Radiological findings in acute Haemophilus influenzae pulmonary infection

OBJECTIVE

The aim of this study was to assess pulmonary thin-section CT findings in patients with acute Haemophilus influenzae pulmonary infection.

METHODS

Thin-section CT scans obtained between January 2004 and March 2009 from 434 patients with acute H. influenzae pulmonary infection were retrospectively evaluated. Patients with concurrent infection diseases, including Streptococcus pneumoniae (n=76), Staphylococcus aureus (n=58) or multiple pathogens (n=89) were excluded from this study. Thus, our study group comprised 211 patients (106 men, 105 women; age range, 16-91 years, mean, 63.9 years). Underlying diseases included cardiac disease (n=35), pulmonary emphysema (n=23), post-operative status for malignancy (n=20) and bronchial asthma (n=15). Frequencies of CT patterns and disease distribution of parenchymal abnormalities, lymph node enlargement and pleural effusion were assessed by thin-section CT.

RESULTS

The CT findings in patients with H. influenzae pulmonary infection consisted mainly of ground-glass opacity (n=185), bronchial wall thickening (n=181), centrilobular nodules (n=137) and consolidation (n=112). These abnormalities were predominantly seen in the peripheral lung parenchyma (n=108). Pleural effusion was found in 22 patients. Two patients had mediastinal lymph node enlargement.

CONCLUSION

These findings in elderly patients with smoking habits or cardiac disease may be characteristic CT findings of H. influenzae pulmonary infection.

Localised right upper-lobe pulmonary oedema caused by extension of giant cell carcinoma to the mitral valve

Giant cell carcinoma of the lung is a very rare primary malignant tumour and localised right upper-lobe pulmonary oedema is also unusual. We report a case of giant cell carcinoma, which invaded the left atrium through the left pulmonary vein and caused localised right upper-lobe pulmonary oedema.

Pulmonary thin-section CT findings in acute Moraxella catarrhalis pulmonary infection

OBJECTIVE

Moraxella catarrhalis is an important pathogen in the exacerbation of chronic obstructive pulmonary disease. The aim of this study was to assess the clinical and pulmonary thin-section CT findings in patients with acute M. catarrhalis pulmonary infection.

METHODS

Thin-section CT scans obtained between January 2004 and March 2009 from 292 patients with acute M. catarrhalis pulmonary infection were retrospectively evaluated. Clinical and pulmonary CT findings in the patients were assessed. Patients with concurrent infection including Streptococcus pneumoniae (n = 72), Haemophilus influenzae (n = 61) or multiple pathogens were excluded from this study.

RESULTS

The study group comprised 109 patients (66 male, 43 female; age range 28-102 years; mean age 74.9 years). Among the 109 patients, 34 had community-acquired and 75 had nosocomial infections. Underlying diseases included pulmonary emphysema (n = 74), cardiovascular disease (n = 44) or malignant disease (n = 41). Abnormal findings were seen on CT scans in all patients and included ground-glass opacity (n = 99), bronchial wall thickening (n = 85) and centrilobular nodules (n = 79). These abnormalities were predominantly seen in the peripheral lung parenchyma (n = 99). Pleural effusion was found in eight patients. No patients had mediastinal and/or hilar lymph node enlargement.

CONCLUSIONS

M. catarrhalis pulmonary infection was observed in elderly patients, often in combination with pulmonary emphysema. CT manifestations of infection were mainly ground-glass opacity, bronchial wall thickening and centilobular nodules.

The correlation between the telomeric parameters and the clinical laboratory data in the patients with brain infarct and metabolic disorders

OBJECTIVE

To elucidate the correlation between the telomere length and subtelomeric methylated status in peripheral leukocytes and the laboratory data of inpatients with brain infarction and metabolic disorders. This is the first report describing a link between routine clinical laboratory data and genomic aging.

DESIGN

Cross-sectional population-based study.

SETTING

Chronic disease ward of Kyushu University Hospital at Beppu in Japan.

PARTICIPANTS

Inpatients with brain infarction and metabolic disorders.

MEASUREMENTS

The laboratory data of male patients were collected and the telomeric parameters in their peripheral leukocytes were determined by a Southern blot analysis with methylation-sensitive and insensitive isoschizomers. Any correlations between the laboratory data and the telomeric parameters were assessed.

RESULTS

The patients revealed a significant correlation among the fasting blood sugar, HbA1c, serum creatinine and urea nitrogen levels with the mean telomere length, expression of long telomeres ( > 9.4 kb), or the subtelomeric hypermethylation status of long telomeres.

CONCLUSION

Our results suggested that the hyperglycemia and renal function of patients with metabolic disorders correlated positively with the aging-associated telomeric changes.

Acute Klebsiella pneumoniae pneumonia alone and with concurrent infection: comparison of clinical and thin-section CT findings

The purpose of this study was to identify the clinical and thin-section CT findings in patients with acute Klebsiella pneumoniae pneumonia (KPP) alone and with concurrent infection. We retrospectively identified 160 patients with acute KPP who underwent chest thin-section CT examinations between August 1998 and August 2008 at our institution. The study group comprised 80 patients (54 male, 26 female; age range 18-97 years, mean age 61.5) with acute KPP alone, 55 (43 male, 12 female; age range 46-92 years, mean age 76.0) with KPP combined with methicillin-resistant Staphylococcus aureus (MRSA) and 25 (23 male, 2 female; age range 56-91 years, mean age 72.7) with KPP combined with Pseudomonas aeruginosa (PA). Underlying diseases in patients with each type of pneumonia were assessed. Parenchymal abnormalities were evaluated along with enlarged lymph nodes and pleural effusion. In patients with concurrent pneumonia, underlying conditions such as cardiac diseases, diabetes mellitus and malignancy were significantly more frequent than in patients with KPP alone. The mortality rate in patients with KPP combined with MRSA or PA was significantly higher than in those with KPP alone. In concurrent KPP, CT findings of centrilobular nodules, bronchial wall thickening, cavity, bronchiectasis, nodules and pleural effusion were significantly more frequent with concurrent pneumonia than in those with KPP alone.

Effects of fentanyl infusion on tracheal intubation and emergence agitation in preschool children anaesthetized with sevoflurane

BACKGROUND

Sevoflurane can be used as a sole agent for intubation in children, but studies have suggested that it is associated with emergence agitation. Fentanyl infusions can be used both to facilitate intubation and decrease emergence agitation. We investigated the effects of fentanyl on conditions at intubation and on emergence from sevoflurane anaesthesia without confounding nitrous oxide or premedication.

METHODS

IRB approval and informed consent were obtained. Subjects comprised 150 ASA physical status I or II (age, 2-6 yr). Anaesthesia was induced with sevoflurane in oxygen and maintained using a predetermined concentration of sevoflurane. Subjects were randomly allocated to receive one of three doses of fentanyl: vehicle only (control group), a bolus dose of 1 microg kg(-1) followed by a continuous infusion of 0.5 microg kg(-1) h(-1) (F1 group), or a bolus dose of 2 microg kg(-1) followed by a continuous infusion of 1 microg kg(-1) h(-1) (F2 group). Sevoflurane minimum alveolar concentration for tracheal intubation (MAC(TI)) and emergence agitation score were assessed.

RESULTS

MAC(TI) values were 2.49%, 1.61%, and 1.16% in control, F1, and F2 groups, respectively (P<0.05). Agitation scores were 11.5, 7.0, and 2.6 in control, F1, and F2 groups, respectively (P<0.05).

CONCLUSIONS

Fentanyl infusion consisting of a bolus dose of 2 microg kg(-1) followed by a continuous infusion of 1 microg kg(-1) h(-1) facilitates tracheal intubation and smooth emergence in children anaesthetized using sevoflurane.

CLINICAL TRIAL REGISTRATION

this study was started in 2000 and was finished in 2008. We had no registration number. IRB approval was obtained.

Distribution of the first metastatic lymph node in colon cancer and its clinical significance

INTRODUCTION

The pattern of distribution of lymph node metastasis in resected specimens of colon cancer has been rarely reported in the English literature. The aim of this study was to determine the location of the first metastatic lymph node, giving insight into the drainage pattern of colon cancer lymphatics.

METHOD

All lymph nodes in the mesentery of the resected specimen were carefully harvested and their precise locations documented. Patients with a single metastatic node in the resected specimen were included in the study.

RESULTS

Ninety-three patients with only one metastatic lymph node found on histology were studied. The mean number of lymph nodes per specimen was 22.3 (range: 8-72). The patients' first metastatic node was not directly below the tumour in 48% of cases. The first metastatic node was found in the region either along the feeding vessels (skipping the pericolic nodes) or in the pericolic area outside 5 cm on either side of the tumour edge in 18% of cases. No factors were found to be predictive for lymph node metastasis occurring elsewhere other than in the pericolic region just below the tumour.

CONCLUSION

Although there has been recent resurgence of interest in using sentinel node biopsy to limit surgical dissection to facilitate minimally access and natural orifice surgery, the present study is a warning that this may compromise oncological clearance. Radical surgery should remain standard practice for colorectal cancer.

Extraction of alkali metal picrates with poly- and bis(crown ether)s

Extraction of alkali metal picrates by new poly- and bis(crown ether)s containing benzo-15-crown-5 and benzo-18-crown-6 moieties was carried out with chloroform as water-immiscible solvent. The poly- and bis(crown ether)s were found to extract the picrates more effectively than the corresponding monocyclic crown ethers. In particular, poly- and bis(benzo-15-crown-5), and bis(benzo-18-crown-6) are remarkably effective extracting reagents for potassium and rubidium, and for caesium, respectively. Extraction equilibrium constants and the complexation constants in the chloroform phase were also evaluated and the contribution of the complexation constants to the extractability is discussed.

Multimedia article. Transanal endoscopic resection of the rectum with high ligation on a swine model--a novel type of natural orifice endoscopic surgery

We present the video of a transanal radical resection of the rectum on a swine model (see Video, Supplemental Digital Content 1, http://links.lww.com/DCR/A4). The equipment used included simple instruments used in perianal surgery and a flexible endoscope with diathermy. The equipment and skill set required for this technique is easily accessible and reproduced. The potential exists to further develop this procedure with the ultimate aim of performing an incisionless and painless radical resection of the rectum in humans.

Influence of humic substances on the63Ni migration through crushed rock media

Column experiments were performed to study effects of humic acid on the mobility of63Ni(II) through crushed granite media. The63Ni concentration passing the column increased with increasing the concentration of humic acid. The migration behavior of63Ni, either retarded or non-retarded, could not be simulated by the widely-accepted, instantaneous equilibrium sorption model. The rate limited transformation model, taking into account non-equilibrium complexation of63Ni with humic acid facilitates the description of the observed migration behavior of63Ni.

[Successful mitral valve plasty in a 6-month-old baby suffering from severe mitral valve regurgitation]

A 6-month-old male infant was referred to our hospital with diagnosis of severe left heart failure stemming from severe mitral valve regurgitation (MR). He showed severe decompensation, and emergency operation was performed. Intraoperative transesophageal echocardiogram showed ruptured chordae of the posterior leaflet at P1 and P3 sites. The both sites of the posterior leaflet were resected and sutured. Bilateral Kay annuloplasty and partial annuloplasty at the sites of P1 and P3 were also performed. Postoperative echocardiogram showed only trivial MR. He made successful recovery after surgery.

High expression of HSP47 in ulcerative colitis-associated carcinomas: proteomic approach

BACKGROUND

Ulcerative colitis (UC) is a chronic relapsing inflammatory bowel disease, known to be associated with a markedly increased risk of colorectal carcinoma development.

METHODS

Using proteomic analysis with two-dimensional gel electrophoresis and mass spectrometry, differentially expressed proteins were assessed between UC-associated cancer and sporadic colon cancer cell lines. Western blot and immunostaining were performed for confirming the expression.

RESULTS

Heat-shock protein of 47 kDa (HSP47) was identified as one of the proteins expressed more highly in UC-associated cancer cell lines, and an immunohistochemical examination confirmed significantly higher levels of HSP47 in UC-associated colon cancers than in sporadic counterparts, the expression increasing with a progression of neoplastic lesions. Heat-shock protein of 47 kDa was further found to be coexpressed with type I collagen in the cytoplasm, and both HSP47 and type I collagen were released from cultured cells into the culture medium.

CONCLUSION

These results suggest that overexpression of HSP47 is a unique characteristic of UC-associated carcinoma related to type I collagen synthesis, with possible clinical applications.

Comparison of incidence and pattern of interstitial lung disease (ILD) during erlotinib and gefitinib treatment in Japanese pts with NSCLC

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Background: Erlotinib was approved in Dec 2007 in Japan, and incidence and pattern of ILD during its therapy for Japanese pts with NSCLC has not still been determined, although we had previously reported the frequency of ILD through the gefitinib treatment [PASCO2004, #7063]. In this study, we intended to elucidate this issue in pts receiving erlotinib therapy. Methods: We reviewed the clinical records of 159 pts who had initiated erlotinib therapy last year (cohort A), and of 330 pts receiving gefitinib between 2000 and 2003 (cohort B) for comparing the incidence and pattern of ILD during the both TKI treatments. Toxicity data during the first months after the initiation of TKIs were obtained. Results: The demographics of 489 pts were as follows; M:63%, Ad:75%, and PS 0–1:69%. None of pts in the cohort B received erlotinib therapy before the gefitinib treatment, whereas 66 of the 159 cohort A pts (42%) were given gefitinib before the erlotinib therapy. In 23% and 28% of the pts in the cohorts A and B, erlotinib and gefitinb treatments were discontinued within 1 month after the initiation of TKI therapy, respectively. Two pts (1.3%) developed ILD in the cohort A during the first month of erlotinib treatment, while 8 ILD-events (2.4%) were observed in the gefitinib therapy (cohort B) during the same treatment period. Both 2 pts who developed ILD during the erlotinib therapy had not had a history of prior gefitinib treatment. The toxicity grades of ILD were as follows: grades 1 and 2 in 1 each (cohort A) and grades 3, 4 and 5 in 1, 1 and 6 pts, respectively (cohort B). Statistically significant factors affecting the occurrence of ILD by multivariate analysis were presence of prior pulmonary fibrosis (OR=37.3, p<0.01) and poor PS (OR=6.4, p=0.02), but type of TKIs was not a significant risk factor for ILD. Conclusions: In this setting, the type of TKIs did not affect the incidence of ILD although its incidence after the initiation of erlotinib was somewhat low as compared with that during gefitinib therapy. In addition, the grade of ILD was less severe in the cohort A. These might be partly due to a patient selection based on the recent awareness of Japanese physicians regarding the risk factors for ILD events who learned it through the gefitinib treatment.

No significant financial relationships to disclose.

[A project of the 6th chapter of the Oncology Research Group, Aichi Prefectural Society of Hospital Pharmacists: an attempt to make a pamphlet for patients undergoing LEED therapy, based on analysis of complications]

To date, medical guidance for patients undergoing cancer chemotherapy has mainly been with regard to individual medicines. Only a few reports have been available dealing with information on side effects by a regimen unit. Therefore, we accumulated information on side effects and made a pamphlet for patients with malignant lymphoma undergoing peripheral blood stem cell transplantation after Melphalan (L-PAM), Cyclophosphamide (Endoxan), VP-16 (etoposide) and Dexamethasone (LEED)therapy, for the purpose of explanation for patients on pharmacist's rounds. This pamphlet consists of time schedule of anticancer therapy, harmful phenomena due to cancer chemotherapy and counterplans for such side effects. Easy-to-understand graphics are used to explain the appearance and duration of side effects by anticancer agents. This pamphlet will serve to improve comprehension and the attitude of patients toward cancer chemotherapy. The pamphlets will also be a useful tool to reassure patients on pharmacist's rounds.

Pioglitazone attenuates tactile allodynia and microglial activation in mice with peripheral nerve injury

To test the possibility of a peroxisome proliferator activated receptor (PPAR) γ agonist to treat neuropathic pain, we examined the effects of pioglitazone, a PPARγ agonist, on tactile allodynia and expression of activated microglia in the dorsal horn of spinal cord using neuropathic pain model. The unilateral sciatic nerve was partially ligated (PSL) in male ICR mice. Pioglitazone (1-25 mg/kg p.o.) was administrated to mice once daily for five days immediately after PSL. We stimulated the footpad of the hind paw of mice using a von Frey filament to estimate tactile allodynia on day 5 of PSL. The activated microglia in the lumbar spinal cord was observed by immunohistochemistry with anti-Iba1 antibody, a marker for activated microglia. The number of Iba1-immunoreactive cells was counted in the dorsal horn spinal cord. On day 5, significant allodynia was developed in PSL mice. Pioglitazone significantly attenuated the tactile allodynia in a dose of 1-25 mg/kg. However, these doses of pioglitazone did not affect nociceptive responses in sham mice. Moreover, on day 6, the number of activated microglia was significantly increased in the ipsilateral dorsal horn of mice. The increase in the number of activated microglia induced by PSL was significantly suppressed by pioglitazone (1-25 mg/kg p.o.). Pioglitazone did not affect the number of activated microglia in sham mice. These results suggest that PPARγ activation inhibits the development of tactile allodynia and the expression of activated microglia in the dorsal horn of spinal cord in mice with PSLinduced peripheral nerve injury.

Metabolism of amyloid precursor protein in COS cells transfected with a beta-secretase candidate

Thimet oligopeptidase (TOP) is a thiol- andmetallo-dependent peptidase and has been shown to beone of the beta-secretase candidates. TOPexpressed in COS cells cleaved amyloid precursorprotein (APP) at the beta-secretase site, and wefound a proteolytic product of APP called secretedform of APP by beta-secretase (sAPPbeta) in theconditioned media. Here we demonstrate thatsAPPbeta was increased in conditioned media whenTOP was coexpressed in COS cells with APP and treatedwith an ADAM inhibitor SI-27. In addition, althoughTOP expressed in COS cell was localized at nuclei orGolgi apparatus, it exclusively colocalized at Golgiapparatus when APP was coexpressed with TOP.

Decrease of 4,5,6,7-tetrachlorophthalide in paddy field soil after aerial application

Variation in the fungicide, 4,5,6,7-tetrachlorophthalide (phthalide), in paddy field soil was investigated in order to evaluate its decrease after aerial application by a radio-controlled helicopter. The maximum concentrations of phthalide were 309-320 microg/kg dry, which were 83%-96% of the applied phthalide. The organic carbon normalized soil sorption coefficient (K(oc)) was calculated to be 94-96 mL/g at 1 h after the application. The calculated K(oc) values increased to 620-1,300 mL/g from 1 through 9 days after the application and then 4,700-7,200 mL/g 14 days after the application. The half-life of the phthalide was calculated to be 20-31 days.

[Construction and evaluation of new anti-cancer drug prescription support system to promote proper use of anticancer drugs]

In the Nagoya City University Hospital, we started an Anti-cancer drug prescription support system according to which physicians input the injection prescription order from the regimen, together with the Outpatient Oncology Unit established in May, 2007. In order to prepare the anti-cancer drug more safely, we constructed a new Anti-cancer drug preparation support system(new system) at the same time. We investigated and evaluated the time and accuracy required for the preparation between the old and new systems. In the old system, we used electronic calculators or manual methods to perform calculations in the prescription procedure. In the new system, notes are automatically printed out with the kind, amount, and extraction amount of the dissolution liquid according to the dosage of the given anti-cancer drug for the injection prescription. Therefore, even a person with little experience in the preparation can confirm the preparative procedure accurately and promptly. Moreover, this system improves the efficiency of the preparation and it is thought that the utility is high as a part of the risk management.

[Investigation of the accurate measurement of the basic imaging properties for the digital radiographic system based on flat panel detector]

PURPOSE/AIM OF THE EXHIBIT: The purpose of this exhibit is: 1. To explain "resampling", an image data processing, performed by the digital radiographic system based on flat panel detector (FPD). 2. To show the influence of "resampling" on the basic imaging properties. 3. To present accurate measurement methods of the basic imaging properties of the FPD system.

CONTENT ORGANIZATION

1. The relationship between the matrix sizes of the output image and the image data acquired on FPD that automatically changes depending on a selected image size (FOV). 2. The explanation of the image data processing of "resampling". 3. The evaluation results of the basic imaging properties of the FPD system using two types of DICOM image to which "resampling" was performed: characteristic curves, presampled MTFs, noise power spectra, detective quantum efficiencies. CONCLUSION/SUMMARY: The major points of the exhibit are as follows: 1. The influence of "resampling" should not be disregarded in the evaluation of the basic imaging properties of the flat panel detector system. 2. It is necessary for the basic imaging properties to be measured by using DICOM image to which no "resampling" is performed.

Bronchodilating effect and anabolic effect of inhaled procaterol

While the use of oral beta (2)-agonists by athletes is prohibited because of their anabolic effects, some inhaled beta (2)-agonists can be used in accordance with the World Anti-Doping Agency regulations. We examined the dose disparity between the bronchodilating effect and anabolic effect of inhaled procaterol, a selective beta (2)-agonist, to determine if the drug might be effective for athletes with asthma. Intact rats were given nebulized procaterol at 0.001, 0.01, 0.1 and 1 mg/mL by inhalation, and its inhibitory effect on carbachol-induced bronchoconstriction was evaluated. Castrated rats were given nebulized procaterol at 0.03, 0.1, 0.3 and 1 mg/mL by inhalation 3 times a day for 14 days, and anabolic markers (body weight gain, weight of the levator ani muscle and gastrocnemius muscle) were measured. At 0.01 mg/mL and higher, procaterol dose-dependently inhibited carbachol-induced bronchoconstriction with a significant effect. At doses of up to 0.3 mg/mL, there were no signs indicating an anabolic effect of procaterol. At 1 mg/mL, however, a slight but statistically significant increase in the weight of the levator ani muscle was observed with no significant changes in other anabolic markers. It was suggested that inhaled procaterol might be useful for athletes with asthma because of the big dose disparity between its bronchodilating effect and anabolic effect in rats.

Variation of 4,5,6,7-tetrachlorophthalide in water after aerial application to rice cultivation area

Variation in the fungicide, 4,5,6,7-phthalide, in water was investigated in order to evaluate the runoff of the fungicide after aerial application to paddy fields by a radio-controlled helicopter. The survey was conducted for 4 months after the application. The average and maximum concentrations of phthalide were 3.7-4.4 microg/L and 30.5-33.8 microg/L in the paddy fields, 0.37-0.64 microg/L and 2.7-7.5 microg/L in the drainage channels, and 0.18 and 0.83 microg/L in a river, respectively. The runoff ratios of the aerially applied phthalide from the paddy fields into the drainage channels were calculated to be 1.7-2.4%.

Asymmetric Oscillation Distorts the Perceived Heaviness of Handheld Objects

Weight perception has been of great interest for over three centuries. Most research has been concerned with the weight of static objects, and some illusions have been discovered. Here, we show a new illusion related to the perception of the heaviness of oscillating objects. We performed experiments that involved comparing the weight of two objects of identical physical appearance but with different gross weights and oscillation patterns (vibrating vertically at frequencies of 5 or 9 cycles per second with symmetric and asymmetric acceleration patterns). The results show that the perceived weight of an object vibrating with asymmetric acceleration increases compared to that with symmetric acceleration when the acceleration peaks in the gravity direction. In contrast, almost no heaviness perception change was observed in the anti-gravity direction. We speculate that the reason for the divergence between these results is caused by the differential impact of these two hypothesized perceptual mechanisms as follows: the salience of pulse stimuli appears to have a strong influence in the gravity direction, whereas filling-in could explain our observations in the anti-gravity direction. The study of this haptic illusion can provide valuable insights into not only human perceptual mechanisms but into the design of ungrounded haptic interfaces.

Hypocarnitinemic hypoglycemia and heart failure in an infant with a constant parenteral elementary nutrition during measles vaccination-related febrile illness

A 1-year and 11-month-old female infant with bilateral lesions of the thalamus, basal ganglia, cerebellar and brainstem disease died from heart failure 9 days after being administered a measles vaccination. She had a high fever, hypocarnitinemic and non-ketotic hypoglycemia, serum levels of total carnitine 7.4 micromol/L, free carnitine 5.6 micromol/L, acylcarnitine 1.8 micromol/L and glucose 13 mg/dL. Due to feeding difficulty, the patient, however, had been administered parenteral elementary nutrition through a feeding tube since early infancy. The commercially available parenteral nutrition solutions do not contain carnitine. A secondary carnitine deficiency followed by non-ketotic hypoglycemia-related heart failure may readily develop even in a patient without valproic acid, during high fever.

Effects of KP-496, a novel dual antagonist at the cysteinyl leukotriene receptor 1 and the thromboxane A(2) receptor, on airway obstruction in guinea pigs

BACKGROUND AND PURPOSE

KP-496 is a novel dual antagonist for cysteinyl leukotriene receptor 1 (CysLT(1)) and thromboxane A(2) (TXA(2)) receptor (TP). The aim of this study was to evaluate the pharmacological profile of inhaled KP-496 and its effects on airway obstruction.

EXPERIMENTAL APPROACH

Antagonist activities of inhaled KP-496 were investigated using bronchoconstriction induced in guinea pigs by LTD(4) or U46619, a stable TXA(2) mimetic. Guinea pigs sensitized with injections of ovalbumin were used to assess the effects of inhaled KP-496 on bronchoconstriction induced by antigen (i.v.). Another set of guinea pigs were sensitized and challenged with ovalbumin by inhalation and the effects of inhaled KP-496 on immediate and late airway responses and airway hyperresponsiveness were investigated.

KEY RESULTS

KP-496 significantly inhibited LTD(4)- and U46619-induced bronchoconstriction in a dose-dependent manner. The inhibitory effects of KP-496 (1%) were comparable to those of montelukast (a CysLT(1) antagonist, p.o., 0.3 mg kg(-1)) or seratrodast (a TP antagonist, p.o., 3 mg kg(-1)). KP-496 (1%) and oral co-administration of montelukast (10 mg kg(-1)) and seratrodast (20 mg kg(-1)) significantly inhibited antigen-induced bronchoconstriction, whereas administration of montelukast or seratrodast separately did not inhibit antigen-induced bronchoconstriction. KP-496 exhibited dose-dependent and significant inhibitory effects on the immediate and late airway responses and airway hyperresponsiveness following antigen challenge.

CONCLUSIONS AND IMPLICATIONS

KP-496 exerts effects in guinea pigs which could be beneficial in asthma. These effects of KP-496 were greater than those of a CysLT(1) antagonist or a TP antagonist, in preventing antigen-induced airway obstruction.

The expression and production of vascular endothelial growth factor in oral mucosa equivalents

Angiogenesis is anticipated during wound healing. Vascular endothelial growth factor (VEGF) is a potent direct angiogenic factor that stimulates endothelial cell migration and proliferation in vitro and angiogenesis in vivo. Ex vivo produced oral mucosa equivalent (EVPOME) grafts have been reported to promote re-vascularization in the underlying tissue after grafting. The aim of this study was to evaluating the following: VEGF mRNA and its protein expression in EVPOME grafts, the protein levels in conditioned media produced by EVPOMEs, and the ability of VEGF to stimulate the growth of microvascular endothelial cells. VEGF mRNA expression and immunoreaction were found in basal and suprabasal layers. VEGF secreted by EVPOME was detected throughout the period of manufacture of the grafts, and became elevated for the first week at an air-liquid interface. Both EVPOME-conditioned media and a medium containing 10ng/mL recombinant human VEGF induced endothelial cell proliferation, while neutralization of VEGF by an antibody blocked cell growth. These results suggest that VEGF secreted by EVPOME grafts might assist initial vascularization after grafting, which is critical to subsequent graft survival.

Appropriate schedule of oral tegafur / uracil (UFT) in combination with irinotecan (CPT-11) and bolus 5-FU / l-leucovorin (LV) in patients (pts) with metastatic colorectal cancer (MCRC): A phase I study

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Background: FOLFIRI is one of the standard regimens for MCRC. Considering the burden of continuous 5-FU administration, oral fluoropyrimidine-based therapy has been proposed in several clinical trials; however, gastrointestinal toxicity makes it difficult to perform successive oral chemotherapy. Therefore, no previous study could confirm whether to replace FOLFIRI with oral regimen. In order to find an appropriate schedule of oral fluoropyrimidine with safety and efficacy instead of continuous infusion of 5-FU, clinical trial using CPT-11, bolus 5-FU / l-LV and oral UFT / LV was conducted in pts with MCRC. Methods: Pts with MCRC, age > 18 years, ECOG PS 0–2, adequate organ function, and no or 1 prior chemotherapy were eligible. Pts received CPT-11 (100mg/m2) / 5-FU (500mg/m2) / l-LV (15mg/m2) i.v. on day 1 and UFT (300mg/m2) / LV (75mg/body) p.o. on days 1–5 (level 1), days 1–7 (level 2), or days 1–10 (level 3). Each course was repeated every 14 days. After determining feasible UFT / LV schedule, CPT-11 was dose-escalated (level 4: 125 mg/m2; level 5: 150mg/m2). Results: Nineteen pts were enrolled. A dose-limiting toxicity (DLT) of grade 4 neutropenia lasting for > 4 days was observed in 1 pt at level 2. Additional 3 pts at this level showed no toxicity of grade 3 or 4. A DLT of treatment delay (>8 days) was observed in 1 pt at level 3 because of prolonged neutropenia. Other 2 pts at level 3 refused to continue treatment within 4 cycles because of prolonged grade 2 anorexia. Obvious difference in toxicity was observed between level 2 and level 3. Therefore, 7-day-administration of UFT / LV was recommended. No DLT was observed at level 4 and 5, and the recommended dose of CPT-11 was 150mg/m2. The overall response rate was 66.7%. The median time to disease progression was 8.0 months. Conclusions: This oral fluoropyrimidine-based regimen is considered feasible and effective. The treatment schedule of UFT might be a key to prevent an early dropout due to gastrointestinal toxicity. Further study will be needed to confirm toxicity and efficacy of this regimen compared to FOLFIRI profile.

No significant financial relationships to disclose.

Bacterial translocation in small intestinal ischemia-reperfusion injury and efficacy of Anti-CINC antibody treatment

The involvement of bacterial translocation in small intestinal ischemia-reperfusion injuries and the efficacy of using anti-CINC antibodies for treatment were investigated. A model for ischemia-reperfusion injury of the small intestine was constructed by clamping the supramesenteric artery (for 90 min) in rats. Anti-CINC antibodies and saline were given just before the induction of ischemia in the treatment group and the control group, respectively. Six hours after reperfusion, bacteria were detected in the mesenteric lymph nodes, but the 'bacteria-positive' rate was significantly lower in the treatment group than in the control group. Bacterial cultures and endotoxins in the blood were negative in both groups up to 24 h later. The plasma cytokine levels showed similar variations, although the increases were significantly lower after reperfusion in the treatment group. In addition, the degrees of neutrophil infiltration and mucosal injury were attenuated in the small intestine, and the structure of the liver was maintained. Furthermore, the 1-week survival was improved. These results suggest that bacterial translocation occurred predominantly via the lymphatic system and that anti-CINC antibody treatment exerted a protective effect against small intestinal ischemia-reperfusion injury.