[The effect of the dosage and route of manganese administration on manganese concentration in rat brain]

We investigated the differences in manganese concentration and distribution in the brains of rats administered MnCl2 perorally, intravenously and intraperitoneally for one week. Forty two male Wistar rats were divided into eight groups, designated A to H. Groups A (n = 5) and B (n = 7) were maintained with synthetic diets, with 50 and 1000 mg manganese per kg diets, respectively. Groups C (n = 5), D (n = 5) and E (n = 5) were administered manganese intravenously with dosages of 0.088, 0.88 and 2.2 mg/kg.b.w./day, respectively. Groups F (n = 5), G (n = 5) and H (n = 5) were administered manganese intraperitoneally with dosages of 0.088, 0.88 and 2.2 mg/kg.b.w/day, respectively. Four brain regions (cerebrum, cerebellum, basal ganglia and the remainder) were analyzed by atomic absorption spectrophotometry for manganese. The manganese concentrations in basal ganglia were increased proportionally to the administration dosages in intravenous administration groups (C, D and E). At the highest dosage of manganese administration, manganese concentrations in cerebrum and basal ganglia were higher with intravenous administration of manganese than with intraperitoneal administration. In addition, manganese concentrations were hardly increased in peroral administration groups. Therefore, we suggested that basal ganglia are vulnerable to manganese exposure and that liver and intestine might play the important roles in the reduction of manganese accumulation in the central nervous system.

[Pilot phase II study of 5-day continuous infusion of cisplatin in treatment of non-small cell lung cancer]

We administered cisplatin (CDDP) as a single agent at a dose of 25 mg/m2/day for 5 days by continuous infusion in 15 patients with inoperable non-small cell lung cancer (3 squamous cell carcinoma, 11 adenocarcinoma and 1 large cell carcinoma), and studied the pharmacokinetics of CDDP, the response rate and toxic effects. The maximum concentration (Cmax) of filtrable platinum (Pt) was 0.092 +/- 0.03 microgram/ml and AUC was 9.3 +/- 3.5 micrograms.hr/ml. The response rate was 40% (6/15). Nausea without vomiting was noticed in 53% of patients and vomiting in 27%. Leukopenia (less than 3,000/mm3) was seen in 53%, thrombocytopenia (less than 70,000/mm3) in 27% and anemia (Hb less than 9.5 g/dl) in 67%. Peak serum creatinine greater than 1.5 mg/dl was not observed. The Cmax of the filtrable Pt was low but AUC level was high compared with that in reported data in which CDDP as a single agent was infused at the same dose in short-term infusion. This was presumably associated with the good response rate in this study. The incidence of hematologic toxicity was slightly high, while that of vomiting and nephrotoxicity was rather low. The 5-day continuous infusion appears to be a safe and effective method of CDDP administration for non-small cell lung cancer, and improved therapeutic results may be expected when this is combined with other effective drugs.

[Effects of total parenteral nutrition containing essential trace elements on their concentrations in rats]

Twenty-four rats were equally divided into 4 groups and maintained for 1 week as follows: Group A (normal control) with a synthetic normal diet and distilled water, group B with conventional total parenteral nutrition (TPN), i.e., TPN without essential trace elements (ETE), group C with TPN supplemented with a usual dose of ETE solution (TE-5), and group D with TPN supplemented with 3 times the usual dose of TE-5. Body weight, trace element concentrations in various tissues and certain blood biochemical parameters were determined in these rats. The results were as follows: 1) No significant differences in body weight were observed among the groups. 2) The iron concentrations in plasma and tibia decreased significantly in group B as compared with group A. The addition of TE-5 prevented these decreases, but dose-dependent increases in the concentrations of iron were observed in liver, spleen and kidney (groups C and D). 3) The zinc concentrations in plasma, whole blood, brain, heart, kidney and tibia decreased significantly in group B as compared with group A. The addition of TE-5 prevented these decreases dose-dependently (groups C and D). 4) The copper concentrations in plasma, whole blood, liver, spleen, kidney, testis and tibia decreased significantly in group B as compared with group A. The addition of TE-5 resulted in a tendency for these decreases to diminish (groups C and D). 5) The manganese concentrations of whole blood in group B decreased significantly as compared with group A. The addition of TE-5 caused the manganese concentrations of various tissues in groups C and D to increase significantly as compared with group A.(ABSTRACT TRUNCATED AT 250 WORDS)

Azinomycins A and B, new antitumor antibiotics. I. Producing organism, fermentation, isolation, and characterization

A strain of Streptomyces griseofuscus S42227 (FERM P-8443) was found to produce new antitumor antibiotics, called azinomycins A and B. The molecular formulas of azinomycins A and B were determined as C30H33N3O10 and C31H33N3O11, respectively. They were active against Gram-positive bacteria, Gram-negative bacteria and L5178Y cells in tissue culture.

Comparative pharmacokinetics of a new benzamide neuroleptic drug in rats, dogs and monkeys using a stable isotope technique

Comparative pharmacokinetics of a new benzamide neuroleptic drug, cis-N-(1-benzyl-2-methylpyrrolidine-3-yl)-5-chloro-2-methoxy-4-met hylamino benzamide (NBND) was studied in rats, dogs and monkeys using two deuterium-labelled compounds. NBND and 2H3-NBND, which showed no biological isotope effect, were co-administered p.o. and i.v. to rats, dogs and monkeys, and the plasma concentrations of unchanged drugs were simultaneously determined by g.l.c.-chemical ionization mass spectrometry with 2H7-NBND as an internal standard. The plasma half-lives (t1/2 beta) after i.v. administration were 1.6, 4.7 and 2.2 h in rats, dogs and monkeys at a dose of 0.2 mg/kg. Plasma clearances were 4.3, 1.7 and 1.4 l/h per kg in rats, dogs and monkeys. Absorption rate constants (Kab) were 1.1, 0.58 and 0.54 per h in rats, dogs and monkeys, at doses of 10, 3 and 5 mg/kg, respectively. Absolute bioavailabilities were 0.8, 9.5 and 1.3% in rats, dogs and monkeys, suggesting that all these species showed large first-pass effects, probably due to hepatic metabolism.

Actinopyrones A, B and C, new physiologically active substances. II. Physico-chemical properties and chemical structures

The structure of physiologically active substances, actinopyrones A, B and C, produced by Streptomyces pactum S12538 were determined on the basis of their spectral and chemical character. These substances were structurally related to piericidin A1.

Actinopyrones A, B and C, new physiologically active substances. I. Producing organism, fermentation, isolation and biological properties

A strain of Streptomyces was found to produce new physiologically active substances. The active compounds were purified and separated into three substances named actinopyrones A, B and C. Actinopyrones exhibited coronary vasodilating activities in anesthetized dogs and weakly antimicrobial activities against some Gram-positive bacteria and dermatophytes.

Determination of indeloxazine in plasma by liquid chromatography and gas chromatography-mass spectrometry

Two methods have been developed for the quantitative determination of indeloxazine, a cerebral activator, in plasma by HPLC or GC-MS. After addition of viloxazine as the internal standard, indeloxazine was extracted from alkalinized plasma. In the HPLC method, the plasma extract was treated with 5-dimethylamino-1-naphthalenesulfonyl chloride and analyzed by HPLC with fluorescence detection. In the GC-MS method, the two plasma compounds were converted to their pentafluoropropionyl derivatives for selected-ion monitoring. The limits of detection were 5 and 2 ng/mL for the HPLC and GC-MS methods, respectively. When plasma samples obtained by giving indeloxazine hydrochloride to volunteers were analyzed by the two methods, good correlation between the data was obtained (r = 0.9901).

[Simultaneous bilateral operations for bullous emphysema by median sternotomy]

Eighteen patients with bilateral bullae underwent simultaneous operations via median sternotomy. Each patient had giant bullae occupying at least one third of the each hemithorax and also had various degree of exertional dyspnea. All patients showed subjective as well as objective improvement and there was no mortality or morbidity. Late follow-up study for objective evaluation of this operative procedure clarified that the forced expiratory volume for one second (FEV1.0) and arterial oxygen tension (PaO2) were significantly improved after the operation, whereas the vital capacity and arterial carbon dioxide tension (PaCO2) showed no apparent changes. Serial study of cardiopulmonary hemodynamics during the bilateral thoracotomy was performed with Swan-Ganz catheter and hemodilution method. By abrupt decompression of the cyst, decreases in pulmonary arterial pressure, cardiac output, or systemic arterial pressure were noted during the bilateral thoracotomy. These hemodynamic changes were much more evident in the cases ventilated by single lumen tube than the cases operated upon using double lumen tube with separate ventilation. This operative procedure was applied on the cases with bilateral spontaneous pneumothorax and metastatic lung tumor. The clinical advantages of this bilateral operation via median sternotomy were discussed.

[A study on the ruptured Valsalva sinus aneurysm using two-dimensional echocardiography]

We visualized the Valsalva sinus aneurysm ruptured into the right ventricle using two-dimensional echocardiography, and analyzed the blood flow by pulsed Doppler technic. Cross-sectional echocardiography was performed on 11 patients with right sinus aneurysm protruding into the right ventricle. The age of the examined subjects ranged from 17 to 40 years. Ten of the 11 revealed a ruptured aneurysm of the right sinus of Valsalva into the right ventricle. Nine of the 11 had ventricular septal defect and five were associated with aortic regurgitation. Pulmonic regurgitation was recognized in one case. The diagnosis was made by cardiac catheterization and angio-cardiography in all cases and was confirmed by cardiac surgery in nine patients. In this study, we employed an electronic (SSH-11A) or mechanical sector scanning system (SSL-51H) for cross-sectional echocardiography. In order to clearly visualize an aneurysm, the cross-section of the left ventricular long-axis was obtained from a slightly lower and more sagittal position than the standard method. In addition, the short axis cross-section of the aortic root was also examined. Furthermore, a pulsed Doppler technic was applied to three patients using a Doppler unit SDS-10A combined with SSH-11A. In all patients, an aneurysm of the right sinus of Valsalva was seen to protrude into the right ventricle by two-dimensional echocardiography. Furthermore, the ruptured orifice of the aneurysm was clearly visualized in ten cases. The shape of the aneurysm was tubular in ten cases and saccular in the remaining one. A continuous blood flow of wide band pattern was recorded in the right ventricle near the ruptured orifice in two of the examined three cases and a disturbed diastolic flow was noted in a saccular aneurysm. In conclusion, two-dimensional echocardiography is useful to visualize an aneurysm of the right sinus of Valsalva ruptured into the right ventricle and a pulsed Doppler technic is greatly contributed in detecting localized disturbed flow due to the ruptured aneurysm.

The development of a radioimmunoassay for formoterol

The development of a radioimmunoassay (RIA) for the beta 2-stimulant formoterol is described. The sensitivity of the method is 0.1 ng/ml in plasma and urine, when a 1-ml sample is used. The cross-reactivity of the antiserum with formoterol glucuronide was 30%. Since formoterol is metabolized extensively to formoterol glucuronide in rats, dogs and humans, extraction with ethyl ether prior to the radioimmunoassay was carried out. Satisfactory agreement was obtained for levels of formoterol in plasma and urine when they were determined by RIA and gas chromatography-mass spectrometry. The concentration of formoterol was determined in dog plasma and human urine after oral administration of formoterol fumarate to dogs (61 mcg/kg) and humans (40 mcg).

[2 Cases of cystic meningioma]

Although meningiomas are usually a solid and firm tumor, some are associated with diagnostically confusing large cysts. The authors experienced two cases of meningioma associated with large cyst (cystic meningioma). The first case was a 20-year-old female. She was admitted because of blurred vision. On admission she was slightly apathetic and showed bilateral papilledema. Computed tomography showed a large area of low density in both frontal regions. CT scan after intravenous contrast enhancement revealed an enhancing mural nodule attached to the falx. At operation, dark-green fluid in an amount of 160 ml from the left cyst and 50 ml from the right cyst was aspirated. The nodular tumor was found attached to the falx. The pathological examination revealed meningotheliomatous meningioma. Neoplastic meningothelial cells were found also in the cyst wall. The second case was a 21-year-old female. She was admitted because of weakness of the left lower extremity. Neurological examination revealed left hemiparesis. Deep tendon reflexes were hyperactive on the left side and there were positive left Babinski and Chaddock reflex. The computed tomography with contrast enhancement showed a large area of low density in the right parietal region with markedly enhancing mural nodule. At operation, 70 ml of xanthochromic fluid was aspirated. The tumor was well-defined, hard and attached to the dura. Histologically the tumor was a typical meningotheliomatous meningioma. The diagnostic value of computed tomography, the pathogenesis of cyst formation and the surgical treatment were discussed. The authors emphasized the important role of computed tomography in the diagnosis of cystic meningioma. Theories were reviewed for the pathogenesis of cyst formation. At operation, not only the mural nodule but also the cyst wall should be removed, because the neoplastic cells are presented in the cyst wall.

[Study on tricuspid regurgitation in Ebstein's anomaly using pulsed Doppler technique combined with two-dimensional echocardiography]

To investigate the localization of tricuspid regurgitant flow in Ebstein's anomaly, pulsed Doppler echocardiography (PDE) was performed on nine patients with or without associated cardiac lesions. The equipment used was characterized by the real time frequency analysis of Doppler signals obtained from the sampling sites confirmed on the cross-sectional images. We employed the apical four-chamber view or right ventricular inflow view in order to facilitate the sampling of Doppler signals from the three-sided heart chambers of this lesion. Doppler signals were recorded from several points in the functional right ventricle, atrialized right ventricle and right atrium. The PDE recording was made in conjunction with M-mode echocardiography at a paper speed of 50 mm per second. In eight of the nine patients, a systolic disturbed flow of wide band pattern was maximally located in the atrialized right ventricle in the vicinity of the tricuspid valve leaflets and had a delayed onset, which were seemed to be the findings characteristic of tricuspid regurgitation in Ebstein's anomaly. In the remaining one, a turbulent flow due to this lesion was obscured by a systolic jet of the associated ventricular septal defect in the vicinity of the tricuspid valve leaflet. In the right atrium, no disturbed flow of wide band pattern existed or only a faint abnormal blood flow was observed during systole. In the functional right ventricle, a smooth blood flow of the right ventricular inflow was recognized in diastole. In contrast, 15 patients with secondary tricuspid regurgitation revealed a holosystolic disturbed flow of wide band pattern maximally in the right atrium in the vicinity of the tricuspid valve leaflets. In eight healthy subjects, there was no systolic disturbed flow in the right atrium. Pulsed Doppler technique combined with two-dimensional echocardiography is thought useful to detect the localization of the disturbed flow in Ebstein's anomaly, thus contributing to the differentiation of various causes of tricuspid regurgitation.

Cross-sectional echocardiographic study on atrial septal defect: pre- and postoperative considerations

The interatrial septum (IAS) has not been readily appreciated by M-mode echocardiography, but cross-sectional echocardiography has the capability of recording the shape and location of the IAS. Thirty-five patients with secundum atrial septal defect (ASD) were studied with cross-sectional echocardiography for detection of the ASD defect and demonstration of the IAS features following ASD closure. The ASD was shown as an echo dropout at the mid-portion of the septum in those patients examined in the present study in the horizontal cross-sections at the fourth intercostal space. The edge of the remaining IAS sharply demarcated and the defect was constantly demonstrated. In the postoperative patients, the IAS was recognized as a smooth series of echoes and the defect was no longer recognized. A notch echo was demonstrated in patients who underwent direct suture of the defect, and two notch echoes were recorded in patients who had a patch closure from a cardiac operation. The size of the defect at cardiac operation ranged from 1.5 to 5.0 cm with an average of 3.3 +/- 0.2 cm. The defect was slightly smaller on cross-sectional echocardiograms than at the time of operation. As the defect grew larger, the right ventricular dimension and the Qp/Qs became larger as well. Postoperatively, the right ventricular dimension was remarkably decreased, and the paradoxical movement of the interventricular septum (IVS) was normalized in the majority of the patients. Cross-sectional echocardiography is useful to diagnose ASD, to measure the size of the IAS defect, and to follow the clinical course.

Ruptured aneurysm of the right sinus of Valsalva: two pulsed Doppler echocardiographic studies

Pulsed Doppler echocardiography (PDE) was performed on two cases with ruptured aneurysm of the right sinus of Valsalva into the right ventricle. PDE revealed a wide band pattern throughout the cardiac cycle when the sample volume was placed within the aneurysm. In the right ventricle below the aneurysm, a continuous disturbed flow in case 1 and a diastolic turbulence in case 2, was widely recorded, respectively. In contrast, the flow pattern of the right ventricular outflow tract distal to the aneurysm showed a systolic disturbed flow in both cases. These PDE findings were consistent with the shunt flows in angiocardiography.

Clinical study on the abnormal flow patterns in Ebstein's anomaly using pulsed Doppler echocardiography

Pulsed Doppler echocardiography (PDE) was performed in 10 patients with Ebstein's anomaly and 10 cases of tricuspid regurgitation secondary to mitral stenosis. Distal atrialized right ventricle (ATRV): In all patients with Ebstein's anomaly, tricuspid regurgitation flow was recognized by PDE. In this lesion with moderate tricuspid regurgitation, a widely dispersed dot pattern was recorded during systole However, in the cases with severe tricuspid regurgitation a relatively smooth dot pattern was recognized. In the case with marked delay in pressure rise in the right ventricle, PDE showed a bimodal regurgitant flow pattern. The interval between the onset of QRS and that of tricuspid regurgitant flow with right ventricular pressure rise was measured. The interval corrected for heart rate ranged from 0.10 to 0.35 with an average of 0.19 +/- 0.08 sec. In the subjects with secondary tricuspid regurgitation, it ranged from 0.07 to 0.11 sec. This interval was significantly prolonged in Ebstein's anomaly as compared to that in secondary tricuspid regurgitation (p less than 0.001). Proximal ATRV: Tricuspid regurgitant flow was detected in 6 to 10 patients with Ebstein's anomaly. The disturbed flow was less apparent in the proximal ATRV than in the distal ATRV.

Clinical investigation of aortic insufficiency by means of pulsed Doppler echocardiography

Pulsed Doppler echocardiography (PDE) was performed on 41 patients with aortic insufficiency (AI), isolated or associated with other cardiac diseases, using an ATL 500A pulsed Doppler system. The diagnosis was confirmed by angiocardiography in 25 cases. The purpose of the present study was to analyze the disturbed flow due to AI, to investigate the sensitivity of PDE to this lesion, and to compare with the angiographic severity of AI (Sellers). The transducer was placed on the left sternal border and the flow pattern was recorded at the aortic valve orifice and the proximal and distal left ventricular outflow tract (LVOT), using a strip chart recorded at a paper speed of 100 mm/sec. The specific feature of AI was a widely dispersed dot pattern which began at the aortic valve closure and extended to late diastole. The severity of AI was graded by supravalvular aortogram in 25 patients. In grades I and II, the abnormal dot pattern due to AI was mostly detected at the aortic valve orifice and the distal LVOT, but it was rather difficult to detect the disturbed flow at the proximal LVOT. In contrast, in grades III and IV, the disturbed flow was recorded at all the sampling sites; with severe aortic regurgitation, it was detected at a wider range in the left ventricular cavity. In grades I and II, the abnormal dot dispersion at the proximal LVOT was not so large at its onset in diastole but it tended to increase after the mitral valve opening, whereas in the majority of patients of grades III and IV, a large dot dispersion was recognized from its onset to late diastole. The typical flow pattern due to AI was detected at the LVOT in 38 out of 41 patients (92.7%). Moreover, it was detected in all the patients with angiographically proved AI except for 1 case of grade I (96.0%).

Improved surgical treatment of tricuspid insufficiency in combined valvular diseases

Tricuspid insufficiency is not infrequent in combined valvular diseases. We used Carpentier's De Vega's or Bex's annuloplasty with our own modification in combined tricuspid insufficiency and found the results much more satisfactory compared with previous methods. Of 152 patients with acquired valvular disease, 24 with combined valvular disease underwent one of these procedures. During the same period, three tricuspid valve replacements, using a glutaraldehyde-treated xenograft, were performed in patients with severly damaged tricuspid valves. Simultaneous procedures for other valves were open mitral commissurotomy in 14, mitral valve replacement in 9 and aortic and mitral valve replacement in 4 patients. Despite the seriousness of their preoperative condition, 25 of 27 patients survived, resulting in a mortality rate of 7.4%. We believe that these annuloplasty methods represent a remarkable progress in the treatment of tricuspid valve insufficiency in combined valvular diseases.