New antiinflammatory agents. 2. 5-Phenyl-3H-imidazo[4,5-c][1,8]naphthyridin-4(5H)-ones: a new class of nonsteroidal antiinflammatory agents with potent activity like glucocorticoids

We previously described new antiinflammatory agents, 4-hydroxy-2-oxo-1-phenyl-1H-1,8-naphthyridine-3-carboxamides 1. Further modification of the compounds bearing 1-phenyl-1,8-naphthyridin-2-one as a mother skeleton led to 5-phenylimidazo[4,5-c][1,8]naphthyridin-4(5H)-one derivatives 2 and 3. Regioselective synthesis of these compounds bearing a substituent at the 1- or 3-position was conducted according to the method shown in Schemes I and II. In this series of compounds, antiinflammatory activities were greatly influenced by the position and nature of substituents on imidazole. 3-Alkyl or 3-benzyl substitution result in the potent activity, but 1-substitution did not. Minor modification of the benzyl group reduced or eliminated the activity. Detailed examination of structure-activity relationships led to 3-benzyl-5-phenyl-3H-imidazo[4,5-c][1,8]naphthyridin-4(5H)-one (22), which exhibited potent oral antiinflammatory activities in carrageenan-, zymosan-, and reversed passive Arthus reaction-induced rat paw edemas (ED40 = 5.3, 0.37 mg/kg, ED50 = 0.47 mg/kg, respectively). This broad activity of 22 was like that of glucocorticoids. Compound 22 did not affect activities of CO and 5-LO enzymes and receptor binding of various ligands. As one of the mechanisms of action, induction of release of glucocorticoids was postulated. These results suggest that 22 represents a novel class of antiinflammatory agents.

Retrograde supernormal conduction, gap phenomenon in concealed accessory atrioventricular pathways

We present four patients with the Wolff-Parkinson-White syndrome who exhibited retrograde supernormal conduction or gap phenomenon in concealed accessory pathways. In the first patient, ventricular extrastimulus testing revealed retrograde block at the coupling interval of 520 msec and reappearance of conduction at the coupling interval of 370 msec. In a second patient, 1:1 retrograde conduction was not present but supernormal conduction was demonstrated at coupling intervals of 360 msec to 310 msec during the ventricular extrastimulus testing when the basic drive consisted of atrioventricular (AV) simultaneous pacing. In a third patient, ventricular extrastimulus testing demonstrated retrograde conduction through the accessory pathway only at coupling intervals of 400 msec to 360 msec. In a fourth patient, retrograde block occurred at the coupling interval of 340 msec and retrograde "slow" conduction reappeared at coupling intervals of 300 msec to 250 msec (gap phenomenon) only when the basic drive consisted of AV simultaneous pacing. Thus, concealed accessory pathways may exhibit retrograde supernormal conduction or gap phenomenon. Ventricular extrastimulus testing consisting of AV simultaneous pacing during the basic drive may facilitate demonstration of these unusual properties.

[Clinical assessment of patients with microscopic hematuria pointed out by mass screening examination]

We clinically examined 445 patients with positive urine occult blood test found by mass screening examination. Among them, 41 cases had the history of macroscopic hematuria. Urological abnormalities were observed in 169 (41.8%) of the patients with microscopic hematuria, and in 22 (53.7%) of those with a history of macroscopic hematuria. Genitourinary neoplasms were found less frequently in the patients with microscopic hematuria (1.2%) than in those with macroscopic hematuria (22%). We couldn't find a correlation between the degree of hematuria and the severity of the underlying diseases. Hematuria is often thought to appear intermittently, and urinalyses of the patients with so-called significant disease may not be found at the first visit.

Excretion of putrescine by the putrescine-ornithine antiporter encoded by the potE gene of Escherichia coli

Excretion of putrescine from Escherichia coli was assessed by measuring its uptake into inside-out membrane vesicles. The vesicles were prepared from wild-type E. coli or E. coli transformed with plasmids containing one of the three polyamine transport systems. The results indicate that excretion of putrescine is catalyzed by the putrescine transport protein, encoded by the potE gene located at 16 min on the E. coli chromosome. Loading of ornithine (or lysine) inside the vesicles was essential for the uptake of putrescine, indicating that the protein exchanges putrescine and ornithine (or lysine) by an antiport mechanism. The Km and Vmax values for the putrescine uptake by inside-out membrane vesicles were 73 microM and 0.82 nmol/min per mg of protein, respectively. The antiport protein (potE protein) also catalyzed putrescine-putrescine and ornithine-ornithine exchange. The transport activity was not disturbed by inhibitors of energy production such as KCN and carbonyl cyanide m-chlorophenylhydrazone. When intact E. coli was used instead of the inside-out membrane vesicles, excretion of putrescine was also catalyzed by the antiport protein in the presence of ornithine in the medium.

Modified method of radical retropubic prostatectomy for localized prostatic cancer

A modified method of retropubic radical prostatectomy was devised. The root of the penis was compressed and the bilateral internal iliac arteries were clamped before the dissection of the prostate. The urethra was divided at the junction of the prostate and bladder so that the bladder stump thus created has the size of the tip of the middle finger. Vesicourethral anastomosis was done by Vest procedure. By this method 24 patients were operated. All patients except one were alive without recurrence after the mean follow-up of 32 months. This method seems to be good enough to recommend.

[Bilateral ureteral obstruction secondary to aneurysm of abdominal aorta: a case report]

A 66-year-old man with the chief complaint of oliguria had been referred to our hospital under the diagnosis of bilateral hydronephrosis and abdominal aortic aneurysm by his family doctor. CT scan and digital subtraction angiography demonstrated an abdominal aortic aneurysm continuing to bilateral internal iliac arteries. The degree of right hydronephrosis was less advanced compared to the left side. Right percutaneous nephrostomy was performed because the retrograde stenting was unsuccessful. After the renal function improved, an operation for the aneurysm was undertaken in the surgical department. Although bilateral ureterolysis was possible, the resection of the aneurysm could not be done. After clamping the nephrostomy catheter, drainage of urine into the ureter was not seen one month after the operation. A double-J ureteral stent was inserted by the antegrade approach and the nephrostomy tube was removed. By exchanging the stent every 3 months, the renal function has been stable and the size of the aneurysm unchanged during the 25 months after the surgery.

A novel synthesis and potent antiinflammatory activity of 4-hydroxy-2(1H)-oxo-1-phenyl-1,8-naphthyridine-3-carboxamides

New antiinflammatory agents 4-hydroxy-2(1H)-oxo-1-phenyl-1,8-naphthyridine-3- carboxamides 7 were designed and synthesized via a valuable intermediate, 1-phenyl-2H-pyrido[2,3-d][1,3]oxazine-2,4(1H)-dione (9). The nature of substituents on the amide nitrogen had a pronounced effect on antiinflamatory activity. Studies of structure-activity relationships led to compounds 33 and 34 bearing a pyridine ring on the amide nitrogen. Compounds 33 and 34 were active against carrageenin-, zymosan-, and arachidonic acid-induced rat paw edemas and also potently inhibited the reversed passive Arthus reaction in rats. Thus, they possess a broader spectrum of antiinflammatory activity than the classical nonsteroidal antiinflammatory drugs (NSAIDs) such as indomethacin and piroxicam.

8-Polycycloalkyl-1,3-dipropylxanthines as potent and selective antagonists for A1-adenosine receptors

With the aim of characterizing the hydrophobic interactions between xanthines and the A1 receptor site, 1,3-dipropyl-8-substituted xanthines were synthesized. Introduction of a quaternary carbon and the conformationally restricted cyclopentyl moiety into the 8-position of xanthines enhanced the adenosine A1 antagonism. 1,3-Dipropyl-8-(3-noradamantyl)xanthine was identified to be a selective and the most potent A1 receptor antagonist reported to date. Under our structure-activity relationship, the 8-substituent of xanthine antagonists and the N6-substituent of adenosine agonists appears to bind to the same region of the A1 receptor.

Inhibition of tumor growth by the intralesional administration of interleukin-3 into mice implanted with solid tumors

The antitumor activity of three interleukin-3 (IL-3) preparations administered intralesionally into mice bearing syngeneic solid tumors was investigated. IL-3 preparations used in this study included S-IL-3, which was isolated from the culture fluid of murine inguinal lymph node cells stimulated with an arabinomannan extracted from Mycobacterium tuberculosis (SSM), the culture fluid of WEHI-3 cells (W-IL-3) and recombinant IL-3 (rIL-3). When a 1,500 U/kg dose of S-IL-3 or W-IL-3 was injected intralesionally into BALB/c mice bearing Meth-A solid tumors three time per week beginning 3 days after tumor inoculation, tumor growth was inhibited by 60% or 74% at 24 days after tumor inoculation, respectively. In these experiments, 1 unit of IL-3 activity was determined to be the concentration that induced 50% of maximal proliferation of an IL-3 dependent cell line (FCD-P2 cells). The administration of this dose of rIL-3 inhibited tumor growth by 34%. When these three preparations of IL-3 were pretreated with anti-IL-3 monoclonal antibody in vitro, the antitumor activity, as well as their growth promoting activity on FDC-P2 cells, was eliminated. Since direct cytotoxic activities of these IL-3 preparations against cultured Meth-A tumor cells in vitro have not been demonstrated, these results suggest that their antitumor activities might be expressed through interactions between tumor cells and antitumor effector cells which were stimulated by the intralesional administration of the IL-3 preparations.

[Retroperitoneal xanthogranuloma: a case report]

A case of retroperitoneal xanthogranuloma is reported. A 51-year-old man was referred to our hospital for the evaluation and treatment of right flank pain and hydronephrosis. Intravenous urography (DIP) and retrograde pyelography revealed the stricture in the middle portion of the right ureter. Ureteroscopy revealed no mucosal lesions. Computed tomography revealed the paraureteric mass lesion. Partial ureterectomy, mass resection and uretero-ureterostomy were performed. Then a double J stent was left in place for 6 weeks. The stricture was due to a yellowish mass adhered to the right side of the ureter. The resected mass measured 1.0 x 2.0 x 1.0 cm. The histopathological diagnosis was xanthogranuloma. The patient is in good health without recurrence 4 months after the surgery.

Demonstration of receptors for epidermal growth factor on cultured rabbit chondrocytes and regulation of their expression by various growth and differentiation factors

Epidermal growth factor (EGF) receptors were demonstrated on cultured rabbit costal chondrocytes. After crosslinking, the receptors on the cells with 125I-EGF, one major band of 170 KDa was separated by SDS-PAGE. Scatchard analysis demonstrated two classes of EGF receptors with Kd values of 0.3 nM and 1.6 nM. The numbers of high and low affinity receptors were 3,000 and 10,000 per cell, respectively. EGF receptors on chondrocytes were increased by treatment with retinoic acid and interleukin-1 beta, which inhibited proteoglycan synthesis. On the other hand, parathyroid hormone and dibutyryl cyclic AMP, which stimulated proteoglycan synthesis, decreased the number of EGF receptors. Treatments with these agents did not change the affinity of the receptors. These findings suggest that the number of EGF receptors is a negative marker of chondrocyte differentiation.

Effects of prorenin on blood pressure and plasma renin concentrations in stroke-prone spontaneously hypertensive rats

To examine the possible activation of prorenin in the circulation, recombinant rat prorenin was intravenously given to pentobarbital-anesthetized rats. Bolus injection of prorenin at the dose of 100 micrograms angiotensin I (ANG I).h-1.kg-1 into Wistar rats, leading to a 15-fold increase in plasma prorenin concentrations (from 27 +/- 6 to 393 +/- 75 ng ANG I.h-1.ml-1) at 5 min after the injection, did not affect blood pressure, heart rate, and plasma active renin concentrations throughout experiments. On the other hand, the administration of active renin at the dose of 1, 3, and 10 micrograms ANG I.h-1.kg-1 increased mean blood pressure of Wistar rats by 8 +/- 2, 15 +/- 2, and 27 +/- 4 mmHg, respectively. Similar results were obtained in Wistar rats at 18 h after bilateral nephrectomy. These results confirmed no activation of prorenin in the circulation of normotensive rats. The activation of prorenin was also examined on both stroke-prone spontaneously hypertensive rats (SHRSP) and 18 h-nephrectomized SHRSP. There was no rise in blood pressure or plasma active renin concentrations in both groups of SHRSP after injection of prorenin. Thus the elevated plasma active renin in SHRSP [Shibota, M., A. Nagaoka, A. Shino, and T. Fujita. Am. J. Physiol. 236 (Heart Circ. Physiol. 5): H409-H416, 1979] seems to be caused by the enhanced release of active renin from the kidney rather than the activation of circulating prorenin.

Effects of congenital hydrocephalus on serotonergic input and barrel cytoarchitecture in the developing somatosensory cortex of rats

The effects of progressive ventricular dilation on the development of the somatosensory cortex (SmI) were studied in congenital hydrocephalic rats, with regard to early serotonergic innervation and formation of functional cellular columns. In hydrocephalic rats, the time course, immunoreactivity, and patterns of formation and synaptogenesis of serotonin immunoreactive (5-HT-IR) terminal aggregations, which characterize the development of the SmI, were preserved. After disappearance of 5-HT-IR terminals, characteristic barrel cytoarchitecture formed normally at the site where 5-HT-IR terminal aggregations had been present. With the progression of hydrocephalus, the cerebral cortex became extremely thin and its total surface area was greatly increased, while barrels were preserved and their areas did not enlarge. These findings suggest that the basic development and the fundamental cytoarchitecture of the cortex are resistant to adverse effects of hydrocephalus.

[A case of renal pelvic carcinoma in situ]

A 72-year-old female visited our hospital with the complaint of macroscopic hematuria on Jan. 29, 1990. Cystoscopic examination revealed hematuria flowing out from the left ureteral orifice. A 1 cm mass was found in the left upper calyx by retrograde pyelography (RP). Urine cytology obtained by RP was class IIIb. Later, the mass was found in the left middle calyx by CT. Repeated RP revealed no mass and the wall of the left upper calyx was irregular. Washing cytology from the left renal pelvis was class V. Left total nephroureterectomy was performed on Feb. 2, 1990. Macroscopically, no tumor mass was apparent. Microscopically, transitional cell carcinoma in situ was widely spread from the left renal pelvis to the middle ureter. The preoperative upper calyceal mass was thought to have been a blood clot. At twelve months after the operation, there has been no evidence of tumor recurrence.

Expression of rat renin in mammalian cells and its purification

Rat renin cDNA was transfected into COS-7 and Chinese hamster ovary (CHO) cells and expressed under the control of the Simian Virus 40 early promoter. Conditioned media of the transfected cells showed renin activity only after trypsin treatment, suggesting prorenin was secreted into the medium. From the trypsinized serum-free culture of the transfected CHO cells active renin was purified to homogeneity by a simple three-step procedure. The active renin had similar specific activity, molecular weight, Km, pH optimum, and isoelectric point compared to native renin. The amino-terminal sequence was the same as that deduced from the renin cDNA. This suggests that the recombinant rat renin is similar to kidney renin in many respects, and is easily obtained by the present procedures.

Reduction of urinary oxalate by combined calcium and citrate administration without increase in urinary calcium oxalate stone formers

Oxalic acid seems to play a far greater role in the formation of calcium oxalate stone than calcium. Three grams of calcium lactate and 3 g of sodium potassium citrate were administered to 46 urolithiasis patients, whose stones were mainly composed of calcium oxalate. Urinary oxalate level was reduced significantly without raising urinary calcium level by the administration of the two drugs for two weeks. The reduction of urinary oxalic acid was particularly remarkable in patients without hypercalciuria. The mechanism of action of these drugs was discussed.

[Evaluation of diet of calcium stone patients]

To clarify the relationship between renal stone formation and the diet, the consumption of various nutrients of calcium stone formers was investigated. The study included 24 male and 12 female stone formers, between 20 and 78 years old (mean 42 years). The daily consumption of nutrients was compared to the daily nutritive requirement for the Japanese. The amounts of total and animal protein ingested by all the patients were significantly larger than the daily nutritive requirements. The animal protein ratio was also significantly higher. Concerning the total protein, animal protein and animal protein ratio, male and female patients showed similar results. Salt consumption was significantly larger for all the patients and the male patients than the daily nutritive requirement for the Japanese. Female stone formers also showed this tendency. Consumption of calcium and carbohydrate by all the patients and the male patients was significantly smaller than the daily nutritive requirement. This tendency was observed for the female patients.

A neuropathological study of early onset Cockayne syndrome with chromosomal anomaly 47XXX

We present the clinical and neuropathological findings in a female patient with early onset Cockayne syndrome and a chromosomal anomaly (47XXX). The girl was the only child of healthy, unrelated parents. She was born with a birth weight of 1,930 gm. She had progeroid facial features with bilateral cataracts. A diagnosis of 47XXX was made on the basis of a chromosomal study. Physical shortness became increasingly prominent while her weight remained stationary. Psychomotor retardation was noted, and she could never sit alone. A brain CT scan showed cerebral atrophy and calcification of the basal ganglia. Cultured skin fibroblast exhibited significant sensitivity to the ultraviolet light. She died from a chest infection at the age of 7 years and 4 months. Microscopically, the renal glomeruli showed diffuse sclerotic changes with thick capillary basement membranes. A neuropathological examination revealed a very small brain (295 gm), extensive myelin deficiency, gliosis in the white matter, and calcifications in the basal ganglia, and cerebral and cerebellar cortices. The loss of both Purkinje and granular cells was noticed in the cerebellar cortex. This is the first report of a case with the Cockayne syndrome and 47XXX, and the 47XXX in this patient seems to be coincidental.

Atrioventricular nodal reentrant tachycardia with retrograde block induced by aprindine

Two patients are described who had atrioventricular nodal reentrant tachycardia (AVNRT) with 1:1 relationship in the control state, but in whom a varying degree of VA block during AVNRT was observed during therapy with aprindine. Aprindine, however, did not cause anterograde blockade of conduction over the slow AV nodal pathway during tachycardia. These observations support the conclusion that the bulk of atrial muscle is not a requisite part of the tachycardia circuit in AVNRT and that antiarrhythmic drugs may have disparate effects on conduction in the retrograde and anterograde limbs of the circuit.

Effects of various growth factors on a chondrocyte differentiation model

We developed a new 4-dimensional differentiation model of growth-cartilage cells (temporally and spatially regulated). composed of a high-density suspension culture of rabbit costal chondrocytes. In this system, fibroblast growth factor (FGF) or transforming growth factor-beta (TGF beta) stimulated proliferation and matrix synthesis, but reversibly inhibited terminal differentiation-induction of alkaline phosphatase (Alpase) activity, type X collagen synthesis and subsequent calcification. When parathyroid hormone (PTH) was added to the differentiation model, both the induction of Alpase and calcium uptake were reversibly suppressed. In contrast, calcitonin (CT) stimulated Alpase activity and calcium uptake dose-dependently. Bone morphogenetic protein (BMP) strongly stimulated DNA synthesis of chondrocytes in the presence of FGF and induced rapid maturation of chondrocytes at a growing stage. Moreover, BMP stimulated Alpase activity in multilayered chondrocytes at the calcifying stage.