Hyperresponsiveness of cough receptors in patients with bronchial asthma

The hyperresponsiveness of cough receptors was evaluated using the acetic acid inhalation test in healthy adults, patients with bronchial asthma, and children with or without cough. The concentration of acetic acid inducing cough was more than 20% in all 16 healthy adults and 18 children in the control group. There were two groups of asthmatic patients: Those in group 1 showed normal response to more than 20% acetic acid (n = 46), and those in group 2 showed a sensitive reaction to less than 10% (n = 11). Mean age was 9.0 +/- 4.2 years in group 1 and 15.1 +/- 7.6 years in group 2 (statistical significance, P less than .001). Six of 11 asthmatic patients in group 2 were classified as nonallergic asthmatics, whereas only five of 46 patients in group 1 were nonallergic (P less than .01). Bronchoconstriction was not induced in any case, in spite of the production of cough. It is suggested that the hyperresponsiveness of individual cough receptors without the stimulation of irritant receptors be evaluated.

Enteral feeding in burn hypermetabolism: nutritional and metabolic effects of different levels of calorie and protein intake

Enteral nutrition was provided by continuous pump-controlled gastrostomy tube feeding for 14 days in 97 guinea pigs bearing a 30% full thickness burn. Seven defined combinations of caloric and protein intake were studied. With a caloric intake of 175 kcal/kg/day, equaling the measured energy expenditure, the animals receiving 10% of calories as protein had a significantly greater postburn weight loss (p less than 0.05) and muscle mass depletion (p less than 0.05), and a significantly lower muscle nitrogen concentration (p less than 0.05), serum albumin level (p less than 0.01) and liver nitrogen content (p less than 0.01). With the same caloric intake but with more than 20% of calories as protein, the weight loss and the muscle wasting were reduced, but not abolished, and the serum albumin level and liver nitrogen content were normalized. Also with the diets containing 200 kcal/kg/day the muscle tissue depletion could not be abolished. However, with this caloric intake, the animals given 20% of calories as protein had a lower weight loss and a higher serum albumin level (p less than 0.01), but also a greater fat infiltration of the liver (p less than 0.01). At both levels of caloric intake, the nitrogen balance correlated significantly with the level of nitrogen intake but did not correlate with the changes of body weight. The incidence of diarrhea was lowest in animals fed 20% protein calories at a caloric intake of 175 kcal/kg/day. All things considered, the best metabolic and nutritional results were obtained with diets containing 20 to 30% of calories as protein and providing a caloric intake that paralleled the measured energy expenditure.

[Quantitative measurement of ventricular dilatation on CT scan--a proposal of new index and review of literature]

CT scan is able to show cerebral atrophy more safely and more easily than pneumo-encephalography or cerebral angiography. Then, various methods have been reported for quantitative analysis of cerebral atrophy on CT scan. Generally, cerebral atrophy might be judged from the ventricular dilatation with some indices, calculated from various ventricular width. But, there is no general agreement on what index is the most reliable. In this paper, we attempted to establish the index, easy to measure and most reliable. Our method is as follow. Method. We carried out the CT scan (EMI 1010) on 89 neurologically intact patients. Scans were parallel to orbito-meatal line (OML), and were 10 mm in thickness. On CT scan films, various width, area of anterior horns and area of bodies of lateral ventricles were measured (Fig. 1). Measurement about the anterior horns of lateral ventricles were carried out on image the most clearly showed the foramen of Monro. And measurements about the bodies of lateral ventricles were on image, 20 mm above the image of anterior horn. Correlations of various width and areas were calculated (Table 1). Then we proposed new indices with high correlations (over 0.9) with ventricular area; Anterior horn CVI (Cerebro-Ventricular Index) and Body CVI (Fig. 2, 3). Patients with myotonic dystrophy show cerebral atrophy. We carried out the CT scan (GE-CT/T 8800) on 17 myotonic dystrophy patients and 30 controls. Between the two groups, age and sex were almost matched (Fig. 4).(ABSTRACT TRUNCATED AT 250 WORDS)

[Adult Chiari malformation--five operative cases]

Recently, the diagnosis of adult Chiari malformation seems to have easy, because of the development of high resolution CT. During the last two years, we experienced with five cases of adult Chiari malformation diagnosed by CT metrizamide myelography. There were two males and three females aged from 15 to 55 years. Three cases had both foramen magnum compression and cerebellar symptoms. One of them had lower cranial nerve symptoms too. Another case had central cord symptoms, and the rest of them complained only of headache and vertigo. All cases underwent suboccipital craniectomy and upper cervical laminectomy. After operation, the cerebellar symptoms improved remarkably. Some of the central cord symptoms improved too. In one case with headache and vertigo, the result was unsuccessful. All cases were followed up in the outpatient clinic more than one year after operation. One case unchanged. Another case deteriorated seven months after surgery. The other three cases were in good condition. Operated cases of adult Chiari malformation are relatively rare in Japan. However, this type of malformation can be found easily by CT metrizamide myelography. A good many patients should be operated on carefully in consideration of their symptoms and severities.

Beat-to-beat variation of the heart rate in children with allergic asthma

Beat-to-beat variation of the heart rate in 53 allergic asthmatic children was quantitatively measured as a coefficient of variation of the R-R interval (CVR-R), and was compared with that of 284 nonallergic and 47 allergic children without asthma. Allergic children both with and without asthma had significantly higher mean CVR-R values (7.08 +/- 1.87 and 7.54 +/- 2.40 and p less than 0.01 and p less than 0.001, respectively) than those of non-allergic children (6.32 +/- 1.88). These results confirm the previous reports that the increased cholinergic tone was related to the allergic state and not only to allergic asthma.

The effects of pepsin on the natural progression of autoimmunity in glomerulonephritis in the NZB/W F1 mouse

The effects of pepsin on autoimmune glomerulonephritis of New Zealand Black and White F1 hybrid (NZB/W F1) mice were investigated. Intravenous pepsin significantly improved survival rate and suppressed progressive increase in urinary protein and histopathological changes in kidney. Increased serum levels of immune complexes, anti-DNA antibody and natural thymocytotoxic autoantibody were decreased and abnormalities in lymphocyte subsets were ameliorated by pepsin. Pepsin suppressed autoantibody production and enhanced antibody production against xenogeneic substance in these mice. The fact that pepsin ameliorates abnormalities in immune function may contribute to the preventive effects of pepsin against pathogenesis and progression of immune complex nephritis.

Optimal lipid content for enteral diets following thermal injury

This study was performed to determine the effects of different amounts of lipid in enteral diets during the postburn period. Forty-five guinea pigs with catheter gastrostomy received a 30% total body surface area full thickness flame burn. After burn they were given intragastric tube feedings using five diets at different dietary lipid composition: 0, 5, 15, 30, and 50% of nonprotein calories. Total calories administered (175 kcal/kg/day), protein content and composition (20% of total calories), total volume, and vitamin and mineral content were constant in all animals. At postburn day 14, body weight, carcass weight, and muscle weight were the greatest in 0 and 5% lipid groups, and the least in 30 and 50% lipid groups. Serum transferrin was highest in the 5 and 15% lipid groups, and lowest in the 30 and 50% lipid groups. Total nitrogen content in muscle and cumulative nitrogen balance were best in the 15% lipid group. Liver fatty infiltration, caused from a larger proportion of carbohydrate administration, was greater in the 0 and 5% lipid groups and less in 15 and 30% groups. It is concluded that dietary lipid levels between 5 and 15% of nonprotein calories are optimal for nutritional support after burn injury. The nutritional management of postburn patients with higher levels of dietary lipid should be reconsidered.

Mechanism of prevention of postburn hypermetabolism and catabolism by early enteral feeding

This study was performed to investigate the mechanism whereby immediate enteral feeding after burn injury reduces postburn hypermetabolism and hypercatabolism. Fifty-seven burned guinea pigs (30% TBSA) were divided into three groups: A (N = 19), given 175 kcal/kg/day beginning 2 hours after burn; B (N = 20), given 175 kcal/kg/day with an initial 72-hour adaptation period; and C (N = 18), given 200 kcal/kg/day with the same adaptation period as B. Resting metabolic expenditure (RME) on PBD 13 was lowest in group A (109% of preburn level), compared with group B (144%, p less than 0.001) and group C (137%, p less than 0.01). On PBD 1, group A had the greatest jejunal mucosal weight and thickness (p less than 0.001), and mucosal weight had negative correlations with plasma cortisol (r = 0.829, p less than 0.001) and glucagon (r = 0.888, p less than 0.001). Two weeks after burn, urinary vanillyl mandelic acid (VMA) excretion, plasma cortisol, and glucagon were lowest in group A (p less than 0.05 to p less than 0.01). These hormones also significantly correlated with RME (p less than 0.01 to p less than 0.001). These findings suggest that immediate postburn enteral feeding can prevent hypermetabolism via preservation of gut mucosal integrity and prevention of excessive secretion of catabolic hormones.

[Fundamental and clinical studies on ceftazidime in the field of pediatrics]

Fundamental and clinical studies were carried out on ceftazidime ( CAZ ), a newly synthesized cephalosporin C antibiotic ( CEPs ). The antibacterial activity of CAZ was compared with those of CER, CEZ, CMZ and CPZ against clinical isolates of S. aureus. S. pyogenes. E. coli, K. pneumoniae and P. mirabilis, and with those of GM and CFS against P. aeruginosa. Against S. aureus, the antibacterial activity of CER was highest, followed by that of CEZ. The peak MIC after inoculation of 100-fold dilution was 0.10 microgram/ml with CER and 0.78 microgram/ml with CEZ. But in view of the peak MIC of 6.25 micrograms/ml, the antibacterial activity of CAZ was inferior to that of CPZ by about 2 tubes. This was not surprising, because CAZ was one of the antibiotics in the fifth group of CEPs . The CEPs in the fifth group naturally show high antibacterial activity against S. pyogenes. CAZ , as expected, inhibited the growth of all the strains at the concentration of 0.10 microgram/ml at the inoculation of 100-fold dilution. In the gut bacterial flora such as E. coli, K. pneumoniae and P. mirabilis, CAZ showed the results almost equal to those of other CEPs in the fifth group; the peak MICs of CAZ were 0.20 approximately 0.39, 0.20 approximately 0.39, 0.10 microgram/ml, respectively, at the inoculation of 100-fold dilution, which was good results. In P. mirabilis with the undiluted inoculation, the result of CAZ was slightly inferior to those of the other CEPs in the fifth group previously reported; however, CAZ was prone to be affected by inoculum size, and with the inoculation of 100-fold dilution, MIC of CAZ turned to be as low as 0.10 microgram/ml. Against P. aeruginosa, CAZ showed the activity comparable to that of CFS, the antibiotic considered to have the highest antibacterial activity of all CEPs used in Japan. This finding is in accordance with the findings reported by other authors. The peak MICs of CAZ were 3.13, 12.5 microgram/ml at the inoculation of undiluted solution, and from 1.56 to 3.13 microgram/ml at the inoculation of 100-fold dilution, which were the results equal to, or even better than those of GM. The change in blood levels of CAZ was studied by one shot intravenous injection and 1 hour intravenous drip infusion.(ABSTRACT TRUNCATED AT 400 WORDS)

Antimutagenic effects of germanium oxide on Trp-P-2-induced frameshift mutations in Salmonella typhimurium TA98 and TA1538

A germanium compound, germanium oxide (GeO2) behaved as a potent antimutagen on frameshift-type reverse mutations induced by 3-amino-1-methyl-5H-pyrido[4,3-b]indole (Trp-P-2) in strains of Salmonella typhimurium TA98 and TA1538 with and without a plasmid pKM101, respectively. This metal antimutagen seems to work independently of the plasmid, a promotive factor in chemically induced mutagenesis through error-prone DNA repair.

Mechanism of action of AC-1370 on phagocyte functions

The mechanism of action of a new semisynthetic cephalosporin AC-1370 on phagocyte functions was investigated. AC-1370 enhanced phagocytic functions of macrophages and neutrophils. AC-1370 bound to 27.4% of mouse peritoneal resident cells. Most of the AC-1370-binding cells were macrophages, and few neutrophils bound AC-1370. Culture supernatant of mouse macrophages cultured with AC-1370 significantly augmented phagocytic functions of mouse neutrophils. This activity of the culture supernatant of AC-1370-stimulated macrophages was abolished by digestion with trypsin but not by heat treatment at 56 degrees C for 30 min. The mechanism of the activation of phagocyte functions by AC-1370 is proposed as follows. First, AC-1370 binds to macrophages and causes their activation. Second, trypsin-sensitive and heat-stable soluble factor(s) is released from these macrophages. And finally, neutrophil functions are activated by the factor(s).

[Experimental and clinical evaluation of cefpiramide in pediatrics]

Fundamental and clinical studies on cefpiramide (CPM), a new semisynthetic cephalosporin were performed and the following results were obtained. Antibacterial activity The antibacterial activity of CPM was investigated in comparison with those of CTT, CPZ, CEZ, LMOX and CFS. Against clinical isolates of S. aureus, CPM was superior to CTT and LMOX, but almost similar to CPZ and inferior to CEZ. Against E. coli, K. pneumoniae, P. mirabilis and S. marcescens, CPM showed the activity almost similar to that of CEZ, but inferior to those of the others. On the contrary, the activity of CPM against P. aeruginosa was satisfactory and was superior to those of CTT, CPZ and LMOX, but slightly inferior to that of CFS. Blood level and urinary recovery Twenty mg/kg of CPM was given intravenously at one shot to 3 patients. The mean serum levels of CPM were 116.9 micrograms/ml at 30 minutes, 90.5 micrograms/ml at 1 hour, 71.1 micrograms/ml at 2 hours, 55.8 micrograms/ml at 4 hours, 24.9 micrograms/ml at 6 hours, 19.3 micrograms/ml at 9 hours and 12.1 micrograms/ml at 12 hours after administration, respectively. The mean half-life was very long and the value was 3.85 hours. The urinary recovery rates in 2 cases were 18.31 and 21.47% respectively up to 12 hours after administration. Clinical results and side effects CPM was given intravenously to 30 diseases including 11 cases of bronchopneumonia, 3 cases of bronchopneumonia and pleurisy, 2 cases of bronchitis, 4 cases of purulent tonsillitis, 5 cases of pyelonephritis and each one case of pyothorax, parotitis, cellulitis, otitis media and salmonellosis. CPM was effective in 29 out of 30 cases, and the effective rate was 96.7%. As side effects, 2 cases of fever and 1 case of cough were observed, but no abnormality in clinical laboratory findings was observed.

Purification and characterization of streptomycin 6-kinase, an enzyme implicated in self-protection of a streptomycin-producing micro-organism

Streptomycin 6-kinase of the streptomycin-producing strain Streptomyces griseus HUT 6037 was purified by fractionation with (NH4)2SO4 and chromatography on DEAE-Sephadex A-25, hydroxyapatite and Sephadex G-100. After PAGE of the final fraction, a protein band corresponding to streptomycin 6-kinase was detected, together with a less intense band having no enzyme activity. Molecular weights determined by SDS-PAGE and by Sephadex G-100 chromatography were about 36000 and 38000, respectively, suggesting that the enzyme was a monomer. The isoelectric point of the enzyme was pH 6.6. Among the nucleoside 5'-triphosphates tested, ATP was the preferred phosphoryl donor. The Km values for streptomycin and ATP were 3.5 mM and 0.4 mM, respectively. The enzyme activity was strongly inhibited by EDTA and AgNO3. It was shown by using an in vitro protein-synthesizing system that purified streptomycin 6-kinase could protect polyphenylalanine synthesis of the streptomycin-susceptible S. griseus strain KSN from inhibition by streptomycin.

Effects of AC-1370, a new semisynthetic cephalosporin, on phagocyte functions

The effects of a new semisynthetic cephalosporin, AC-1370, on phagocyte functions were compared with those of cefoperazone. AC-1370 augmented phagocytosis by mouse macrophages in vitro and in vivo, by mouse neutrophils in vivo, and by human neutrophils in vitro. Cefoperazone suppressed phagocytosis by mouse macrophages and neutrophils. Random migration and chemotaxis of mouse and human neutrophils were increased by the addition of AC-1370. Nitroblue tetrazolium reduction by human neutrophils was enhanced by the addition of AC-1370. Intracellular killing of bacteria by macrophages was also enhanced by AC-1370. Further, bactericidal effects of AC-1370 against Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae were augmented when they were each cultured with mouse or human leukocytes. These results suggest that AC-1370 is an unique beta-lactam antibiotic which has a potentiating effect on phagocyte functions as well as a bactericidal effect.

[Laboratory and clinical studies on T-1982 (cefbuperazone) in the field of pediatrics]

T-1982 (cefbuperazone), a new 7 alpha-methoxycephem antibiotic, was fundamentally and clinically studied, and the following results were obtained. The antibacterial activities of T-1982 against clinical isolates of S. aureus, E. coli, K. pneumoniae, S. marcescens, P. mirabilis and P. aeruginosa were determined in comparison with those of CER, CEZ, CMZ and CTT. Against S. aureus, CER and CEZ exhibited excellent activity, whereas T-1982 was less active with the peak MIC of 12.5 micrograms/ml even with the inoculum size of 10(6) cells/ml. The activity of T-1982 was equal to that of CTT and by far superior to that of CER, CEZ and CMZ against E. coli, K. pneumoniae and P. mirabilis, the peak MICs with the inoculum size of 10(6) cells/ml being less than or equal to 0.1-0.2 microgram/ml, less than or equal to 0.1-0.2 microgram/ml and 0.2-0.39 microgram/ml, respectively. Against S. marcescens, T-1982 was superior to CMZ and CTT and 48% of the strains were inhibited by 3.13 micrograms/ml or less, whereas all the strains were resistant to CER and CEZ. The MIC of T-1982 against most strains of P. aeruginosa was more than 100 micrograms/ml. 10 mg/kg or 20 mg/kg of T-1982 was administered by one shot intravenous injection or 1 hour drip infusion to 23 pediatric patients to measure serum levels and urinary recovery. At 30 minutes after one shot injection of 10 mg/kg and 20 mg/kg, the highest serum levels of 22.0-38.8 micrograms/ml and 52.4-80 micrograms/ml were observed, the half-lives being 1.32 hours and 1.76 hours. When given by 1 hour drip infusion, the serum levels attained the peaks of 29.2-42.6 micrograms/ml and 49.0-75.6 micrograms/ml at the end of infusion, the half-lives being 1.24 hours and 1.19 hours. The urinary recovery rates within 6 hours were 74.2-92.5% and 50.2-66.5% by one shot injection and 63.4-84.2% and 53.9-79.0% by drip infusion. T-1982 was administered at a dose of 50 mg/kg by 30 minutes drip infusion to a child with purulent meningitis. The levels of T-1982 in the cerebrospinal fluid at 1 hour after administration were 4.8-6.7 micrograms/ml with the CSF/serum ratios of 4.4-8.4%. A total of 36 pediatric patients (21 cases of respiratory tract infection, 9 cases of urinary tract infection and each 1 case of purulent cervical lymphadenitis, scarlet fever, purulent meningitis, acute colitis, peritonitis and sinusitis) was treated with 40-80 mg/kg/day of T-1982 (252.6 mg/kg/day in purulent meningitis). The response was excellent in 27 patients and good in 7 patients, the efficacy rate being 94.4%. Diarrhea or eruption were observed in each 1 case. No abnormal laboratory findings were noted in any cases.

Mechanism of host defense suppression induced by viral infection: mode of action of inosiplex as an antiviral agent

The mechanism of influenza virus (INFV)-induced immunosuppression and the mode of inosiplex action against INFV infection were studied. INFV suppressed both anti-lipopolysaccharide and anti-sheep erythrocyte antibody production in mice. INFV infection caused viral mRNA synthesis and increased total RNA synthesis in lymphocytes, but total mRNA synthesis was decreased. The translational ability of INFV-infected lymphocytes was also suppressed. Thus, INFV seemed to cause suppression of both mRNA synthesis and the translational ability of lymphocytes, resulting in suppression of lymphocyte functions. Inosiplex potentiated antibody production against sheep erythrocytes but not against lipopolysaccharide in normal and INFV-infected mice. Adamantanamine did not produce such a potentiating effect. The lymphocytes obtained from INFV-immunized and inosiplex-treated mice conferred resistance against INFV infection. This resistance was partially inhibited by anti-Thy 1.2 antibody treatment of the lymphocytes. In an adoptive cell transfer system, inosiplex treatment of T-cell donors potentiated antibody production when a non-immunosuppressive carrier (human serum albumin) was used. When an immunosuppressive carrier (INFV) was used, inosiplex treatment of either B-cell donors or T-cell donors increased antibody production. Direct introduction of inosiplex into lymphocytes by a cell fusion technique stimulated anti-sheep erythrocyte antibody production more effectively than the addition of inosiplex to cultures. Inosiplex increased total RNA and total mRNA syntheses in phytohemagglutinin-treated lymphocytes. In INFV-infected lymphocytes, inosiplex decreased syntheses of total RNA, total mRNA, and viral mRNA and restored translational ability. From these results, we concluded that inosiplex penetrates into lymphocytes and suppresses viral RNA synthesis and that it supports lymphocyte functions by promoting RNA synthesis and translational ability, both of which are necessary for hosts.

Mechanism of protection of protein synthesis against streptomycin inhibition in a producing strain

The influence of streptomycin (SM) on protein synthesis in a SM-producing strain was investigated using polyuridylic acid-directed polyphenylalanine synthesis in cell-free extracts. Tolerance of protein synthesis to SM developed with increasing culture age of cells and could be attributed to a decrease in affinity of the ribosomes for SM and in increase in SM 6-kinase activity in cells. SM 6-phosphate produced from SM by SM 6-kinase did not bind to ribosomes and, furthermore, ribosome-bound SM was effectively released on phosphorylation with SM 6-kinase. Also a decrease in cell permeability to SM during the production phase may contribute in protecting protein synthesis from the antibiotic.

A comparison between the computed tomogram and the neuropathological findings in cerebrovascular disease

The findings on computed tomography (CT) and neuropathological examinations were correlated in 87 autopsied cases of cerebrovascular disease with regard to the seize and location of lesions, experience of reviewers, and improvement in CT quality. Small infarctions less than 5 mm were very difficult to detect accurately on CT. This was largely because of the limitations in the efficiency of the CT scanner. Accurate diagnosis of medium sized infarctions was also often difficult. This was mainly due to the anatomical location of lesions, the confluence of deep and widened sulci, periventricular white matter, and structures in the posterior fossa. Large infections could be visualized easily on CT, except in their early periods or in cases with hemorrhagic infarctions. The improved accuracy of CT diagnosis for small and medium sized infarctions could not be attained by the experience of reviewers, but was only possible by instrumental improvement of CT quality.

Polyclonal B cell activation by cell wall preparations of gram-positive bacteria. In vitro responses of spleen cells obtained from Balb/c, nu/nu, nu/+, C3H/He, C3H/HeJ and hybrid (DBA/N x Balb/c)F1 mice

The effects of polyclonal B cell activation (PBA) of cell walls and their cell wall fractions obtained from several kinds of gram-positive bacteria were studied using the anti-sheep red blood cell (SRBC) or anti-trinitrophenylated (TNP) SRBC plaque forming cell (PFC) responses of cultured spleen cells from Balb/c, athymic nu/nu, their littermates (nu/+), C3H/He (LPS-responder), C3H/HeJ (LPS-nonresponder), (CBA/N x Balb/c) F1 male with an X-linked defect in B cell function and the F1 female mice. The cell walls of Staphylococcus epidermidis (ATCC 155), Lactobacillus plantarum (ATCC 8014), Micrococcus lysodeikticus (NCTC 2665), Mycobacterium rhodochrous (ATCC 184), Streptomyces gardneri (ATCC 23911) and Nocardia corynebacteriodes (ATCC 14898) had the ability to induce polyclonal B cell responses in the spleen cells of Balb/c, nu/nu, nu/+, C3H/He and C3H/HeJ mice. The cell wall fractions prepared by enzymatic digestion from the cell walls of S. epidermidis, S. gardneri or N. corynebacteriodes were also capable of inducing polyclonal B cell responses. The responses of spleen cells from (CBA/N x Balb/c) F1 male mice to these active preparations, except the cell walls of M. rhodochrous which possess this ability. The PBA-ability of synthetic peptidoglycan, muramyl dipeptide (N-acetylmuramyl-L-alanyl-D-isoglutamine, MDP), was also examined, and a similar activity was observed in MDP.