Effect of pyridone carboxylic acid anti-microbials on the generation of reactive oxygen species in vitro

The effects of ofloxacin, ciprofloxacin and balofloxacin on the reactive oxygen species (ROS) levels generated by human neutrophils was examined in vitro; ROS generated in a cell-free, xanthine-xanthine oxidase system was also assessed. The species investigated were superoxide radical anion (O2-), hydrogen peroxide (H2O2) and hydroxyl radical (OH*). Both ofloxacin and ciprofloxacin markedly decreased the levels of O2-, H2O2 and OH* generated by human neutrophils. On the other hand, these drugs did not affect any of the ROS examined in the xanthine-xanthine oxidase system. Balofloxacin showed no significant effect on ROS generated by either system. The present study indicates that ofloxacin and ciprofloxacin may exert an anti-inflammatory action by reducing the potent ROS species excessively generated by neutrophils at the sites of inflammation.

Role of cytokines, tyrosine kinase, and protein kinase C on production of superoxide and induction of scavenging enzymes in human leukocytes

We investigated the effects of proximal modulators of cytokines, tyrosine kinase (TK), and protein kinase C (PKC) on reactive oxygen species (ROS) generation and the induction of scavenging enzymes, superoxide dismutase (SOD), catalase, and glutathione peroxidase (GSH-Px) of human neutrophils and lymphocytes, by using IL1-alpha, TNF-alpha, and IFN-gamma and neutralizing antibodies to these cytokines. Inhibitors of TK (ST638 and herbimycin) or PKC (H-7, calphostin, and staurosporine) were also used. The results revealed that both (O2)- generation stimulated by five different agents (opsonized zymosan, A23187, PAF, PMA, and fMLP) and the inductions of all three scavenging enzymes were potentiated by priming with TNF-alpha. In contrast, both (O2)- generation and enzyme induction were attenuated by priming with IL1-alpha, with the exception of PMA-stimulated (O2)- generation. IFN-gamma decreased (O2)- generation but increased scavenging enzyme induction. Antibodies to all three cytokines and all the TK and PKC inhibitors decreased (O2)- stimulated by most agents, but markedly enhanced (O2)- levels stimulated by PAF. Induction of all three enzymes was enhanced equally by low concentrations of each of the three anticytokine antibodies, while each of the TK or PKC inhibitors decreased induction of SOD and GSH-Px and increased catalase induction. These results suggest that both ROS generation and scavenging enzyme induction are controlled in complex ways by the actions of these three proximal mediators. This supports our hypothesis that disturbances in the regulation of early events of cell activation can lead to oxidative tissue injury.

Enhanced effect of clarithromycin on neutrophil function in vitro

An in vitro study was carried out to investigate the effect of clarithromycin, a new oral macrolide, on neutrophil reactive oxygen species generation and chemotaxis. It was found that neutrophil-generated O2-, H2O2 and OH. levels were significantly increased by clarithromycin at concentrations of 50 micrograms/ml (P < 0.05). The drug also significantly increased chemotaxis (P < 0.05). These results indicate that clarithromycin may enhance the activation of neutrophils in vivo.

Changes of intraaortic balloon volume during pumping in a mock circulation system

The effects of hemodynamic changes on intraaortic balloon (IAB) volumes were studied experimentally using a helium tachometer in a mock circulatory system. The IAB volume decreased with increases in the heart rate and mean aortic pressure, but the degree of reduction in the IAB volume was different among 4 commercially available IAB drivers. Improvements in IAB consoles are needed to compliment the progress made in percutaneous techniques for IAB insertion resulting in smaller balloons.

Effects of right ventricular failure on renal function during pneumatic left ventricular assist

In an experiment dog model of acute biventricular failure, the effects of left ventricular (LV) assist on renal hemodynamics and function were evaluated. After the induction of severe cardiac failure by multiple ligation of the coronary arteries, LV assist with a 40 ml pneumatic pulsatile pump was initiated, and the aortic flow was maintained at control values. The right atrial pressure (RAP) rose to 21.3 mm Hg with the appearance of profound right ventricular (RV) failure. Renal arterial blood flow (RAF) decreased to about 60% of the control value after 2 h of LV assist. The urine volume decreased and renal function deteriorated progressively. RV assist decreased the RAP to 4.8 mm Hg, and the reduced RAF recovered. After 3 h of RV assist, the RAF returned to initial values and the urine volume increased, but renal function did not recover. Advanced biventricular failure with elevated RAP during LV assist reduced renal perfusion and impaired renal function and may be an indication for early RV assist.

Activity of nadifloxacin against methicillin-resistant Staphylococcus aureus isolated from skin infections: comparative study with seven other fluoroquinolones

The in vitro susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) to nadifloxacin and seven other fluoroquinolones (norfloxacin, ofloxacin, enoxacin, ciprofloxacin, lomefloxacin, tosufloxacin and sparfloxacin) was evaluated. The MRSA isolates were isolated from 114 skin infections between 1991 and 1994. Nadifloxacin exhibited the lowest minimum inhibitory concentration and there were no MRSA isolates resistant to nadifloxacin, while there were some resistant to all of the other seven fluoroquinolones. The minimum concentrations of these drugs needed to cause 50% inhibition of the isolates increased dramatically from 1991 to 1992, but has hardly changed since 1992.

Clinical evaluation of roxithromycin in patients with acne

On the basis of reports that erythromycin is effective in the treatment of acne, we investigated whether roxithromycin (ROM), a new derivative of erythromycin, might also be effective in treating acne. Roxithromycin was administered to 30 patients with acne for 8 weeks. General improvement was assessed 8 weeks after the initiation of the therapy with a six-graded scale as follows; 1: good improvement, 2: moderate improvement, 3: slight improvement, 4: no change, 5: worsening, and 6: no assessment. The percentage of good or moderate improvement was 73.3%, and that of good improvement alone was 20.0%. Our results suggest that ROM is effective in the treatment of acne.

The effect of roxithromycin on the generation of reactive oxygen species in vitro

The effect of roxithromycin (ROM), a new oral semi-synthetic macrolide, on the generation of reactive oxygen species (ROS), using human neutrophils and a cell-free, xanthine-xanthine oxidase system was examined. The species investigated were the superoxide radical anion (O2-), hydrogen peroxide (H2O2), and the hydroxyl radical (OH.). ROM effectively inhibited the generation of O2-, H2O2 and OH. by human neutrophils. On the other hand, the drug did not markedly affect the ROS levels generated in the xanthine-xanthine oxidase system. The present study indicates that ROM may exert an anti-inflammatory action by inhibiting neutrophil oxygen radical generation at the sites of inflammation.

A novel enzymatic assay for the quantification of skin surface lipids

The applicability of a novel enzymatic assay for quantifying skin surface lipids was investigated experimentally. The standard curves for the assays of glycerol esters, free fatty acids, and cholesterol and its esters were linear over a wide range of lipid concentrations, which ensures the accuracy of measurements. The assay system also showed good simultaneous reproducibility. There were significant positive correlations (P < 0.001) between the quantities of glycerol esters, free fatty acids, and cholesterol and its esters sampled from the skin surface of women when measured by the enzymatic assay compared with the gas chromatographic method. The enzymatic assay was applied to studies of the relationships between age, acne and menstrual cycle, and skin surface lipids in women. The quantities of glycerol esters and free fatty acids reached peaks in females in their twenties and thirties. Increased quantities of glycerol esters, free fatty acids, and cholesterol and its esters were observed in women with acne compared with women without acne. Among the women with acne, those in the premenstrual phase of the menstrual cycle showed increased levels of glycerol esters, free fatty acids, and cholesterol and its esters compared with those in the menstrual phase. The results suggest that the enzymatic method is a satisfactory new technique for the quantification of skin surface lipids.

[Successful treatment of hemopneumothorax with intrapleural OK432 in pulmonary metastases of cutaneous angiosarcoma]

An 80-year-old woman with angiosarcoma of the scalp was treated with radiation and interleukin 2. The patient experienced dyspnea one month later because of pulmonary metastases, and underwent video-assisted thoracoscopic surgery for a right pneumothorax. Right hemopneumothorax recurred 3 weeks after the surgery and left hemopneumothorax occurred 4 months later. Both were successfully treated with intrapleural OK432 and drainage. As of March 1995 the patient had been alive and well for one year since the right pneumothorax developed.

Sensitivity of Staphylococcus aureus, isolated from skin infections in 1994, to 19 antimicrobial agents

The most common pathogen causing skin infections is Staphylococcus aureus and the incidence of multiply resistant strains of S. aureus has been increasing. The in vitro susceptibility of 130 isolates of S. aureus to 19 antimicrobial agents: ampicillin (ABPC), methicillin, cefaclor, cefpodoxime proxetil, gentamicin, erythromycin, clindamycin, minocycline, vancomycin, fusidic acid, norfloxacin, ofloxacin, enoxacin, ciprofloxacin, lomefloxacin, tosufloxacin, sparfloxacin, nadifloxacin and grepafloxacin, was evaluated by agar dilution tests. The S. aureus isolates were isolated from 130 patients with skin infections in 1994. The proportion of methicillin-resistant S. aureus isolates among the strains isolated was 19.2%. The concentration needed to inhibit 50% of the isolates was 3.13 mg/ml or less for all of the drugs, but the concentration needed to inhibit 90% of isolates was over 12.5 micrograms/ml, except in the cases of minocycline, vancomycin, fusidic acid, tosufloxacin and nadifloxacin. Tosufloxacin and nadifloxacin had the lowest minimum inhibitory concentrations. None of the S. aureus strains was resistant to nadifloxacin.

[Two cases underwent patch closure and mitral annuloplasty for ventricular septal perforation and mitral regurgitation caused by acute inferior myocardial infarction]

Two cases underwent successful operation for the ventricular septal perforation (VSP) and mitral regurgitation (MR) caused by acute myocardial infarction (AMI) are reported. Patch closure of VSP and mitral annuloplasty (MAP) by Kay-Suzuki method were performed. Location of VSP were posterior ventricular septum and moderate MR were detected in both cases. Case 1 was a 74-year-old man. Four weeks after AMI, patch closure of VSP through right ventricular approach and MAP through trans-atrial approach and also aorto-coronary bypass to left anterior descending artery were performed. Doppler echocardiography was effective to evaluate the severity of VSP and MR. Case 2 was a 69-year-old man. Eight days after AMI, patch closure of VSP and MAP were performed through biventricular approach. Postoperative examination revealed the disappearance of left-to-right shunt and MR in both cases. These cases operated successfully were thought to be rare.

[Resection of lung cancer complicated by pleural empyema]

In a 53-year-old man, carcinoma of the lung was resected and was complicated by pleural empyema. Two days after fiberoptic bronchoscopy, he developed a high fever and was found to have pleural empyema. After thoracic drainage and other palliative treatment, the right lower lobe and empyema cavity were resected. The postoperative course was uneventful and he was discharged 3 weeks after the operation, but he died of cervical and intrathoracic lymph node recurrence 5 months later. Surgical treatment of malignant lung cancer complicated by pleural empyema has been reported 10 times, including 3 reports from Japan. According to those reports, post-operative complications are rare, and long survival is possible. Therefore, surgical resection is indicated in some cases.

[Neoadjuvant chemotherapy with tegafur suppository for rectal cancer--effects of tegafur on nuclear DNA content of cancer cells--Tochigi Colorectal Cancer Study Group]

To assess the significance of neoadjuvant chemotherapy for large bowel cancer, we investigated an effect of tegafur on cancer cell kinetics by DNA content flow cytometric analysis. The pathologic specimens analyzed in this study were obtained from 28 patients with rectal cancer who had received tegafur suppositories prior to surgery. Mean cumulative doses administered were 13.4 g, and mean duration was 12.7 days. In 24 of the 28 specimens, the DNA ploidy and DNA index of the cancer cells were essentially unchanged after the chemotherapy, and DNA aneuploidy was present in 67%. The proportion of cells in S-phase in DNA aneuploid tumors was significantly higher than in DNA diploid tumors. The proportion of cells in G0G1-phase was inversely correlated to that in S-phase. After the chemotherapy, the proportions of cells in S-phase increased both in DNA diploid and aneuploid tumors, although a significantly higher mean value was found only for the latter (p < 0.05). In the DNA aneuploid tumors, there was a higher frequency of responders confirmed by histological evaluation (44%) as compared to the DNA diploid tumors (25%), and a tendency for increases in S-phase fraction of the responders to be greater than in non-responders. These results suggest that DNA flow cytometry-derived parameters may conceivably be useful in predicting the antitumor effect of 5-FU and its derivatives against large bowel cancer.

Activity of eight fluoroquinolones against both methicillin-susceptible and -resistant Staphylococcus aureus isolated from skin infections

The in vitro susceptibility of Staphylococcus aureus to eight fluoroquinolones, norfloxacin, ofloxacin, enoxacin, ciprofloxacin, lomefloxacin, tosufloxacin, sparfloxacin, and nadifloxacin was established by agar dilution tests, 71 isolates of methicillin-susceptible (MSSA) and 74 isolates of -resistant S. aureus (MRSA) isolated from skin infections. Among all of the fluoroquinolones, nadifloxacin exhibited the lowest MIC for both MSSA and MRSA. In addition, there were no resistant S. aureus, neither MSSA and MRSA, to nadifloxacin. With the exception of nadifloxacin, the incidence of MRSA resistant to fluoroquinolones has gradually increased in recent years. Over half of the MRSA strains were resistant to norfloxacin, ofloxacin, enoxacin, ciprofloxacin, and lomefloxacin.

Neutrophil chemotaxis, phagocytosis, and generation of reaction oxygen species show a hierarchy of responsiveness to increasing concentrations of N-formyl-Met-Leu-Phe

We assessed the effect of varying concentrations of N-formyl-methionyl-leucyl-phenylalanine (fMLP) on neutrophil chemotaxis, phagocytosis, and reactive oxygen species generation. Boyden chamber chemotaxis was first elicited at an fMLP concentration of 10(-11) M, reached a peak at 10(-10) M, and declined at higher concentrations. Phagocytosis was first activated at 10(-10) M, reached its highest level at 10(-9) M, and declined at higher concentrations. O2-, H2O2 and OH. generation were elicited to a significant degree only at a fMLP concentration of 10(-8) M, or higher, reaching a peak at 10(-6) M. Thus, a distinct hierarchy was observed in the order of activation of these three neutrophil functions to varying concentrations of a soluble agonist. A teleologic model of neutrophil function that accounts for these observations is proposed.

Effect of nadifloxacin on neutrophil functions

Recent reports indicate that nadifloxacin is an effective therapy for acne vulgaris and has a mechanism of action similar to that of the tetracyclines which act directly as antioxidants against infiltrated neutrophils. The effects of nadifloxacin on neutrophil functions, including the generation of reactive oxygen species, chemotaxis and phagocytosis were investigated. Nadifloxacin reduced the numbers of superoxide radical anions (O2-) and hydroxyl radicals (OH.) generated by neutrophils. The drug did not, however, significantly inhibit neutrophil chemotaxis and phagocytosis nor did it decrease the levels generated in a cell-free, xanthine-xanthine oxidase system. These results indicate that the clinical effectiveness of nadifloxacin may be partly due to its inhibitory action on the generation of O2- and OH. by neutrophils leading to a reduction in oxidative tissue injury.