The effect of age on plasma level of setiptiline maleate in depressed patients

1. Setiptiline maleate (SPT) was administered orally to 45 subjects aged 22-86 years and steady state plasma levels were determined by mass fragment chromatography (GC-MF) to examine the effect of aging on those values. 2. There was a significant correlation between the plasma levels and daily dose. However, there was a wide interindividual variability. 3. Dose-corrected plasma level (DC-PL), or values corrected by dividing the plasma level by daily dose/body weight, was used as the systemic drug clearance parameter. 4. DC-PL was compared among 7 age groups of the subjects distributed in 10-year-intervals. DC-PL showed no difference among groups of subjects between the > 29 years bracket to the 70 years bracket, but showed significantly higher values in those in the > 80 bracket compared to all age groups and subjects in the < 79 bracket. 5. There was a significant correlation between the age of patients and DC-PL according to polynomial response curve analysis. Regression analysis yielded the equation y = -52.72 + 7.05 x -0.17 x2 + 0.01 x3 (n = 45, r = 0.49, p < 0.01).

Localization of 63-kDa calmodulin-stimulated phosphodiesterase mRNA in the rat brain by in situ hybridization histochemistry

We studied the localization of 63-kDa Ca2+/calmodulin stimulated phosphodiesterase mRNA in the rat brain by in situ hybridization histochemistry using an oligonucleotides probe specific to this enzyme. The signals were especially concentrated in several brain regions such as the olfactory tubercle, accumbens nucleus, caudate putamen, fundus striati, dentate gyrus of the hippocampus, pontine nuclei and dorsal tegmental nucleus. These results suggest that in the neuronal groups containing the strong signals this enzyme is involved in calcium-dependent signal transduction system coupled to cyclic nucleotides messenger systems.

Pyridonecarboxylic acids as antibacterial agents. VI. Synthesis and structure-activity relationship of 7-(alkyl, cycloalkyl, and vinyl)-1-cyclopropyl-6-fluoro-4-quinolone-3-carboxylic acids

The title compounds (1a-i) have been synthesized starting with ethyl 1-cyclopropyl-6,7-difluoro-4-quinolone-3-carboxylate (2). The 7-cyclopropyl and 7-vinyl derivative (1e and 1i) exhibited potent in vitro antibacterial activities against both gram-positive and gram-negative bacteria, being equipotent with ciprofloxacin (CPFX) except for the activity against Pseudomonas aeruginosa. The two compounds were significantly less toxic than CPFX in terms of convulsion-induction as determined by intracerebral administration to mice, but showed lower urinary recoveries on intravenous administration.

Portal venous invasion by pancreatobiliary carcinoma: diagnosis with intraportal endovascular US

PURPOSE

To evaluate use of intraportal endovascular ultrasonography (IPEUS) in diagnosing portal venous invasion by pancreatobiliary carcinoma.

MATERIALS AND METHODS

IPEUS was performed in 26 consecutive patients with pancreatobiliary carcinoma. All patients underwent surgery. IPEUS was performed intraoperatively in 20 cases and preoperatively in six. The sonographic criterion for detection of portal venous invasion was obliteration of the echogenic band of the portal vein. The IPEUS results were compared with those of computed tomography (CT) and arterial portography.

RESULTS

Vascular invasion was confirmed with use of resected specimens in seven patients and operative findings in five patients. For diagnosis of portal venous invasion, the sensitivity, specificity, and overall accuracy of IPEUS were all 100%; respective values were 92%, 64%, and 77% for angiography and 50%, 79%, and 65% for CT.

CONCLUSION

IPEUS allows detection or exclusion of early invasion of the portal venous wall by pancreatobiliary carcinoma.

Neuroblastoma of parotid gland: report of a case and immunohistochemical characteristics

A case of a parotid mass in a 2-year-old boy, postoperatively diagnosed as neuroblastoma, a rare tumour not previously reported in the parotid gland is presented. The neoplasm developed within the parotid gland as a painless mass without regional lymphadenopathy. Histopathologically, the tumour showed primitive nerve cells-neuroblasts-with round or oval dark basophilic nuclei and scanty cytoplasm. The cells were arranged in circular rosettes around an eosinophilic mass consisting of very fine filaments originating in the tumour cells or papillary configuration and sometimes scattered in the poorly developed stroma. Immunohistochemical evaluation of the tumour showed a positive immunoreactivity for vimentin, alpha and beta subunits of S-100 protein, neurone-specific enolase (NSE), substance P, met-enkephalin and chromogranin but cytokeratins, desmin, actin, myosin, glial fibrillary acidic protein (GFAP) and calcitonin gene related peptide (CGRP) were negative. The histopathological and immunohistochemical findings conclude a diagnosis of neuroblastoma of the parotid gland.

[Organ xenotransplantation using human complement regulatory factor gene]

For the success of xenotransplantation, hyperacute rejection must be controlled. Hyperacute rejection is induced by the activation of complement system via alternative pathway and/or classical pathway. Complement regulatory factors can inhibit activation of complement system via the both pathways. To overcome hyperacute rejection in organ xenotransplantation, gene engineering in the establishment of xeno-endothelial cells and transgenic animals (mouse and pig) using human complement regulatory factors are studied. In the near future, transgenic pig using human complement regulatory factor genes can be used as a potential donor in organ xenotransplantation.

[A case of acute cervical spinal epidural hematoma caused by extradural arterio-venous malformation]

The authors report a rare case of acute cervical epidural hematoma caused by the hemorrhage from extradural arterio-venous malformation. The patient was a 74-year-old Japanese man with a past history of total gastrectomy after being diagnosed as having gastric cancer 12 years before. Six hours prior to admission, the patient had experienced a sudden episode of severe nuchal pain radiating to both scapular areas, followed by rapid development of left-side Brown-Sequard Syndrome below the C4 cord level, and urinary incontinence. Plain cervical X-ray films did not show any destructive lesion suggesting a metastatic tumor. T1 and T2 weighted images of MRI demonstrated a high intensity mass lesion, suggesting an acute epidural hematoma, extending from C3 to C6 and compressing severely the left side spinal cord posteriorly. Twelve hours after the onset of symptoms, emergency laminectomy from C3 to C6 was performed and a fresh epidural clot with small vascular tissue was totally removed. Histological examination of the small vascular tissue in the hematoma revealed arterio-venous malformation. The postoperative recovery of the patient was dramatic. He regained full muscle strength and there was complete disappearance of sensory deficits 2 weeks after the operation. Although acute spinal epidural hematoma caused by extradural arterio-venous malformation is a rare clinical entity, MRI is the most helpful diagnostic tool for this condition. It should be stressed that accurate neuroradiological diagnosis and prompt surgical decompression of the spinal cord are essential to obtain an excellent surgical outcome.

Altered frequency-dependent characteristics of the cardiac baroreflex in essential hypertension

Blood pressure (BP) oscillations contain rhythmic components of low-, mid-, and high-frequency bands (0.02-0.06, 0.07-0.14, 0.15-0.40 Hz, respectively). Baroreceptors may sense each BP oscillation and induce a buffer reaction. To clarify the frequency-dependent baroreflex response and its possible alteration in patients with high BP, both BP (Finapres) and the RR interval (electrocardiogram) were continuously monitored in untreated patients with essential hypertension (EH) (n = 52) and normotensive subjects (NT) (n = 43). The magnitude and phase response of cardiac beats to BP oscillations were examined by transfer function analysis. Spontaneous baroreflex sensitivity was assessed by linear regression analysis of the BP and RR oscillations. The heart rate responded linearly to BP oscillations in more subjects at mid- and high-frequency bands (83% or more) than at the low-frequency band (60% or less). The phase was approximately zero at the high-frequency band and was consistently negative at the mid- and low-frequency bands. In general, all frequency gains were significantly and positively correlated with spontaneous baroreflex sensitivity. Each frequency gain was smaller in EH patients than in NT subjects, the high-frequency gain more so than the gains at the lower frequencies. In seven young EH patients, treatment with a beta 1-adrenoceptor selective blocker normalized the high-frequency gain and tended to increase the gains at the lower frequencies. These results suggest that the spontaneous baroreflex modulates RR oscillations over a broad frequency range from 0.02 to 0.40 Hz; the effect was most marked at frequencies higher than 0.07 Hz. Furthermore the frequency-dependent characteristics of the cardiac baroreflex were altered in essential hypertension partly because of an increased beta-adrenergic activity.

Constrictive effects of paraquat on the ductus arteriosus in fetal rats

Rats on day 21 of pregnancy received a subcutaneous injection of paraquat (2, 7 or 25 mg/kg). The inner diameter of the ductus arteriosus (DA) of their fetuses was measured using the whole-body freezing method 1, 3, 6 and 24 hours after injection. The 7 mg/kg dose group showed a significant constriction of the DA 3 hours after paraquat treatment. The 25 mg/kg dose group showed a significant constriction 3 and 6 hours after treatment. The constrictive effect was dose-dependent, that is, the magnitude of constriction observed 3 hours after paraquat injection was greater in the 25 mg/kg dose group than in the 7 mg/kg dose group. The 2 mg/kg dose group showed no significant change in the inner diameter of the DA at any point of measurement (1, 3, 6 and 24 hours after injection), compared to the saline treated controls. These results indicate that paraquat induces constriction of the fetal rat DA in a dose-dependent manner when administered in late stages of gestation, and that this effect of paraquat is not seen at a dose level of 2 mg/kg.

Endothelin-1 promotes corneal epithelial wound healing in rabbits

This study is an attempt to determine the effect of endothelin-1 (ET-1)-containing eyedrops on the rate of corneal epithelial wound closure in rabbits. After corneal epithelial debridement of about 50-60 mm2 with n-heptanol, eyedrops containing either 10(-8) M ET-1 or 10(-6) M ET-1 were applied at five different times for the next three days. The wound was serially photographed 12, 24, 36, 48, 60 and 72 hours later to measure the extent of healing with a computerized planimeter. The respective wound healing rate at 10(-6) and 10(-8) M ET-1 was 1.293 +/- 0.040 mm2/hour (n = 11) and 1.262 +/- 0.087 mm2/hour (n = 6), respectively. These rates were 29% (p < 0.01) and 26% (p < 0.05) above the control value, 1.005 +/- 0.063 mm2/hour (n = 13). Reepithelialization was not associated with any epithelial hyperplasia, neovascularization or conjunctival hyperemia. These results suggest that ET-1-containing eyedrops could be of therapeutic value in the remedy of corneal epithelial defects.

[Efficacy and safety of electroshock therapy without convulsions under general anesthesia in senile depression]

We examined the efficacy and safety of electroshock therapy (EST) under general anesthesia in 26 depressed patients (9 males, 17 females, age range 55-79). The scores of the Hamilton Psychiatric Rating Scale for depression were significantly decreased after EST and clinical symptoms such as depressive mood. psychomotor retardation, anxiety, agitation, suicidal tendencies, hypochondria and sleeplessness improved in all of the patients. Complications included amnesia (16/26), delirium (3/26) and transient arrhythmia (1/26) after EST, but neither lethal nor lasting complications were observed. In summary, EST was an effective and convenient method of treatment for senile depression.

Selective inhibition of a step of myotube formation with wheat germ agglutinin in a murine myoblast cell line, C2C12

Myoblast cells, C2C12, which is an established cell line from satellite cells of skeletal muscle of C3H mouse, start to fuse and form multinucleated cells (myotubes) and begin to express creatine phosphokinase and myosin, when culture medium is changed from the growth medium to the differentiation medium. Among the 12 lectins that we tested, wheat germ agglutinin apparently suppressed the myotube development judged by phase-contrast microscopy, but did not affect the induction of creatine phosphokinase activity. The addition of N-acetylglucosamine or N,N',N"-triacetylchitotriose, which is a specific ligand for wheat germ agglutinin, to the differentiation medium, recovered this apparently suppressive effect of wheat germ agglutinin on the myotube development. Tachypleus tridentatus (Japanese horseshoe crab) lectin that specifically recognizes N-acetylneuraminic acid, one of the sialic acids, showed no effect on the myotube development. It was suggested that wheat germ agglutinin suppressed the process through recognizing N-acetylglucosamine containing sugar. Surprisingly, even in the presence of wheat germ agglutinin, the ratio of mononucleated cell numbers to the genomic DNA content, which represents the fusion level, decreased after incubation in the differentiation medium, indicating that even when wheat germ agglutinin was present in the medium, cell fusion, which is the initial step of the myotube formation, occurred. Immunostaining with anti-skeletal muscle myosin antiserum confirmed that the myosin expressing cells actually fused and formed multinucleated cells. Their shape, however, was thin compared to that in the absence of wheat germ agglutinin. We propose that the membrane fusion step to form myotubes is composed of two distinct steps in C2C12; one fusion step is to form long and thin myotubes from mononucleated cells and the other one is to develop fat myotubes. Wheat germ agglutinin specifically inhibits the latter fusion step.

GABA-ergic and substance P-ergic double-innervation to noradrenergic neurons in the rat locus coeruleus

Synaptic contacts between noradrenaline (NA) neurons and GABA (gamma-aminobutyric acid) afferents and/or substance P (SP) afferents in the locus coeruleus (LC) were examined by a combination of immunoelectron microscopic mirror method and double-immunostaining method. For visualization of NA and GABA, we used antibodies against NA and GABA synthesizing enzymes, i.e., tyrosine hydroxylase (TH) and glutamic acid decarboxylase (GAD). GAD-immunoreactive (IR) and SP-IR axon terminals often made synaptic contacts with NA neurons, respectively. Furthermore, we identified that a single NA neuron simultaneously receives synaptic inputs from GAD-IR and SP-IR afferents. These NA neurons made symmetrical synaptic contacts with GAD-IR axon terminals and asymmetrical contacts with SP-IR axon terminals. This suggests that central NA neuronal mechanisms are affected by GABA and SP neurons in a different manner.

Enhancement of tumor proliferation by cyclosporine A in early phase of experimental hepatic metastasis

The effect of cyclosporine A (CsA) on in vivo growth of hepatic metastasis was studied. Murine colon 38 tumor cells (1 x 10(5) were inoculated via the superior mesenteric vein. Mice were grouped depending on CsA dosage and time schedules: Group A: CsA 30 mg/kg body weight on the 7, 8 and 9th post tumor inoculation days by gavage; Group B: CsA 15 mg/kg body weight 30 min before tumor inoculation and 2 times more at 24 h intervals; Group C: CsA 30 mg/kg body weight at the same dose timing as Group B. Measurement of the diameter of the largest tumor serially by weekly laparotomy up to 4 weeks revealed that the tumor growth rates were significantly greater in Groups B and C than those in Group A or the control (without CsA). The mean tumor doubling times in the control, and Groups A, B and C were 2.2 +/- 1.3, 2.0 +/- 0.5, 1.5 +/- 0.4 and 1.3 +/- 0.8 days, respectively. The mean tumor numbers of hepatic metastasis were 13.2 +/- 8.3, 11.3 +/- 7.3, 19.4 +/- 8.7 and 19.6 +/- 6.8, respectively. Values of tumor proliferation index obtained by bromodeoxyuridine immunohistochemistry were 10.0 +/- 6.1%, 14.9 +/- 8.0%, 28.6 +/- 8.2% and 30.1 +/- 12.4%, respectively, with significant differences (Groups B and C vs. A or control, P < 0.05). In vitro MTT assay showed that cell viability rates were greater than 100% in the medium containing CsA concentrations of less than 10(-7) mol/liter. However, a cytostatic effect of CsA was apparent at higher concentrations. In contrast to the previous in vivo finding of a cytostatic effect of CsA on tumor cells, we found a cytoproliferative action when CsA was administered early in the course of metastatic tumor implantation in the liver. The mechanism of cytoproliferative effect of CsA is unknown but may involve multiple factors.

Pelvic actinomycosis presenting with a rectal stricture: report of a case

We present herein the case of a patient with actinomycosis involving the pelvic cavity, who presented with a rectal stricture. It is rare for this type of actinomycosis to be accurately diagnosed preoperatively, but a precise diagnosis, made using needle biopsy guided by computed tomography allowed for successful treatment by resection of the granulation tissue surrounding the rectal stricture through a transsacral approach.

Effects of bromocriptine in Huntington chorea. Case report

1. The effects of bromocriptine (BC) on choreiform movement were compared with those of bromperidol (BP) and fluphenazine (FLZ) in a patient with Huntington disease. The patient (male, 42 years old) was treated with BP (15 mg/day, 4 weeks), FLZ (3 mg/day, 4 weeks), low dose of BC (5 mg/day, 4 weeks) and relatively high dose of BC (10 mg/day, 8 weeks). The CSF content of homovanilic acid (HVA) was assayed at last day of the each drug trial. The efficacy of the drugs was evaluated by electromyography. 2. Although BP and FLZ did not succeed to ameliorate the choreiform movement, both low dose and high dose BC showed rapid improvement of the involuntary movement. The CSF HVA concentration was 35.0 ng/ml before beginning treatment. Whereas FLZ and high dose of BC substantially increased the levels of HVA after the dosage (49.3 and 53.1 ng/ml, respectively), moderate increase of HVA (41.5 ng/ml) was observed when the low dose of BC was administered. These observations suggest that increase of CSF HVA might be necessary for clinical improvement of choreiform movement but not correlate with the degree of improvement and dopamine agonists could be useful drug for the treatment of choreiform movement which is refractory to the administration of neuroleptics.

Comparison of antinociception induced by supraspinally administered L-arginine and kyotorphin

1. Intracerebroventricular (i.c.v.) or intracisternal (i.cist.) administration of kyotorphin (KTP), an endogenous Met-enkephalin releaser, at 5 micrograms per mouse, and L-arginine (L-Arg), a possible KTP precursor, at 30 micrograms per mouse, elicited antinociception in mice to a similar extent, as assessed by the tail-flick test. 2. Intracisternal preadministration of anti-KTP serum abolished the effect of i.cist. KTP and i.c.v. or i.cist. L-Arg, but not of i.c.v. KTP. 3. The antinociceptive effects of i.cist. KTP and of i.c.v. or i.cist. L-Arg disappeared in reserpinized mice, whereas the effect of i.c.v. KTP was unaffected by treatment of mice with reserpine. 4. Intrathecal (i.t.) phentolamine markedly reduced the antinociception induced by i.cist. KTP and by i.c.v. or i.cist. L-Arg, but not by i.c.v. KTP. 5. Intrathecal methysergide attenuated the antinociceptive effects of i.cist. KTP, but not of i.c.v. KTP and i.c.v. or i.cist. L-Arg. 6. These results suggest that the antinociception produced by i.cist. KTP, but not by i.c.v. KTP, is mediated by the brainstem-spinal noradrenergic and 5-hydroxytryptaminergic systems, and that L-Arg given i.c.v. or i.cist. increases KTP formation in the lower brain, possibly the brainstem, resulting in antinociception mediated by the descending noradrenergic system. Therefore, the regional distribution of KTP receptors and KTP synthetase in the brain does not appear to be common.

Low oxygen tension decreases receptor binding of peptide growth factors in dermal fibroblast cultures

We have investigated receptor binding of epidermal growth factor (EGF) and transforming growth factor-beta 1 (TGF-beta) in cultures of human dermal fibroblasts exposed to low (2%, hypoxia) or standard (20%) oxygen tension. Compared to standard oxygen, the binding of both 125I-TGF-beta and 125I-EGF in low oxygen tension was diminished by a mean of 65 and 62%, respectively (P < 0.02), and was reversed by reexposure of cultures to standard oxygen tension. Low oxygen tension decreased the number of binding sites of both EGF (mean = 44%) and TGF-beta (mean = 33%). Preincubation of the media in the two different oxygen conditions showed that alterations in the redox potential of the medium was not responsible for the changes observed in receptor binding. As shown by Northern analysis, diminished TGF-beta receptor binding in hypoxia was accompanied by up to a 10-fold decrease in mRNA levels of TGF-beta type II receptor. We conclude that low oxygen tension decreases EGF and TGF-beta receptor binding and synthesis.

Co-existence of PACAP and nitric oxide synthase in the rat hypothalamus

The possible co-existence of pituitary adenylate cyclase-activating polypeptide (PACAP)-38 and nitric oxide synthase (NOS) in the rat hypothalamus was examined by a combination of PACAP-immunocytochemistry and NADPH-diaphorase histochemistry. Virtually all PACAP-38-immunoreactive neurones in the paraventricular and supraoptic nuclei exhibited NADPH-diaphorase activity. Since NADPH-diaphorase activity was identical to NOS-immunoreactivity in the magnocellular neurosecretory neurones, this finding indicates that the PACAP neurones synthesize NO.