Effects of electric footshock and water immersion restraint stresses on fibrinolytic parameters in the plasma of rats

Wistar rats were exposed to electric footshock (ES) or water immersion restraint stress (WS). Blood was taken immediately after, 24, or 48 hours after the stress. The stomachs of rats taken 1 hour after stress application indicate that there were many bleeding spots in the stomachs of WS rats, but practically no visible bleeding spots in the stomachs of ES rats. Plasma levels of t-PA antigens increased in ES rats up to 24 hours after the stress, but the t-PA antigen levels decreased up to 48 hours in ES rats. There were no changes in t-PA activities in plasma of WS rats, but the levels in ES rats decreased immediately and 48 hours after the stress. PAI activity did not change immediately after WS but increased 24 hours after the stress. There was no change in PAI activity in ES rats up to 48 hours. ELT did not change in ES rats, but prolonged in WS rats at 24 hours after the stress. There were significant negative correlations between t-PA antigen levels or activities and ELT in control rats. No correlation was observed in ES or WS rats between t-PA antigen levels and ELT, and no correlation was shown in WS rats between t-PA activities and ELT. Plasma levels of catecholamines increased at the 20-minute period during ES, which may not explain the delayed effects of ES on hemostatic balance. Plasma levels of arginine vasopressin increased significantly immediately after the shock up to 2 hours, indicating that the stress was conveyed to the hypothalamus during the stress application. These results may indicate that some stressors induce an increase or decrease in the local balance of fibrinolytic activities, resulting in bleeding or thrombosis in the local vessels. Such changes may not be detected in the general circulation due to the neutralization of locally induced fibrinolytic changes or the involvement of other hepatically originated hemostatic factors induced by stressors.

BMP-induced osteogenesis on the surface of hydroxyapatite with geometrically feasible and nonfeasible structures: topology of osteogenesis

Bone morphogenetic protein (BMP) is known to require a suitable carrier to induce ectopic bone formation in vivo. Hydroxyapatite ceramics have been reported to be effective in some forms but ineffective in others as a carrier of BMP-induced bone formation. In this study we compare three geometrically different forms of hydroxyapatite to examine their functions as carriers of BMP-induced bone formation. A fraction containing all the active BMPs (BMP cocktail) was partially purified from a 4M guanidine extract from bovine bone by a three-step chromatographic procedure. The BMP cocktail was combined with each of three forms of hydroxyapatite--solid particles (SPHAP), porous particles (PPHAP), and coral-replicated porous tablets (coral-HAP)--and implanted subcutaneously into rats. Both the PPHAP and coral-HAP systems induced osteogenesis 2 weeks after implantation, as evidenced by morphological and biochemical observations. Details of the osteogenetic process were followed by double-fluorescence labeling in the coral-HAP system to confirm bone formation on the surface of hydroxyapatite. However, there was no evidence of osteogenesis or chondrogenesis in the SPHAP system. The results indicate that the geometry of the interconnected porous structure in PPHAP and coral-HAP create spaces for vasculature that lead to osteogenesis while the smooth structure and close contact of particles in SPHAP inhibit vascular formation and proliferation of mesenchymal cells, preventing bone and cartilage formation. It was concluded that the geometrical structure in hydroxyapatite ceramics that induces vasculature is crucial as a carrier for BMP-induced bone formation.

Effects of nicotine and footshock stress on dopamine release in the striatum and nucleus accumbens

We have used a microdialysis technique to analyze the effects of nicotine administration on the release of dopamine in the striatum and the nucleus accumbens (NAC) in rats under footshock stress. In the striatum, neither chronic systemic nicotine administration alone nor stress alone changed the extent of dopamine release. During stress application, however, chronic nicotine administration significantly increased dopamine release. In the NAC, stress did not induce increase in dopamine release in rats given nicotine chronically. However, in rats subjected to stress alone, dopamine release in the NAC was significantly increased after stress. In the striatum, the local infusion of 1.0 mM nicotine increased dopamine release. Furthermore, stress significantly increased nicotine-induced dopamine release. The local infusion of 1.0 mM nicotine into the NAC significantly increased dopamine release, but the levels returned to the baseline 30 min later. On the other hand, stress alone induced the release of dopamine 30 min later and the combination of stress and nicotine induced the release of dopamine during the stress and the effects lasted for 30 min. These results suggest that the responses of nicotine-induced dopamine release were different in the striatum and in the NAC under the stress. Stress and nicotine (systematically or locally administered) induced an immediate effect on dopamine release in the striatum, but in the nucleus accumbens stress alone and the combination of stress and nicotine induced a lasting release of dopamine (DA).

Importance of dissolution process on systemic availability of drugs delivered by colon delivery system

The relationship between in vitro drug release characteristics from colon delivery systems and in vivo drug absorption was investigated using three kinds of delayed-release systems. 5-aminosalicylic acid (5-ASA), tegafur (FT) and carbamazepine (CBZ) were selected as model drugs. Pressure-controlled colon delivery capsules (PCC) for liquid preparations, time-controlled colon delivery capsules (TCC) for liquid and solid preparations and Eudragit S coated tablets for solid preparations were used in this study. At first, in vitro dissolution tests for all preparations were performed. Drug release from solid preparations was delayed compared to that from liquid preparations with all three drugs. Next, these preparations were administered to fasted beagle dogs. For 5-ASA, the mean Cmaxs (peak level) of Eudragit S coated tablets and PCC were 5.52 and 16.89 micrograms ml-1, respectively. The mean Tmaxs (time when drug reached peak level) were 3.0 and 5.3 h. AUCs were 22.57 and 48.09 micrograms.h ml-1, respectively. For FT, Cmaxs of Eudragit S coated tablet and PCC were 0.87 and 1.46 micrograms ml-1, and Tmaxs were 7.0 and 6.7 h, respectively. AUCs were 9.73 and 15.55 micrograms.h ml-1 and bioavailabilities were 43.79 and 70.84%. For CBZ, the mean Cmaxs of liquid preparations and solid preparations were 0.37 and 0.22 micrograms ml-1, respectively. The mean Tmaxs were 4.7 and 4.3 h. AUCs were 0.673 and 0.392 micrograms.h ml-1. With liquid preparations, drug was thought to contact to the colonic membrane easily because of lack of interference by stools, and to be absorbed well as compared with solid preparations. From these findings, drug release from colon delivery systems and drug dissolution in the colonic lumen are very important factors for the systemic availability of drugs from the colon delivery systems.

Structural characterization of the molten globule and native states of ovalbumin: a 1H NMR study

Molecular characteristics of ovalbumin (OVA) in the acidic (pD 3.08, the E-form) and neutral [pD 7.29, the N-form (native form)] regions were studied by measuring effective radii, 1H NMR spectra, spin-echo 1H NMR spectra and cross-relaxation times (TIS) from irradiated to observed protein protons which are particularly sensitive for detection of the mobile segments and/or structural looseness in proteins. 1H NMR spectra did not show significant differences between the N- and E-forms except for the spectral lines in the CH3, epsilon CH2 and aromatic regions. Effective radii and TIS values for main- and side-chains showed 1.08 and 1.5- to 2.0-fold increases on going from the N- to E-forms, respectively. The elongation of TIS values might indicate the appearance of the fluctuating tertiary structure in the E-form. Molecular characteristics of the E-form, inferred from reported far ultraviolet-circular dichroism (UV-CD) spectra in the peptide region, near UV-CD spectra in the aromatic region [Koseki et al. (1988) J. Biochem. 103, 425-430], effective radii and especially elongation of TIS values might indicate that the E-form could be in the molten globule state. The onset of denaturation of OVA using TIS measurements was also studied.

Diurnal variation in serum remnant-like lipoproteins, platelet aggregation and fibrinolysis in healthy volunteers

Postprandial triglyceridemia and 'remnantemia' may better reflect the atherosclerotic risk than triglyceride (TG) levels in the fasting state. Recently, a new method was developed based on a monoclonal antibody recognizing an epitope distal to the carboxyl end of apo B48 which allows easy measurement of remnant-like lipoproteins (RLP). This study was performed in order to investigate RLP response to a standardized fat meal and establish a normal diurnal pattern of RLP in blood and compare it to platelet aggregation and fibrinolysis in healthy young men. We investigated 7 male volunteers (age range 18-23 years) who received a standardized fat meal (Othsuka Pharmaceutical Company, Japan) containing 32.9% lipids, 2.5% protein, 2.5% carbohydrate, 0.3% calcium and 0.1% phospholipids, and 74 mg/100 g cholesterol (C) at 7:30. The energetic value of this cocktail was 341 kcal/100 g. Area under curve (AUC) responses in TG, RLP-TG and RLP-C after the meal were as follows: for TG 28.66 +/- 8.94; for RLP-TG 17.54 +/- 5.55; for RLP-C 1.27 +/- 0.42 mg x dl-1 x h-1. These responses were correlated to each other. Surprisingly, collagen-induced platelet aggregation in whole blood was negatively related to RLP-C AUC. Fluctuation patterns of TG, RLP-TG and RLP-C concentrations during the day were remarkably similar, peaking in this particular group of subjects at 10:00-12:00 and at about 23:00, whereas cholesterol was decreasing late in the night and very early in the morning. This pattern was different from those of platelet aggregation and fibrinolysis parameters.

Telomerase activity in ovarian tumors

BACKGROUND

Shortening of telomeres occurs with each cell division and eventually results in cell death. The activity of telomerase, an enzyme that catalyzes telomere elongation, has been detected in germ cell lines and cancer cells, and has been detected in immortal cell lines but not in normal somatic cells. The relationship between telomerase expression and ovarian carcinogenesis was investigated.

METHODS

Ovarian tissue was obtained from 41 women with ovarian tumors (10 benign, 6 borderline-malignant, and 25 malignant tumors) and 6 with uterine disease (2 with uterine myoma and 4 with uterine carcinoma). These specimens were analyzed for telomerase activity and telomere length by the telomeric repeat amplification protocol and Southern blot hybridization, respectively.

RESULTS

Telomerase activity was detected in 23 of 25 malignant ovarian tumors (92%), in 1 of 6 borderline-malignant tumors (16.7%), and in 2 of 10 benign tumors (20%) (both of which were germ cell tumors). Weak telomerase activity was present in the cortex of normal ovaries from premenopausal women, and appeared to be attributable to follicles. Telomerase activity in malignant and poorly differentiated tumors tended to be higher than that in other tumors. Terminal restriction fragment length ranged between 8 and 13 kilobase pairs (kbp) for normal ovaries, and was <8 kbp in 1 of 6 malignant Stage I tumors (16.7%), 1 of 2 Stage II tumors (50%), and 9 of 17 Stage III tumors (52.9%).

CONCLUSIONS

Telomerase activity may be a useful marker for the diagnosis of ovarian tumors.

Verruciform xanthoma of the oral mucosa: an immunohistochemical and ultrastructural study of two cases

Verruciform xanthoma is an uncommon benign lesion of unknown aetiology and pathogenesis. Two cases of verruciform xanthoma are presented together with an immunohistochemical and ultrastructural study. One case co-occurred with an odontogenic keratocyst which, to our knowledge, has not been previously reported, and another case occurred on masticatory mucosa with an asymptomatic, granular, exophytic lesion causing a cleft-like gingival recession. In an immunohistochemical study using antibodies to macrophage (CD 68[KP1]), alpha-1-antitrypsin, vimentin, desmin, keratin, neuron-specific enolase (NSE) and S-100 protein, the characteristic foam cells of verruciform xanthoma showed strong positive staining for CD 68[KP1] and vimentin and weak positive staining for alpha-1-antitrypsin, while the other antibodies were negative. As in previous studies, S-100 protein positive dendritic cells were detected in lesional connective tissue. In addition, the ultrastructural findings revealed characteristics of macrophages containing varying sized lipid vacuoles and degenerating epithelial cells. These findings support the concepts that the foam cells in verruciform xanthoma are of monocyte-macrophage lineage and that the epithelial degeneration from uncertain causes may be related to the pathogenesis of the lesion.

Fibrinolytic parameters as an admission prognostic marker of head injury in patients who talk and deteriorate

Because it has been difficult to predict the outcome of patients with head injury in the early period after admission, a clinical study was undertaken to evaluate if the fibrinolytic parameters could be reliable indicators of outcome. Seventy patients presenting with head injury without obvious trauma in other regions were studied, and plasma levels of alpha2-plasmin inhibitor-plasmin complex (PIC) and D-dimer on admission (within 2 hours postinjury) were assessed. Plasma levels of both PIC and D-dimer were elevated and correlated well to patient outcomes. When plasma PIC levels were higher than 15 microg/ml or D-dimer levels were higher than 5 microg/ml, 92% of patients died regardless of their consciousness level on admission, whereas all patients made good recoveries when their PIC levels were less than 2 microg/ml or D-dimer levels were less than 1 microg/ml. Therefore, plasma levels of both PIC and D-dimer on admission were revealed to be reliable prognostic markers of head injury. Using these markers, patients with poor outcomes (progressive brain injury), such as "talk and deteriorate" types, could be readily identified on admission.

Little or no response to 24-hr water-deprivation of Fos-like immunoreactivity in vasopressinergic magnocellular neurons in the hypothalamus of hereditary microphthalmic rats

In normal rats, 24-hr water-deprivation was found to cause a significant increase in the plasma concentration of arginine vasopressin (AVP), and marked induction of Fos in the AVP-positive magnocellular neurons in the paraventricular nucleus (PVN) and the supraoptic nucleus (SON) of the hypothalamus. On the other hand, 24-hr water-deprivation also caused a significant increase in the plasma AVP concentration in hereditary microphthalmic rats, but much less than in normal rats. Consistent with this, the extent of induction of Fos in the nuclei of the PVN and SON of these rats was lesser than in normal rats. These results suggest that hereditary microphthalmic rats have a defect or decrease in the response to water-deprivation of vasopressinergic magnocellular neurons in the PVN and SON.

Interleukin-1 as an autocrine stimulator in the growth of human ovarian cancer cells

The role of interleukin-1 (IL-1), a multifunctional cytokine which mediates important immune responses, was investigated in the growth of ovarian cancer cell lines in vitro. The messenger RNA for IL-1 alpha and IL-1 beta was expressed in six and four ovarian cancer cell lines, respectively out of eight. Measurement of IL-1 in the eight cell lines by enzyme-linked immunosorbent assay revealed that two lines, MCAS and TYK-nu, secreted a high amount of IL-1 alpha, but that none secreted IL-1 beta after 72 hours of incubation. The growth of these cells was significantly stimulated by the addition of recombinant IL-1 alpha (rIL-1 alpha) in a concentration-dependent manner in a 96 hour culture. The maximum response was obtained with 10 ng/ml of IL-1 alpha by counting the viable cell number using trypan blue. [3H]-thymidine incorporation by these cells was also stimulated by a 72 hour incubation with rIL-1 alpha. The spontaneous growth of these cells was inhibited by the addition of anti-IL-1 alpha antibody, anti-IL-1 receptor antibody or IL-1 receptor antagonist. These cells expressed two classes of IL-1 binding receptors on their surface as detected by [125I]-labeled rIL-1 alpha. These results indicate that IL-1 alpha is an autocrine growth stimulator for some ovarian cancer cells and suggest that IL-1 alpha plays an important role in the progression of this disease.

Expression of CD44 alternative splicing variants in primary and lymph node metastatic lesions of gynecological cancer

CD44 is known as an adhesion molecule which is involved in lymphocyte activation and lymphocyte homing. In recent years, its role in the invasion and metastasis of malignant tumors has attracted the attention of investigators. In this study, the expression of CD44 variants was investigated in primary lesions and metastasis into the lymph node in 53 patients with gynecological cancer. The following patients with various types of gynecological carcinoma, established by operation and pre-treatment biopsy, were included in this study: 19 patients with cancer of the uterine cervix, 23 with cancer of the uterine endometrium, and 11 with ovarian cancer. Tissue samples were obtained from a primary lesion and a nodal metastasis of each patient, and immunohistochemical staining was performed by the ABC method through the use of monoclonal antibodies against CD44v1-10. Specimens proving CD44v1-10 positive were then submitted to immunohistochemical staining through the use of monoclonal antibodies against CD44v6 and CD44v9. Expression of CD44v was judged positive when DAB revealed color development, irrespective of the degree of staining intensity. CD44v were all expressed in the cancer cell membrane. In normal endometrium, expression of CD44v1-10 and v9 was observed in the endometrial gland cell membrane. In normal ovarian tissues, CD44v6 and v9 were not detected. The expression of CD44v6 in patients with endometrial cancer was noted in 13 (72.2%) of 18 patients with vascular invasion and in one (20.0%) of 5 patients without it, indicating a significant relation to vascular invasion. It was also remarkably higher in those for whom the invasion exceeded 1/2 of the myometrium than in those for whom the invasion did not exceed 1/2 of the myometrium, and was higher too in advanced stages and in node-positive patients. In one patient, CD44v6 was detected not in the primary lesion but in the nodal metastasis. The expression of CD44v6 in patients with ovarian cancer occurred more frequently in node-positive patients. Our study results suggest that the expression of CD44v6 in endometrial adenocarcinoma cells is involved in the progression of the carcinoma, nodal metastasis, myometrial invasion, and vascular invasion, and that in ovarian cancer, the expression of CD44v6 is involved in nodal metastasis.

Quantitative relationship between pharmacokinetics of unchanged cisplatin and nephrotoxicity in rats: importance of area under the concentration-time curve (AUC) as the major toxicodynamic determinant in vivo

PURPOSE

The major pharmacokinetic parameters of unchanged cisplatin (CDDP) related to nephrotoxicity were evaluated in rats in vivo using a pharmacodynamic model.

METHODS

CDDP was administered according to various dosing schedules (single bolus, intermittent bolus, or continuous infusion). Unchanged CDDP in plasma and urine was quantified using high-performance liquid chromatography (HPLC). The pharmacokinetics were assessed by model-independent methods. The relationship between pharmacokinetics and BUN levels was evaluated using a sigmoid maximum response (Emax) model.

RESULTS

Unchanged CDDP showed linear pharmacokinetics after single bolus injections of 1 to 5 mg/kg CDDP. Nephrotoxicity was ameliorated following intermittent bolus injection (1 mg/kg per day for 5 days) and continuous infusions (over 2 and 3 h) of the same CDDP doses (5 mg/kg), although these dosing schedules did not change the area under the concentration-time curve (AUC), total clearance (Clt), urinary excretion of unchanged CDDP or kidney platinum levels significantly. The maximum BUN level, as a nephrotoxicity marker, showed dose-related increases after single bolus injection of 1 to 5 mg/kg CDDP and after 3-h infusion of 5 to 25 mg/kg. The pharmacodynamic relationship between the maximum BUN level and Cmax and between the maximum BUN level and AUC were apparently different between single bolus injection and 3-h infusion. The maximum BUN level was related to the AUC calculated by plasma concentrations of unchanged CDDP greater than the threshold level (AUC > Cmin), a relationship most successfully described by the signoid Emax model, regardless of CDDP dose and schedule. The plasma threshold level of unchanged CDDP was determined as 0.9 microgram Pt/ml in rats.

CONCLUSIONS

The present results substantiated the importance of C x T (AUC) value as an indicator of CDDP-induced nephrotoxicity in vivo as well as of tumor cell-killing effect of CDDP in vitro. The AUC > Cmin of unchanged CDDP was found to be an important pharmacokinetic parameter predicting CDDP nephrotoxicity.

The inhibition of human factor Xa by plasminogen activator inhibitor type 1 in the presence of calcium ion, and its enhancement by heparin and vitronectin

Plasminogen activator inhibitor type 1 (PAI-1), a member of serine proteinase inhibitor superfamily, is known to inhibit thrombin in the presence of either heparin or vitronectin. We analyzed possible inhibitory activity of PAI-1 on human factor Xa. PAI-1 inhibited factor Xa in the presence of calcium ion (Ca2+), whereas no inhibition was observed in the absence of Ca2+. Half maximal enhancement by Ca2+ was obtained at 0.8 mM. An equimolar complex formation between factor Xa and PAI-1 in the presence of Ca2+ was observed by SDS polyacrylamide gel electrophoresis. Both unfractionated heparin and vitronectin enhanced the inhibition only in the presence of Ca2+. Apparent second-order rate constant (ki) for the inhibition of factor Xa by PAI-1 at 5 mM Ca2+ was 1.6 x 10(4) M-1 s-1, and was enhanced 3-fold by 2 u/ml of heparin (4.6 x 10(4) M-1 s-1) and 10-fold by 100 nM vitronectin (1.6 x 10(5) M-1 s-1), respectively. The interaction between Ca(2+)-bound factor Xa and PAI-1 could be important from the view of PAI-1 neutralization and enhancement of fibrinolysis.

Relationship between pharmacokinetics of unchanged cisplatin and nephrotoxicity after intravenous infusions of cisplatin to cancer patients

PURPOSE

The relationships between pharmacokinetic parameters of unchanged cisplatin (CDDP) and several markers for nephrotoxicity after CDDP infusion (80 mg/m2) over 2 and 4 h were quantitated in patients with various cancers (lung, stomach and colon cancers and mediastinal tumor).

METHODS

Plasma and urinary levels of unchanged CDDP were measured using a specific high-performance liquid chromatography method. Pharmacokinetic parameters were calculated according to the model-independent method. The nephrotoxicity markers, blood urea nitrogen (BUN), serum creatinine (SCr), plasma and urinary beta2-microglobulin (BMGp and BMGu), urinary N-acetyl-beta-D-glucosaminidase (NAG) and creatinine clearance (CCR) were monitored for 30 days following CDDP administration.

RESULTS

The maximum plasma concentration (Cmax), maximum urinary excretion rate (dAe/dt(max)), area under the plasma concentration-time curve from time zero to infinity (AUC), cumulative amount excreted in urine from time zero to infinity (Ae), total clearance (Clt), renal clearance (Clr) and plasma half-life (t1/2) of unchanged CDDP were not significantly different between the 2-h and 4-h infusion schedules. The values of the nephrotoxicity markers changed significantly following CDDP administration, suggesting that CDDP chemotherapy (80 mg/m2) caused nephrotoxicity. The Cmax of unchanged CDDP was the most informative pharmacokinetic parameter for nephrotoxicity. Cmax was related to maximum BUN, maximum SCr and minimum CCR levels in 27 CDDP treatments according to an exponential model.

CONCLUSION

In order to attain more effective CDDP chemotherapy with minimum nephrotoxicity, the present pharmacokinetic and pharmacodynamic studies suggest that the Cmax or steady-state plasma level of unchanged CDDP should be maintained between 1.5 and 2 microg/ml in a standard continuous infusion schedule over 2 h and 4 h.

Decomposition kinetics of cisplatin in human biological fluids

Cisplatin is metabolized to high- and low-molecular mass complexes by exchanging of one or both chloride ligands with nucleophilic species. The decomposition of cisplatin and the formation of its metabolites in human biological fluids was investigated in-vitro. In nucleophile-free medium, cisplatin was decomposed by a reversible chloride ligand exchange reaction, which was dependent upon both chloride ion concentration and medium pH. The effect of pH was observed in the second-order rate constant for cisplatin re-formation, which was far smaller in neutral and alkaline media than in acidic media. In the medium containing nucleophilic species (glutathione, human albumin and globulin), cisplatin was irreversibly decomposed according to apparent first-order kinetics. The linear relationship between apparent decomposition rate constant and concentration of nucleophilic species suggested that nucleophilic species in biological fluids might react with cisplatin directly. Both high- and low-molecular mass metabolites were formed in human plasma and ascites; however, only a low-molecular mass metabolite was produced in urine. The faster decomposition of cisplatin and the greater ratio of fixed and mobile metabolites formed in plasma were mainly attributed to higher albumin concentration in plasma than in ascites and urine. The in-vitro decomposition of unchanged cisplatin and formation of high- and low-molecular mass metabolites in human biological fluids were simultaneously evaluated according to the kinetic model which combined both pathways via hydrolysis and by the direct reaction process with nucleophilic species.

Cardiac rescue of an infant with fulminant myocarditis using extracorporeal membrane oxygenation

A 7-month-old boy presented with fulminant myocarditis. He was in cardiac shock and cardiac dysfunction progressed despite aggressive support. Extracorporeal membrane oxygenation (ECMO) was applied for 8 days and he recovered with mild dilated cardiomyopathy.

[Evaluation of prognostic factors in gynecological cancer examined by molecular biological study]

The usefulness of prognostic factors in gynecological cancer was evaluated using the oncogenes, tumor suppressor genes and DNA viruses detected with the molecular biological technique. In uterine cervical cancer, HPV types 16 and 18 are considered to have a high oncogenic risk, and are commonly associated with high grade CIN and invasive cancer under persistent HPV infection. C-myc overexpression in advanced stage and p53 mutation in HPV negative case are associated with poor survival. In endometrial cancer, oncogene activation and expression are less frequent than in cervical and ovarian cancer. K-ras point mutation (codon 12) tumors are more aggressive and c-erbB-2 overexpression are associated with metastasis and poor survival. In ovarian cancer, there are numerous abnormalities of oncogenes and tumor suppressor genes. Especially, EGF-R and PDGF-R alpha expression are associated with decreased survival. p53 mutation also decreases survival and response to chemotherapy. Recently. MSH2 (Lynch II syndrome) and BRCA1 gene are known to relate with familial ovarian cancer.

Pharmacokinetics and polymorphic oxidation of dextromethorphan in a Japanese population

The plasma concentration and cumulative urinary excretion over 34 h of dextromethorphan, free and conjugated dextrorphan, and 3-hydroxymorphinan were determined in seven healthy Japanese subjects after oral administration of 30 mg dextromethorphan hydrobromide. Conjugated metabolites were extensively present, whereas no detectable dextromethorphan or free metabolites were observed in the plasma of any subject. On average, 72% of the dose was excreted in urine within 34 h. This was detected mainly as conjugated metabolites with only slight traces of dextromethorphan and free metabolites. From the time-courses of the metabolic ratio (the ratio of urinary output of dextromethorphan to dextrorphan), the metabolic ratios seemed to become constant 7.5 h after oral administration. Phenotyping was performed using metabolic ratios in 75 unrelated healthy Japanese subjects (43 males and 32 females). The logarithmic metabolic ratio was bimodally distributed and one subject (1.3%) was identified as a poor metabolizer.

The renal clearance of unchanged cisplatin during furosemide and mannitol diuresis is dependent on glomerular filtration rate in rats

The disposition of unchanged cisplatin (CDDP) in plasma and urine after bolus injection of CDDP (5 mg/kg) was compared in rats treated with furosemide (25 mg/kg as a 40-min iv infusion) and mannitol (2 g/kg as a 40-min iv infusion). Forced diuresis significantly increased renal clearance (Clr) of unchanged CDDP in the first 10-min period after CDDP administration, compared to that in the rats given CDDP alone. Compared with furosemide, mannitol showed greater modification in Clr of unchanged CDDP in the early phase and more accelerated urinary excretion of unchanged CDDP during the study. Furosemide increased plasma concentration and reduced urinary excretion of unchanged CDDP in the terminal phase. Clr of unchanged CDDP was found to be dependent of glomerular filtration rate (GFR) during diuretic coadministration. Linear relationships among urine flow rate, GFR, and Clr of unchanged CDDP were observed only in diuretic-treated rats. Although the relationships between GFR and Clr were almost identical, there was a difference in the GFR-urine flow rate relationship between furosemide- and mannitol-treated rats. GFR was gradually reduced during diuretic treatment, and furosemide induced greater GFR reduction than mannitol. This resulted in a modification of unchanged CDDP disposition by furosemide in the terminal phase. The present study suggests that careful monitoring and maintaining of GFR during coadministration of diuretic may be useful for predicting the urinary excretion behavior of unchanged CDDP in CDDP chemotherapy.