/- 0.1 and 0.17 +/- 0.04 mu m, respectively. The fertilisation envelopes of activated (or fertilised) immature oocytes also differed morphologically from those of mature oocytes. In activated, immature oocytes, the fertilisation envelope was not uniform in its thickness and possessed thick and thin regions as well as fenestrations. Additionally, it lacked a complete electron-dense stratum that characterised the fertilisation envelopes of mature oocytes. The nascent perivitelline space of immature oocytes was also distinguished by the presence of numerous vesicles which appeared to be derived from microvilli. Differences in the morphology of cortices from activated (fertilised) and non-activated, immature and mature oocytes substantiate previous investigations demonstrating three phases of cortical maturation, and are consistent with physiological changes that occur during oocyte maturation, involving ionic conductance of the plasma membrane, establishment of slow and fast blocks to polyspermy and elevation of a fertilisation envelope.

Comparison of the kinetic disposition and metabolism of E3810, a new proton pump inhibitor, and omeprazole in relation to S-mephenytoin 4'-hydroxylation status

We studied the kinetic disposition and metabolism of E3810 [(+/-)-sodium 2-[[4-(3-methoxypropoxy)-3-methylpyridin-2-yl]methylsulfinyl ]-1H- benzimidazole], a new proton pump inhibitor, and omeprazole in 15 Japanese male volunteers, six of whom were poor metabolizers and nine of whom were extensive metabolizers of S-mephenytoin. All received once-daily 20 mg doses of E3810 or omeprazole for 7 days in a randomized crossover manner, with a 3-week washout period between the two trial phases. The parent drugs and their principal metabolites in plasma and urine were measured on days 1 and 7 after drug administration. The mean values for area under the plasma concentration-time curve (AUC) of omeprazole were 6.3- and 4.4-fold greater, whereas those of E3810 were 1.8- and 1.9-fold greater in poor metabolizers than in extensive metabolizers after the first and final doses, respectively. Although the mean AUC values for both drugs were significantly (p < 0.01 or p < 0.05) greater in poor metabolizers than in extensive metabolizers, the difference in the AUC between the two groups was smaller after E3810 than after omeprazole administration. The AUC of omeprazole tended to increase with the repeated doses in extensive metabolizers, whereas no such change was observed for E3810. The urinary excretions of the principal metabolite(s) of two proton pump inhibitors also reflected the data derived from plasma samples in relation to S-mephenytoin 4'-hydroxylation status. We conclude that the metabolism of two proton pump inhibitors is under coregulatory control of S-mephenytoin 4'-hydroxylase (CYP2C19), but that the magnitude of CYP2C19-mediated metabolism appears to differ between the two drugs. In contrast to omeprazole, the metabolism of E3810 is less saturable in extensive metabolizers during the repetitive dosings.

Development and preliminary application of high-performance liquid chromatographic assay of urinary metabolites of diazepam in humans

A simple high-performance liquid chromatographic method for the measurement of diazepam (DZP) and its major metabolites, N-desmethyldiazepam (DMDZP), temazepam (TZP) and oxazepam (OZP) in urine was developed. Preliminary studies of DZP metabolism were also undertaken in four healthy volunteers after administration of a single oral dose (4 mg) of DZP. The assay allowed the simultaneous determination of all analytes in 1 ml of urine and the detection limit was 2 ng/ml with a signal-to-noise ratio of 3. None of 22 drugs and 17 metabolites, except for mianserin, maprotiline and imipramine N-oxide, interfered with the detection of DZP metabolites. Recoveries of the analytes and the internal standard (prazepam) were > 82%. Intra- and inter-assay coefficients of variation for all analytes were < 5.5 and 4.1%, respectively. The mean (+/- S.D.) cumulative urinary excretions of DMDZP, TZP and OZP over 96 h after a single oral administration of DZP were 3.9 +/- 0.4, 6.6 +/- 1.4 and 2.8 +/- 0.6% of the dose, respectively. The urinary excretion of DZP was under the detection limit.

A periodic network of G protein beta gamma subunit coexisting with cytokeratin filament in starfish oocytes

Heterotrimeric G proteins are membrane-bound and carry signals from activated receptors on plasma membranes to cytoplasmic effector enzymes and channels. In starfish oocytes, the beta gamma subunit of G protein mediates 1-methyladenine stimulation of oocyte maturation. In order to investigate the localization of beta gamma subunits in starfish oocytes during oocyte maturation, we raised a monoclonal antibody against the beta subunit. By immunofluorescence microscopy using the antibody, immature oocytes show a network of fibers in the cytoplasm. The staining of fibers is beaded with a periodicity of 0.7 microns. The same staining pattern is obtained by anti-gamma subunit antibody. In addition, the fibers are stained by anti-cytokeratin antibody. These results indicate that the G protein beta gamma subunit coexists with cytokeratin filaments in starfish oocytes. Stimulation of oocyte maturation by 1-methyladenine causes the beta gamma subunit to be disassembled.

N-oxygenation of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine by the rat liver flavin-containing monooxygenase expressed in yeast cells

N-oxygenation of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), a dopaminergic neurotoxin, was studied using recombinant rat liver flavin-containing monooxygenase (FMO), FMO1A1, expressed in yeast cells. The mean (+/- S.D.) kinetic parameters of MPTP N-oxygenation were: Km = 1.8 +/- 0.5 microM, Vmax = 9.5 +/- 1.6 nmol/mg per min, and Vmax/Km = 4.6 +/- 0.5 ml/mg per min. n-Octylamine, an activator of FMO, enhanced the MPTP N-oxygenation activity by 51%, while methimazole, thiobenzamide and alpha-naphthylthiourea, alternate substrates of FMO, inhibited it by 27.4, 68.0 and 59.2%, respectively. The results indicate that MPTP is efficiently N-oxygenated by the recombinant rat liver FMO1A1, and that the responses to the modulators of FMO activity found in the recombinant rat liver FMO1A1 resemble those of mouse and rat liver microsomes as reported previously. The findings suggest that the recombinant FMO expressed in yeast cells is considered as a useful tool to study an involvement of FMO in the metabolism of environmental toxins or chemicals. In addition, FMO1A1 appears to be one of the predominant enzymes responsible for the N-oxygenation of MPTP at least in rat liver.

[The uptake of nalidixic acid and enoxacin by rat renal cortical slices in rat]

The mechanisms involved in the renal excretion of quinolone and new quinolone antibacterial drugs are still incompletely understood. The purpose of this study was to examine the renal handling of nalidixic acid (NA) and enoxacin (ENX), using the renal cortical slices uptake techniques in rats. It was demonstrated that both NA and ENX were taken against a concentration gradient by a saturable processes resulting from the ratio of slice to medium (ratio of S/M) being dependent on the time and the concentration. It was indicated that the inhibition of uptake by 2,4-dinitrophenol, ouabain and sodium cyanate was shown to be an energy dependence. Probenecid and cimetidine exhibited that they might inhibit NA uptake slightly. ENX uptake was inhibited by probenecid, cimetidine, guanidine and disopyramide, suggesting that ENX might possess an affinity for both anionic and cationic transport mechanisms.

[Single-stomal ureterostomy by extraperitoneal approach]

Single-stomal ureterostomy such as double barreled ureterocutaneostomy and cutaneous transureteroureterostomy have usually been performed by transperitoneal approach. However, extraperitoneal method is preferable since the patients for whom ureterocutaneostomy is indicated usually have a deteriorating general condition. We have reported single-stomal ureterocutaneostomy which can be done extraperitoneally. A total of thirteen patients, one man and twelve women, for whom permanent urinary diversion was indicated, have undergone this extraperitoneal ureterocutaneostomy for February 1988 to June 1994. Those with retroperitoneal lesions or with a history of paraaortic radiotherapy were excluded. The mean age was 61.7 (range: 42-76). The reasons for urinary diversion were vesicovaginal fistula in seven, obstructive nephropathy in four, rectovesical fistula in one and postoperative urine leak from the bladder in one. All patients had been treated for malignant diseases and had undergone transperitoneal surgery. Six patients had colostomy and ten had clinically evident recurrent diseases. In the operation, left ureter was dissected and severed extraperitoneally through left paramedian incision or left lumbotomy. The ureteral end was pushed to the right in a retroperitoneal tunnel created by blunt dissection. Then the ureter was picked up through the contralateral retroperitoneal approach. After both ureters were exposed, ureterocutaneostomy was made in right hypogastrium. Transureteroureterstomy with end-cutaneous ureterostomy, double barreled ureterocutaneostomy and ureteroureterostomy with loop ureterostomy were done in six, four and three patients, respectively. The mean operative time was 119 (range: 75-175) minutes and the mean intraoperative blood loss was 210 (range: 48-682) grams. Arrhythmia developed during retroperitoneal manipulation in one patient for whom the operation was done under spinal anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)

Differential distribution of gangliosides in adult rat ovary during the oestrous cycle

Gangliosides are ubiquitous membrane components in mammalian cells and are suggested to play important roles in various cell functions, such as cell-cell recognition, differentiation and transmembrane signalling. Rat ovary contained GM3, GD3 and GD1a as major gangliosides, and GM1 as a minor one. In order to study their distribution in the rat ovary and its possible changes during the oestrous cycle, frozen sections were stained with specific monoclonal antibodies against 11 ganglio-series gangliosides including those mentioned above. GM3, GM1 and GD1a were expressed in a spatio-temporally different manner during the oestrous cycle, but GD3 and other gangliosides were not immunohistochemically detected. In primary and secondary follicles, GM3, GM1 and GD1a were expressed in theca cells, but not in granulosa cells. The oocyte in primary, but not secondary, follicles was positive to the anti-GD1a antibody. In Graafian follicles, GM1 and GD1a were similarly expressed as in secondary follicles, however, the expression of GM3 spread gradually from theca cells to granulosa cells. In early Graafian follicles, only GM3 was expressed to a detectable extent from the outer part of the granulosa layer to the inner part. Shortly before ovulation, all granulosa cells and cumulus cells became positive to anti-GM3 antibody. After ovulation, differential distribution of GM3, GM1 and GD1a was also observed in luteal cells. GD1a was localized in thread-like structures, while GM3 was distributed throughout the cytoplasm, but not in the nucleus. GM1 was localized only in the plasma membrane and/or its close vicinity. Other ganglio-series gangliosides, including GD3, were not detected to an appreciable extent in the ovaries by immunohistochemistry.

Ultrastructural localization of acrosome reaction-inducing substance (ARIS) on sperm of the starfish Asterias amurensis

Using colloidal gold tagged ligands we have identified the ultrastructural site of ARIS binding to intact and acrosome-reacted starfish sperm. In intact sperm, colloidal gold conjugated ARIS was specifically localized to a single domain (0.1-0.3 micron in diameter) on the plasma membrane. This site was located on the anterior-lateral aspect of the sperm head, that is, just peripheral to the region occupied by the acrosomal vesicle and periacrosomal components. When sperm were labeled with colloidal gold conjugated ARIS, washed to remove unbound label, and then induced to undergo the acrosome reaction, the labeled patch remained associated with the plasma membrane and was positioned just lateral to the acrosomal process. However, when sperm were suspended in labeled ARIS and induced to undergo the acrosome reaction, label was observed along the entire anterior aspect of the sperm head with the exception of the acrosomal process. Labeling along the entire anterior aspect of the sperm head in this case was deemed to be nonspecific and due to binding of colloidal gold tagged molecules to components formerly located within the acrosomal vesicle, as the same pattern was obtained using colloidal gold tagged bovine serum albumin. Quantitative and qualitative aspects of ARIS binding observed here by electron microscopy are in agreement with measured binding characteristics previously reported (Ushiyama et al., 1993a: Zygote 1:121-127; Ushiyama et al., 1993b: J Reprod Dev 39:53-54), and indicate that the site of labeled ARIS binding represents a specific plasma membrane domain occupied by ARIS receptors.

Collimation of emissions from a high-power multistripe laser-diode bar with multiprism array coupling and focusing to a small spot

Twelve beams emitting from twelve stripes, with 200-microm apertures spaced 800 microm apart, of a 1-cm linear diode array were collimated by a multiprism array consisting of fourteen 800-microm-wide prismlets. The spatial intensity distribution of each beam was twisted around its optical axis through three total reflections in a prismlet, transforming a series arrangement of emitters into a parallel arrangement to prevent overlap of adjacent beams. Collimated beams were focused to a spot of ~200 microm (FWHM).

[Extracorporeal shock wave lithotripsy for urinary calculi in an ileal reservoir following reconstruction of the urinary bladder]

A new method for reconstruction of the urinary bladder was introduced by Taguchi in 1977. It consisted of two components; making of pseudo-urethra and the reconstruction of urinary reservoir in the pelvis. The latter was made of the ileum and the peritoneum with temporary use of Japanese paper. This operative method was applied to a 28-year-old female patient when she had cystectomy and bilateral ureterostomy. Thereafter she had has no trouble for 13 years. However, her recent rentogenogram showed urinary tract calculi in the reservoir. Endoscopic treatment was not indicated because of the deformed reservoir and the inflexible pseudourethra. Thus, extracorporeal shock wave lithotripsy (ESWL) was applied to the case with successful results. We herrin reported the case and discussed the usefulness of ESWL for urinali calculi in the ileal reservoir.

[A case of middle ureteral tumor treated by end-to-end anastomosis following resection of 6.7 cm segment]

A 71-year-old male with a right ureteral tumor in the midportion and contracted kidney of the opposite side, due to complete vesicoureteral reflux, underwent end-to-end anastomosis after partial ureterectomy 6.7 cm in length. Our experience in this case led us to conclude that end-to-end anastomosis of the upper or mid-portion of the ureter was possible for the maximal 7.0 cm length of the ureteral loss, when the kidney could be fixed downward as much as possible.

Prognosis of neurological deficits associated with upper cervical spine injuries

We investigated the type of injury and neurological prognosis in 82 patients with an upper cervical spine injury with neurological deficits, from a total of 247 such patients that we treated, from which 11 patients who were dead on arrival had been excluded. The incidence of neurological deficits in upper cervical spine injury was 33%. They were classified into three signs; cord, upper cervical nerve root, and cranial nerve signs. The types of injury accompanied by neurological deficits were burst fracture of the atlas, type II dens fracture, body fracture of the axis, type II traumatic spondylolisthesis of the axis, atlanto-occipital dislocation, and atlanto-axial dislocation. Most were unstable vertebral injuries. The four patients who died after arrival at hospital had complete tetraplegia with respiratory distress. The neurological deficit was one of paresis in the 78 patients who survived; in many, the paresis was mild with a resulting good neurological prognosis.

[Dysarthria due to small cerebral infarction--the localization of lesion and clinical characteristics]

We compared locations of infarctions and clinical characteristics for patients with dysarthria and those without dysarthria. Subjects were 40 patients with a small infarction in the corona radiata or junctional zone to the capsule and 13 patients with infarctions in the internal capsule. Left corona radiata/junctional zone infarctions were significantly smaller than right sided lesions. Dysarthria was associated more frequently with the corona/junctional lesions on the left side than the right sided lesions. Asymptomatic infarctions on the contralateral side were seen in 41% of the patients with dysarthria. In these cases, dysarthria continued longer and dysphagia occurred more frequently than the cases without right sided lesions. Corona radiata/junctional zone infarctions with dysarthria were located significantly more anteriorly than those without dysarthria. The corona radiata/junctional zone infarctions presenting with dysarthria alone, upper limb dominant hemiparesis, and lower dominant hemiparesis were located in the anterior, middle, and posterior areas, respectively. In conclusion, dysarthria may occur with unilateral small cerebral infarctions, more frequently with left sided lesions than with right sided lesions. It is assumed that the left corona radiata/junctional zone infarction may interrupt simultaneously the corticobulbar pathway and callosal fibers to the right hemisphere which transmit motor information for speech to the right hemisphere. It is also possible that there are individual variations in the proportion of crossed and uncrossed corticobulbar innervation, which may explain dysarthria with unilateral cerebral lesions in some patients. It was suggested that there is an anterior-posterior somatotopy in the corona radiata/junctional zone as well as in the internal capsule.

Identification of human CYP isoforms involved in the metabolism of propranolol enantiomers--N-desisopropylation is mediated mainly by CYP1A2

1. Studies using human liver microsomes and six recombinant human CYP isoforms (i.e. CYP1A2, 2A6, 2B6, 2D6, 2E1 and 3A4) were performed to identify the cytochrome P450 (CYP) isoform(s) involved in the ring 4-hydroxylation and side-chain N-desisopropylation of propranolol enantiomers in humans. 2. alpha-Naphthoflavone and 7-ethoxyresorufin (selective inhibitors of CYP1A1/2) inhibited the N-desisopropylation of R- and S-propranolol by human liver microsomes by 20 and 40%, respectively, while quinidine (a selective inhibitor of CYP2D6) abolished the 4-hydroxylation of both propranolol enantiomers almost completely. In contrast, sulphaphenazole (CYP2C8/9 inhibitor), S-mephenytoin (CYP2C19 inhibitor), troleandomycin (CYP3A3/4 inhibitor) and diethyldithiocarbamate (CYP2E1 inhibitor) elicited only weak inhibitory effects on propranolol metabolism via the two measured metabolic pathways. 3. Significant (P < 0.01) correlations were observed between the microsomal N-desisopropylation of both propranolol enantiomers and that for the O-deethylation of phenacetin among the 11 different human liver microsome samples (r = 0.98 and 0.77 for R- and S-propranolol, respectively). A marginally significant (r = 0.60, P congruent to 0.05) correlation was also observed between N-desisopropylation of S-, but not of R-propranolol and the 4'-hydroxylation of S-mephenytoin. No significant correlations were observed between the N-desisopropylation of propranolol enantiomers and the 2-hydroxylation of desipramine, the hydroxylation of tolbutamide or the 6 beta-hydroxylation of testosterone. 4. Significant (P < 0.01) correlations were observed between the microsomal 4-hydroxylation of R- and S-propranolol and the 2-hydroxylation of desipramine (r = 0.85 and 0.98, respectively). A weak (r = 0.66), albeit significant (P < 0.05) correlation was observed between the 4-hydroxylation of R-, but not of S-propranolol and the hydroxylation of tolbutamide. No significant correlations were observed between the 4-hydroxylation of propranolol enantiomers and the oxidation of other substrates for CYP1A2, 2C19, and 3A3/4. 5. Recombinant human CYP1A2 and CYP2D6 exhibited comparable catalytic activity with respect to the N-desisopropylation of both propranolol enantiomers; only expressed CYP2D6 exhibited a marked catalytic activity with respect to the 4-hydroxylation of both propranolol enantiomers.(ABSTRACT TRUNCATED AT 400 WORDS)

Metabolic disposition of proguanil in extensive and poor metabolisers of S-mephenytoin 4'-hydroxylation recruited from an Indonesian population

1. The metabolism of proguanil (PG) was studied by measuring PG, cycloguanil (CG) and 4-chlorophenylbiguanide (CPB) in plasma and urine samples after an oral 200 mg dose of PG hydrochloride administered to 14 extensive (EMs) and 10 poor hydroxylators (PMs) of S-mephenytoin of Indonesian origin. 2. The mean ( +/- s.d.) values of the elimination half-life (t 1/2) and AUC of PG were significantly (P < 0.01) greater in the PM than in the EM group (20.6 +/- 3.1 vs 14.6 +/- 3.5 (95% confidence intervals of difference 3.1 to 8.9) h; and 5.43 +/- 1.89 vs 3.68 +/- 0.83 (0.58 to 2.91) micrograms ml-1 h). 3. Plasma concentrations of CG, an active metabolite, could not be detected in all PMs, and those of CPB were sufficiently high to determine a time-course in only four PMs. Mean AUC(0,24 h) values of CPB were significantly (P < 0.05) lower in the PM (n = 4) than in the EM group (n = 14) (0.47 +/- 0.13 vs 0.88 +/- 0.50 (-0.14 to 0.96) micrograms ml-1 h). 4. Log10 percentage urinary recovery of 4'-hydroxymephenytoin correlated significantly (P < 0.05) with the t 1/2 (rs = -0.661) and AUC (rs = -0.652) of PG. 5. PG, CG and CPB were detectable in urine at 12 h in all subjects. Log10 percentage urinary recovery of 4'-hydroxymephenytoin correlated significantly (P < 0.01) with urinary PG/CG (rs = -0.876), PG/CPB (rs = -0.833) and PG/(CG + CPB) (rs = -0.831) metabolic ratios.(ABSTRACT TRUNCATED AT 250 WORDS)