Synthesis of antimicrobial agents. 5. In vivo metabolism of 7-(4-hydroxypiperazin-1-yl)quinolones

A series of novel pyridone carboxylic acids having a 4-hydroxypiperazin-1-yl, a 4-hydroxy-3-methylpiperazin-1-yl, and a 4-hydroxy-3,5-dimethylpiperazin-1-yl group was prepared, and their metabolism to corresponding piperazinyl derivatives after oral administration to mice and rats was studied. This reductive metabolism appeared to be more extensive in mice than in rats. Moreover, the introduction of a methyl group into the alpha-position of the 4-hydroxy group depressed the metabolism in both species.

Importance of successive prolines in the carboxy-terminal region of P450 2C2 and P450 2C14 for the hydroxylase activities

Proline-480 and proline-481 are highly conserved in the P450 2 family. When these successive prolines of P450 2C2 were replaced by Ala-Thr, its activities of laurate (omega-1)-hydroxylation and benzphetamine N-demethylation were lost. On the other hand, the mutated P450 which retained one of the proline residues was 60-100% active in the (omega-1)-hydroxylation and 100-120% active in the N-demethylation. Pro-Pro (480, 481) to Ala-Thr mutated P450 2C14 was also inactive in testosterone 16 alpha-hydroxylation and benzphetamine N-demethylation, the activities of the wild-type P450 2C14. In the carboxyterminal region of the P450 2C subfamily, the sequence of P450 2C2 from residues 469-473 is noticeably different from those of the other members of this subfamily. The Ser-473 to Val mutation of P450 2C2 caused a decrease in the (omega-1)-hydroxylase activity to one-fifth but the N-demethylase activity was not much affected. When the sequence of P450 2C2 from residues 469-473 was replaced by that of P450 2C14 (mutation at four residues), the 16 alpha-hydroxylase and N-demethylase activities were increased by seven- and three-fold, respectively, and the (omega-1)-hydroxylase activity was decreased to one-third. The mutated P450 2C2, in which the carboxy-terminal four residue sequence or the proline cluster adjacent to the amino-terminal membrane-anchor signal sequences was deleted, was not accumulated in yeast cells transformed with plasmids directing the synthesis of such P450s.(ABSTRACT TRUNCATED AT 250 WORDS)

[Expression of major histocompatibility complex antigens, and kinetics of infiltrated lymphocytes in murine herpetic keratitis]

Immunohistochemical techniques were used to study expression of HSV-1 antigen, induction of class I and II major histocompatibility complex (MHC) antigens, and infiltration of L3T4+ and Lyt2+ cells were analyzed during the acute phase of herpetic keratitis. The results were as follows: 1) HSV-1 antigens were detectable in the corneal epithelium at 2 days post infection (p.i.), then localized in the stroma after 5 days p.i.. 2) Class I MHC antigens (H-2d) were evenly expressed in all layers of infected as well as uninfected corneas. On the other hand, class II MHC antigens (Iad) were induced in the superficial corneal stroma 2 days p.i., then gradually spread in the entire corneal stroma with increased intensity. 3) L3T4+ (helper/inducer) cells penetrated the stroma at 2 days p.i.. These cells infiltrated the central stroma at 5 days p.i.. Lyt2+ (suppressor/killer) cells were first seen in the corneal stroma as late as at 5 days p.i.. These results imply that L3T4+ cells play a role in the early immunological events concerning class II MHC antigens and viral antigens, both concomitantly expressed in the corneal stroma.

[Evaluation of blood purification in perioperative acute renal failure]

The technical aspects of blood purification have made a great progress during 1980's. We reviewed our experiences of blood purification for the past six years. Between 1986 to 1991, we treated 48 perioperative patients with acute renal failure (ARF). Four were intraoperative cases and 46 were postoperative cases. Three of four intraoperative patients received major cardiovascular surgery, and hemodialysis was connected directly to ECC in these three cases, and in other one case, ARF was treated with continuous hemofiltration (CHF). There was no intraoperative complication. One patient died of septic multiple organ failure (MOF), but other three patients were discharged uneventfully. Thirty five postoperative ARF patients showed oliguric ARF, and their major causes were LOS (65%) and septic shock (29%). We treated these ARF patients with CHF combined with HD (63%), CHF only (28%) and HD only (9%). There were 21 deaths (60%) in this group and most common cause of death was septic MOF. Eleven postoperative ARF patients showed non-oliguric renal failure, and major cause of this type of ARF was thought to be aortic dissection and relative hypotension (45%). We treated these non-oliguric ARF patient with HD only (73%) and HD combined with CHF (27%). One of these non-oliguric ARF patients died from ARDS.

Effect of ibudilast, a novel antiasthmatic agent, on anaphylactic bronchoconstriction: predominant involvement of endogenous slow reacting substance of anaphylaxis

The effect of ibudilast on anaphylactic bronchoconstriction was studied in guinea pigs sensitized actively with ovalbumin (OA). Animals were treated with indomethacin, tripelennamine and propranolol prior to the antigen challenge. Anaphylactic bronchoconstriction was prevented by ibudilast (1-4 mg/kg i.v. and 5-20 mg/kg p.o.) dose-dependently. FPL55712 and phenidone were also effective. Even when administered at the maximum development of bronchoconstriction, ibudilast (0.5 and 2 mg/kg i.v.) and FPL 55712 caused significant reduction of the increased airway tone, while phenidone did not. Ibudilast (1-4 mg/kg i.v.) and FPL55712 inhibited leukotriene D4-induced airway responses in nonsensitized guinea pigs pretreated with indomethacin and propranolol. Ibudilast (1.6 and 4 mg/kg i.v.) inhibited platelet-activating-factor (PAF)-induced airway responses in nonsensitized guinea pigs pretreated with indomethacin and propranolol, however, FPL 55712 inhibited PAF-induced airway responses only at a high dose such as 10 mg/kg i.v. Ibudilast (4 mg/kg i.v.) did not inhibit acetylcholine-induced airway response. Ibudilast showed inhibition of the release of slow-reacting substance of anaphylaxis (SRS-A) from guinea pig chopped lung sensitized with OA, which was significantly diminished by indomethacin. The drug little affected the activity of phospholipase A2 and 5-lipoxygenase in guinea pig polymorphonuclear leukocytes. These results indicate that ibudilast inhibits anaphylactic bronchoconstriction which is considered to be largely mediated by endogenously released SRS-A. The inhibitory effect of ibudilast on anaphylactic bronchoconstriction in the presence of indomethacin is considered to be exerted through its antagonism to SRS-A.

[Autonomic neurons sending fibers into the canine laryngeal nerves--using a retrograde tracer technique with cholera toxin]

The distribution of the autonomic neurons sending fibers into the canine superior and inferior laryngeal nerves was investigated by an immunohistochemical technique with cholera toxin B subunit as a retrograde tracer. Cholera toxin was applied to the right internal branch of the superior laryngeal nerve (SLNI), external branch of the superior laryngeal nerve (SLNE) or inferior laryngeal nerve (ILN) in 2-month-old dogs. In every case of cholera toxin application, labeled neurons were seen mainly in the caudal portion of the ipsilateral superior cervical ganglion, whereas none were seen in the stellate ganglion. The number of labeled neurons in the superior cervical ganglion after application of cholera toxin to the SLNI was over 20 times that observed after application to the SLNE or ILN. When cholera toxin was applied to the SLNI or SLNE, labeled neurons were found mainly in the ipsilateral dorsal motor nucleus of the vagus (DMNV), and a few labeled neurons were found in the ipsilateral reticular formation. The neurons in the DMNV were localized, on the average, between 2.7 mm and 5.3 mm rostral to the obex. The number of neurons in the DMNV labeled retrogradely from the SLNI was much larger than that from the SLNE. In contrast, no labeled neurons were detected in the DMNV after application to the ILN. These results demonstrate the following: 1) The sympathetic neurons innervating the canine larynx are distributed mainly in the caudal portion of the superior cervical ganglion and they send their fibers mainly into the SLNI. 2) The parasympathetic neurons innervating the canine larynx have a limited distribution in the dorsal motor nucleus of the vagus and their main pathway is also the SLNI.

Distribution of the afferent neurons from the canine recurrent laryngeal nerve

Localization of the afferent neurons from the canine recurrent laryngeal nerve in the nodose ganglia (NG) and jugular ganglia was studied using the horseradish peroxidase technique. Labeled cells were detected in the ipsilateral NG and presented no distinct pattern of distribution, but rather were scattered throughout the ganglion. No labeled cells were found in the contralateral NG or bilateral jugular ganglia. The size of labeled cells varied from 15 microns to 60 microns. Two to six labeled cells larger than 45 microns were detected in each dog. Most of the labeled cells (62%) had a diameter between 30 microns and 45 microns. The percentage of labeled cells with a diameter between 15 microns and 30 microns was 30% and between 45 microns and 60 microns was 8%. This difference in size of labeled cells in the NG may be related to functional differences among the receptors mediated.

A case of mixed-type dysgerminoma with a high serum concentration of both human chorionic gonadotropin and alpha-fetoprotein in a child

Dysgerminoma is divided into two types: pure and mixed. The mixed type is related to other various elements of germ cell tumors. We experienced a case of mixed type dysgerminoma with a high serum concentration of both human chorionic gonadotropin and alpha-fetoprotein. The patient was a 6 year old girl who was admitted to the Hamamatsu University School of Medicine with an abdominal mass. Laboratory investigations revealed elevated serum alpha-fetoprotein and high concentration of serum beta-human chorionic gonadotropin. The tumor originated from the left ovary. The histopathological diagnosis was dysgerminoma. Serum human chorionic gonadotropin and alpha-fetoprotein levels were useful markers in monitoring the response to treatment in this patient.

Further studies on chimeric P450 2C2/2C14 having testosterone 16 beta-hydroxylase activity which is absent in the parental P450s

cDNAs for various chimeras between P450 2C2, P450 2C14, P450 2B5, and P450 2E1 were constructed, the chimeric P450s were expressed in yeast cells, and their catalytic activities were compared in the reconstituted system containing partially purified P450 preparations. The chimera P450(2Hc3), consisting of the 462 amino-terminal residues of P450 2C2 and the remaining 28 residues of P450 2C14, had testosterone 16 beta-hydroxylase activity, which is not seen in either of the parental P450s, in addition to higher activities of laurate (omega-1)-hydroxylation and benzphetamine N-demethylation than the parental P450s [Uno, T. et al. (1990) Biochem. Biophys. Res. Commun. 167, 498-503]. When either of the segments from P450 2C2 and P450 2C14 in this chimera was replaced with the corresponding sequences of P450 2E1 or when the 35 carboxy-terminal residues of P450(2Hc3) were replaced with those of P450 2B5, the 16 beta-hydroxylase activity disappeared. When the 262 amino-terminal residues, except for residues 90-125 (region 90-125), of P450(2Hc3) were replaced with those of P450 2C14, the resulting chimera retained both testosterone 16 beta- and laurate (omega-1)-hydroxylase activities. Further replacing the region 90-125 with that of P450 2C14 resulted in disappearance of the 16 beta-hydroxylase activity and profound decrease in the (omega-1)-hydroxylase activity. Testosterone 16 beta-hydroxylation was inhibited by laurate and laurate (omega-1)-hydroxylation by testosterone.(ABSTRACT TRUNCATED AT 250 WORDS)

[Results of radiation therapy of extrahepatic bile duct carcinoma]

From January 1975 to August 1988, 40 patients with extrahepatic bile duct carcinoma were treated by external irradiation at Chiba University Hospital and the National Medical Center Hospital. Thirty-four patients (male: 20, female: 14) were evaluable. Eighteen patients were postoperative cases because the surgical margin was positive for tumor cells in the postoperative pathological examination; the other 16 were inoperable cases. Survival in postoperative and inoperable cases was not significantly different, with median survival times of 13.8 and 8.1 months, respectively. Survival in the recanalization-positive and negative-groups was significantly different (p less than 0.05) after irradiation, with median survival times of 13.5 and 6.0 months, respectively. Complications of therapy were recognized in 68% of all cases. They were mainly gastrointestinal symptoms such as nausea, vomiting, erosive gastritis and loss of appetite, but they were not severe. Distant metastasis was recognized in only 4 patients (10%): three had bony metastasis and one had supraclavicular and pulmonary hilar lymph node metastasis. Ninety percent of all cases died from hepatic failure or peritonitis carcinomatosa due to failure to obtain local control by external irradiation. A more effective modality of treatment is necessary to cure these patients.

Distribution of tyrosine hydroxylase immunoreactive nerve fibers in the canine larynx

The sympathetic innervation of the canine larynx was investigated using tyrosine hydroxylase (TH) immunohistochemistry. Many tyrosine hydroxylase immunoreactive (TH-IR) nerve fibers were observed around arteries and arterioles in the laryngeal mucosa and intrinsic laryngeal muscles. In the glandular region, TH-IR fibers were also found, with some of these fibers terminating around the basement membranes of the glandular cells. The quantity of TH-IR fibers in the mucosa differed among regions of the larynx. Many of these fibers could be found in the laryngeal surface of the epiglottis as well as the posterior glottis. These findings suggest that TH-IR fibers may directly innervate muscles in the intrinsic larynx.

Distribution of calcitonin gene-related peptide nerve fibers in the canine larynx

Immunohistochemistry was used to investigate the distribution pattern of calcitonin gene-related peptide (CGRP) nerve fibers in the laryngeal mucosa, glands and intrinsic muscles of the dog. CGRP immunoreactive nerve fibers were found more frequently than substance P immunoreactive nerve fibers in every region of the larynx. In the epithelia, CGRP nerve fibers were mainly found in the epiglottis, arytenoid region and subglottis. Many taste buds were observed in the arytenoid region and were densely innervated by the CGRP nerve fibers. In the lamina propria, the plexus of CGRP nerve fibers was present, with some of these fibers associated with blood vessels. Laryngeal glands were also innervated by a few CGRP nerve fibers. In the intrinsic laryngeal muscles, abundant immunoreactivity was observed and many motor end-plate-like structures were found with CGRP immunoreactivity. These findings strongly suggest that CGRP plays an important role in all of the sensory, motor and autonomic nervous systems of the larynx.

Radiation therapy in patients with unresectable hepatocellular carcinoma

From April 1978 through December 1989, a total of 17 patients with unresectable hepatocellular carcinoma (HCC) were treated with radiation therapy alone or radiation therapy in conjunction with percutaneous ethanol injection (PEI), transarterial infusion chemotherapy (TAI), or transarterial embolization (TAE) at the National Medical Center Hospital. The median survival of all patients was 13.8 months. The survival values determined at 1, 2, and 3 years were 58.8%, 26.1%, and 9.8%, respectively. Only the pretreatment liver function affected the survival value. Between patients who did not have liver cirrhosis (LC) as well as those who had LC of Child's class A and patients who had LC of Child's class B or C, the differences observed in the 1-year survival value and the median duration of survival were statistically significant (P < 0.05). The serum cholinesterase (ChE) level seemed to be a good indicator of liver function during the radiation therapy. A field size of 150 cm2 and a total dose of 5000 cGy (TDF 82) seemed to be well tolerated by patients who did not have LC and those who had LC of Child's class A. The field size determined whether patients with poor liver function such as LC of Child's class B or C would develop severe hepatic deterioration after undergoing radiation therapy.

Radiotherapy of cholangiocarcinoma: the roles for primary and adjuvant therapies

A total of 22 patients with cholangiocarcinoma who had been treated with external radiotherapy between 1978 and 1989 were analyzed. Of the 22 patients, 18 had cancer of the hepatic hilus (Klatskin) and 4 had intrahepatic biliary cancer; all but 2 of the subjects had advanced disease. In all, 16 patients underwent primary irradiation for unresectable tumors, 4 were subjected to adjuvant irradiation after gross tumor resection, and 2 received preoperative irradiation followed by gross tumor resection. The mean initial irradiation dose was 52.0 Gy (range, 26-78 Gy). The TDF (time-dose-fractionation) for the entire course of radiotherapy ranged from 49 to 154 (mean, 100). The median survival of all patients was 10 months, and the cumulative 1-year survival value was 37.7%. The external radiotherapy proved to be effective in the treatment of cholangiocarcinoma in terms of palliation and survival.

A case report of intraoperative ultrasonic exploration for an inferior vena cava thrombectomy of the right Wilms' tumor

The intraoperative ultrasonic explorations for a case of right Wilms' tumor with inferior vena cava thrombosis are reported. This method of assessment is most appropriate for cases of inferior vena cava thrombectomy of malignant tumors either with or without an inferior vena cava resection.

Ultrasonic exploration of contralateral side in pediatric patients with inguinal hernia

The width of low echoic region at the internal ring (WLIR) of an inguinal canal demonstrated by ultrasonography was applied in the preoperative diagnosis of the contralateral side in pediatric patients with inguinal hernia. The ultrasonic diagnosis of 39 pediatric patients with inguinal hernia and 38 children without inguinal hernia under 15 years of age were conducted at Hamamatsu University Hospital from April 1988 to January 1989. The WLIR of children without inguinal hernia were within 6 mm in boys under 15 years of age and within 3 mm in girls under 5 years of age. There were no statistically significant differences between the WLIR of the right side and that of the left side, and the WLIR of the following three age groups also demonstrated no statistical significance: under 1 year of age, 1 to 5 years of age, 5 to 15 years of age. On the other hand, the WLIR of the hernia side of pediatric patients with inguinal hernia were significantly wider than that of the contralateral side in boys and girls under 5 years of age (P less than 0.01), as well as in boys 5 to 15 years of age (P less than 0.05). Therefore, we recommend a contralateral exploration for pediatric patients with inguinal hernia when the WLIR is 7 mm or more in boys under 15 years of age and 4 mm or more in girls under 5 years of age.

Detection of one attomole of [Arg8]-vasopressin by novel noncompetitive enzyme immunoassay (hetero-two-site complex transfer enzyme immunoassay)

One attomole of [Arg8]-vasopressin (AVP) was detected by a novel noncompetitive enzyme immunoassay (hetero-two-site complex transfer enzyme immunoassay). AVP was indirectly biotinylated using N-hydroxysuccinimidobiotin and trapped onto an anti-AVP IgG-coated polystyrene ball. After washing, biotinylated AVP was eluted from the polystyrene ball with HCl and was reacted with 2,4-dinitrophenyl-fluorescein disulfide-bovine serum albumin-rabbit anti-AVP IgG conjugate. The complex formed was trapped on [anti-2,4-dinitrophenyl group] IgG-coated polystyrene balls and, after washing, reacted with avidin-beta-D-galactosidase conjugate. The polystyrene balls were washed, and the complex of the three components was eluted with 2,4-dinitrophenyl-L-lysine and transferred to anti-fluorescein IgG-coated polystyrene balls. After washing, the complex was released from the polystyrene balls by reduction with 2-mercaptoethylamine and transferred to [anti-rabbit IgG] IgG-coated polystyrene balls. beta-D-Galactosidase activity bound to the last polystyrene balls was assayed by fluorometry. The detection limit of AVP was 1.1 fg (1 amol)/tube. Interference by proteins in biological fluids was eliminated by separation of peptides from proteins using a molecular sieve. The principle of the present method may be applicable to the measurement of haptens, including peptides, that can be derivatized so as to be bound simultaneously by both anti-hapten antibody and avidin molecules.

Hemolytic anemia caused by Babesia gibsoni infection in dogs

Babesia gibsoni caused severe hemolytic anemia in 11 dogs from southern California. The most common clinical signs of B gibsoni infection were lethargy, anorexia, anemia, and thrombocytopenia. Acute infection with B gibsoni may be misdiagnosed as autoimmune hemolytic anemia. Diagnosis was most reliably determined by identification of the intraerythrocytic parasites on Giemsa-stained blood smears. The pathogenicity of B gibsoni, difficulties in diagnosis, the parasite's resistance to treatment with available drugs, and frequent interstate movement of dogs indicate that this disease may be a serious threat to dogs throughout the United States.

[A non-invasive quantitative measurement of cerebral blood flow using N-isopropyl-[123I]p-iodoamphetamine and single photon emission CT]

A non-invasive quantitative method using N-isopropyl-[123I]p-iodoamphetamine (IMP) was described for assessing regional cerebral blood flow (rCBF). Twenty four cases, composed of 11 patients with brain tumors, 9 patients having cerebrovascular disease and 4 other patients aged 15-73 years, all underwent the SPECT 133Xe inhalation method (Xe-SPECT) and IMP-SPECT using a Tomomatic 564. In the IMP-SPECT cases, 111-222 MBq (3-6 mCi) of IMP was injected intravenously and then sequential imaging was performed 9.5 +/- 1.2 (mean +/- SD) min (E1 image), 20.6 +/- 1.2 min (E2 image), 227.5 +/- 22.1 min (D1 image), and 236.6 +/- 22.4 min (D2 image) after the injection. The IMP-uptake value (counts/pixel/sampling time) in the region of interest (ROI), which was chosen in the non-affected cortex in the middle cerebral artery territory (MCAC), was counted on each image (E1 value, E2 value, D1 value and D2 value) and the E1/D1 ratios and E2/D2 ratios were consequently calculated. On the other hand, the absolute value of the ROIrCBF (Xe-rCBF) was obtained by Xe-SPECT. There were significant correlations noted between both the E1/D1 ratios and the E2/D2 ratios, and the Xe-rCBFs. Those correlation coefficients were found to be: r = 0.741 and 0.810 respectively. Based on this significant relationship, equations were deduced to involve the rCBF values by use of IMP-SPECT: y = Ax + B (y: rCBF, x: E1/D1 ratio (E2/D2 ratio), A = 52.8 (68.2), B = 6.3 (-14.9), where A and B indicate the slope and deviation of the regression line).(ABSTRACT TRUNCATED AT 250 WORDS)

Localization of the sensory neurons in the canine nodose ganglion sending fibers into the internal branch of the superior laryngeal nerve

The distinct localization of the sensory neurons in the canine nodose ganglion that send fibers into the internal branch of the superior laryngeal nerve (the main sensory pathway from the larynx) was studied using horseradish peroxidase technique. The labeled cells were located mainly in the rostral one-third of the lateral side of the nodose ganglion. We conclude that the localization of these labeled cells does not reflect a difference in cellular role or function but is due to the course of the nerve's fibers.

An analysis of the subpopulations in draining lymph node cells and MHC antigen induction in murine herpetic keratitis

The protective role of T cell subsets in corneal herpes simplex virus type 1 (HSV-1) infection has been studied. However, the relative contribution of, and the role played by, each particular T cell subset still remain a controversial issue. We studied sequentially the appearance of major histocompatibility (MHC) and viral antigens in HSV-1 infected corneas of Balb/C mice and related them to induction of T cell subsets in local lymph nodes and corneal lesions. Immunohistochemical study has revealed a marked increase of expression of class II MHC antigen in the corneal stromal cells, while class I MHC antigen gradually increased in the corneal epithelium and stroma. Further immunohistochemical survey has revealed that L3T4 antigen bearing and Lyt 2 antigen bearing cells were induced to a similar extent with an equal rapidity in the local lymph nodes as well as in the corneal stroma. Transfer of these subpopulations to syngeneic nude mice showed that they played a role to prevent severe outcome of corneal herpetic infection. These results indicate that the corneal stroma is a major site of the host's immunological activities and both L3T4 and Lyt 2 bearing cells are equally important for the prevention of corneal herpetic infection.

Characterization of rabbit liver P450IIE1 synthesized in transformed yeast cells

cDNA for chimeric protein, P450(3P4), consisting of the amino-terminal 43 residues (the membrane-anchor region) of rabbit P450IIC14 and the remaining 447 residues of rabbit P450IIE1 was constructed, then cloned into expression vector pAAH5, and expressed in Saccharomyces cerevisiae AH22 cells under the control of yeast ADH1 promoter. P450(3P4) thus synthesized in the transformed yeast cells was partially purified, and its spectral and catalytic properties were examined. In the oxidized state P450(3P4) exhibited a high-spin type absorption spectrum even in the absence of a substrate. The reduced CO complex of the P450 showed a Soret absorption maximum at 452 nm. P450(3P4) catalyzed aniline p-hydroxylation, N-nitrosodimethylamine demethylation, benzphetamine N-demethylation, and laurate and caprate (omega-1)-hydroxylation in the reconstituted system containing the P450 and NADPH-P450 reductase. These results indicate that P450(3P4) preparation obtained from the transformed yeast cells has spectral and catalytic characteristics identical with those of P450IIE1 purified from rabbit liver microsomes, confirming the substrate specificity reported of P450IIE1.

Synthesis of antimicrobial agents. 3. Syntheses and antibacterial activities of 7-(4-hydroxypiperazin-1-yl)quinolones

A series of novel pyridone carboxylic acids having a 4-hydroxypiperazinyl group at the 7-position of norfloxacin and ciprofloxacin were prepared. The in vivo antibacterial efficacies of these compounds were superior to those of corresponding piperazinyl derivatives. From the results of the studies on the pharmacokinetic profile and toxicity, the 4-hydroxypiperazinyl derivatives were confirmed to be pharmacologically superior to corresponding piperazinyl derivatives. Thus, a 4-hydroxypiperazinyl group was revealed to be a beneficial substituent for potential use in future quinolone antibacterials.

Studies on antibacterial agents. II. Synthesis and antibacterial activities of substituted 1,2-dihydro-6-oxo-6H-pyrrolo[3,2,1-ij]quinoline-5-carboxylic acids

A series of substituted 1,2-dihydro-6-oxo-pyrrolo[3,2,1-ij]quinoline-5-carboxylic acids for the treatment of systemic infections was synthesized via 7-bromo-3-ethylthio-4,5-difluoro-2-methylindole (3), which was prepared by Gassman's indole synthesis in excellent yield. The synthesized pyrroloquinolines were tested for their antibacterial activities. 8-Fluoro-1,2-dihydro-2-methyl-9-(4-methyl-1-piperazinyl)-6-oxo-6H- pyrrolo[3,2,1-ij]quinoline-5-carboxylic acid showed a potent antibacterial activity against gram-positive and gram-negative bacteria.

Direct evidence that the cuticle surface of Trichinella spiralis muscle larvae shares antigenicity with stichocyte alpha-granules and the esophagus-occupying substance

Antibodies against the cuticle surface of Trichinella spiralis muscle larvae were purified by means of immunoaffinity chromatography and incubated with ultrathin sections of muscle larvae. Major constituents of the parasite reactive with the purified antibodies included the cuticle surface, stichocyte alpha-granules, and the esophagus occupying substance of the muscle larvae. Thus the present data suggest that the cuticle surface is an antigenically different entity from the cuticle inner layers and its origin is likely stichocyte alpha-granules.

A spectrum of antibody response with time after Trichinella spiralis infection in rats

A chronology of class-specific antibody response against the Trichinella spiralis infection in Fischer rats was investigated. G-class antibodies against the cuticle inner layer(s), hypodermis, hemolymph, glycogen aggregates, discrete areas in genital primordial cells, intestinal gland cell granules, and cytoplasmic granules in the cords were detectable 2 wk after infection (the rapid-responding group), whereas G-class antibodies against the cuticle surface, stichocyte granules, and the esophagus-occupying substance were detected 6 wk after infection (the slow-responding group). M-class antibodies recognized a narrower spectrum of antigens than did G-class antibodies; M-class antibodies against hemolymph, cord granules, and intestinal gland cell granules were not detectable. M-class antibodies tended to decrease in titer with time after infection. This tendency was more striking with antibodies against the rapid-responding group than with those against the slow-responding group. This information sheds light upon antibody response against many antigenic components of T. spiralis muscle larvae.

Replacing the carboxy-terminal 28 residues of rabbit liver P-450 (laurate (omega-1)-hydroxylase) with those of P-450 (testosterone 16 alpha-hydroxylase) produces a new stereospecific hydroxylase activity

cDNA for chimeric P-450 consisting of the amino-terminal 462 residues of P-450 (laurate (omega-1)-hydroxylase) and the remaining 28 residues of P-450 (testosterone 16 alpha-hydroxylase) was constructed and expressed in yeast cells. The resulting chimera could catalyze laurate (omega-1)-hydroxylation and benzphetamine N-demethylation at much higher rates than the parental P-450s, but exhibited the same specificity towards fatty acid substrates as the wild-type laurate hydroxylase. When testosterone was examined as a substrate, the 16 beta-hydroxylated product, which cannot be formed by either of the parental P-450s, was detected, suggesting that the laurate hydroxylase contains a structure that is capable of binding testosterone at a proper orientation so that it can be hydroxylated at the 16 beta position.

[Blood flow in the operating field during controlled hypotension by nitroglycerin, trimetaphan and prostaglandin E1]

We used the laser flowmeter to measure and compare the effect of nitroglycerin (TNG), trimetaphan (TMP) and prostaglandin E1 (PGE1) on the blood flow of operating field during hypotension induced by each drug. The study was done in 33 patients (TNG:13, TMP:13 and PGE1:7) anesthetized with modified NLA who underwent radical mastectomy. We put the probe of the laser flowmeter on the skin of the opposite breast to the operating field and measured the skin blood flow change. Measurements were made before and during hypotension induced by each drug. TMP-induced hypotension decreased blood flow significantly (P less than 0.05), but TNG and PGE1 had no significant effect. Intraoperative blood losses of TNG and PGE1 group were not significantly larger than that of TMP group. From this study we conclude that TNG, TMP and PGE1 can dry the operating field and decrease intraoperative blood loss similarly. Therefore we should choose the drugs to induce hypotension considering the effect of the drug on blood flow of the important organs and each patient's complications.

[Experimental study on the changes in circulatory kinetics due to an increase of intraabdominal pressure: the effective monitoring of the pressure of inferior vena cava]

We examined the change in circulatory kinetics due to an increase in intraabdominal pressure by adding pressure quantitatively to the abdominal wall by means of the manchette technique by using mongrel dogs, and obtained the following results: 1) By adding to the pressure to the abdominal wall, the pressure of inferior vena cava at the confluence of right and left common iliac veins showed a significantly higher value (p less than 0.05) than those at other 4 areas of the vena cava from just above the diaphragm to the above confluence. 2) All the dogs in the group with 20mmHg pressure survived for 24 hours, while those in the group with 40mmHg pressure died in all after survival between 13.8 +/- 2.05 hours. 3) The pressures of the inferior vena cava at the confluence of right and left common iliac veins with 20 and 40mmHg showed no significant difference immediately after the pressurization, but thereafter showed a increasing tendency in the group with 40mmHg (p less than 0.05). This increase in the pressure of the inferior vena cava lead to peripheral circulatory insufficiency. 4) The measurement of the pressure of the inferior vena cava at the confluence of right and left iliac veins in case of increased intraabdominal pressure seems to be an effective index for the risk of intraabdominal pressure.

Identification of regions functioning in substrate interaction of rabbit liver cytochrome P-450 (laurate (omega-1)-hydroxylase)

The nucleotide sequence of cDNA for rabbit liver cytochrome P-450 (laurate (omega-1) hydroxylase) was replaced with that for rabbit liver cytochrome P-450 (testosterone 16 alpha-hydroxylase) in various regions coding for the amino acid sequence between residues 43 and 261. Six chimeric cDNAs thus constructed were cloned into expression vector pAAH5, and expressed in Saccharomyces cerevisiae AH22 cells under the control of yeast ADH1 promoter. Chimeric P-450s synthesized in the transformed yeast cells were purified partially and their catalytic and spectral properties were examined and compared with those of the chimeric P-450 which is considered to possess the same catalytic properties as the wild-type P-450. In the oxidized state the chimeric P-450s exhibited a low-and high-spin mixed-type absorption spectrum of cytochrome P-450 and the spectrum was converted to a typical high-spin type on addition of laurate or caprate, indicating the binding of the fatty acids to the substrate site of the chimeric P-450s. However the affinities of the fatty acids for the chimeras devoid of the sequence of P-450 (laurate (omega-1)-hydroxylase) in either of the regions spanning residues 90-125 and 210-261 were 10 to 20 times lower than those for the chimeras containing the sequence of the wild-type P-450 in both regions. The latter chimeras have about the same affinities as the chimera which is essentially the wild-type P-450.(ABSTRACT TRUNCATED AT 250 WORDS)

[A case of adenocarcinoma of the nasal cavity associated with syndrome of inappropriate secretion of antidiuretic hormone(SIADH)]

An inappropriate antidiuretic hormone secretion (SIADH) has been recognized as the cause of hypotonic hyponatremia, and the occurrence of this syndrome, accompanied by an ADH-producing adenocarcinoma in the nasal cavity, is reported. In February, 1987, a 50-year-old male, showing sights of delirium, disorientation, and irritability was admitted to the hospital. The patient was observed to be healthy, except for a neck lymphnode metastasis that was present up to the time of his hospitalization. The hyponatremia was incidentally found, although dehydration or intravascular volume depletion were not noted. These neuropsychiatric symptoms were considered to be associated with hyponatremia due to SIADH. He had had a partial maxillectomy, a neck dissection, and irradiation to the nose and nasal cavity 32 months earlier, and then underwent a surgical resection of the neck metastasis; he had a total of 10 other operations before the onset of the symptoms. Upon initial inspection, since neither an intracranial invasion nor a brain metastasis was found, we diagnosed that his symptoms were due to an autonomic disturbance caused by surgical and mental "stress". When he died of cardiac failure due to a mediastinal invasion 8 months after the onset of SIADH, tumor tissues was extirpated in an autopsy and was then cultured. In this manner, it was proved that the tumor cells had been producing ADH. This procedure clarified that the syndrome had resulted from an ADH-producing tumor of the nasal cavity.

[A case of congenital laryngeal web with subglottic stenosis]

A severe case of congenital laryngeal web with subglottic stenosis was reported. The patient had weak crying after birth and stridor was noticed from one month old. He had tracheostomy at two month old and the incision of the web was attempted under laryngomicrosurgery with CO2 LASER, although the attempt failed due to combined subglottic stenosis. The "trough method" was applied at the age of one year. The web was incised and subglottic granulation including the excessive cartilaginous tissue was removed through a laryngotracheal fissure. A piece of silicone membrane was inserted between the vocal cords preventing from adhesion and a silicone tube stent was also inserted into the subglottic space and trachea to keep the laryngotracheal space open widely. After one month and a half, the silicon membrane and silicon tube were removed and a silicon T-tube was inserted instead of the silicon tube. The anterior wall of the laryngotracheal space was closed using a hinge flap. The patient can vocalize and does not complain of dyspnea at present, one year after the removal of the T-tube.

[A case report of large cell lung cancer detected in the course of antituberculous therapy after a giant bullectomy]

A case of a 60-year-old who male developed lung cancer after surgical resection of a emphysematous giant bulla. At first, he showed a emphysematous giant bulla associated with infected bulla in the right lung on the chest roentgenograph. After a giant bullectomy the resected specimen, suggested possible pulmonary tuberculosis. Thereafter, he was followed for one year with antituberculous therapy. Nevertheless, the chest roentgenograph taken one year after surgery, showed a new tumor density (1.5 x 2.0 cm) in the right lung. Due to the rapid growth of the lung tumor, right upper lobectomy was performed. The histological diagnosis was a large cell lung cancer (giant cell type). The postoperative staging of the tumor proved to be T2N0M0. He was treated with systemic chemotherapy of CDDP 120 mg, VDS 4.5 mg, and MMC 12 mg. Unfortunately, he died of cancer recurrence 5 months after lobectomy. Clinical evaluation of the emphysematous giant bulla associated with lung cancer was performed.

Trichinella spiralis: antigenic substances associated with the alimentary tract

Postembedding immunogold and immunoperoxidase staining methods revealed that substances occupying the lumen of the esophagus and the midgut were antigenic for both Wistar rats and humans. Specificity of the alimentary tract-associated antigen was assessed by reacting these substances with a panel of serum pools from patients with non-Trichinella helminth infections, including anisakiasis, paragonimiasis, gnathostomiasis, fascioliasis, dirofilariasis, and trichuriasis. The substances had no, or negligible, cross-reactivity among the serum pools with the only exception of severe trichuriasis serum. Cytochemical staining revealed that the substances are PAS positive and are stained red by azan, and the midgut-occupying substance was equipped with exposed concanavalin A-binding sites. The present data suggest the alimentary tract-associated antigen can be purified by lectin affinity chromatography and may be used as a fairly specific antigen for immunodiagnostic purposes.

[Enzyme immunoassay for arginine vasopressin (AVP). 2. Serum interference and the measurement of plasma samples]

The effect of serum interference on enzyme immunoassay (EIA) for arginine vasopressin (AVP) was studied. Before measurement, plasma was applied on an affinity chromatography to remove AVP and then treated with the acetone-ether method which is usually used for AVP extraction of plasma samples. The AVP-free plasma extract was used to obtain a plasma AVP standard which was compared with various buffer standards of AVP. As a result, the enzyme activities of plasma AVP standard were always lower than those of buffer standards even though the concentration of buffer was increased or added by gelatin. Therefore, EIA for AVP was clinically applicable by using the AVP-free plasma for the standard. Plasma samples were drawn in various clinical conditions and measured for AVP by plasma AVP standard to examine reproducibility and correlation with radioimmunoassay (RIA). The values measured repetitively for the same samples were reproducible. The values measured by EIA correlated well with those measured by RIA (y = 0.67 + 1.13x, r = 0.96). These indicates that EIA for AVP could be applied clinically to measure physiological levels of plasma AVP.

[Enzyme immunoassay for arginine vasopressin (AVP). 1. Enzyme labelling of AVP and its application for AVP standard curve]

Enzyme immunoassay for arginine vasopressin (AVP) was developed in this study. Enzyme-labelling of AVP and then application of the enzyme-labelled AVP to make an AVP standard curve were done. Also, the anti-AVP antibody was obtained from the immunized rabbits. The enzyme (beta-D-galactosidase) was combined with AVP by using the N-hydroxysuccinimide ester of N-(4-carboxycyclohexylmethyl)-maleimide. The AVP-beta-D-galactosidase complex was examined for the competitive binding with AVP to the anti-AVP antibody. Then, the solid phase (polystylene bead) coupled with IgG fraction of anti-rabbit IgG serum (goat) was used to separate the antigen-antibody complex. The enzyme activity of this complex was measured to obtain an AVP standard curve. As a result, enzyme immunoassay for AVP described here was sufficiently sensitive and specific. Thus, this enzyme immunoassay could be applied for the determination of physiological levels of AVP in plasma. It is advantageous that the AVP-beta-D-galactosidase complex was stable for several years with respect to enzyme activity and immunological activity. The specific anti-AVP antibody with high titer was gained from the immunized rabbits using bovine thyroid globulin as a carrier protein.

Studies on prodrugs. 11. Synthesis and antimicrobial activity of N-[(4-methyl-5-methylene-2-oxo-1,3-dioxolan-4-yl)oxy]norfloxacin

The chemical oxidation of N-[(5-methyl-2-oxo-1,3-dioxol-4-yl)methyl] norfloxacin (2) was carried out to afford N-[(4-methyl-5-methylene-2-oxo-1,3-dioxolan-4-yl)oxy]norfloxacin (4). In vitro, 4 exhibited lower activity than that of norfloxacin (NFLX, 1) for both Gram-positive and Gram-negative bacteria. However, in vivo the activity of 4 was higher than that of NFLX. Bioavailability studies in mice showed that 4 liberated a higher concentration of NFLX in plasma than NFLX itself when administered orally. From these data, 4 obtained by the chemical oxidation of 2 functioned as a prodrug of NFLX as well as did 2. The mechanism of the formation of 4 is interpreted in terms of [2,3]-sigmatropic rearrangement.

Ultrastructural localization of antigenic substances in Trichinella spiralis

The in situ localization of antigenic substances in Trichinella spiralis muscle larvae was demonstrated at the subcellular level. Larvae recovered from mouse muscle were fixed with half-strength Karnovsky fixative, dehydrated with alcohol, and embedded in LR White resin. Ultrathin sections were incubated with sera from infected Wistar rats and, subsequently, protein A-gold complex. The specificity of the immunostaining was confirmed by a control experiment. Positively immunostaining structures included the stichocyte granules, body cuticle, hindgut cuticle, hypodermis, hemolymph, glycogen aggregates, esophagus-occupying substance (EOS), midgut-occupying substance (MOS), brush border, cytoplasmic granules in the cord, intestinal gland cell granules, and discrete areas in the genital primordial cell. However, the esophageal cuticle, nucleus, nucleolus, mitochondria, rough endoplasmic reticulum, and muscle fibers were negative by immunostaining.

[Occlusion of a perforating artery, by descending tentorial herniation after head injury, supplying deep cerebral structure--report of 4 cases and their CT evaluation]

Four cases with descending tentorial herniation (DTH) after head injury which showed thalamic, mesencephalic and basal ganglionic low density areas (LDAs) manifesting a infarction in postoperative CT films are reported, and a possible mechanism are discussed in this paper. Case 1: Bilateral acute subdural hematoma with left DTH showed LDAs in the anterior part of the bilateral thalami, left occipital lobe and midbrain. The estimated occluded arteries included the anterior thalamoperforating artery(AThA), posterior cerebral artery and midbrain perforator. Case 2: Right acute epidural hematoma with DTH showed LDAs in the anterior part of the right thalamus and in the left globus pallidus. The estimated occluded arteries included the AThA and anterior choroidal artery. Case 3: Right acute epidural hematoma with DTH showed LDAs in the anterior part of the left thalamus, and in the left midbrain tegmentum. The estimated occluded artery was the interpeduncular thalamoperforating artery (IThA). Case 4: Right chronic subdural hematoma with DTH showed LDA mainly in the left thalamus except for the superior thalamic region. The estimated occluded arteries included the AThA and/or IThA and thalamogeniculate artery. Cases 1 and 4 were adult males and cases 2 and 3 were infant males, and the prognosis was good in the infant males, and poor in the adult males. Each of the 4 cases showed no loss of consciousness just after the head injury while 3 out of them deteriorated within several hours, and one was a case of chronic subdural hematoma.(ABSTRACT TRUNCATED AT 250 WORDS)

[Central nervous cryptococcosis giving rise to ascites after ventriculo-peritoneal shunting--a case report]

The ascites retention as a complication after ventriculo-peritoneal shunting (V-P shunt) is very rare. In this paper, a case of central nervous cryptococcosis giving rise to ascites after a V-P shunt is presented. A 45-year-old female was referred to Prefectural Gifu Hospital complaining of nausea and disturbance of recent memory. She had no remarkable medical history. CT scan films on admission showed enlarged ventricles except for the fourth ventricle, indicating an obstructed hydrocephalus. Lumbar cerebrospinal fluid (CSF) examinations revealed an increase in cell counts (mostly lymphocytes) and protein content, and positive Pandy and Nonne-Apelt reactions. Based on this information, it was tentatively suggested that she had a certain infection in the central nervous system such as mycosis or tuberculosis etc. Continuous ventricular drainage was performed for about three weeks. During this period, several lumbar and ventricular CSF cultures were negative. Therefore, a V-P shunt operation was performed. However, about seven weeks after the V-P shunt, she developed abdominal distention without any peritoneal signs. Abdominal CT scan films showed an abnormal ascites retention. Laboratory tests revealed positive CRP and increased ESR values. Again, it was suggested that she had not only a central nervous but also a peritoneal infection giving rise to ascites. From samples of ventricular CSF and ascites, cryptococcus neoformans was cultured. The lumbar CSF revealed positive latex agglutination titer for cryptococcal antigen, although the culture was negative. The ascites examination revealed an increase in cell counts (mostly lymphocytes) and protein content, and positive Rivalta and Runneberg reactions.(ABSTRACT TRUNCATED AT 250 WORDS)