Inhibitory effect of prostaglandin E1 on human neutrophil function

Neutrophils accumulated in the lung are thought to play a pivotal role in the pathogenesis of host auto-injury such as adult respiratory distress syndrome (ARDS). We investigated the effect of prostaglandin E1 (PGE1) on several aspects of human neutrophil function. PGE1 significantly decreased reactive oxygen species (ROS), (O2-, H2O2, OH.) generation by neutrophils as well as neutrophil phagocytosis and chemotaxis. In contrast, the drug did not affect the levels of ROS generated by a cell-free ROS generating system. In addition, intracellular calcium concentrations ([Ca2+]i) in neutrophils stimulated by f-Met-Leu-Phe were decreased in the presence of PGE1. These data suggest that the reduction in ROS production and neutrophil phagocytosis and chemotaxis by PGE1 may contribute to the effectiveness of the drug in host auto-injury including ARDS. The suppression of the increase in [Ca2+]i may at least be responsible for inhibition of these neutrophil functions by PGE1.

Acceleration of phagocytosis in human neutrophils incubated with gabexate mesilate

It has recently been shown that gabexate mesilate inhibited human neutrophil functions including chemotaxis and reactive oxygen species production. In the present study, the effects of gabexate mesilate on phagocytosis by human neutrophils in vitro were investigated. Gabexate mesilate significantly enhanced neutrophil phagocytosis in a dose-dependent manner. This characteristic of gabexate mesilate may facilitate protection against infecting micro-organisms, although the inhibition of reactive oxygen species production by neutrophils may be a disadvantage for host-defense against infection.

[A case of squamous cell carcinoma of negative tumor shadow arising from pulmonary cyst]

We report a case of 53-year-old man who performed resection of infected cystic lung lesion seen from his childhood. Chest X-ray showed no remarkable change in the wall of the cyst, and tumor shadow was negative. As the chest cavity was severely adhesive, operation was ended in partial resection including the cyst. Pathological study revealed moderately differentiated squamous cell carcinoma replacing the entire cystic wall. Right upper lobectomy and dissection of lymph nodes were performed as second operation. Microscopically, carcinoma was limited in the wall of the cyst.

Inhibitory effect of gabexate mesilate on human neutrophil function

Neutrophils accumulated in the lung are thought to play a key role in the pathogenesis of adult respiratory distress syndrome and interstitial pneumonia following bone-marrow transplantation. The effects of gabexate mesilate on several aspects of human neutrophil function have been investigated. Gabexate mesilate significantly decreased both the generation of reactive oxygen species (O2-, H2O2, OH.) by neutrophils and neutrophil chemotaxis. In contrast, the drug did not affect the levels of reactive oxygen species generated by a cell-free reactive-oxygen-species generating system. Intracellular calcium concentrations in neutrophils stimulated by f-Met-Leu-Phe were decreased in the presence of gabexate mesilate. These data suggest that the reduction in reactive-oxygen-species production and neutrophil chemotaxis by gabexate mesilate may contribute to the effectiveness of the drug in adult respiratory distress syndrome and interstitial pneumonia after bone-marrow transplantation. The suppression of the increase in intracellular calcium concentration may at least be responsible for the inhibition of these neutrophil functions by gabexate mesilate.

Primary chylopericardium

To evaluate the surgical treatment of primary chylopericardium, 2 cases of primary chylopericardium are described and previous case reports are reviewed. Enhanced computed tomography combined with lymphangiography is a very reliable diagnostic tool for identifying abnormalities of the thoracic duct and its lymphatic channels connecting to the pericardium. When the course of the thoracic duct was identified exactly, ligation and resection of the thoracic duct with establishment of a pericardial window proved to be the most effective surgical procedure. Because the thoracic duct and the pericardium can be exposed easily, left thoracotomy seems to be the most preferable approach for the operation.

[CT guided percutaneous needle biopsy of mediastinal lymph nodes for staging of primary lung carcinoma]

In cases of primary lung carcinoma, diagnosis of metastatic mediastinal lymph nodes using computed tomography (CT) is usually difficult, and mediastinoscopy is highly invasive for patients. By using CT guided percutaneous needle aspiration technique, we diagnosed the metastasis to mediastinal lymph nodes in three cases of primary lung carcinoma. In this method, percutaneous biopsy was easily performed even in obesed patient, and metastatic lymph nodes were differentiated from large vessels by using enhanced CT to avoid dangerous punctures. Furthermore, biopsy of almost all mediastinal lymph nodes may be feasible by using both anterior and posterior approach. This method seems to be very useful for the diagnosis of the staging of primary lung carcinoma.

Response of right ventricular systolic function to exercise stress: effects of pulmonary vascular resistance on right ventricular systolic function

To elucidate factors influencing responses of right ventricular systolic function to exercise stress, we evaluated the right ventricular ejection fraction and peak ejection rate with two different loading conditions, atrial septal defect and mitral stenosis, at rest and during exercise by means of gated equilibrium blood pool radionuclide ventriculography. In both atrial septal defect and mitral stenosis, strong correlations between changes in the right ventricular ejection fraction with exercise and pulmonary vascular resistance at rest (r = -0.97, p < 0.001; r = -0.86, p < 0.005: respectively) were found. Significant correlations between changes in the right ventricular peak ejection rate with exercise and pulmonary vascular resistance at rest (r = -0.85, p < 0.05; r = -0.75, p < 0.01: respectively) were found in atrial septal defect and mitral stenosis. Both the right ventricular ejection fraction and peak ejection rate were lower during exercise than at rest when pulmonary vascular resistance at rest was more than 200 dynes.sec.cm-5.m2 in both atrial septal defect and mitral stenosis. In conclusion, right ventricular systolic function responding to exercise stress was influenced by the pulmonary vascular resistance in both atrial septal defect and mitral stenosis.

[A case of micro-metastatic lung adenocarcinoma into adenoma of the thyroid]

In a case of 46-year-old woman, small nodules appeared in the anterior neck which was diagnosed as follicular adenoma of the left lower lobe of the thyroid. Four months before, she experienced resection of the lung and three courses chemotherapy of MVP for stage IIIb well-differentiated lung adenocarcinoma. Pathologically, micro-metastatic lung adenocarcinoma was found in the adenoma. It is very rare occurrence for lung carcinoma to metastasize into adenoma of the thyroid. But when tumors of the anterior neck are found in a patient of lung carcinoma, thyroid tumor must be considered for differential diagnosis.

Sensitivity of Staphylococcus aureus and Streptococcus pyogenes isolated from skin infections in 1992 to antimicrobial agents

We studied the efficacy of antimicrobial agents against Staphylococcus aureus (S. aureus) and Streptococcus pyogenes (S. pyogenes) isolated from skin infections in 1992. For S. aureus, we measured the minimum inhibitory concentrations (MICs) of the following 10 drugs: methicillin (DMPPC), cefaclor (CCL), gentamicin (GM), erythromycin (EM), clindamycin (CLDM), minocycline (MINO), vancomycin (VAN), fusidic acid (FA), ofloxacin (OFLX) and nadifloxacin (NDFX); for S. pyogenes, we determined the MICs of the following 9 drugs: ampicillin (ABPC), amoxicillin (AMPC), cefpodoxime proxetil (CPDX-PR), erythromycin (EM), clindamycin (CLDM), minocycline (MINO), norfloxacin (NFLX), of loxacin (OFLX) and nadifloxacin (NDFX). These drugs are frequently used to treat skin infections, either systemically or topically. NDFX is a new synthetic fluoroquinolone, recently developed for use as a topical acne medication in Japan. It is used NDFX for acne, but not for skin infections. There were no strains of S. aureus resistant to NDFX, VAN or FA. The resistance (> or = 12.5 micrograms/ml) of S. aureus was highest to GM and lowest to OFLX. Four strains of methicillin-resistant (> or = 12.5 micrograms/ml) S. aureus (MRSA) were found. In contrast, no resistant strains of S. pyogenes were found except to MINO. Only two strains of S. pyogenes were susceptible to MINO. The sensitivity of S. pyogenes to ABPC, AMPC, CPDX-PR, EM and CLDM was very good. All the strains were susceptible at a MIC below > or = 0.05 microgram/ml. However, the S. pyogenes strains were not very sensitive to the new quinolones, especially NFLX. We concluded that penicillins, cephalosporins and macrolides are still effective against streptococcal infections.(ABSTRACT TRUNCATED AT 250 WORDS)

The antibiotic susceptibility of Propionibacterium acnes and Staphylococcus epidermidis isolated from acne

We studied the susceptibility of antimicrobial agents to Propionibacterium acnes (P. acnes) and Staphylococcus epidermidis (S. epidermidis) isolated from acne patients. We measured the minimum inhibitory concentrations (MICs) of the following five drugs: roxithromycin (RXM), erythromycin (EM), clindamycin (CLDM), minocycline (MINO) and ofloxacin (OFLX), which are frequently used to treat acne and skin infections. We found many resistant strains of S. epidermidis and some resistant strains of P. acnes. There was a correlation between the resistance of S. epidermidis and the former therapy for acne, but no distinct correlation between the resistance of P. acnes and the former therapy for acne.

Long-term follow-up study of changes in lipid peroxide levels and the activity of superoxide dismutase, catalase and glutathione peroxidase in mouse skin after acute and chronic UV irradiation

Lipid peroxide levels, the activities of superoxide dismutase (SOD), catalase and glutathione peroxidase (GSH-Px), and the development of tanning in the skin of C57 BL/6 mice were assessed for long periods, from very early to late stages, after acute or chronic UVB irradiation. Acute UVB irradiation produced an increase in lipid peroxide levels that peaked 18 h after irradiation, after which the levels declined to a minimum 2-3 days after irradiation and then gradually rose to baseline. Chronic irradiation caused the lipid peroxide level to fall to a minimum at 0.5-1.0 weeks, after which it gradually returned to baseline by the third week. SOD and GSH-Px activities decreased sharply after acute irradiation, reaching a minimum 18 h after irradiation. Following chronic irradiation, these enzyme levels peaked after 0.5 weeks, and thereafter declined gradually to the original levels 3 weeks after irradiation. In contrast, catalase activity did not change significantly. Tanning began to increase at 1.5 weeks after irradiation, with an accelerated rate of increase from the third week.(ABSTRACT TRUNCATED AT 250 WORDS)

Androgens affect the activity of human sebocytes in culture in a manner dependent on the localization of the sebaceous glands and their effect is antagonized by spironolactone

To investigate the varying response of the pilosebaceous unit to androgens functional studies were performed on the effects of testosterone and 5 alpha-dihydrotestosterone on cultured human sebocytes derived from different skin regions. In addition, the effect of spironolactone on the proliferation of androgen-stimulated human sebocytes derived from facial skin was evaluated. Testosterone (10(-11) to 10(-5) M), 5 alpha-dihydrotestosterone (10(-11) to 10(-5) M) and spironolactone (10(-12) to 10(-7) M) were added for 10 days as single substances or in combinations to human sebocytes in secondary culture maintained in a serum-free medium. Cell proliferation was assessed using a fluorometric assay. Intracellular lipids were extracted from sebocytes treated with androgens (10(-7) M) for 10 days after confluency. Testosterone inhibited the proliferation of sebocytes derived from the legs with a 50%-inhibitory concentration at 10(-5) M and induced a 50% decrease of intracellular lipids. In contrast, 5 alpha-dihydrotestosterone stimulated the activity of leg sebocytes with a 50% increase of proliferation at 10(-5) M, and a 175% increase of intracellular lipids. On the other hand, the proliferation of facial sebocytes was significantly stimulated by testosterone with a 50%-stimulatory concentration at 10(-6) to 10(-5) M and mostly by 5 alpha-dihydrotestosterone with a 50% enhancement at 10(-8) to 10(-7) M. Spironolactone inhibited the proliferation of facial sebocytes in a dose-dependent manner with a 25%-inhibitory concentration at 10(-9) M. Simultaneous treatment of facial sebocytes with spironolactone and testosterone or 5 alpha-dihydrotestosterone resulted in decreased proliferation when compared to the growth obtained under androgens alone.(ABSTRACT TRUNCATED AT 250 WORDS)

[Study of combination therapy for thymoma: a case of stage IV which presented as total spinal block caused by epidural metastasis and which preoperative combination therapy was effective for minimizing the tumor]

We experienced 24 cases of thymoma in the past 17 years. Associated syndromes as myasthenia gravis and pure red cell anemia (PRCA) were found in 7 patients. Preoperative therapies were done for the cases of stage IV. Total resection of the tumor was performed except 3 cases which ended in exploratory thoracotomy. Postoperative therapies were done except the cases of stage I. Each one case of stage III and IV a whose operation ended in exploratory thoracotomy died of tumors, but latter case had some period of PR after chemotherapy. A case of stage I with PRCA died from pneumonia but other cases of autoimmune disease had been well controlled by medical treatment. A case of stage IVb was first admitted to the hospital for paralysis of bilateral lower limb. After resecting the epidural tumor of thoracic spine, chemotherapy (CAV 1 kur) and radiotherapy (4,200 rad) was performed which was effective for minimizing the antero-mediastinal tumor. Though operation ended in exploratory thoracotomy, majority of the tumor was found to be replaced for fibrous tissue which suggested the effectiveness of the combination therapy. But this case died from pancreatitis during the postoperative therapy. In conclusion, combination therapy of surgical resection and adjuvant radiotherapy & chemotherapy including the care for autoimmune disease is important in the treatment of thymoma.

Age-dependent basal level and induction capacity of copper-zinc and manganese superoxide dismutase and other scavenging enzyme activities in leukocytes from young and elderly adults

Several enzymes, including superoxide dismutase (SOD), catalase, glutathione peroxidase, and D-glucose-6-phosphate dehydrogenase are capable of scavenging reactive oxygen species in in vivo. We assessed both basal levels and the capacity of these enzyme activities to be induced in human leukocytes in response to a variety of agents. Basal activity of copper-zinc SOD, and manganese SOD showed little variation with age. In contrast, the basal activity of the three H2O2 scavenging enzymes, catalase, glutathione peroxidase, and D-glucose-6-phosphate dehydrogenase, was significantly higher in younger adults than in elderly individuals. Both manganese SOD and copper, zinc SOD activities were significantly induced by paraquat, interleukin-1, tumor necrosis factor, adriamycin, and bleomycin in lymphocytes and neutrophils from asymptomatic non-aged adults, whereas neither activity was induced in aged individuals. In contrast, glutathione peroxidase activity was significantly induced in both groups of subjects, whereas catalase and D-glucose-6-phosphate dehydrogenase were only slightly induced in either. Enzyme induction with paraquat, adriamycin, or bleomycin was inhibitable by neutralizing antibody to interleukin-1 and tumor necrosis factor, suggesting that the inductions observed with these three drugs are due to the distal mediators, interleukin-1 or tumor necrosis factor released from the cells. Finally, as observed in the regulation of genes in eukaryotes (Storz et al: Bacterial defenses against oxidative stress. Trends Genetics 1990, 6:363-368, ref. 1) O2- and H2O2 seem to differ in the rate of change with age in both basal levels and inducibility under oxygen stress.

The effect of oxatomide on neutrophil oxygen radical generation

The effect of oxatomide on reactive oxygen species (ROS) generated both by neutrophils and in a cell-free, xanthine-xanthine oxidase system was examined. The species investigated were superoxide radical anion (O2-), hydrogen peroxide (H2O2) and hydroxyl radical (OH.). Oxatomide significantly decreased neutrophil-generated O2-, H2O2 and OH. in a dose-dependent manner. H2O2 and OH. generated in a cell-free system were also reduced in the presence of oxatomide. The present study indicates that oxatomide decreases ROS generation presumably by inhibiting the neutrophil oxygen metabolism, and has the ability to scavenge H2O2 and OH.

Spironolactone directly inhibits proliferation of cultured human facial sebocytes and acts antagonistically to testosterone and 5 alpha-dihydrotestosterone in vitro

Spironolactone produces antiacne effects and has recently been shown to inhibit 5 alpha-dihydrotestosterone (5 alpha-DHT) receptors in human sebaceous glands. We applied spironolactone alone and combined with testosterone and 5 alpha-DHT to investigate its effects on the proliferation of human sebocyte cultures derived from facial skin. Secondary human facial sebocytes in 96-well culture plates were treated for 10 d by a single or combined application of testosterone (10(-8)-10(-5) M), 5 alpha-DHT (10(-8)-10(-5) M), and spironolactone (10(-12)-10(-7) M) in serum-free basal medium. Cell proliferation was assessed in six wells using a fluorometric assay. Testosterone and 5 alpha-DHT significantly stimulated sebocyte proliferation in a dose-dependent manner, the effect being strongest with 5 alpha-DHT. Spironolactone, on the other hand, caused a dose-dependent inhibition (25% and 50% at 10(-9) and 10(-7) M, respectively). Combined treatment of human facial sebocytes with spironolactone and testosterone or 5 alpha-DHT resulted in a lower proliferation than with androgens alone. The fact that spironolactone directly and dose dependently inhibits the proliferation of cultured human facial sebocytes and acts antagonistically to testosterone and 5 alpha-DHT at the cellular level is indicative of a receptor-mediated effect.

Development of the sleep and wakefulness rhythm in preterm infants discharged from a neonatal care unit

The purpose of this study was to investigate the effect of constant light in a neonatal care unit on the development of the sleep-and-wakefulness rhythm in preterm infants. Two groups of infants (57 preterm infants without other complications and 58 healthy term infants) were prospectively studied over infancy by a day-by-day plot method, by which sleep-and-wakefulness states were recorded at home for more than 14 d to compare developmental courses of the sleep-and-wakefulness rhythm between the two groups at corrected and postnatal ages. In the two groups, there were no significant differences in distribution of emergence of periodicity of sleep states and wakeful states, total sleep time, nocturnal sleep time, diurnal sleep time, longest sustained sleep period, and longest sustained wakeful period at the same corrected ages. Moreover, the SD of the time of onset of the longest sustained sleep period of each subject diminished with increase in postconceptional weeks. The results suggest that the development of the sleep-and-wakefulness rhythm in preterm infants is not necessarily retarded if they are discharged from the neonatal care unit under constant light before an infant's innate biologic clock is mature enough to respond to an environmental cycle; rather it depends on their corrected ages.

Blood flow velocities in the cerebral arteries and descending aorta in small-for-dates infants

Resistive indices (RI) in the anterior cerebral artery (ACA), basilar artery (BA), middle cerebral artery (MCA) and descending aorta (DA) were obtained in 15 small-for-dates (SFD) infants who were, growth retarded because of maternal pregnancy-induced hypertension and in 20 appropriate-for-dates (AFD) infants matched for gestational age between 24 h and 48 h after birth. The RIs in the MCA, ACA and BA were significantly lower, while the RI in the DA was significantly higher, in the SFD infants than in the AFD infants. These changes in RIs in the SFD infants might be similar to the "brain sparing" effect as reported in growth-retarded fetuses.

[Incidence and causes of neonatal seizures in the last 10 years (1981-1990)]

We report the incidence of neonatal seizures in the last 10 years. Between 1981-1990, 28,925 infants were born in the Japanese Red Cross Medical Center. Very low-birth-weight infants (< 1,500 g) were excluded in this study. Seizures were identified in 67 infants (0.23%) during the first 7 days of life. Seizures occurred more frequently in low-birth-weight infants (1,500-2,499 g) than in normal-birth-weight infants (> 2,499 g). Fifty-one infants (0.19%) of 27,276 normal-birth-weight infants and 16 (0.97%) of 1,649 low-birth-weight infants developed seizures. The frequency of seizures was 0.25% during the first 5 years and 0.20% during the second 5 years. In low-birth-weight group, the frequency of seizures decreased form 1.49% to 0.48% during the 5-year periods, and seizures due to post asphyxial hypoxic-ischemic encephalopathy also decreased from 0.14% to 0.06%. The decreased incidence in neonatal seizures during the last 10 years was probably achieved by the progress in intervention of low-birth-weight infants in NICU and by the obstetrical prevention of intrapartum asphyxia.

Effect of doxycycline on the generation of reactive oxygen species: a possible mechanism of action of acne therapy with doxycycline

On the basis of a recent report that minocycline is effective in the treatment of acne inflammation by acting directly as an antioxidant on infiltrating neutrophils, we investigated whether doxycycline might also be capable of reducing the generation of reactive oxygen species, using human neutrophils and a cell-free, xanthine-xanthine oxidase system. The species investigated are superoxide radical anion (O2-), hydrogen peroxide (H2O2) and hydroxyl radical (OH.). Doxycycline significantly reduced the levels of O2-, H2O2 and OH. generated by both systems. Our results seem to suggest that the clinical effectiveness of doxycycline in the treatment of acne inflammation is due partly to its antioxidant effect on neutrophils.

Control of human sebocyte proliferation in vitro by testosterone and 5-alpha-dihydrotestosterone is dependent on the localization of the sebaceous glands

Androgens stimulate the activity of sebaceous glands in vivo. In this study the in vitro effect of androgens on the proliferation of cultured human sebocytes derived from facial and non-facial skin were assessed. Human sebocytes from sebaceous glands isolated from the face and the upper and lower legs of five individuals were cultured in vitro with or without testosterone or 5-alpha-dihydrotestosterone (5 alpha-DHT) at different concentrations (10(-11)-10(-5) M). Cell proliferation was assessed in 96-well culture plates using a fluorometric assay. Testosterone and 5 alpha-DHT stimulated the proliferation of human facial sebocytes in a significant dose-dependent manner. In our system 5 alpha-DHT exhibited the strongest effect; on the contrary, the proliferation of non-facial sebocytes was inhibited by testosterone, whereas 5 alpha-DHT enhanced their growth. The stimulatory effect of 5 alpha-DHT was more prominent on facial than on non-facial sebocytes. These results provide first evidence that the effect of testosterone and 5 alpha-DHT on the proliferation of cultured human sebocytes may depend on the localization of the sebaceous glands at different skin regions.