Two new taxane diterpenoids from the seeds of the Chinese yew, Taxus yunnanensis

A new taxoid and a taxinine analogue were isolated from the seeds of the Chinese yew, Taxus yunnanensis. The structures were established as 13 alpha-acetoxy-5 alpha-(3'-dimethylamino-3'-phenyl)-propionyloxy-11(15-->1)-abeotaxa- 4(20),11-diene-9 alpha, 10 beta-diol and 2 alpha-acetoxy-5 alpha-cinnamoyloxy-9 alpha, 10 beta-dihydroxy-taxa- 4(20),11-diene-13-one on the basis of 1D, 2D NMR, and MS spectral analysis.

Three new bicyclic taxane diterpenoids from the needles of Japanese yew, Taxus cuspidata Sieb. et Zucc

Three new bicyclic taxane diterpenes were isolated from the needles of the Japanese yew, Taxus cuspidata Sieb. et Zucc. Their structures were established to be 7,9,10,13-tetraacetoxy-5-cinnamoyloxy-4-hydroxy-methyl-8,12,15,15- tetramethyl-bicyclo[9.3.1] pentadeca-3,8,11-trien-2-ol (2,20-dideacetyl taxuspine X), 7,9,10,13,20-pentaacetoxy-5-cinnamoyloxy-8,12,15,15-tetramethyl bicyclo[9.3.1] pentadeca-3,8,11-trien-2-ol (2-deacetyl taxuspine X), and 9,10,13,20-tetraacetoxy-5-cinnamoyloxy-8,12,15,15-tetramethyl-bicyclo[9.3.1] pentadeca-3,8,11-trien-2,7-diol (2,7-dideacetyl taxuspine X) with the aid of spectroscopic techniques and by comparing with taxuspine X.

Radical surgery after neoadjuvant intra-arterial chemotherapy in stage IIIb squamous cell carcinoma of the cervix

We examined the efficacy and safety of neoadjuvant intra-arterial chemotherapy (NAC) followed by radical hysterectomy and/or radiotherapy in patients with stage IIIb cervical cancer. Treatment consisted of bilateral internal iliac artery infusion of cisplatin or carboplatin and peplomycin every 21 days for two courses. Patients who responded to NAC underwent radical surgery. Patients who did not respond to NAC were treated with pelvic radiotherapy. Complete response was achieved in 2 (7.1%) of 28 patients, while a partial response was observed in 17 (60.7%) and stable disease in 9 (32.1%) patients. Sixteen patients (57.2%) were able to undergo surgery. The median blood loss (674 ml) and operating time (232 min) for radical surgery in patients with stage IIIb disease was similar to that in patients with stages Ib to IIb disease. No intra-operative or immediate postoperative complications were observed. The 5-year disease-free survival (DFS) for patients who underwent surgery (81.3%) was higher than for patients who underwent radiotherapy after NAC (31.3%). Radical surgery after NAC for stage IIIb disease was safe, and a survival benefit followed by surgery with or without radiotherapy.

[The appropriate time for the assessment of Helicobacter pylori eradication]

As all of the guidelines on the management of H. pylori infection suggest, the assessment of the eradication is generally performed at least 4 weeks after the completion of eradication treatment. However, H. pylori occasionally re-appears after one month, even the successful eradication was confirmed by the guideline. In this study, we investigated the appropriate time for the assessment of H. pylori eradication, mainly by using 13C urea breath tests (UBT) as a positive standard. From July 1992 to December 1997, 386 patients with H. pylori infection received eradication treatments. The presence of H. pylori was assessed by rapid urease test, UBT, culture and histologic examination. Eradication of the bacteria was determined by the negative results in all of these four tests. At 4 weeks after completion of therapy, 312 cases (80.8%) were judged as being free of H. pylori. Mean observation period was up to 12 months, and 113 cases were followed up to more than 1 year, and 50 cases were followed up to more than 2 years. H. pylori had re-appeared in 3 cases after 3 months, 1 case after 6 months, 2 cases after 12 months, and 1 case 24 months after the treatment, respectively. For the purpose of more accurate diagnosis, the assessment of eradication of H. pylori should be performed at 1 year after the completion of therapy. Since all the recrudescence could be diagnosed with UBT earlier and be confirmed by the other tests later, UBT is recommended as a useful methods in the assessment of Helicobacter pylori eradication.

[Helicobacter pylori as a new paradigm in the pathogenesis of upper GI diseases]

Discovery of H. pylori from human gastric mucosa have induced an evolution in the concepts of upper GI diseases, especially in those of gastritis, peptic ulcer and gastric cancer. A new classification of gastritis, Sydney system and updated Sydney system, are proposed and commonly used in worldwide. Eradication treatment against H. pylori infection can completely improve the histologic gastritis, which is defined by the infiltration of inflammatory cells. In gastric and duodenal ulceration, the eradication of H. pylori accelerates the ulcer healing without acid suppression, and prevents the ulcer recurrence without any maintenance therapy. These accumulating data suggest that H. pylori could have an etiologic relation to ulcer diseases, because these are a kind of intervention study on etiology. Thus, in ulcer diseases, H. pylori is proven to play an etiologic role. On the basis of these studies, a new treatment strategy is proposed in upper GI diseases. This is a new paradigm on upper GI diseases.

Ten minute 13C-urea breath test for the diagnosis of Helicobacter pylori infection

We investigated the utility of a 10-min 13C-urea breath test (13C-UBT) using 100mg of 13C-urea; this is a simple and rapid method for the detection of Helicobacter pylori infection. One hundred and fifty-one patients in whom the identification of H. pylori was established by rapid urease test, culture, and histology of six biopsy specimens underwent 254 13C-UBT examinations before and/or after eradication treatment. In the 133 patients who did not receive eradication treatment, the calculated sensitivity of the 10-min 13C-UBT was 99.4% and specificity 100% when the cut-off point was set at 3.5/1000, using a mass spectrometer. In the 121 patients who received eradication treatment, this cut-off point gave a sensitivity of 86.7%, a specificity of 99.1%, and a positive predictive value of 92.9%, with a negative predictive value of 98.1%. There were no significant differences between the diagnosis of H. pylori infection at 1 month and more than 3 months after the endpoint of eradication treatment. The 10-min 13C-UBT is suitable for the diagnosis of H. pylori infection before and after eradication treatment.

Cell death in the brain of the HTx rat

The structural changes in the hydrocephalic brain suggest that cell death must be a significant factor in the loss of cortical mantle thickness and cell numbers. In the developing hydrocephalic brain a similar conclusion might also be reached. We present data suggesting that in the developing hydrocephalic HTx rat brain, there are at least two processes that underlie the structural deficit in the cortex. The first is abnormal development of the cortex probably resulting from a combination of the genetic defect and blockage of CSF circulation in the fetus. The second is a direct consequence of raised intracranial pressure and is manifested in a lack of development of glial cells in the neonatal brain and in the loss of myelination and neurones as pressure rises after birth, particularly after skull plate fusion. We find little evidence of increased cell death by apoptosis, recording instead a decrease in apoptotic index. There is evidence that necrosis must have occurred.

Two new taxanes from Taxus chinensis var. mairei

Two bicyclic taxanes and two abeotaxanes were isolated from the bark and the needles of the Chinese yew, Taxus chinensis var. mairei. The structures of the two new compounds, 5-( N,N-dimethyl-3'-phenylisoseryl)taxachitriene A and 13-acetyl-9-deacetyl-9-benzoyl-10-debenzoyltaxchinin A, were established by spectral methods.

Safety and efficacy of one-week triple therapy for eradicating Helicobacter pylori in children

BACKGROUND

Proton pump inhibitor-based eradication therapy of Helicobacter pylori has been widely studied in adults, but there have been only a few reports about this therapy in children. The purpose of this study was to investigate the safety and efficacy of 1-week triple therapy for eradication of H. pylori and ulcer healing in children.

PATIENTS AND METHODS

We prospectively studied 15 patients aged 2-17 years (5 with gastric ulcers, 8 with duodenal ulcers, and 2 with nodular gastritis alone). Three patients had H2 blocker-resistant duodenal ulcers. Patients received 0.75 mg/kg of lansoprazole b.i.d., 25 mg/kg of amoxicillin b.i.d., and 10 mg/kg of clarithromycin b.i.d. for 7 days. No additional therapy (including antisecretory drugs) was administered to any patients following eradication therapy. Patients underwent endoscopy to obtain antral biopsies (culture, urease test and histology) and to evaluate the mucosal status, and underwent a 13C-urea breath test before and 4-8 weeks after the completion of a 1-week course of therapy.

RESULTS

All patients received the full drug regimen. Endoscopy showed complete healing of ulcers in 12 of 13 patients with peptic ulcer disease (92%). H. pylori was eradicated in 13 of 15 patients (87%). Diarrhea and/or an altered taste sensation occurred in 5 patients (33%). There were no hematological or biochemical abnormalities related to therapy.

CONCLUSION

The 1-week triple therapy was safe and effective for eradicating H. pylori. The present study showed that ulcer healing in juveniles is closely associated with eradication of H. pylori, and that no additional therapy is required when H. pylori is eradicated. A shorter course of eradication therapy than 2 weeks may be suitable for children with H. pylori infection.

Enhancing effects of green tea components on the antitumor activity of adriamycin against M5076 ovarian sarcoma

We have investigated the combined treatment of components of green tea with adriamycin against M5076 ovarian sarcoma, which exhibits low sensitivity to adriamycin. In M5076 tumor-bearing mice, the injection of adriamycin alone did not inhibit tumor growth, whereas the combination of theanine and adriamycin significantly reduced the tumor weight to 62% of the control level. When combined with theanine, effective antitumor activity of adriamycin was observed without an increase in the dosage. Theanine specifically increased the adriamycin concentration in the tumor by 2.7-fold. In contrast, theanine decreased the adriamycin concentrations in normal tissues. On the other hand, in vitro experiments proved that theanine inhibited the efflux of adriamycin from tumor cells, suggesting a theanine-induced increase in the adriamycin concentration in such tumors in vivo. Furthermore, the oral administration of theanine or green tea similarly enhanced the antitumor activity of adriamycin. In conclusion, the combination of theanine with adriamycin showed antitumor efficacy in spite of the non-effective dose of adriamycin on M5076 ovarian sarcoma. We have found that the modulating action of theanine is useful in clinical cancer chemotherapy.

Cloning of the rat proto-oncogene bmi-1

The bmi-1 gene was identified as a common proviral integration site in Moloney murine leukemia virus. In the present studies, we cloned and sequenced the rat bmi-1 gene by reverse transcriptase-polymerase chain reaction (RT-PCR) using degenerate PCR primers of homologous sequences between mouse and human. We found 93% identity to the mouse bmi-1 cDNA and 90% identity to the human bmi-1. The open reading frame encodes a protein of 324 amino acids. In the deduced amino acid sequence we observed 95% and 94% homology to the mouse and human, respectively. The structural motifs, a novel zinc finger motif and a putative helix-turn-helix motif, were conserved in the predicted rat BMI-1 protein. We also confirmed ubiquitous expression of bmi-1 in normal tissues except brain. These results suggest functional conservation of the bmi-1 gene in the rat.

Dual effects of anti-inflammatory 2-arylpropionic acid derivatives on a major isoform of human liver 3alpha-hydroxysteroid dehydrogenase

Nonsteroidal anti-inflammatory drugs have been shown to be potent inhibitors of mammalian 3alpha-hydroxysteroid dehydrogenase. Here, we report that the drugs of the 2-arylpropionic acid class act as both activators and inhibitors for a predominant isoform of the human liver enzyme which is involved in the metabolism of steroid hormones, bile acids, drug ketones and xenobiotic aromatic hydrocarbons. Flurbiprofen, fenoprofen, ibuprofen, naproxen, ketoprofen and suprofen stimulated the activity of the human enzyme (1.5-2.4-fold) at low concentrations of less than 20-100 microM, whereas at higher concentrations they inhibited the activity. Comparison of the effects of the structurally related compounds with the drugs revealed that the essential structure required as the activator molecule is 2-phenylpropionic acid with a hydrophobic substituent on the aromatic ring. In addition, an R-enantiomer of ibuprofen showed higher activation (3-fold) than its S-enantiomer. Kinetic analysis with respect to NADP+ concentration indicated that R- and S-ibuprofens are nonessential activators showing binding constants of 23 and 34 microM, respectively. Neither enantiomers activated, but rather inhibited the enzyme, with Met replacing Arg-276 which has been shown to interact with the 2'-phosphate of NADP+. The inhibitions of the mutant enzyme by R- and S-ibuprofens were competitive with respect to the substrate, giving Ki values of 95 and 18 microM, respectively. The results suggest that the human liver 3alpha-hydroxysteroid dehydrogenase isoform possesses the two distinct sites, activator and inhibitor sites, to which anti-inflammatory 2-arylpropionates stereoselectively bind.

G protein beta3 subunit variant and essential hypertension in Japanese

Enhanced G protein activation has been implicated to underlie the increased sodium-proton transport in blood cells, an impaired characteristic observed in 30% to 50% of patients with essential hypertension. Recently, significant association between a C825T polymorphism of the gene encoding the G protein beta3 subunit and hypertension was demonstrated in a white population, together with the finding that the T825 variant might be related to alternative splicing through unidentified mechanisms. We therefore investigated the disease relevance of this candidate gene by conducting an association study in a relatively large Japanese population. Participants comprised 718 hypertensive case subjects (without diabetes mellitus), 515 normotensive control subjects, and 191 hypertensive subjects with borderline or established diabetes mellitus; all individuals were recruited at a single institution. Genotype distribution of the C825T polymorphism was compared between hypertensive subjects, with or without diabetes, and the control group with chi2 statistics. No significant association was observed in the present study. Results were still not significant when the case group was subdivided according to more stringent classification criteria. Allele frequencies of T825 proved to be almost concordant among the 3 study groups and higher in Japanese (49.0% to 49.6%) compared with a reported prevalence of 25% to 31% in whites. Our data suggest that the T825 variant of the G protein beta3 subunit gene is unlikely to constitute major susceptibility for essential hypertension in the Japanese population studied. However, further investigation is required to answer the question of whether the lack of association reflects ethnic differences in the nature of genetic susceptibility loci.

Sustained hemoconcentration in patients with chronic atrial fibrillation, a potential risk for stroke and thromboembolic complications. A retrospective study

Hemoconcentration has been observed during paroxysms of atrial fibrillation and at the early stage of chronic atrial fibrillation. The present study was designed to determine how long the hemoconcentration continues after complete transition to atrial fibrillation from sinus rhythm by retrospective long-term observation of 9 patients with chronic atrial fibrillation and 18 age-gender matched control patients. Hematocrit levels significantly increased with transition to chronic atrial fibrillation from sinus rhythm (from 44.88 +/- 0.87% to 46.87 +/- 1.12%, p < 0.01) and remained high for at least another 4 years. They remained unchanged throughout the observation period in the control patients. There is a significant difference in the hematocrit level between patients with chronic atrial fibrillation and control patients (p < 0.001). The hemoconcentration may present a potential risk for stroke and thromboembolic complications.

Three novel bicyclic 3,8-secotaxane diterpenoids from the needles of the chinese yew, taxus chinensis var. mairei

Three novel (1-3) and five known bicyclic 3,8-secotaxane diterpenoids were isolated from the needles of the Chinese yew, Taxus chinensis var. mairei. The structures of the new compounds were established, respectively, as (3E,7E)-2alpha,10beta, 13alpha-triacetoxy-5alpha,20-dihydroxy-3,8-secotaxa-3,7, 11-trien-9-one (1), (3E,7E)-2alpha,10beta-diacetoxy-5alpha,13alpha, 20-trihydroxy-3,8-secotaxa-3,7,11-trien-9-one (2), and (3E,8E)-7beta, 9,10beta,13alpha,20-pentaacetoxy-3,8-secotaxa-3,8,11-triene-2alpha, 5alpha-diol (2-deacetyltaxachitriene A) (3), on the basis of spectral analysis. The other five bicyclic taxane diterpenoids were determined as canadensene, 5-deacetyltaxachitriene B, taxachitriene B, taxuspine U, and taxuspine X by comparison of their physical properties and spectral data with those previously reported.

[Effect of KW-8232 on bone turnover in ovariectomized rats]

The effects of 3-[bis(4-hydroxyphenyl)methyl]-2-[4-(2-chlorophenyl)- piperazin-1-ylcarbonyl]-1-(2-dimethylamino ethyl) indole methanesulfonate (KW-8232) on the bone turnover in ovariectomized (OVX) rats were studied by the oral administration for 6 weeks. KW-8232 inhibited the decreased bone mineral densities of the femur and tibia in OVX rats. OVX induced the increase of serum alkaline phosphatase and osteocalcin levels, markers of high bone turnover, and also increased urinary hydroxyproline, pyridinoline and deoxypyridinoline excretion, markers of bone resorption. KW-8232 significantly inhibited the increase of serum alkaline phosphatase level at doses of 10 and 30 mg/kg and the increase of osteocalcin level at a dose of 3 mg/kg. KW-8232 (1 mg/kg) markedly suppressed the OVX-induced increase of urinary hydroxyproline, pyridinoline and deoxypyridinoline excretion. KW-8232 didn't affect serum calcium level, but significantly decreased urinary calcium excretion at doses of 10 and 30 mg/kg. These results suggest that KW-8232 decreased bone loss in this model by suppressing bone resorption.

Involvement of caspase-like proteinases in apoptosis of neuronal PC12 cells and primary cultured microglia induced by 6-hydroxydopamine

Activation of proteolytic enzymes, including the caspase family of proteinases, is a feature characteristic of the apoptotic program. In the present study, we examined a potential role of intracellular proteinases in the death of neuronal PC12 and primary cultured rat microglial cells induced by 6-hydroxydopamine (6-OHDA). In both neuronal PC12 and microglial cells, 6-OHDA (10-200 microM) induced apoptosis in a dose-dependent manner as judged by the DNA break. The 6-OHDA was ineffective in Bcl-2-overexpressing neuronal PC12 cells. Pretreatment of these cells with two caspase inhibitors, acetyl-Try-Val-Ala-Asp-aldehyde and acetyl-Asp-Glu-Val-Asp-aldehyde, prevented the 6-OHDA-induced apoptosis. Pepstatin A and leupeptin, potent inhibitors of aspartic and cysteine proteinases, respectively, partly inhibited the apoptosis of microglia but not neuronal PC12 cells. In contrast, GBR12935, a dopamine uptake inhibitor, significantly inhibited the apoptotic death of neuronal PC12 cells but not microglia. These results suggest that mechanisms by which 6-OHDA induces apoptosis in these two cell types are distinct; 6-OHDA incorporated into neuronal PC12 cells and its metabolites may activate the caspase-like enzymes, whereas oxidative metabolites of the agent produced extracellularly may activate the caspase and the endosomal/lysosomal proteolytic systems in microglia.

Effect of KW-8232, a novel anti-osteoporotic agent, on bone loss in sciatic neurectomized rats

The purpose of this study was to evaluate the effects of 3-[bis(4-hydroxyphenyl)methyl]-2-[4-(2-chlorophenyl)-piperazin-1-+ ++ylcarbonyl]-1-(2-dimethylaminoethyl) indole methanesulfonate (KW-8232), a novel anti-osteoporotic agent, on bone loss in neurectomized rats. We also investigated the effect of KW-8232 on bone resorption in this animal model. Male Sprague-Dawley rats underwent unilateral hind-limb immobilization by sciatic neurectomy. KW-8232 (3, 10 and 30 mg/kg, p.o.) was effective in inhibiting femoral bone loss. KW-8232 decreased urinary pyridinoline and deoxypyridinoline excretion. These results indicate that KW-8232 effectively prevents the bone loss due to immobilization.

Antibodies against Helicobacter pylori were detected in the cerebrospinal fluid obtained from patients with Guillain-Barré syndrome

We examined the antibodies against Helicobacter pylori proteins in the cerebrospinal fluid (CSF) of 7 patients with Guillain-Barré syndrome (GBS). Crude H. pylori antigens, fractionated heat shock protein (HSP), and urease B (UB) from H. pylori antigens were separated by SDS-PAGE. With Western blot analysis, four of seven CSF samples had several IgG antibodies against H. pylori proteins, including HSP and UB. No cross reactivity against Campylobacter jejuni was observed. These antibodies may be involved in the immune responses of patients with GBS.

[Clinical experience of transurethral collagen injections for urinary stress incontinence--analysis of subjective symptoms]

We evaluated the results of transurethral collagen injections for urinary stress incontinence. Twenty five women (mean age was 61.3 years) with urinary incontinence were treated with transurethral collagen injections using local or spinal anesthesia. The mean follow-up was 11.7 months (range 2 to 30). We examined the results based on subjective symptoms for incontinence. We could judge convalescence efficacy to some degree 1 month after operation, but patient age, type of stress incontinence, pad test and volume of collagen were not significantly different between patients who were cured and those not cured. Of the patients who needed injections more then 2 times, treatment was effective in type III patients. The patients whose symptoms were improved 3 months after operation wanted a re-operation when their incontinence recurred. Injection of transurethral collagen appears to be a safe and effective method for treating urinary incontinence. This procedure is a first choice for urinary incontinence.

Two cases of endometrial adenocarcinoma arising from atypical polypoid adenomyoma

Atypical polypoid adenomyoma (APA) most frequently presents as an endometrial polyp in premenopausal women and is believed to follow a benign course. In hysterectomy specimens from postmenopausal Japanease women, the endometrium contained an APA with an area of endometrial adenocarcinoma. A convincing transition zone between the APA and the adenocarcinoma was seen in our cases, suggesting that APA may develop into endometrial adenocarcinoma in postmenopausal women.

ATP7B (WND) protein

Wilson's disease is a genetic disorder of copper metabolism characterized by the excessive accumulation of this metal in the liver. The gene for Wilson's disease, designated ATP7B, encodes a copper transporting P-type ATPase expressed predominantly in the liver. Over 60 disease specific mutations of ATP7B have now been reported in patients with Wilson's disease. The gene for ATP7B is approximately 80 kb and contains 21 exons that encode an approximately 7.5 kb transcript. Recent studies that focus on the structure and expression of the ATP7B protein support its role as a copper transporter involved in the intracellular trafficking of copper in hepatocytes. The introduction of functional ATP7B protein by recombinant adenovirus mediated gene delivery will be a potential approach for correcting Wilson's disease.

[The effect of continuous and intravenous application of carteolol chloride on tissue blood flow in the rabbit optic nerve head]

The effect of systemic application of carteolol, which induces almost the same plasma carteolol level as obtained by a long-term instillation on rabbit eyes, on the tissue blood flow in the optic nerve head (ONH) was investigated in rabbits. The plasma carteolol levels in 27 rabbits which received 3-week instillation, intravenous injection (10, 20, 30 micrograms/kg), or continuous intravenous injection (2.5, 5, 20, 40, 80 micrograms/kg/hr) were measured by gas chromatography-negative-ion chemical ionization mass spectrometry. The plasma level with 3-week instillation was determined as 5.55 ng/ml and a continuous intravenous injection (5 micrograms/kg/hr) caused nearly the same plasma level. The intravenous injection of this dose significantly increased the ONH blood flow which was determined by the hydrogen clearance method, compared with controls from 30 minutes to 2 hours after the injection (n = 10). The vascular resistance in ONH was thought to be reduced because mean blood pressure and intraocular pressure (n = 6) were not significantly changed. The results suggest that the plasma carteolol level in rabbits after a long-term instillation can increase ONH blood flow due to a decreased vascular resistance.