[Pharmacokinetics and clinical evaluation of imipenem/cilastatin sodium in pediatric surgery]

Pharmacokinetic and clinical studies on imipenem/cilastatin sodium (IPM/CS) in pediatric surgery were performed and the results obtained are summarized below. 1. Plasma and urinary levels of IPM/CS were measured in 9 neonate patients following drip-infusion for 1 hour of IPM/CS (dose of IPM 10 mg/kg for 5 patients, 20 mg/kg for 4 patients). In the 10 mg/kg group, peak plasma levels were observed at the end of infusion or after 1 hour of it. IPM 9.95-14.2 micrograms/ml, CS 7.7-30.1 micrograms/ml. In the 20 mg/kg group, peak levels were found at the end of the infusion, IPM 39.2-41.7 micrograms/ml, CS 48.1-58.8 micrograms/ml. In both groups, plasma levels of IPM/CS decreased rapidly, and plasma half-lives (T 1/2) in the 20 mg/kg group were 0.9-1.2 hours (IPM) and 0.8-1.1 hours (CS). Urinary recovery rates were 17.7-28.7% (10 mg/kg), 21.1-36.9% (20 mg/kg) for IPM and 27.1-43.8% (10 mg/kg) and 21.5-76.5% (20 mg/kg) for CS. 2. Bile levels of IPM/CS were measured in 3 patients with congenital biliary atresia and 1 patient with neonatal hepatitis. Peak levels of IPM/CS in bile were noted 1 hour after the end of infusion, and they were 3.01-12.3 micrograms/ml for IPM, and 2.5-13.1 micrograms/ml for CS. Recovery rates in bile in 7 hours after the end of infusion were 0.03-0.12% (IPM), 0.01-0.12% (CS). 3. IPM/CS was administered to 9 patients as prophylaxis against postoperative infections and to 2 patients with postoperative cholangitis. No infectious complications were observed in patients after the prophylactic use. In 1 patient with cholangitis, clinical effect was good and organisms were eradicated. No clinical or laboratory adverse reactions due to the administration of IPM/CS were noted. It is concluded that IPM/CS is an effective and safe antibiotic in pediatric surgery.

Long-term results after strabismus surgery

The results of surgery after 4 years' or more postoperative follow-up have been evaluated in a total of 1031 cases (575 esotropia, 456 exotropia). There is a difference in the angle of strabismus 1 month after surgery and 4 years after surgery. Based on these findings, the results of strabismus surgery must be evaluated after a sufficient amount of time has passed. The angle of strabismus to be aimed at, to provide best binocular vision and patient satisfaction, should be in the range of -2 +7 degree for esotropia and +2 -10 degree for exotropia, regardless of the patient's age at surgery.

[Pharmacokinetics and clinical evaluation of ceftriaxone in pediatric surgery]

Pharmacokinetics and clinical studies on ceftriaxone (CTRX) in pediatric surgery were performed and the results obtained are summarized below. 1. In neonates, serum and urinary levels of CTRX were measured in 4 patients following injection (CTRX 20 mg/kg, intravenous bolus injection). Highest levels in serum were observed at 15 or 30 minutes, 59.4-212.5 micrograms/ml. Serum levels of CTRX then decreased very slowly, and serum half-lives (T 1/2) were 7.9-27.1 hours. Urinary recovery rates were 17.0-54.7% in 12 hours. 2. Bile levels of CTRX were also measured in 8 patients with congenital biliary atresia and a patient with congenital biliary dilatation (CBD). Highest levels of CTRX in bile, 10.2 and 13.2 micrograms/ml, were noted in 2 hours following injection to 2 patients. But in other patients, CTRX was undetectable in bile. Recovery rate in bile in 12 hours in a CBD patient was 0.19%. 3. The CTRX was administered to 7 patients (a case of infected lung cyst, 2 cases of peritonitis and 4 cases as prophylaxis to postoperative infection). Clinical results were good in all cases. No clinical and laboratory adverse reaction due to the administration of CTRX was observed. It is concluded that CTRX is a safe and effective antibiotic in pediatric surgery. However, care has to be practiced in determining dosage and interval of CTRX administration because of its pharmacokinetical characteristics.

Effects of intrahippocampal injections of the cholinergic neurotoxin AF64A on presynaptic cholinergic markers and on passive avoidance response in the rat

1. The effects of the intrahippocampal injection of ethylcholine mustard aziridinium ion (AF64A) on the following cholinergic markers were examined. 2. Bilateral injection of 10 nmol of AF64A into the dorsal hippocampus caused a loss of choline acetyltransferase (CAT) activity in the dorsal hippocampus, ventral hippocampus, cortex and striatum. 3. This treatment caused significant decreases in ACh contents in the dorsal hippocampus, ventral hippocampus and cortex, but not in the striatum. 4. The step-down latencies during the test trials of both 10 and 50 nmol AF64A-treated groups were significantly shorter than those of vehicle-treated groups. 5. None of the control animals stepped down to the large box where they had previously received a foot shock, but 40% of the 10 nmol and 60% of the 50 nmol AF64A-treated animals stepped down to the large box within 600 s. 6. These results indicate that AF64A treatment produces biochemical and functional deficits in the cholinergic neurons in the CNS.

[Pharmacokinetics of amikacin in the pediatric surgical field]

Amikacin (AMK) was intravenously administered to pediatric surgical patients, and its pharmacokinetics was studied. The results obtained are summarized as follow: 1. The serum levels following administration were similar to those which had been reported by others. Urinary excretion was excellent. 2. The concentration of AMK in pleural effusion of a postoperative premature baby was an effective level higher than MIC's to target organisms. 3. Bile levels of AMK were the highest soon after surgery on patients with biliary atresia, these declined as time passed. The high levels obtained were in the effective range where the levels were higher than MIC's against organisms isolated from bile of patients with biliary tract infections. Biliary excretions were good in cases with good hepato-enteric circulation. 4. Biliary and urinary excretion rates were well correlated.

The loss of carbon-20 in C19-gibberellin biosynthesis in a cell-free system from Pisum sativum L

The fate of the carbon-20 atom in gibberellin (GA) biosynthesis was studied in a cell-free system from Pisum sativum. This carbon atom is lost at the aldehyde stage of oxidation when C20-GAs are converted to C19-GAs. Gibberellin A12 labeled with (14)C at C-20 was prepared from [3'-(14)C]mevalonic acid with a cell-free system from Cucurbita maxima and incubated with the pea system. Analysis of the gas and aqueous phases showed that (14)CO2 was formed at the same rate and in nearly equivalent amounts as (14)C-labeled C19-GAs whereas [(14)C]formic acid and [(14)C]formaldehyde were not detectable. The possibility that C-20 had been lost as formic acid which had then been converted to CO2 was investigated by control incubations with [(14)C]formic acid. The rate of release of (14)CO2 from [(14)C]formic acid was only one fiftieth of the rate of (14)CO2 release from [(14)C]GA12 as the substrate. We conclude that in the formation of C19-GAs from C20-GAs, the C-20 is removed directly as CO2.

Activity, cardiac and respiratory responses of blindfold preterm infants in a neonatal intensive care unit

The purposes of the present study were to examine 24-h periods in the life of preterm infants incubated in a Neonatal Intensive Care Unit (NICU) using indices of activity, cardiac and respiratory responses, and to examine the effects of blindfolding incubated infants upon these behavioural indices. Ten healthy preterm infants were individually observed for 2 days a week for a 24-h period, using a continuous video recording system. Each infant was blindfolded with an eye-mask and a black head-cap for approximately equal to 10 h during a night out of the 2 days. Analyses on activity, cardiac and respiratory responses were done for (1) 20 min sampled from every other hour during the 2 days, and (2) for 1 h during the night, both a blindfolded day and unblindfolded, respectively. The results showed that activity was less and respiration rate lower when blindfolded than when unblindfolded. Respiration rate was also found to be stable when blindfolded.

Free radical chain oxidation and hemolysis of erythrocytes by molecular oxygen and their inhibition by vitamin E

Erythrocytes of vitamin E-deficient rats and normal rats were oxidized at 37 degrees C by molecular oxygen using a free radical initiator. The erythrocytes were oxidized by a free radical chain mechanism with kinetic chain length considerably larger than 1 and resulted in hemolysis. Vitamin E suppressed both oxidation and hemolysis, but the extent of hemolysis was determined primarily by the extent of oxidation independent of the presence or absence of vitamin E.

[Pharmacokinetics and clinical evaluation of cefotiam in pediatric surgery]

Pharmacokinetics and clinical studies on cefotiam (CTM) in pediatric surgery were performed and the results obtained are summarized below. In neonates without congenital heart disease (CHD), serum levels of CTM were rapidly increased following injection of CTM (20 mg/kg, one shot intravenous administration) and the peak values were found at 15 minutes. Six hours later, CTM almost disappeared from the blood. In the patient with CHD, however, CTM was retained in the serum and the urinary excretion was poor. The CTM was administrated prophylactically to prevent postoperative infections in 10 patients. Eight of 10 had no episodes during postoperative period. Wound infection, however, was found in 2 patients. No clinical and laboratory side effects were caused by CTM.

[Fundamental and clinical studies on ceftazidime in pediatric surgery]

Fundamental and clinical studies of ceftazidime (CAZ) were performed in pediatric surgery. The results obtained were summarized below. Serum and urinary levels of CAZ were measured in 5 patients following injection (CAZ: 10 or 20 mg/kg, intravenous bolus injection). Highest levels in serum were observed within 30 minutes, 30.4 micrograms/ml and 49.5-62.9 micrograms/ml with 10 mg/kg and 20 mg/kg doses, respectively. Then serum levels of CAZ decreased gradually except in 1 case with a metabolic disease, and serum half-lives (T 1/2) were 1.19-1.88 hours for the high doses. The highest levels in urine were observed in 0-2 hours, and the urinary recovery rate was 59-100%. The bile levels were also measured in 3 patients who underwent radical operations of congenital biliary atresia (CBA). Highest levels of CAZ in bile, 4.47-9.66 micrograms/ml, were noted in 0-2 or 2-4 hours following injection. Recovery rates for 8 hours were 0.11, 0.17 and 0.20% for the 3 patients. The CAZ was administrated to 7 patients for prophylaxis of the postoperative infection (5 cases) or to treat ascending cholangitis in CBA (2 cases). Clinical results were good in 4, fair in 1, poor in 1 and unknown in 1. No clinical and laboratory side effect due to the administration of CAZ was observed. It is concluded that CAZ is a safe and effective antibiotic in pediatric surgery.

Metabolism of gibberellins in a cell-free system from immature seeds of Phaseolus vulgaris L

The biosynthetic steps from gibberellin A12-aldehyde (GA12-aldehyde) to C19-GAs were studied by means of a cell-free system from the embryos of immature Phaseolus vulgaris seeds. Stable-isotope-labeled GAs were used as substrates and the products were identified by gas chromatography-mass spectrometry. Gibberellin A12-aldehyde was converted to GA4 via non-hydroxylated intermediates and to GA1 via 13-hydroxylated intermediates. 13-Hydroxylation took place at the beginning of the pathway by the conversion of GA12-aldehyde to GA53-aldehyde. The conversion of GA20 to GA5 and GA6 was also shown but no 2β-hydroxylating activity was found. Endogenous GAs from embryos and testas of 17-dold seeds were re-examined by gas chromatography-selected ion monitoring using stable-isotopelabeled GAs as internal standards. Gibberellins A9, A12, A15, A19, A23, A24, and A53 were identified for the first time in P. vulgaris, in addition to GA1, GA4, GA5, GA6, GA8, GA17, GA20, GA29, GA37, GA38 and GA44, which were previously known to occur in this species. The levels of all GAs, except the 2β-hydroxylated ones, were greater in the embryos than in the testas. Conversely, the contents of GA8 and GA29, both 2β-hydroxylated, were much higher in the testas than in the embryos.

Effect of injection of CCK-8 into the nucleus caudatus on the behavior of rats

This report deals with the effect of cholecystokinin octapeptide (CCK-8) on the regulation of the behavior stimulated by dopaminergic drugs. Bilateral injection of CCK-8 (1 microgram per side) into the nucleus caudatus significantly reduced the locomotor hyperactivity induced by methamphetamine. Stereotyped sniffing and yawning occurred after intrastriatal administration of apomorphine (20 micrograms per side). Injections of CCK-8 into the nucleus caudatus completely inhibited the sniffing, but did not affect the yawning induced by apomorphine. It also had no effect on the basal dopamine (DA) level or the methamphetamine-induced DA level in the striatum. These results suggest that the injection of CCK-8 into the nucleus caudatus selectively inhibited the function of the dopaminergic system in the striatum, and blocked post-synaptic DA receptors.

Oxidation of biological membranes and its inhibition. Free radical chain oxidation of erythrocyte ghost membranes by oxygen

The oxidation of human and rat erythrocyte ghost membranes by molecular oxygen has been performed in an aqueous suspension at 37 degrees C. A constant rate of oxygen uptake was observed in the presence of radical initiator. alpha-Tocopherol in the membrane suppressed the oxidation and the induction period was clearly observed. alpha-Tocopherol decreased linearly during the induction period and when it was depleted the induction period was over and a rapid oxidation started. The rate of oxidation was proportional to the square root of the rate of initial radical generation. The kinetic chain length, the ratio of the rate of propagation to that of initiation, was long, ranging from 7 to 100. These results indicate that the erythrocyte ghost membranes are oxidized by a free radical chain mechanism by molecular oxygen. Among the fatty acids of membrane lipids, polyunsaturated fatty acids were oxidized exclusively. Proteins as well as polyunsaturated fatty acids were oxidized and the formation of the high- and low-molecular-weight proteins and the decrease of protein bands were observed on gel electrophoresis.

Effect of phytyl side chain of vitamin E on its antioxidant activity

Inhibition of the oxidation of methyl linoleate and soybean phosphatidylcholine in homogeneous solution and in aqueous dispersion by four chain-breaking antioxidants, vitamin E (alpha-tocopherol), 2,2,5,7,8-pentamethyl-6-chromanol, 2,6-di-tert-butyl-4-methylphenol, and stearyl 3-(3,5-di-tert-butyl-4-hydroxyphenyl)propionate, was studied to examine the effect of the phytyl side chain of vitamin E on its antioxidant activity. These four antioxidants exerted similar antioxidative activities. They were also effective as antioxidants in protecting the oxidation of soybean phosphatidylcholine liposomes in water dispersion. However, when they were incorporated into dimyristoyl phosphatidylcholine liposomes, only 2,2,5,7,8-pentamethyl-6-chromanol and 2,6-di-tert-butyl-4-methylphenol could suppress the oxidation of soybean phosphatidylcholine liposomes dispersed in the same aqueous system. It was concluded that the antioxidative properties of vitamin E and its model without the phytyl side chain are quite similar within micelles and liposomes as well as in homogeneous solution but that the phytyl side chain enhances the retainment of vitamin E in liposomes and suppresses the transfer of vitamin E between liposomal membranes.

Familial odontogenic keratocysts. Report of 3 cases and review of Japanese dental literature

Familial odontogenic keratocysts are described in this report. The Case 1 patient, who has 3 sisters, developed odontogenic keratocysts. The 2 younger sisters (Cases 2 and 3) also had odontogenic keratocysts, although the elder sister did not have any odontogenic cysts. The father of the patients had a history of removal of a jaw cyst, and the mother was found later to have malignant ameloblastoma. Besides the odontogenic keratocysts, the Case 1 patient had basal cell nevus, prominent frontal process, and ocular hypertelorism; the Case 2 patient had prominent frontal process; the Case 3 patient had prominent frontal process, ocular hypertelorism, and squint. All 3 sisters are suspected of being patients with the basal cell nevus syndrome. The Japanese dental literature concerning the basal cell nevus syndrome is reviewed.

Oxidation of lipids. 7. Oxidation of phosphatidylcholines in homogeneous solution and in water dispersion

The rates and products of the oxidations of phosphatidylcholines (PCs) in organic homogeneous solutions and as multilamellar liposomes in an aqueous dispersion were studied at 50 degrees C initiated by oil-soluble and water-soluble azo compounds and with the aim primarily of elucidating the effect of substrate and the reaction medium. Polyunsaturated fatty acids were oxidized exclusively among the fatty acids in PC. The product distribution was determined by the number of double bonds: in the oxidation of methyl linoleate and dilinoleoyl PC, the conjugated diene hydroperoxides were formed almost quantitatively, whereas in the oxidation of PC and polyunsaturated fatty acids having three or more double-bonds, cyclic peroxides were also formed. The oxidizability of PC was dependent on the content of doubly allylic hydrogens and their reactivities were suggested to be similar, independent of parent substrate and reaction medium, although the oxidizability of PC in nonpolar organic solvents is markedly enhanced by the formation of reverse-phase micelles.

Conversion of gibberellin A20 to gibberellins A 1 and A 5 in a cell-free system from Phaseolus vulgaris

The soluble fraction of a cell-free system from immature seeds of Phaseolus vulgaris L. converts gibberellin A20 (GA20) to GA1 and GA5. It does however not metabolize GA1 and GA29 to GA5, showing that in this system GA20 is converted directly to GA5. The steps from GA20 to GA1 (3-hydroxylation) and from GA20 to GA5 (Δ(2) double-bond formation) require oxygen, Fe(2+) and α-ketoglutarate, and are stimulated by ascorbate. The enzymes catalyzing these conversions bate. The enzymes catalyzing these conversions have properties similar to those of GA oxidases found in Cucurbita maxima and Pisum sativum.

Inhibition of oxidation of methyl linoleate in solution by vitamin E and vitamin C

The oxidation of methyl linoleate in solution initiated with azo compounds has been studied in the absence and presence of vitamin E and vitamin C. Both vitamin E and vitamin C acted as a chain-breaking antioxidant and they suppressed the oxidation and produced an induction period. The inhibition rate constant for the scavenging of peroxy radical was calculated at 37 degrees C as kinh = 5.1 X 10(5) M-1 s-1 and 7.5 X 10(4) M-1 s-1 for vitamin E and vitamin C, respectively. It was suggested that each vitamin E could trap two peroxy radicals, whereas vitamin C could trap only one peroxy radical under the reaction conditions employed in this study. When both vitamin E and vitamin C were present, the oxidation was suppressed quite efficiently and the apparent inhibition rate constant was obtained as kinh = 4.0 X 10(5) M-1 s-1. Furthermore, vitamin E remained almost unchanged and only vitamin C was consumed at the initial stage and vitamin E was consumed after vitamin C was exhausted. It was concluded that vitamin E trapped the peroxy radical and the resulting alpha-chromanoxy radical reacted with vitamin C to regenerate vitamin E.

[Experimental and clinical evaluation of latamoxef in pediatric surgery]

Latamoxef (LMOX), a new oxacephem antibiotic, was studied for assessment of fundamental and clinical efficacy in 6 patients with neonatal surgical diseases, and in 1 with congenital bile duct atresia. The results were obtained as follows: The serum levels of LMOX were 73.4--89.6 micrograms/ml at 15--30 minutes following 20 mg/kg intravenous one shot injection in postoperative neonatal surgical patients. The mean rate of urinary excretion was 29.1% for 6 hours following administration of LMOX. The biliary levels of LMOX were 5.52--10.2 micrograms/ml in maximum following 20 mg/kg intravenous one shot injection in a patient with congenital bile duct atresia, but the excretion rate in bile was poor from liver disfunction. Also, the negative correlationship was obtained between bile and urine excretion rate. LMOX was administered to 6 cases of neonatal surgical patients for prevention of the postoperative infection. The clinical results were good in 4, fair in 1 and not evaluated in 1 of these cases. No side effect was experienced.

Alignment of x-ray tube focal spots for spectral measurement

A general method to align a diagnostic x-ray machine for x-ray spectrum measurement purpose was theoretically and experimentally investigated by means of the optical alignment of focal pinhole images. Focal pinhole images were obtained by using a multi-pinholed lead plate. the vertical plane, including the central axis and tube axis, was decided upon by observing the symmetry of focal images. the central axis was designated as a line through the center of focus parallel to the target surface lying in the vertical plane. A method to determine the manipulation of the central axis in any direction is presented.

Purification and some properties of microsome-bound thyroglobulins

The sonicate of microsomal fraction of hog thyroid was found to contain two species of proteins which reacted with anti-thyroglobulin antiserum and corresponded to 2 to 3% of total protein of the fraction. The two species were purified by ammonium sulfate precipitation, repeated sucrose density gradient centrifugations and separated from each other by polyacrylamide gel electrophoresis into S-mb thyroglobulin (the slower-migrating microsomal-bound fraction), F-mb thyroglobulin (the faster-migrating microsomal-bound fraction), and thyroglobulin itself. Amino acid compositions of the proteins were essentially the same as that of thyroglobulin. Mannose contents also were close to that of thyroglobulin while galactose and fucose contents decreased in the order: thyroglobulin, F-mb thyroglobulin and S-mb thyroglobulin. S-mb thyroglobulin had no sialic acid and no iodine at all. F-mb thyroglobulin was sialylated to an extent of less than 80% of, and iodinated to an extent of less than 50% of that of thyroglobulin, respectively. Antigenic activities of F-mb thyroglobulin and of S-mb thyroglobulin were qualitatively the same as, but quantitatively less than, that of thyroglobulin. Sedimentation coefficients of S-mb thyroglobulin and F-mb thyroglobulin were approximately 1 S lower than that of thyroglobulin. All the properties of the thyroglobulin-related proteins suggested that S-mb thyroglobulin and F-mb thyroglobulin were the products by the sequential modification of thyroglobulin polypeptide in the pathway of thyroid hormone production.