Fate of tetraplegic patients managed by ileal conduit for urinary control: long-term follow-up

BACKGROUND

A study was conducted to evaluate our experience of ileal-conduit formation in tetraplegic patients with special reference to late complications due to upper urinary tract stones and pyocystis.

METHODS

Ileal-conduit formation was performed in 16 patients with tetraplegia to improve urinary management. The mean age at operation was 46 years (range 19-70) and the mean follow-up period was 8.7 years (range 2-17). We evaluated the results retrospectively from patients' medical records.

RESULTS

Two patients died 2 years after the procedure and one patient died 8 years after the ileal-conduit formation. Five patients suffered from repeated renal or ureteral stone. In three of these cases, serious urinary tract infections developed whenever the stone caused an obstruction. Three patients received a cystectomy at the time of the ileal-conduit formation. Eight patients suffered from empyema of the bladder and in two of these cases a subsequent cystectomy was required.

CONCLUSIONS

Ileal-conduit formation should be cautiously considered as an option in the urinary management of tetraplegic patients, particularly when more conservative management strategies have proved unsuccessful. However, an antirefluxing mechanism for the ileal conduit may be necessary, and a simultaneous cystectomy may improve the results.

Cloned transgenic mouse fetuses from embryonic stem cells

Development of efficient efficient system for genetic modification and large-scale cloning of livestock is of importance for agriculture, biotechnology, or human medicine. The mouse, on the other hand, is an ideal model in the basic studies of genetic modification. In this study, we investigated about production of clone mice from established embryonic stem (ES) cell line by nuclear transfer. Further, we had try of production of cloned transgenic mouse fetuses/offspring using ES cells modified with a marker gene, EGFP. With the ES cell line TT2 which is at least 15 passages, reconstructed oocytes developed to 2-8 cell embryos, morulae, or blastocysts (44.8%), and 17.2% of them developed to term (19.5 days post-coitum, dpc). When 40 embryos with the marker gene transferred to 11 surrogate mothers (pseudopregnant females), 5 live fetuses were recognized in the uteli at 13.5 dpc and in these fetuses expression of GFP was observed, but none developed beyond 19.5 dpc. The present results suggest that ES cells can be used tg produce cloned mice.

Cloned murine fetuses produced by nuclear transfer using metaphase-arrested embryonic stem cells

We examined whether metaphase nuclei could be used as nuclear donors in nuclear transfer in mice. The reconstructed embryos were developed to fetuses in both the metaphase-nuclear transfer and the G1-nuclear transfer. We also performed enucleation of oocytes following nuclear injection (injection-enucleation method) using microinjection method with a piezo-driven micromanipulator in order to produce the cloned murine fetuses. We found that this method could shorten time for manipulation in comparison with the conventional method performing nuclear injection following enucleation of oocytes (enucleation-injection method). We produced successfully cloned fetuses by the injection-enucleation method. Furthermore, there was no difference of developmental efficiency in reconstructed embryos from between B6D2F1 and ddY strain as oocyte donor.

[Opportunistic pneumonia after kidney transplantation]

This study was conducted to evaluate clinical features at the onset of pneumonia and the usefulness of methods for diagnosing pneumonia in patients who have undergone kidney transplantation. From January 1990 to December 1998. 174 kidney transplantations were performed, and were followed by 22 cases of pneumonia. Of the 22 pneumonia patients, 16 were male and 6 were female. The median age of the 22 patients was 37.2 +/- 13.3 years. All the patients received cyclosporin A and corticosteroids. In 11 cases, the organisms were identified in the microbiology or pathology laboratory, either during life or at autopsy. Six cases were due to Pneumocystis carinii (PC), three to PC and Cytomegalovirus (CMV), one to Aspergillus, and one resulted from miliary tuberculosis. Pneumonia occurred within 4 months after kidney transplantation in most cases. The mean interval between the transplantation and the appearance of pneumonia was 77.3 +/- 34.3 days, except in the cases of Aspergillosis and miliary tuberculosis, where the intervals were 46 and 50 months, respectively. The mean interval from the appearance of symptoms to the detection of pulmonary infiltration was 3.3 +/- 4.3 days. The clinical features present when pulmonary infiltration was detected by CT were fever (91%), cough (32%), and crackles (27%). However, at this time, 55% of the cases had no symptoms other than fever. Chest radiographs were positive for pulmonary infiltration in 64% of the cases at the same time that the pulmonary infiltrates were detected by CT. Eighty percent of the cases exhibited diffuse interstitial infiltrates. Organisms were detected in 7 of 9 cases examined with bronchofiberscopy (BF). But in only one of 13 cases that did not undergo BF. Increased values of serum beta-D-glucan were detected in the early phase of three PC pneumonia cases, suggesting that beta-D-glucan is useful as a marker of PC pneumonia. The use of bronchofiberscopy was more frequent in survivors of PC pneumonia than in non-survivors, whereas the mean age was higher and coexisting CMV infections were identified more frequently in the non-survivors. We concluded that fever is important as an initial symptom of pulmonary infection. In addition, we find that CT is very useful for the detection of interstitial infiltrates, and BF is an excellent method for detecting organisms in the pneumonia patient after kidney transplantation.

Mouse fetuses by nuclear transfer from embryonic stem cells

At present, two methods for cloning mammals by nuclear transfer are employed. The first is based on cell fusion and has been applied to domestic animals, such as sheep, cows, and goats. While, nuclear microinjection has been used in mice only. Cloning by nuclear transfer has been reported mainly with cells from primary culture and freshly isolated cells. Here, using ES cell line TT2, we tried to produce clone mouse embryos by the two methods. With ES cell line TT2 (10-13 passaged), 16% of reconstructed oocytes microinjected with the nuclei developed in vitro to the morula/blastocycst stage, and 50% of these embryos developed to fetuses until 14 dpc when transferred to pseudopregnant females. At 20 dpc implanted sites were degenerated and absorbed. Also, in vitro development of embryos reconstructed by electrofusion shown similar results. But, when transferred to recipients, subsequent development of embryos showed lower rates, as compared with embryos microinjected and from recipients live-born pups could not be obtained.

Cloned mice derived from somatic cell nuclei

In 1997, a cloned sheep "Dolly" was produced by nuclear transfer of somatic cell. The first birth of cloned mice derived from some somatic cells were succeeded in 1998. At present, it is shown that somatic cells, cumulus cells, fibroblasts and Sertoli cells can be used to the study of cloned animal as nuclear donor. In this study investigation was designed to compare with efficiency on the production of cloned embryos by using the microinjection and the electrofusion methods for nuclear transfer. Oocyte enucleation was performed with a micromanipulator. The oocyte was held by holding pipette, and was enucleated using a beveled pipette. Microinjection method: Cell's nucleus injection was carried out by piezo-micromanipulator. Cytochalasin B treated cumulus cell was aspirated into a injection pipette, and was broken its plasma membrane using the injection pipette. Then, the cumulus cell was injected into the enucleated ooplasm directly. Electrofusion method: The cell was aspirated into a beveled pipette, and then an aspirated cell was inserted into perivitelline space. Then, the pair of enucleated oocyte and cell was fused using electrical cell fusion apparatus. The reconstituted embryos were activated after nuclear transfer using St2+. Reconstituted embryos had been produced by the microinjection showed the embryonic development to over 8-cell stages. But, the rate of fragmentation of reconstituted embryos by the microinjection showed a little high rate in comparison with the electrofusion. When some reconstituted embryos by the microinjection were transplanted to pseudopregnant females' oviduct, 9 fetuses were observed at 14 days post coitum.

[A new method for pharmacokinetic analysis of 99mTc-GSA using two-compartment and two-parameter model]

Technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin (99mTc-GSA) is a liver scintigraphy agent which binds to asialoglycoprotein receptor in hepatocyte. Twenty-six patients with liver dysfunction were examined with 99mTc-GSA liver scintigraphy using two-compartment and two-parameter model (2C2P model). The 99mTc-GSA was assumed to move within two compartments (whole blood and liver). k1 and k2 were parameters which represented transfer rate constant from blood to liver, and from liver to blood, respectively. Two differential equations based on 2C2P model were integrated, so that k1, k2, k1/k2 and VLmg were estimated from the time-activity curves of the heart and liver. VLmg was computed as maximum amount of 99mTc-GSA binding to liver. The results were compared with the liver function tests and the conventional 99mTc-GSA indices: HH15, LHL15, and LU15. k1/k2 and VLmg values had positive correlation with the result of the serum liver function tests, Plt., T.Bil., ChE, GOT, LDH, ALP and gamma GTP. It is concluded that this new method using 2C2P model is not invasive and simplest in the 99mTc-GSA liver scintigraphies, and may be useful in evaluating liver function.

Production of inbred progenies of diploid potatoes using an S-locus inhibitor (Sli) gene, and their characterization

To develop inbred lines from self-incompatible, cultivated diploid potatoes, an S-locus inhibitor (Sli) gene derived from a self-compatible variant of a wild potato species, Solanum chacoense, was incorporated into various cultivated diploid potatoes. The progeny was selfed twice by the action of the Sli gene to obtain 74 S2 inbred clones belonging to 8 families. More than 40% of them were either non-flowering or pollen sterile. Among the pollen fertile clones, self-compatible clones occurred with a much lower frequency (20.9%) than expected (83.3%). The result demonstrated that self-compatibility was introduced and expressed in the gene pool of cultivated diploid potatoes by an action of the Sli gene, although serious inbreeding depression associated with selfing occurred. The genotypes of S2 inbreds were surveyed using 46 S. chacoense-specific RFLP (restriction fragment length polymorphism) markers covering the whole potato genome. More than half of the markers (67.4%) showed distorted segregation. Particularly, all markers on chromosome 12 were overrepresented in the S2 inbreds. This confirms our earlier finding that the Sli gene locates on chromosome 12 and the alleles linked with this gene are preferentially transmitted because of its essential requirement for selfing.

Cloning of Arabidopsis thaliana phosphatidylinositol synthase and functional expression in the yeast pis mutant

It is believed that phosphatidylinositol (PI) metabolism plays a central role in signalling pathways in both animals and higher plants. PI is synthesized from CDP-diacylglycerol (CDP-DG) and myo-inositol by phosphatidylinositol synthase (PI synthase, EC 2.7.8.11). Here we report the identification of a plant cDNA (AtPIS1) encoding a 26 kDa PI synthase from Arabidopsis thaliana. The plant enzyme as deduced from its cDNA sequence shares 35-41% identical amino acids with PI synthases from Saccharomyces cerevisiae and mammals. AtPIS1 functionally complements a mutant of S. cerevisiae with a lesion in PI synthase, and recombinant AtPIS1 protein present in yeast membranes strongly depends on the two principal substrates, myo-inositol and CDP-DG, and requires Mg2+ ions for full activity.

Relationship between breast milk feeding and atopic dermatitis in children

OBJECTIVE

To determine whether or not the breast milk feeding has a role in the prevalence of atopic dermatitis among children.

METHODS

The target population of the study was all children participating in health check-up program for 3-year-old children in 60 municipalities locating 10 selected prefectures during designated 2 months between October and December 1997. Using a questionnaire, information on nutrition in infants (breast milk only, bottled milk only, or mixed), parity, mothers' age at birth, and a history of atopic dermatitis was obtained. Besides, data on potential confounding factors were obtained.

RESULTS

Questionnaires from 3856 children (81.6% of those who were to participate in the programs, and 96.4% of children who participated them) were analyzed. After the adjustment for all potential confounding factors using unconditional logistic models, the risk of atopic dermatitis was slightly higher among children with breast milk (odds ratio [OR] = 1.16 with 95% confidence interval [CI] 0.96-1.40). Mothers' age at birth (OR for those who were more than 30 years or older in comparison with those who were younger than 30 years = 1.15; 95% CI, 0.96-1.37) and those with second or later parity orders (OR = 1.14, 95% CI; 0.95-1.35) showed odds ratios that were higher than unity without statistical significance.

CONCLUSION

Breast milk elevates the risk of atopic dermatitis slightly without statistical significance; the risk may be, however, higher in children in second or later parity orders.

[A case of infected renal cyst extending to leg abscess]

A 45-year-old woman was referred to our hospital with the chief complaint of left flank pain, left leg pain and loss of appetite. Computed tomography scan and magnetic resonance imaging demonstrated a large cystic mass in the left kidney, which we diagnosed as an infected renal cyst. Under ultrasonic guidance, percutaneous puncture and drainage of the renal cyst were performed. After her leg pain worsened, computed tomography revealed abscesses in the left leg, suggesting an infected renal cyst extending to the leg through the obturator foramen. Under general anesthesia, incision and drainage were performed. Cultures from the cyst and abscess fluid showed Klebsiella pneumoniae. Our case is the 82nd case of an infected renal cyst in the Japanese literature.

Role of prostaglandin E2 and leukotriene B4 in skin reaction induced by transdermal application of propranolol

Dermal application of propranolol (PRL) induced formation of erythema and edema, and pseudoeosinophil infiltration in epidermis and dermis at the application site in guinea pigs. We investigated the production of prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) at the application site of PRL and the role of these inflammatory chemical mediators in the occurrence of the skin reactions. PGE2 was found to be produced at the application site slightly after the accumulation of PRL released from the adhesive bandage in the patch test, and the amount of PGE2 increased continuously, with a peak value obtained at 24 h after application. The time-course changes resembled those of delta a* value, the index of erythema formation determined by colorimetric measurement, and edema formation. The production of PGE2 by dermal application of PRL was suppressed by local pretreatment with dexamethasone or indomethacin. However, no notable production of LTB4 was observed at the application site of PRL.

[A case of vesicovaginal fistula with vaginal stone]

The patient, a 51-year-old woman developed urinary incontinence after an abdominal hysterectomy 3 years earlier. She was referred to our hospital complaining of urine leakage from her vagina after spontaneous passage of a stone. Drip infusion pyelography and cystography demonstrated a vesicovaginal fistula. She underwent repair of the fistula with an abdominal procedure. The stone was composed of magnesium ammonium phosphate.

The putative morphogen, DIF-1, of Dictyostelium discoideum activates Akt/PKB in human leukemia K562 cells

The differentiation-inducing factor-1 (DIF-1) is a putative morphogen that induces stalk-cell formation in the lower eukaryote Dictyostelium discoideum. This molecule has been shown to inhibit cell growth and induce erythroid differentiation in human leukemia K562 cells. In the present study, to clarify the mechanism of the actions of DIF-1, we examined the effect of DIF-1 on Akt/protein kinase B (PKB) in K562 cells. Akt/PKB is a serine/threonine kinase that plays a pivotal role in the regulation of cell survival and differentiation in a variety of cells. A nonphosphorylated (inactive) form of Akt/PKB was ordinarily expressed in K562 cells. However, Akt/PKB was phosphorylated and potently activated within several hours of incubation with 5-30 microM DIF-1, and this activation was inhibited by wortmannin, an inhibitor of phosphatidylinositol 3-kinase (PI3-kinase). Calcium-increasing agents thapsigargin and A23187 also activated Akt/PKB slightly, which was inhibited by wortmannin. By contrast, calcium-reducing agents TMB-8 and EGTA together with A23187 inhibited the DIF-1-induced activation of Akt/PKB. PMA (PKC activator) also activated Akt/PKB but this activation was not inhibited by wortmannin. DIF-1 exhibited no marked effect on the activation of PKCalpha, beta, and gamma, which were activated by PMA. These results indicate that DIF-1 activates Akt/PKB possibly via cytosolic calcium and subsequent activation of PI3-kinase and also that PMA activates Akt/PKB in a PI3-kinase-independent manner.

[Pulmonary thromboembolism accompanied by abnormal plasminogen]

A 38-year-old man was admitted to our hospital because of sudden chest pain and bloody sputum. Lung perfusion scintigraphy disclosed segmental defects in both lungs. An enhanced thin-section computed tomographic scan of the chest showed a low-density area in the right main pulmonary artery. These findings yielded a diagnosis of pulmonary thromboembolism. Serum plasminogen activity was low, not only in the patient but in his elder brother and daughter. Gene analysis revealed a point mutation at exon 15 of the plasminogen gene, suggesting abnormal plasminogen. Abnormal plasminogen is more prevalent in Japan than in the USA or Europe, and is usually asymptomatic. Thromboembolism in patients with abnormal plasminogen is very rare. Further studies are needed to elucidate the relationship between plasminogen abnormalities and pulmonary thromboembolism.

Presence of activating transcription factor 4 (ATF4) in the porcine anterior pituitary

The two-hybrid system that identifies protein-protein interactions in a yeast expression system was used to investigate porcine anterior pituitary transcription factors. Four cDNA clones of a protein interacting with the leucine zipper domain of porcine cJun were obtained. Their nucleotide sequences revealed that they encode activating transcription factor 4 (ATF4). A full-length cDNA of porcine ATF4 was obtained by the polymerase chain reaction, and its deduced amino acid sequence showed 88 and 83% identity to human and mouse ATF4, respectively. Reverse transcription-polymerase chain reaction analysis of mRNAs prepared from 11 porcine tissues demonstrated that ATF4 is ubiquitous. Immunohistochemistry showed that ATF4 is present in the hormone producing cells of the anterior pituitary, but absent in some cells of the anterior pituitary. Further binding analysis revealed that ATF4 also interacts with itself and cFos. This evidence of ATF4 homodimerization, as well as heterodimerization with cJun and cFos in the anterior pituitary suggests a novel mechanism for the regulation of gene expression in this tissue.

Pleiotropic alterations in lipid metabolism in yeast sac1 mutants: relationship to "bypass Sec14p" and inositol auxotrophy

SacIp dysfunction results in bypass of the requirement for phosphatidylinositol transfer protein (Sec14p) function in yeast Golgi processes. This effect is accompanied by alterations in inositol phospholipid metabolism and inositol auxotrophy. Elucidation of how sac1 mutants effect "bypass Sec14p" will provide insights into Sec14p function in vivo. We now report that, in addition to a dramatic accumulation of phosphatidylinositol-4-phosphate, sac1 mutants also exhibit a specific acceleration of phosphatidylcholine biosynthesis via the CDP-choline pathway. This phosphatidylcholine metabolic phenotype is sensitive to the two physiological challenges that abolish bypass Sec14p in sac1 strains; i.e. phospholipase D inactivation and expression of bacterial diacylglycerol (DAG) kinase. Moreover, we demonstrate that accumulation of phosphatidylinositol-4-phosphate in sac1 mutants is insufficient to effect bypass Sec14p. These data support a model in which phospholipase D activity contributes to generation of DAG that, in turn, effects bypass Sec14p. A significant fate for this DAG is consumption by the CDP-choline pathway. Finally, we determine that CDP-choline pathway activity contributes to the inositol auxotrophy of sac1 strains in a novel manner that does not involve obvious defects in transcriptional expression of the INO1 gene.

Cell death-inducing activity by gallic acid derivatives

In this study, the cytotoxic activity of gallic acid derivatives (GDs) was studied using some cancer cell lines. Among them, 3,4-methylenedioxyphenyl 3,4,5-trihydroxybenzoate (GD-1) and S-(3,4-methylenedioxyphenyl)-3,4,5-trihydroxy-thiobenzoate (GD-3) were found to induce cell death in cancer cell lines with IC50s ranging from 2.9 to 114.4 microM, a concentration comparable with or lower than that of gallic acid. On the other hand, although gallic acid did not show any cytotoxicity against primary cultured rat hepatocytes and human keratinocytes, GD-1 and -3 showed slightly higher sensitivity against such normal cells, when compared with gallic acid. The cell death induced by gallic acid and GD-1 was accompanied by internucleosomal DNA fragmentation characteristic of apoptosis, whereas only smear DNA degradation was detected following GD-3 treatment. When the mechanism by which GD-1 and -3 caused cell death in HL-60RG cells was examined, GD-1 and -3-induced cell death was inhibited by the intracellular Ca2+ chelator, bis-(o-aminophenoxy)-N,N,N,N'-tetraacetic acid acetoxymethyl ester (BAPTA-AM), calmodulin inhibitor, W-7, and the Ca2+/Mg2+ -dependent endonuclease inhibitor zinc sulfate. In contrast, catalase, N-acetylcysteine (NAC), and ascorbic acid inhibited gallic acid-induced apoptosis in HL-60RG cells, whereas they had no effect on GD-1- and -3-induced cell death. This result suggests that GD-1 and -3 induced cell death in a different manner to gallic acid. In conclusion, esterification of gallic acid with a 3,4-methylenedioxyphenyl group yielded potent agents to treat cancer with a different signaling pathway from gallic acid, although selectivity was lost.

Skin toxicity of propranolol in guinea pigs

The skin toxicities of propranolol were studied in guinea pigs. In the primary and cumulative skin irritation studies, the skin reactions and the histopathological changes were observed in all animals treated with propranolol, and those tended to increase with the increase of propranolol dosage. The skin reactions increased with the application times of propranolol up to 7 days in the cumulative skin irritation study. In the skin sensitization, the phototoxicity and the skin photosensitization studies, no skin reactions were observed in any animals used in the studies. These results indicate that propranolol caused skin irritation, but was negative for skin sensitization, phototoxicity and skin photosensitization in guinea pigs.

[Effective treatment of AFP-producing lung cancer with UFT]

The main form of chemotherapy for non small cell lung cancer is a multiple combination therapy centered on cisplatin (CDDP). We herein report a case in which a favorable course was obtained for a patient with extremely rare AFP-producing lung cancer by single oral administrations of UFT, following extirpation of brain metastasis. The patient was an 80-year-old male whose main complaints were headache and aphasia. Following close examination, a diagnosis was made of moderately differentiated adenocarcinoma with the primary lesion in S6 of the right lung. A metastatic lesion was found in the left occipital lobe. Blood AFP was an abnormally high 17,000 ng/ml. No tumorous lesions were found in the liver. The brain metastasis were extirpated to alleviate cranial nerve symptoms, and the tissue was found to be the same as that of the primary lesion. AFP staining of the tumor tissue revealed positive cells. Because there was proliferation in the primary tumor following surgery, administration of UFT (300 mg/day Tegafur) was begun. Four weeks later the tumor had begun to shrink, and at 15 weeks was judged to be a partial response. A reduction in AFP was also seen. The patient showed absolutely no side effects from UFT, thus enabling outpatient treatment. Good results were obtained both in reducing the tumor and in maintaining the patient's quality of life.

Cytological and molecular characterization of BC1 progeny from two somatic hybrids between dihaploid Solanum acaule and tetraploid S. tuberosum

Two hexaploid somatic hybrids, DA12-3 (2n = 68) and DA28 (2n = 74), derived from cell fusion between dihaploid Solanum acaule and tetraploid Solanum tuberosum, were crossed with S. tuberosum. Two BC1 families, DA12T and DA28T, were generated, each containing 25 plants. Although the average of somatic chromosome numbers fitted hypothetical numbers assuming equal separation, considerable variation was found: 2n = 54-62 in DA12T and 2n = 58-65 in DA28T. Fifty-two of 80 RFLP single-copy probes generated 108 marker bands specific for S. acaule, by which BC1 progeny were analyzed. The segregation of marker bands from at least 44 probes was explained by two alleles per locus, which had to be heterozygous in dihaploid S. acaule and maintained in homozygous condition in homoeologous chromosomes of tetraploid S. acaule. On average, 73.7% of the chromosomes derived from S. acaule were detected as recombinants, suggesting that frequent homoeologous recombination occurred between S. acaule and S. tuberosum chromosomes. Therefore, S. acaule germplasm can be effectively transferred to the cultivated potato gene pool through backcrossing hexaploid somatic hybrids with S. tuberosum. In both BC1 families, S. acaule chromosomes 3, 4, 6, and 11 were detected as recombinants with higher frequencies (84-98%) than those of chromosomes 9 and 10 (60 and 58%, respectively), suggesting that chromosomal differentiation exists between S. acaule genomes.Key words: hexaploid somatic hybrids, Solanum acaule, homoeologous recombination, RFLP markers.

Effect of the leukotriene receptor antagonist pranlukast on cellular infiltration in the bronchial mucosa of patients with asthma

BACKGROUND

It has been reported that pranlukast reduces the antigen induced immediate and late phase asthmatic responses, airway hyperreactivity to acetylcholine, and pulmonary eosinophil accumulation in guinea pigs. A study was undertaken to test the hypothesis that pranlukast may reduce the number of inflammatory cells in the bronchial mucosa of patients with asthma.

METHODS

A double blind, placebo controlled study was performed in 17 mild to moderate asthmatic subjects to examine changes in inflammatory cell infiltration in response to pranlukast (225 mg orally twice per day for four weeks). Comparisons of the mean daily beta 2 agonist use, symptom score, FEV1 percentage predicted, and airway methacholine responsiveness were made before and after treatment. Using fibreoptic bronchoscopy, bronchial biopsy specimens were obtained before and after treatment with either pranlukast (n = 10) or placebo (n = 7). Immunohistology was performed using monoclonal antibodies for CD3, CD4, CD8, CD68, NP57, AA1, EG1, EG2, gamma GTP and CD19.

RESULTS

When the pranlukast and placebo treated groups were compared there were decreases in beta 2 agonist use, symptom score, and airway methacholine responsiveness after pranlukast but no increase in FEV1 was seen. The clinical response in patients treated with pranlukast was accompanied by a reduction in CD3 (median difference -37, 95% confidence interval (CI) -69 to -1; p < 0.05), CD4 (median difference -28, 95% CI -49 to -8; p < 0.01), AA1 (median difference -15, 95% CI -26 to 0; p < 0.05) and EG2 positive cells (95% CI -35 to 0; p < 0.05), but not in EG1 positive eosinophils, gamma GTP positive cells, and CD19 positive plasma cells.

CONCLUSIONS

These results support the view that pranlukast may act by inhibition of bronchial inflammation in patients with asthma.

Relationship between the skin permeation movement of propranolol and skin inflammatory reactions

We studied inflammatory reactions induced by dermal application of the beta-blocker propranolol (PRL) in ethanol to guinea pigs in order to elucidate the relation of the reactions with the cumulative PRL permeating amount through the stratum corneum or the PRL content in the stripped skin, and to investigate the chemical mediators responsible for the reactions. The cumulative PRL permeating amount through the stratum corneum increased rapidly up to 2 h after dermal application, then increased linearly with time up to 24 h after application. Visual observation revealed formation of erythema and edema at the applied site of PRL, and histopathological examination revealed infiltration of pseudoeosinophiles of dermis and epidermis and degeneration/necrosis of epidermis. In general, it was considered that the duration and the extent of these reactions were dependent on the PRL dosage and application time. It was expected that the cumulative PRL permeating amount through the stratum corneum could be used to predict possible inflammatory reactions during development of transdermal drug delivery systems. On the other hand, contact of PRL with guinea pig skin tissues released histamine, and intradermal injection of PRL caused an increase of capillary permeability at the site of application. Also, the inhibitory effects of anti-inflammatory agents (diphenhydramine, dexamethasone, indomethacin, cyproheptadine hydrochloride, CV3988 and AA-861) to PRL-induced erythema formation demonstrated that histamine and prostaglandins were responsible for the inflammatory reactions induced by PRL.