[A comparison of two doses of tamoxifen in patients with advanced breast cancer: 20 mg/day versus 40 mg/day]

In order to establish the optimal dose of Tamoxifen in the treatment of advanced breast cancer, a randomized trial comparing 40 mg/day to 20 mg/day was conducted. Thirty-four patients were entered in the study, and the results were as follows: 1) The response rates of 40 mg/day and 20 mg/day were 35.3% and 23.5%, respectively, without any significant difference between them. 2) The response rate in relation to metastatic sites were also similar at the two dose levels. 3) There was no significant difference in the median duration of response, either. 4) Among nine patients, one PR and three NC case were observed with subsequent increase of the dosage to 40 mg/day after 20 mg/day. The conclusion from this study was that 20 mg/day of Tamoxifen was suitable as an initial dosage for the treatment of advanced breast cancer. But, in certain cases who failed to respond, a dose-escalation to 40 mg/day appeared to be effective.

[Amelioration of cisplatin-induced vomiting and anorexia by methylprednisolone]

Amelioration of cisplatin (CDDP)-induced vomiting and anorexia by methylprednisolone (MP) was studied using conscious dogs. The incidence of vomiting was 88.9% and the mean number of emetic episodes was 8.22 +/- 1.25/dog during 5 hours after i.v. administration of 1.5 mg/kg CDDP in 9 dogs. In control dogs, food intake on the day after administration of CDDP was markedly reduced to 60 +/- 22.4 g/day from 461 +/- 23 g. Continuous high-dose infusion of MP (10 mg/kg, 10 min before the start of CDDP infusion and 50 mg/kg/h for 5 h) markedly reduced the incidence (33%) and mean number of vomiting episodes (2.00 +/- 1.51/dog) and also mitigated the reduction of food intake (350 +/- 30.6 g/day). However, continuous low-dose infusion of MP (5 mg/kg, 10 min before CDDP infusion and 16.6 mg/kg/h for 5 h) showed a little effect on CDDP-induced vomiting. Plasma MP levels after the high-dose and the low-dose regimens were 6.20 +/- 0.628 micrograms/ml and 4.66 +/- 1.72 micrograms/ml, respectively, 30 min after CDDP infusion. In both cases, MP levels gradually increased and reached to those more than twice 5 hours after CDDP infusion. Bolus administrations of MP (30 mg/kg, each time) 2 hr and 30 min before CDDP infusion also significantly reduced the mean number of emetic episodes (3.22 +/- 1.33/dog) and mitigated the reduction of food intake (325 +/- 37.3 g/day). No significant changes in catecholamines, prostaglandins, vasopressin, plasma renin activity, Na+, K+, Mg++ and osmolality in peripheral blood were noted after administration of CDDP and/or MP. The results suggest that administration of MP was effective against CDDP-induced vomiting and anorexia in dogs.

Effects of galactose depletion from oligosaccharide chains on immunological activities of human IgG

We previously reported a decrease in the content of galactose residues in oligosaccharide chains of serum IgG from patients with rheumatoid arthritis, which was presumed to affect the 3 dimensional structure of CH2 domain. In the present study, we prepared the galactose depleted IgG (agalacto IgG) and characterized its immunological activities. Significant reduction in Clq binding and Fc receptor binding was observed in agalacto IgG. However, IgM rheumatoid factor binding and protein A binding were the same as with intact IgG. Our results implied the biological function of the carbohydrate moiety of human IgG.

Leukotriene C4 and B4 in bronchoalveolar lavage fluid during biphasic allergic bronchoconstriction in sheep

To study the contribution of leukotriene C4 (LTC4), leukotriene D4 (LTD4), leukotriene B4 (LTB4), and inflammation to the antigen-induced late bronchial response, these leukotrienes, histamine, and cell differentials were evaluated in bronchoalveolar lavage fluid (BALF). Immediate and late responses were induced by Ascaris suum antigen inhalation in 11 conscious sheep. Bronchoalveolar lavage was performed on 3 separate test days, before challenge (control), during the immediate response, and during the late response. Leukotrienes were measured by radioimmunoassay after purification by reverse-phase high-performance liquid chromatography. LTB4 and LTC4 were detected in control BALF, but LTD4 was not. LTC4 and LTB4 were increased in the late response (p less than 0.05 compared with each control). The percent neutrophils recovered by bronchoalveolar lavage was increased during the late response, and this was significantly correlated with pulmonary resistance (p less than 0.01). Histamine levels in BALF were elevated during the immediate response but not during the late response. Our results suggest that histamine and LTC4 may contribute to the contraction of bronchial smooth muscle in the immediate and the late response, respectively. The increase in LTB4, a neutrophil chemotactic factor, during the late response may be responsible for the increase in the percent neutrophils.

K channels of human alveolar macrophages

The activation of macrophages has been reported to be associated with Ca-activated K permeability change. In order to study this permeability change in human alveolar macrophages, we examined alveolar macrophages electrophysiologically at a single channel level. We observed two types of Ca-activated K channel currents having conductances of 218 +/- 2 and 32 +/- 0.6 picosiemens in symmetrical 154 mmol/L KCl solutions. The characteristics, such as voltage dependency and Ca sensitivity, as well as channel conductance, were different between these two types of channel currents. Quinine (a blocker of Ca-activated K conductance), 0.5 mmol/L, reduced these channel currents by 45 +/- 8% and 31 +/- 8%. Quinine, 0.5 mmol/L, also inhibited chemiluminescence and leukotriene B4 release by 82 +/- 6 to 88 +/- 3% and 88 +/- 2%, respectively. These results suggest the presence of two types of Ca-activated K channels, which may be related to the release of inflammatory mediators from human alveolar macrophages.

Bronchoalveolar lavage during inhalation provocation test in a case of farmer's lung disease

Bronchoalveolar lavage (BAL) was performed in order to reveal inflammatory immune processes during inhalation provocation test in a patient with farmer's lung disease. Three hours after inhalation challenge the patient showed dyspnea and an increase in body temperature to 38.9 degrees C, restrictive and obstructive impairment, and a decrease in peripheral lymphocytes from, 2.8 x 10(3)/mm3 to 1.8 x 10(3)/mm3, although peripheral granulocytes increased from 4.4 x 10(3)/mm3 to 10.3 x 10(3)/mm. BAL fluid at that time showed increases in lymphocytes, granulocytes and macrophage, as well as proteins and complements, compared with that before the inhalation test. These findings indicate that with inhalation challenge in a patient with farmer's lung disease, inflammation increases vascular permeability while protein loss is followed by an increase in lymphocytes, granulocytes and macrophage; the lymphocytes migrate to the lung from peripheral blood.

Effects of qing-fei-tang (seihai-to) and baicalein, its main component flavonoid, on lucigenin-dependent chemiluminescence and leukotriene B4 synthesis of human alveolar macrophages

A traditional Chinese remedy, Qing-Fei-Tang (Seihai-to, T90), has been used for treatment of chronic respiratory diseases with long-lasting cough and sputum, e.g. chronic bronchitis. We examined the effect of T90 and its main component flavonoid, baicalein, on the lucigenin-dependent chemiluminescence (CL) and leukotriene B4 (LTB4) synthesis of human alveolar macrophages (AM). AM were obtained by bronchoalveolar lavage from patients with various respiratory diseases, including sarcoidosis, idiopathic pulmonary fibrosis, bronchial asthma, chronic bronchitis and lung cancer. CL were observed by stimulating 1 x 10(5) AM with phorbol myristate acetate in the presence of lucigenin. LTB4 were generated by incubating 1 x 10(6)/ml AM with Ca ionophore A23187 for 30 min and determined by reverse phase high performance liquid chromatography and radioimmunoassay. T90 (0.2-2.0 mg/ml) and baicalein (0.1-100 microM) inhibited both CL and LTB4 production of AM in a dose-dependent fashion. These inhibitory effects were not due to cytotoxic effects of the procedure because neither 2 mg/ml T90 nor 100 M baicalein affected the viability of AM nor lactate dehydrogenase release from AM. These results suggest that T90 exerts its effect on inflammatory lung diseases through the anti-inflammatory action, i.e. inhibiting the oxidative and arachidonate metabolism of local inflammatory lung cells.

Late asthmatic response to Ascaris antigen challenge in dogs treated with metyrapone

We developed an experimental dog preparation that shows a biphasic bronchoconstriction after allergen exposure. After anesthetization, the dogs were intubated with endotracheal tubes and manually ventilated. Respiratory resistance (Rrs) was measured by the forced oscillation method at 3 Hz. Ascaris suum, diluted from 10(-5) to 10(-2) of the extract, was inhaled during tidal breathing for 5 min. One hour before antigen challenge, 10 dogs received 70 mg/kg of metyrapone (cortisol synthesis inhibitor), and 2 h after antigen challenge 35 mg/kg of metyrapone were injected intravenously. In another 10 dogs, metyrapone was not administered. After the maximal increase in Rrs had been assessed (immediate asthmatic response), Rrs increased again 4 to 6 h after antigen challenge in 8 of the 10 dogs treated with metyrapone (late asthmatic response, 443 +/- 282% mean +/- SD of initial Rrs), which was significantly higher than Rrs 6 h after antigen challenge (124 +/- 41%) in dogs without metyrapone (p less than 0.01). In another 5 dogs, ragweed challenge with metyrapone caused no change in Rrs. Bronchoalveolar lavage at the time of the late response revealed a significant correlation between late asthmatic response and neutrophil accumulation (p less than 0.01) in all dogs. We conclude that cortisol depletion augments the occurrence of the late response. The present dog model may be a useful tool for study of the late response in bronchial asthma.

On the pathogenesis of chronic alcoholic pancreatitis from the viewpoint of experimental results in rats

To elucidate the pathogenesis of chronic alcoholic pancreatitis, light-microscopic and electron microscopic observations of pancreases from Wistar strain rats given 20% ethanol ad lib, instead of water, were performed. Results were as follows: (1) In 3 (11%) rats, focal lobular unit acinar cell damage was observed under light-microscopy. In these cases, the intercalated ducts and centroacinar cells showed proliferation independently of protein plugs in ducts. (2) After ethanol intake, several degenerative changes in the acinar cells and ductular cells were observed under electron microscopy. The earliest and most consistent change was the irregular formation of microvilli and interdigitation between the parenchymal cells, accompanied by widening of the intercellular space, especially between the acinar and centroacinar cells. After three months of ethanol intake, an increase in the lysosomes and mitochondrial alteration occurred in acinar cells, and after six months of ethanol ingestion, there was tortuous ductular proliferation accompanied by the degeneration of the ductular cells. In addition to these parenchymal changes, the capillary endothelium and nervous tissue of the pancreas showed occasional degenerative changes after three to six months of ethanol intake. These results suggest that repeated degeneration and regeneration of the ductular cells results in deformation of ductular structures, with subsequent stenosis, and represents the primary event in the development of chronic alcoholic pancreatitis in rats.

[A case of pseudoxanthoma elasticum showing various heteroptics due to infarction of right parieto-occipital lobe]

A case of pseudoxanthoma elasticum showing various heteroptics due to infarction of the right parieto-occipital lobe was reported. The patient was 48-year-old male. Angiography revealed an obstruction of the right internal carotid artery, aneurysmal dilation of the right posterior communicating artery, and obstructions of the right parieto-occipital artery and calcarine artery. A low density area was found in right occipital lobe by CT. MRI clearly identified lesions in the right cuneus and precuneus. Pseudopsia in the left homonymous quadrantanopsia, various types of visual illusion in the remaining visual field, and moreover, palinopsia were existed. Visual illusion was recognized in the early stage after the onset, while the pseudopsia was recognized about one month after the onset. Both abnormalities tended to improve from the peripheral region with the improvement of the defect in the visual field. Administration of phenytoin resulted in an improvement in the pseudopsia but it resulted in an aggravation in the visual illusion. Thus, the mechanisms of development of this phenomena were thought to be different from each other. It was found by dynamic CT that the blood flow in the primary visual cortex was rather increased in the affected site in comparison with that in the healthy site. It was speculated that the pseudopsia in the defective region of the visual field reflected a pathological repair process represented by a development of the collateral circulation. On the other hand, the visual illusion was thought to originate from visual unstability due to incomplete damage of the visual pathway at the affected site.

Bronchodilating effect of intravenous magnesium sulfate in bronchial asthma

The bronchodilating effect of magnesium sulfate (MgSO4) was studied in ten asthmatic patients with mild attacks. In five patients, 0.5 mmol/min of MgSO4 was administered intravenously for 20 minutes, and the time courses of respiratory resistance, forced vital capacity, and forced expiratory volume at 1 s were studied. In another five patients, MgSO4 dose-response curves were obtained. Soon after administration began, MgSO4 relieved bronchoconstriction in a dose-dependent manner. Maximum responses (mean +/- SE) of respiratory resistance, forced vital capacity, and forced expiratory volume were 71% +/- 3%, 117% +/- 5%, and 118% +/- 1% of initial values, respectively, and were similar to the effects of additional albuterol inhalation. The infusion of MgSO4 also improved dyspnea and piping rales in three other asthmatic patients with a severe attack. We conclude that intravenous infusion of MgSO4 produces a rapid and marked bronchodilation in both mild and severe asthma and may be a unique bronchodilating agent.

Kinetic characteristics and binding process of substrate analogs to the adenosine deaminase in the marine mussel, Mytilus edulis

1. The purified mussel enzyme deaminated several adenosine analogs with different Km and relative Vmax values. Affinity for adenine was similar to that for adenosine but the deamination rate was extremely slow. 2. Purine riboside was competitive, coformycin was a tight, slow binding inhibitor, and inhibition by both these compounds was pH-dependent. 3. Inosine, hypoxanthine, guanosine and 6-mercapto-purine riboside were slightly inhibitory. 4. The results suggested that initial binding of the substrate was guided by the adenine moiety followed by a stereospecific steering due to a ribose-dependent distortion in the complex to facilitate nucleophilic attack at C-6.

Central and peripheral airways as determinants of ventilatory function in patients with chronic bronchitis, emphysema, and bronchial asthma

We studied central and peripheral airways as determinants of ventilatory function in patients with chronic bronchitis (CB), bronchial asthma (BA), and emphysema (CPE), which were identified using the selective alveolobronchogram (SAB) (see reference 14). First, the relationship between SAB and morphologic findings in the airway was examined in 16 autopsy lungs. The irregularity indices of both central (C-II) and peripheral airways (P-II), obtained from SAB, showed a significant correlation with pathologic abnormalities in both airways (p less than 0.01). Second, SAB were obtained in 38 CB, 25 BA, and 62 CPE patients in whom pulmonary function tests were performed. In CB, C-II were significantly correlated with P-II (p less than 0.001). In CB, inspiratory lung resistance (RL) was significantly correlated with P-II (p less than 0.001) and with C-II (p less than 0.01), and FEV/VC% was significantly correlated with P-II (p less than 0.0001) but not with C-II. In BA and CPE, little correlation was observed between any SAB parameter and RL or FEV/VC%. We conclude that the present SAB parameters represent morphometric abnormalities of the central and peripheral airways, and that in CB, peripheral airway abnormalities correlated well with chronic airway obstruction.

Enhanced endothelial cell proliferation in acute Kawasaki disease (muco-cutaneous lymph node syndrome)

Paired sera from 30 patients with muco-cutaneous lymph node syndrome (Kawasaki disease) were studied for possible effects on human vascular endothelial cells growth in vitro. The majority of sera from acute phase muco-cutaneous lymph node syndrome patients significantly enhanced endothelial cell proliferation more than those from convalescent phase patients, infectious diseases patients, and age-matched normal controls. This stimulation was considered to be specific for EC since muco-cutaneous lymph node syndrome sera did not enhance fibroblast growth more than normal sera. Fractionation of the serum with gel filtration failed to clearly detect the molecular properties of this effect, although both heavy and light material possessed this activity. Extensive search for circulating immune complex in muco-cutaneous lymph node syndrome sera were negative, suggesting that the enhanced endothelial cell proliferation was due to serum components other than immune complexes.

Cellular analysis in bronchoalveolar lavage fluids in infiltrative and fibrotic stages of idiopathic pulmonary fibrosis

We performed cellular analysis of bronchoalveolar lavage fluids (BALF) from 20 patients in different stages of idiopathic pulmonary fibrosis (IPF) and compared the results with those from 16 controls and 10 sarcoidosis patients. Patients with IPF were divided into infiltrative and fibrotic groups as diagnosed by transbronchial lung biopsy and chest x-rays. Total cell numbers counted from BALF in IPF patients were not different from those from controls and were lower than in sarcoidosis patients (p less than 0.01). Lymphocytes in BALF were significantly higher in the infiltrative type IPF than in the fibrotic type (p less than 0.05), but there was no significant difference in fibrotic type IPF and control subjects. Numbers of neutrophils and eosinophils counts were not significantly different between infiltrative type and fibrotic type. The neutrophil count in fibrotic type IPF was higher than in control subjects (p less than 0.01) but not in infiltrative type IPF. 67Ga scintiscanning uptake correlated with the lymphocyte population (r = 0.65, p less than 0.01) but with neutrophils. These findings suggest that lymphocytes play a major role in the pathogenesis of the infiltrative type of IPF and that neutrophils are related to the development of fibrotic changes in IPF.

H1 action of histamine on aldosterone and cortisol secretion by perfused dog adrenal

The left adrenal of hypophysectomized-nephrectomized dogs was perfused in situ with artificial medium equilibrated with 95% O2-5% CO2. Repeated secretory responses of aldosterone to ACTH and histamine were almost reproducible during 2 h of perfusion, but those of cortisol and corticosterone gradually reduced. The secretion of aldosterone in response to histamine markedly increased at 1 microM and those of cortisol and corticosterone significantly increased at 1 and 10 microM, respectively. The secretory response of aldosterone to 10 microM histamine was comparable with that to 300 microU/ml ACTH, but the secretory responses of cortisol and corticosterone to 10 microM histamine were very much lower than those to 1 microU/ml ACTH. The secretory responses of these three steroids to 10 microM histamine were almost completely depressed by continuous administration of 10 microM pyrilamine maleate, but not abolished by that of 100 microM metiamide. The secretory responses of these three steroids to 10 microM histamine were slightly depressed by continuous infusion of 10 microM methysergide maleate. These results suggest that histamine at pathophysiological concentrations stimulates the secretion of aldosterone markedly, and those of cortisol and corticosterone slightly, via an H1 receptor of adrenocortical cells in the dog.

Noonan's syndrome with syringomyelia

A case of Noonan's syndrome with cervical syringomyelia is presented here representing the second reported instance of such association. A CT of metrizamide myelography revealed a high density in the middle subintradural space in the cervical region below C2. Sensory dissociation was minimal and localized in the left C4. It could not be determined whether this association between syringomyelia and Noonan's syndrome is related or represents a chance.

Protective effect of fosfomycin against aminoglycoside ototoxicity

The protective effect of fosfomycin against aminoglycoside (dibekacin)-induced ototoxicity was studied in rats. Rats were injected with 100 or 50 mg/kg of dibekacin with or without 500 mg/kg of fosfomycin for 60 or 120 consecutive days. Inner ear damage appeared to be more reduced histopathologically in animals given both dibekacin and fosfomycin than in animals given dibekacin alone. Similarly, renal damage appeared to be reduced histopathologically and functionally by the combined administration of dibekacin and fosfomycin. The mechanism of reduced ototoxicity may be as follows: fosfomycin inhibits the accumulation of dibekacin in the kidney, and reduces its concentration in the kidney and serum. Consequently, the amounts of dibekacin reaching the inner ear are decreased, and ototoxicity is reduced.

Low ototoxicity and its mechanism of netilmicin

The ototoxicity and nephrotoxicity of netilmicin were compared with those of dibekacin, kanamycin and amikacin using rabbits. Groups of 5 rabbits each were given doses of 50 or 100 mg/kg of either one of the four drugs for 30 days, and 10 days after the last injection, all animals were prepared for histopathological studies. Results show the least ototoxicity of netilmicin in comparison to the other three antibiotics. It has been concluded that the low ototoxicity of netilmicin is due not to its lack of accumulation in the perilymph but to its low toxicity to the hair cells.

Reduction of cisplatin ototoxicity by fosfomycin in animal model

The protective effect of fosfomycin against cisplatin-induced ototoxicity was studied in rats. Sixty-four Fischer rats were injected intravenously with daily doses of 1, 2, 5, and 10 mg/kg of cisplatin with or without 300 mg/kg of fosfomycin for a varying period from 1 to 10 days. The total dose of 10 mg/kg of cisplatin was given equally in all animals. Inner ear damage appeared to be more reduced histopathologically in animals given both cisplatin and fosfomycin than in animals given cisplatin alone. Similarly, renal damage appeared to be reduced histopathologically and functionally by the combined administration of cisplatin and fosfomycin.

[Reduction of cisplatin toxicity by fosfomycin in animal models]

The protective effect of fosfomycin against cisplatin-induced toxicities was studied in rats. A total of 64 Fischer rats were injected intravenously with daily doses of 1, 2, 5 and 10 mg/kg of cisplatin with or without 300 mg/kg of fosfomycin for a period varying from 1 to 10 days. The same total dose of 10 mg/kg of cisplatin was given to all animals. Cisplatin-induced toxic side-effects of body weight loss, nephrotoxicity and ototoxicity were significantly reduced functionally or histopathologically by the combined administration of cisplatin and fosfomycin. A comparison of different dosage schedules with a total dose of 10 mg/kg of cisplatin showed that a higher daily dose for a shorter time period produced more marked toxicities.

Decreased serum levels of various hydrolytic enzymes in patients with rheumatoid arthritis

It is known that the serum level of glycylproline aminopeptidase (Gly-Pro-AP) is decreased in the patients with rheumatoid arthritis. In the present study, the serum levels of various hydrolytic enzymes were tested in such patients. In comparison to the controls, many enzymes, including Ala-AP, Ser-AP, Phe-AP, Gly-Pro-AP, Gly-Pro-Leu-AP, dipeptidyl carboxypeptidase (angiotensin converting enzyme), and esterase, showed significantly decreased activities in the patients' sera. Only the activity of Trp-AP was significantly increased. Of these enzymatic activities in serum, several ones including those of Gly-Pro-AP, Ala-AP, Phe-AP, trypsin-like enzyme, and esterase, were significantly correlated with the severity of the disease. Although a part of these findings are compatible with previous observations, they suggest rather more extensive disorders of peptide metabolism in this immunological disease.

[An acute syndrome of opsoclonus and body tremulousness. A case report of benign encephalitis]

A 30-year-old woman was admitted to our hospital in May 1977, suffering from oscillation, body tremulousness and astasia-abasia. Two months prior to admission she had caught a common cold and felt paresthesia on the right arm. Three days before admission, she had photophobia, tremulousness of the trunk and head, and astasia-abasia. A neurological examination revealed difficulty in standing, and jerky movement of the body and right arm, her limbs were well coordinated. An ocular examination resulted in normal findings except for intermittent oscillation of the eyeballs. As the pupils and fundi were normal, so were the routine laboratory tests. The cerebrospinal fluid was clear and colorless under normal pressure, and showed no more than 6 mononuclear cells in any of the three examinations. CSF protein was registered 20 mg/dl, glucose 75 mg/dl, and no virus titers were elevated. Electroencephalogram was slightly abnormal due to a slowing of the Alpha wave in the background activity. Both computerized tomography and vertebral-angiography were normal. A slow and steady abatement of all symptoms started while she was taking steroid treatment in hospital. Electrooculogram showed irregular disconjugation of the eyes rotating or moving in horizontal and vertical direction. There movements conjugated or disconjugated in both eyes with 5-7 Hz of frequency and 10-20 degrees of amplitude. They decreased when the eyelids were closed or staying in a dark room. These ocular movements were regarded as opsoclonus. Then opsoclonus changed to flutter-like oscillation.(ABSTRACT TRUNCATED AT 250 WORDS)

Circulating immune complexes in patients with bladder cancer and other malignancies of the urogenital tract

Sera from 70 patients with bladder cancer, 26 patients with kidney cancer, and 20 patients with prostate cancer were studied for the presence of circulating immune complexes (CIC) utilizing the human red blood cell (HRBC) radioimmunoassay. Elevated CIC levels were found in 32% of patients with bladder cancer, 30% of patients with kidney cancer, and 20% of patients with prostate cancer. For comparison, CIC was also measured in 37 sera from patients with bladder cancer by the polyethylene glycol precipitation complement consumption (PEG-CC) test. 13 of them (35%) had elevated CIC levels. The correlation between the results of the two tests was significant. There were significant correlations between CIC levels and the extent of tumor invasion and the degree of malignancy in patients with bladder cancer. The elevation of CIC level was also significantly associated with poor prognosis of these bladder cancer patients. It is proposed that measurement of CIC in patients with bladder cancer by the HRBC radioimmunoassay may be useful to evaluate their stage, degree of malignancy, and prognosis.

Mechanism of protective effect of fosfomycin against aminoglycoside ototoxicity

The purpose of this study was to clarify the mechanism of the protective effect of fosfomycin (FOM) against inner ear damage induced by an aminoglycoside dibekacin (DKB), when administered concurrently DKB and FOM. Rats were treated with 50 mg/kg of DKB with or without 500 mg/kg of FOM for short-term administration. No significant difference was seen in the serum peak level and in the area under the curve between the group receiving DKB alone and the combined administration group of DKB and FOM. On the other hand, the DKB level in the kidney was significantly lower in the combined administration group than in the group receiving DKB alone. The mechanism of protective effect of FOM against DKB-induced ototoxicity may be considered as follows: FOM inhibits the accumulation of DKB in the kidney and reduces its concentration in the kidney and serum. Consequently, the transferability of DKB into the inner ear is decreased, and finally inner ear damage is reduced.

Osteoma of the external auditory canal

A case of osteoma of the external auditory canal in a 19-year-old male patient was reported. The differentiation between osteoma and exostosis was discussed clinically, histopathologically and scanning electron microscopically.

Relationship between ototoxicity of aminoglycoside antibiotics and their transferability into inner ear fluids

The purpose of this study is to clarify the question whether the difference of severity of ototoxicity induced by the aminoglycoside antibiotics depends on the difference of quantity of transferability into inner ear. Aminoglycoside antibiotics (tobramycin, kanamycin, netilmicin and ribostamycin) were injected for 30 consecutive days to rabbits. The relationship between the severity of hair cell damage and concentration of antibiotics in perilymph was investigated. The drug concentration in the perilymph was determined by the bioassay method, and using the surface preparation technique the hair cell damage was observed under a phase contrast microscope. It was concluded that the difference of severity of ototoxicity induced by the aminoglycoside antibiotics is due to the difference of their own toxicity to hair cells but not to the difference of their transferability into the perilymph.

[Clinical effect of cefroxadine on surgical infections]

Cefroxadine (CXD), an orally active cephalosporin antibiotic, has a broad spectrum and a bactericidal action. The efficacy of CXD in the surgical field was investigated and the following results were obtained. CXD was administered to 31 cases in all; 13 cases with mastitis, 9 with wound infection, 4 with infected atheroma, 3 with periproctal abscess and 2 with phlegmon, respectively. The daily dose was ranged from 750 mg to 1,500 mg. Clinical effects were good in 27 cases and fair in 4 cases, and the effective rate was 87.1%. As to side effects, a slight diarrhea was observed in 1 case, but the symptom was disappeared after 2 days without a special treatment.

[Central pontine myelinolysis--pathogenesis and review of the literature]

A 77-year-old, nonalcoholic man was admitted to the Omiya Red Cross Hospital with the complaint of fever and delirium state of two days' duration. Two months prior to admission he had had cough and sputum. Chest X-ray revealed honey comb lungs. Cultures of sputum revealed mycobacterium tuberculosis after eight weeks incubation. He had no liver disease in his past history. The patient appeared cachetic. His vital signs were as follows; temperature 38 degrees C, blood pressure 132/68 mmHg, with a pulse rate of 84/min. He was delirium and excited. Findings of the cranial, motor and sensory nerve examination were normal. Initial laboratory studies showed a serum sodium value of 133 mEq/l, potassium 4.5 mEq/l, chloride 98 mEq/l; a serum GOT value of 51 units, GPT 36 units; a total protein content of 7.8 g/dl and ESR rate of 87 mm/hr. Six days after admission, the patients' consciousness level began to stupor and nuchal rigidity was appeared. Spinal fluid examination revealed opening pressure 270 mm H2O, cell counts 720 (N 712, L 8)/cumm, sugar 57 mg/dl and protein 170 mg/dl. Spinal fluid cultures were positive in mycobacterium tuberculosis after eight weeks incubation. Laboratory studies showed a serum sodium value of 114 mEq/l, potassium 4.4 mEq/l, chloride 86 mEq/l, a serum osmorality (SeOs) 225 mOsm/l and urine osmorality (UOs) 958 mOsm/l.(ABSTRACT TRUNCATED AT 250 WORDS)

Heterogeneity of antilymphocyte antibody in SLE and its correlation with disease activity

The cytotoxic activities of individual lupus sera were demonstrated against T gamma cells, T gamma (-) cells and B cells. Immunoglobulin classes were also determined in these antilymphocyte antibodies (ALA) in SLE. T gamma-specific ALA and B-cell-specific ALA were almost equally distributed as regards IgG-dominant type, mixed IgG and IgM type and IgM dominant type, while IgM dominant type was predominant in T gamma (-)-specific ALA. Only the IgG type of T gamma-specific ALA among these ALA was significantly associated with clinical parameters, including hypocomplementemia, elevated immune complex levels and high anti-double-stranded (ds) DNA titres. Serial studies on ALA in a typical case of SLE were performed. Active clinical signs were associated with elevated cytotoxicities of IgG type of T gamma-specific ALA and with relatively low cytotoxicities of the IgM type, whereas after massive corticosteroid therapy, these signs disappeared in tact with the reduction in cytotoxic activities of IgG type of the ALA and the relative rise in cytotoxicities of IgM type of the ALA. These results suggested that IgG class of T gamma-specific ALA seemed to play a major role among several types of ALA in SLE.

Modification by Su-10'603 of the response to histamine on the production of cortisol and corticosterone in isolated canine adrenocortical cells

The effect of Su-10'603 on the cortisol and corticosterone response to histamine in dispersed canine adrenocortical cells was examined. The production of cortisol and corticosterone in isolated dog adrenocortical cell incubations increased in a dose-dependent manner at concentrations of histamine between 0.01 and 10.0 micrograms/ml medium, with the predominant production of cortisol. When Su-10'603 (0.005 to 5.0 micrograms/ml medium), an inhibitor of 17 alpha-hydroxylation on corticosteroidogenesis, was added in cell incubations with histamine (1.0 micrograms/ml medium), the production of cortisol decreased in a reciprocal fashion, with a concomitant increase of corticosterone production. At the concentration between 0.05 and 0.1 microgram Su-10'603/ml medium, there was a shift from cortisol to corticosterone as the predominant product. These results indicate that in the dog, histamine at pathophysiological concentration stimulates steroidogenesis and acts at a relatively early stage in the biosynthetic pathway.

Individual variation and mechanism of kanamycin ototoxicity in rabbits

In order to elucidate the mechanism of individual variation of kanamycin ototoxicity, the possible relationship between the outer hair cell damage induced by kanamycin and the levels of kanamycin in serum or perilymph and of renal damage was investigated in rabbits. No relationship was found between the extent of the outer hair cell damage and the level of kanamycin in the serum or the renal damage. The extent of the outer hair cell damage was closely correlated to the levels of kanamycin in the perilymph. These findings suggest that the individual variations in the outer hair cell damage induced by kanamycin are more closely correlated to the individual differences in the transferability of kanamycin into inner ear than to those in the vulnerability of the outer hair cells or kidneys.

Usefulness and rapidity of screening for the toxicity and carcinogenicity of chemicals in medaka, Oryzias latipes

The toxicity and carcinogenicity of number of chemicals, for which there are toxicity and/or carcinogenicity data in mouse and rat, were tested in medaka, a small aquarium fish (Oryzias latipes). The water-soluble chemicals were dissolved in the water and the water-insoluble chemicals were incorporated into the diet. Observation for 24 wk revealed induction of liver cell carcinoma by 6 chemicals; aflatoxins B1 and G1, sterigmatocystin, ortho-aminoazotoluene, methylazoxymethanol acetate and N-nitrosodiethylamine. In medaka fed PCB or DDT only preneoplastic liver cell nodules were observed. No evident carcinogenicity was found in medaka treated with 2-fluorenylamine, 2-fluorenylacetamide, DL-ethionine, luteoskyrin, ochratoxin A, phenobarbital, 1-(2-tetrahydrofuryl)-5-fluorouracil, sodium benzoate, 2,3,4,5,6-penta-O-acetyl-D-gluconyl isothiocyanate, citrinin and fusarenon X, respectively, although toxic lesions or hyperplastic changes were demonstrated histologically. These results confirm the practical utility and rapidity of the use of medaka for screening carcinogenicity and toxicity of chemicals, since neoplastic or toxic morphological changes develop rapidly following administration of relatively small quantities of test materials.