Oral administration of nipradilol and the acute and chronic splanchnic hemodynamic effects of a new beta-blocker with nitrovasodilating properties in patients with liver cirrhosis

OBJECTIVES

We studied the effects of nipradilol, which has both a nonselective beta-blocker action and a vasodilating action similar to nitroglycerin, on portal hypertension.

METHODS

We measured hepatic venous pressure gradient and splanchnic and systemic hemodynamics before beginning therapy, 2 h after an oral dose of 6 mg, and after either 6 months of nipradilol 6 mg twice a day (n = 14) or of a placebo (n = 6) in 20 cirrhotic patients.

RESULTS

No significant changes were observed after the administration of the placebo. Oral nipradilol induced a significant reduction in the hepatic venous pressure gradient (base line: 14.8 +/- 3.2 mm Hg vs 2 h: 12.3 +/- 3.4 mm Hg, p < 0.01; 6 mo: 12.5 +/- 3.2 mm Hg, p < 0.05) without a significant change in the free hepatic venous pressure. The hepatic vascular resistance decreased significantly (base line: 1811 +/- 778 dyn.sec.cm-5 vs 2 h: 1540 +/- 701 dyn.sec.cm-5, p < 0.05; 6 mo: 1564 +/- 693 dyn.sec.cm-5, p < 0.05) without a significant change in hepatic blood flow. A decrease in the hepatic venous pressure gradient greater than 10% was observed in nine patients (64%), defined as "responders," at 2 h and in 10 patients (71%) at 6 months. The reduction of mean heart rate and hepatic venous pressure gradient in these responders was 16.2% and 28.3% at 2 h and 15.1% and 27.1% at 6 months, respectively.

CONCLUSIONS

We found that in some cirrhotic patients, at the doses used in this study, long term oral nipradilol administration produces a reduction in the hepatic venous pressure gradient with both a beta-blocking and a nitrovasodilating action.

Subperiosteal implantation of octacalcium phosphate (OCP) stimulates both chondrogenesis and osteogenesis in the tibia, but only osteogenesis in the parietal bone of a rat

BACKGROUND

It is not known whether long bones and calvaria have distinct biological characteristics. Octacalcium phosphate (OCP), which is a precursor phase of the hydroxyapatite, has been reported to stimulate bone formation if implanted in the subperiosteal region of mouse calvaria. The present study was designed to investigate how the long bone and the calvarium respond to OCP implantation and to compare their biological characteristics.

METHODS

The synthetic OCP was implanted into the subperiosteal region of rat tibiae and parietal bones being mixed with bovine type I collagen treated by pepsin (Atelocollagen). The biological response was examined histologically and immunohistochemically for collagen matrix phenotypes of types I and II to identify bone and cartilage formation.

RESULTS

Both chondrogenesis and osteogenesis were initiated in the tibia 1 week after implantation of OCP and most of the cartilage was replaced by bone at week 2. However, the parietal bone did not show osteogenesis responding to OCP implantation until week 3, and no cartilage formation was associated with the osteogenesis.

CONCLUSIONS

The present study demonstrated the distinct characteristics of biological response to OCP implantation between the long bone and the calvarium in terms of whether or not cartilage formation is involved in the stimulated osteogenesis by OCP, and in terms of timing of the stimulated chondrogenesis and/or osteogenesis, i.e., the parietal bone takes more time to respond to OCP implantation than the tibia.

Rational use of oral antibiotics for pediatric infections

We carried out a survey in Japan to investigate compliance among children given oral antibiotics in an outpatient setting. The results of our survey revealed that, in Japan, approximately one-quarter of patients did not take their full course of antibiotics. Reasons for unsupervised self-discontinuation included: (1) the parent or guardian judged the infection to be cured; (2) the child refused to take the drug; and (3) the appearance of side effects. Causative organisms often involved in respiratory infections experienced in out-patient medicine include pneumococci, streptococci, staphylococci, Haemophilus influenzae, Moraxella (Branhamella) catarrhalis and Mycoplasma pneumoniae. The beta-lactams are effective against all of these bacterial species, with the exception of M. pneumoniae. We conducted a survey of beta-lactam antibiotics currently on the Japanese market and compared them to other oral antibiotics used to treat respiratory infections. Ease of administration, based on the incidence of adverse effects, particularly diarrhea, the dosage form, taste, dosage per administration and the number of doses required per day, are reported.

[Fundamental and clinical studies of SY5555 in pediatrics]

We assessed the in vitro antimicrobial activity and the clinical efficacy and safety of SY5555 in the field of pediatrics. The results obtained are summarized below. 1. In vitro antibacterial activities of SY5555 against 52 clinical isolates were compared with those of clavulanic acid/amoxicillin (CVA/AMPC), cefotiam (CTM), cefpodoxime (CPDX), cefaclor (CCL) and cefdinir (CFDN). Against Gram-positive bacteria, including Staphylococcus aureus, Streptococcus pneumoniae and Streptococcus pyogenes, SY5555 displayed antimicrobial activities superior or nearly equivalent to those of the reference agents used in the study. In cases of Gram-negative bacteria, the antimicrobial activity of SY5555 against Haemophilus influenzae was inferior to those of CPDX and CFDN. Against Klebsiella pneumoniae, the antimicrobial activity of SY5555 was less potent than that of CPDX. 2. Forty-seven children with infectious diseases were treated with SY5555 dry syrup (powder dissolved just before use). The clinical results were excellent in 24 and good in 16, with an efficacy rate of 85.1%. 3. Bacteriological screening identified 30 pathogenic organisms, and the eradication rate was 76.7%. 4. Side effects consisted of diarrhea in 12.5% (6 cases), loose stools in 4.2% (2 cases) and urticaria in 2.1% (1 case) of the patients. The only abnormal laboratory test value observed was an increase in eosinophil count in one child. 5. The palatability of SY5555 dry syrup was very good; it was very easily ingestable or easily ingestable by 32 of the 48 children. From the above results, SY5555 dry syrup appears to be a useful drug with a preferable safety profile in the treatment of pediatric patients with infectious diseases.

Cholesteryl ester transfer protein gene: two common mutations and their effect on plasma high-density lipoprotein cholesterol content

Cholesteryl ester transfer protein regulates high-density lipoprotein cholesterol (HDL-C) level, and genetic deficiency causes hyperalphalipoproteinemia (HALP). The G to A mutation in the intron 14 splice donor (I14A) has been known to be a common mutation in HALP. Recently, another mutant, D442G (Asp 442 to Gly), was ascertained. The allelic frequencies of I14A and D442G were investigated using 226 unrelated patients with HDL-C of 1.03 mmol/L (40 mg/dL) or greater. Of these, 44 had a mutation I14A and/or D442G. The I14A was found in 15, including 4 compound heterozygotes (I14A/D442G) in patients with HDL-C of 2.05 mmol/L (80 mg/dL) or greater. All I14A homozygotes (n = 5) were present in the group with HDL-C of 3.08 mmol/L (120 mg/dL) or greater, and the allelic frequency paralleled the increase in HDL-C level. D442G was identified in 33, including the 4 compound heterozygotes. Its allelic frequency appeared as two clusters, one at HDL-C around 1.79-2.03 mmol/L (70-79 mg/dL) and the other at HDL-C of 2.82 mmol/L (110 mg/dL) or greater; the latter consisted exclusively of compound heterozygotes. Allelic frequency in the general population for I14A and D442G was 0.81% and 4.62%, respectively. These data suggest that D442G is a common mutation and that, although I14A is responsible for the most severe HALP, D442G leads to a relatively smaller increase in HDL-C.

[Effect of biapenem (L-627) on fecal flora in gnotobiotic mice and children]

Biapenem (L-627), a novel injectable carbapenem antibiotic, was studied with regard to its effect on mice inoculated with four types of bacteria and on the intestinal flora of pediatric patients. L-627 was given i.m., 40 mg/kg once daily for 5 consecutive days, to mice inoculated enterically with four types of bacteria (Escherichia coli, Enterococcus faecalis, Bacteroides fragilis, and Bifidobacterium breve). Except for a mild decrease in E. coli, there were no major fluctuations in viable bacterial counts in the feces during the treatment. Five children with bacterial infections (3 boys and 2 girls; ages: 1 month to 7 years and 7 months; body weights 4.62-21.8 kg) were given L-627 at 6.0 to 11.7 mg/kg 3 times daily for 7 to 11 days. Among aerobes, although Enterobacteriaceae such as E. coli tended to decrease remarkably in all patients, there was no major change in Enterococcus. Consequently, total aerobe counts did not change significantly in any patient. Among anaerobes, Bifidobacterium, Bacteroides, and Eubacterium, which are the predominant organisms in infants, decreased remarkably in some patients. One of the patients showed a marked decrease in total anaerobe count associated with a change in fecal characteristics (diarrhea). Glucose nonfermenting Gram-negative bacilli or fungi did not become predominant organisms in any patient. Recovery from these changes in the intestinal flora was noted promptly after terminating L-627 treatment. L-627 was detected in the feces of 4 patients during treatment. The fecal concentration ranged from 0.24 to 2.22 micrograms/g. Clostridium difficile was not detected in any patient. Although C. difficile D-1 antigen was observed in 2 patients, it bore no relationship to fecal properties. The results indicated that L-627 had relatively few effects on the intestinal flora compared to other new beta-lactam antibiotics.

[Pharmacokinetic and clinical studies on cefozopran in pediatrics]

Cefozopran (CZOP, SCE-2787), a new parenteral cephalosporin antibiotic, was studied for its pharmacokinetics, bacteriological and clinical effects in the field of pediatrics. The serum and cerebrospinal fluid concentrations 1 hour after a bolus intravenous injection of 50 mg/kg were, respectively, 92.1, 10.5 micrograms/ml, and penetration rate to cerebrospinal fluid of CZOP in patients with purulent meningitis was 11.4%. 25 patients, including those with purulent meningitis, pneumonia, urinary tract infections, staphylococcal scalded skin syndrome (SSSS) etc., were treated with CZOP at dose levels of 16.0 to 50.0 mg/kg 3-4 times daily, via intravenous injection and intravenous drip infusion. CZOP gave "excellent" or "good" responses in all the 25 patients. In bacteriological examinations, 25 strains were identified and were eradicated except 1 strain of Staphylococcus aureus and 2 strains of Salmonella sp. As a side effect, diarrhea was observed in 1 patient among the 27 patients treated with the drug. As for abnormal laboratory findings, eosinophilia was observed in 1 patient, increases of thrombocytes in 3 and GPT in 2. Influences on blood coagulation parameters were studied. No changes in PIVKA II, HPT or APTT were observed during the treatment. Based on the above results, it has been concluded that CZOP is a safe and effective drug to use in the treatment of pediatric infections. The normal recommended dosage and administration should be 20 to 50 mg/kg of CZOP at a time, using intravenous injection or intravenous drip infusion 3 to 4 times a day.

[Clinical studies on clarithromycin dry syrup in the pediatric field. Pediatric Study Group of TE-031 Dry Syrup]

Clarithromycin dry syrup, a new drug preparation, was clinically evaluated in the pediatric field and the following results were obtained: 1. Absorption and excretion In infants administered with single oral dose of 5 mg (potency)/kg and 10 mg/kg, the Cmax was 2.26 +/- 0.42 and 3.23 micrograms/ml; Tmax, 1.6 +/- 0.1 and 2.0 hours; T 1/2, 3.89 +/- 0.52 and 2.06 hours; AUC (0-infinity), 13.48 +/- 1.93 and 13.84 micrograms.hr/ml, respectively. Urinary concentrations peaked in 2-4 hours after administration at 5 mg/kg and 0-2 hours at 10 mg/kg. Urinary recovery rates in the first 6 hours were 25.8 +/- 3.9% at 5 mg/kg and 20.7% at 10 mg/kg. 2. Clinical results The clinical efficacy of the drug was evaluated in 150 patients with various infections. Clarithromycin dry syrup was administered to all the patients at daily doses of 10-15 mg/kg divided into 2-3 equal doses. The overall clinical efficacy rate was 98.0%, and this drug was effective in 98.9% of 90 patients for whom the causative pathogens were identified and in 96.7% of the other 60 patients for whom the causative pathogens were unknown. The bacteriological eradication rate was 88.5%. The efficacy and eradication rates for 19 patients who had not responded to previous chemotherapy that lasted for more than three days were 94.7% (18/19) and 75.0%, respectively. Side effects occurred in 4 (2.4%) of 169 patients subjected to safety analyses, but none was serious. As to abnormal laboratory test results, moderate increases of eosinophils and elevations of transaminases were observed in 5.9% of the cases. No particular and serious problems were associated with administration of this drug. Based on the above results, clarithromycin dry syrup is considered to be very useful and have a good compliance at a daily dose of 10-15 mg/kg divided into 2-3 doses.

Localization of uncalcified cementum in adult rat molar roots and its relation to physiological tooth movement

The study was designed to elucidate the effect of physiological tooth movement on cellular cementum, using the upper molar roots of 10-week-old rats. Paraffin sections stained with haematoxylin and eosin displayed two types of cellular cementum, lightly and darkly staining. The lightly stained was present on the distal half of all molar roots except the mesial root of the first molar. The alveolar bone facing the lightly stained cementum showed resorption lacunae and multinucleated osteoclasts, while the opposite bone surface was lined with osteoblasts. In contact microradiographs of undemineralized ground sections, the X-ray density of the lightly stained cementum was similar to that of the periodontal ligament and pulp, while the X-ray density of the darkly stained cementum was similar to that of alveolar bone. Tetracycline labelling lines were seen at the interface between the two types of cellular cementum as well as on surfaces of bone and cementum located mesially to the root dentine. The results suggest that the mechanical stress of tooth movement differently affects the alveolar bone and cellular cementum; the bone is resorbed whereas the cementum resists resorption and its calcification is inhibited under the compressive force of tooth movement.

New operative method for tracheal compression in congenital heart disease

A new technique is described for repairing tracheal compression caused by ascending aorta associated with corrected transposition of the great arteries and pulmonary atresia in a 113-day-old infant. Surgical repair for the tracheal compression was accomplished by suspending the pericardium around the aortic arch to the underside of the sternum. This method seems to be useful for some patients with tracheal compression caused by the ascending aorta.

Hyperuricemia in an infant with Taussig-Bing anomaly and interruption of the aortic arch

Hyperuricemia is commonly recognized in adolescents and adults with cyanotic congenital heart disease. We report a case of a male infant with hyperuricemia, Taussig-Bing anomaly, and interruption of the aortic arch. The patient underwent correction of interrupted aortic arch and pulmonary arterial banding at the age of 7 days. Hyperuricemia appeared when he was 2 months old (max 17.7 mg/dl) and persisted until he underwent a Jatene operation at the age of 10 months. The hyperuricemia improved gradually after the disappearance of hypoxia and polycythemia. The laboratory findings suggest that hyperuricemia can result from uric acid overproduction due to secondary polycythemia, impairment of uric acid excretion by the kidney, or the acceleration of anaerobic metabolism. Allopurinol and benzbromarone together were partially effective treatments for hyperuricemia in this patient with cyanotic congenital heart disease.

Catalytic properties of carbonyl reductase from rabbit liver for analogs of acetohexamide and 4-acetylpyridine

A correlation was observed between the values of specificity constant (kcat/Km) of carbonyl reductase from rabbit liver for acetohexamide analogs and their partition coefficients. This result indicates that the hydrophobicity in straight-chain alkyl groups of acetohexamide analogs plays an important role in the catalytic activity and substrate-binding capacity of the enzyme. Furthermore, the double logarithmic plots of kcat/Km values of the enzyme for 4-acetylpyridine analogs with a straight-chain alkyl group up to five carbon atoms against their partition coefficients gave a straight line. On the other hand, the plots for 4-acetylpyridine analogs with a straight-chain alkyl group over five carbon atoms and with a branched-chain alkyl group were away from the straight line. It is reasonable to postulate that a hydrophobic pocket is located in the substrate-binding domain of the enzyme.

[Bacteriological and clinical studies of biapenem (L-627) in pediatrics]

Bacteriological and clinical studies in the pediatric field have been performed on biapenem (L-627), a newly-developed carbapenem antibiotic, and the following results were obtained. 1. In the pharmacokinetic study, the plasma concentration of L-627 showed dose-dependant change: Cmax was 14.6 micrograms/ml and AUC was 15.4 micrograms.hr/ml with the administration of 6 mg/kg, while Cmax was 49.2 micrograms/ml and AUC was 60.1 micrograms.hr/ml with the administration of 12 mg/kg. After the administration of 6 mg/kg, the urinary concentration reached maximum within 2 hours and the cumulative urinary excretion rate in the first 6 hours was 49.4%. 2. Antibacterial activities of L-627 against 27 strains of clinical isolates were determined. MICs of L-627 against such Gram-positive cocci as Staphylococcus aureus, Streptococcus pneumoniae and Streptococcus pyogenes were sufficiently low, and those against such Gram-negative rods as Haemophilus influenzae, Escherichia coli and Bordetella pertussis were satisfactory and as low as those of imipenem or ceftazidime. 3. Clinical efficacies of L-627 were evaluated in 36 cases of bacterial infections. The overall efficacy rate was 100%, and excellent responses in 26 cases and good in 10 cases were obtained. As for bacteriological efficacies, all strains except 1 of B. pertussis were eradicated and a high eradication rate of 96.6% was obtained. 4. No side effects were observed in 37 evaluated cases. As abnormal laboratory test results, eosinophilia was noted in 2 cases (5.4%), but they returned to normal values rapidly after the drug was discontinued. From these results, it has been concluded that L-627 is a safe and effective drug to be used in treatment of pediatric infectious diseases.

A family with complete deficiency of plasma cholesteryl ester transfer protein activities

A 43-year-old male with a high value of high density lipoprotein cholesterol (151 mg/dl) was found among subjects receiving annual health checks. We investigated the cholesteryl ester transfer protein (CETP) activity and conducted a family study. There was complete deficiency of CETP activities in the proband and his sister, and partial deficiency of CETP activities in his mother and daughter. Genetic analysis revealed a splicing defect (G to A point mutation) in intron 14 of the CETP gene.

Transforming growth factor-beta 1 potentiated alpha 1-adrenergic and stretch-induced c-fos mRNA expression in rat myocardial cells

Since transforming growth factor-beta 1 (TGF-beta 1) has been recently shown to be expressed in the heart by mechanical stretch and ischemic injury, we examined the modulation of c-fos mRNA expression and amino acid uptake by TGF-beta 1 in rat myocardial cells. Pretreatment with TGF-beta 1 potentiated norepinephrine (NE)-induced and stretch-induced (+10% and +20% elongation, for 30 minutes) c-fos mRNA expression by 2.2-fold, whereas TGF-beta 1 alone did not induce c-fos mRNA expression in Northern blot analysis. NE-induced [14C]phenylalanine uptake was also potentiated with TGF-beta 1 pretreatment. The effect of TGF-beta 1 on the NE action was not blocked by propranolol but by prazosin. The protein kinase C activators (12-O-tetradecanoylphorbol 13-acetate [TPA], phorbol 12,13-dibutyrate, and 1-oleyl-2-acetyl-rac-glycerol) induced c-fos mRNA expression, which was also potentiated by TGF-beta 1. Cycloheximide (protein synthesis inhibitor) could not suppress the TGF-beta 1 actions. In nonmuscle cells, TGF-beta 1 modified neither adrenergic nor TPA-induced c-fos mRNA expression. These data suggested that TGF-beta 1 potentiated the c-fos mRNA expression and amino acid incorporation by modification of the alpha 1-adrenergic and stretch-activated protein kinase C pathway. This mechanism did not require protein synthesis.

Signal-averaged electrocardiographic late potentials in children with complete heart block

The purpose of this study was to examine signal-averaged electrocardiographic (SA-ECG) late potentials to predict ventricular arrhythmias during intrinsic cardiac rhythm and during ventricular pacing in children with complete heart block (CHB). Recordings of SA-ECG were obtained from eight patients (aged 3-18 years) with documented CHB. The etiology of CHB was congenital in four cases and acquired in four cases. Six of these patients underwent permanent pacemaker implantation. Comparisons of the SA-ECG were made before and during ventricular pacing. Abnormalities of SA-ECG during intrinsic cardiac rhythm were noted in four patients, all of whom were older than 14 years. Although there was no significant difference in SA-ECG parameters between patients with congenital CHB and acquired CHB, abnormal SA-ECG was noted in one of four patients with congenital CHB and in three of four patients with acquired CHB. Two patients without permanent pacemaker implantation had normal SA-ECG, but four of six patients with permanent pacemaker implantation had abnormal SA-ECG. Three of the four patients had abnormal SA-ECG during ventricular pacing, but the abnormal SA-ECG in one patient had normalized during ventricular pacing. It is important to record SA-ECG before and during ventricular pacing to detect late potentials in patients with CHB. It may be useful to record SA-ECG while changing the pacing site to find ideal sites for electrode implantation for the potential prevention of ventricular arrhythmias.

Purification and antigenicity of a novel glucan-binding protein of Streptococcus mutans

A novel glucan-binding protein (GBP) having an apparent molecular mass of 59 kDa (GBP59) has been purified from Streptococcus mutans SJ by a combination of affinity chromatography on alpha-1,6-linked glucan, gel filtration chromatography, and ion-exchange chromatography. GBP59 was distinct from the quantitatively predominant S. mutans GBP (GBP74) on the basis of size, elution position in a salt gradient, and antigenicity. Rat antisera to purified GBP59 and GBP74 did not cross-react. GBP59 is apparently immunogenic in humans, since immunoglobulin A (IgA) antibody in 20 of 24 adult parotid saliva samples was shown to react with GBP59 in an enzyme-linked immunosorbent assay. The glucan-binding activity of GBP59 was confirmed by anti-GBP59 immunogold labelling of Sephadex G-50 that had been preincubated with S. mutans culture supernatant. GBP59 could be detected in culture supernatants of all laboratory strains of S. mutans (e.g., Ingbritt), as well as all strains of S. mutans that had been recently isolated from young children. GBP59 was often the only component in protease inhibitor-containing 4-h S. mutans culture supernatants that reacted with human parotid salivary IgA antibody in Western blot (immunoblot) analyses. These studies suggest that GBP59 is a structurally and antigenically distinct S. mutans GBP that can elicit significant levels of salivary IgA antibody in humans.

Age-related criteria for signal-averaged electrocardiographic late potentials in children

This study examined the age-related criteria of signal-averaged electrocardiographic (SA-ECG) parameters in children. SA-ECGs were obtained in 82 healthy volunteers in six groups depending on age (group 1: 1 day to < 1 month; group 2: 1 month to < 1 year; group 3: 1 to < 6 years; group 4: 6 to < 12 years; group 5: 12 to < 20 years; group 6: 20 to < 40 years). To examine the effect of heart rate on the parameters of SA-ECG, right atrial pacings were performed in 4 children with a ventricular septal defect aged 1-7 years. The root mean square voltage (RMS) was high; and the filtered QRS (f-QRS) duration and the duration of the low amplitude signal (LAS) were low during childhood, especially in infants (group 2), compared with those in adults. Late duration (LD) had no significant difference among age groups. The criteria for ventricular late potential were as follows: RMS < 25 microV, LAS > 35 ms, f-QRS duration > 110 ms, and LD > 35 ms for those age 1 day to < 1 month; RMS < 40 microV, LAS > 30 ms, f-QRS duration > 100 ms, and LD > 35 ms for those age 1 month to < 1 year; RMS < 20 microV, LAS > 40 ms, f-QRS duration > 130 ms, and LD > 35 ms for those age 1 to < 20 years; and RMS < 15 microV, LAS > 45 ms, f-QRS duration > 135 ms, and LD > 35 ms for those age 20 to < 40 years. RMS and LAS correlated with f-QRS duration (r = -0.78 and 0.76, respectively; p < 0.05), suggesting that these parameters are associated with the thickness of the ventricular muscle and the ventricular conduction time. Right atrial pacing had no effect on the measured SA-ECG parameters. The age-related differences in SA-ECG parameters might be due to age-related differences in the thickness of the ventricular muscle and the ventricular conduction time but are not due to differences in the heart rate. The age difference of each parameter on SA-ECG should be considered for ventricular late potentials.

[Pharmacokinetic and clinical studies on fluconazole in the pediatric field]

Pharmacokinetic, bacteriological and clinical studies on intravenous fluconazole (FLCZ) in deep seated mycoses were performed involving 4 pediatric patients. Clinical and bacteriological assessments were made on 4 patients; clinical improvements were good in 3 patients and bacteriological efficacies were rated as "eradicated" in 3 patients. No side effects nor abnormal laboratory values were observed. The pharmacokinetics were investigated in 2 patients. Good serum FLCZ concentrations were obtained at an intravenous dose of 3-6 mg/kg daily. These results indicate that FLCZ is a useful drug in the treatment of pediatric patients with systemic deep-seated mycosis.

[The intractable bacterial infection in the pediatric field]

In recent years, medical treatment of neonates, especially premature infants, has made a remarkable progress, but the rate of neonatal mortality from bacterial infection has not decreased. Our early diagnosis and treatment of neonatal bacterial infection was discussed as below, 1) The rate of onset of neonatal sepsis was higher in neonates under 1500 gr birth weight, and a trend for increase of E. cloacae, which is the main causative organism of sepsis in recent years, was recognized. 2) The intestinal tract, skin, and some kinds of catheters were suggested as the main root of sepsis. Therefore the following three points, namely, selection of antibiotics which has less influence in the intestinal flora, early treatment of skin infection, and regular culture of surveillance are highly important in early diagnosis and treatment and prevention of infections.

Palmitoyl-L-carnitine modifies the function of vascular endothelium

OBJECTIVE

Palmitoyl-L-carnitine, which accumulates in ischaemic myocardium, may influence the function of vascular endothelium in the ischaemic area. The aim of the study was therefore to examine the effect of palmitoyl-L-carnitine on endothelium dependent relaxations of rabbit thoracic aortas and its effects on the intracellular calcium regulation in cultured bovine aortic endothelial cells (BAEC).

METHODS

Isometric contraction experiments on rabbit thoracic aorta were performed to evaluate the effect of palmitoyl-L-carnitine on endothelium dependent relaxation. BAEC were isolated by scraping the internal surface of the aorta from slaughtered cow, and were cultured in Dulbecco's modified Eagle's medium supplemented with fetal calf serum (15% v/v). Cultures used in the present study were from the third to the 12th passage. The cytosolic Ca2+ level in BAEC was monitored by the fura-2 method.

RESULTS

Palmitoyl-L-carnitine (1-20 microM) inhibited endothelium dependent relaxation induced by acetylcholine and substance P in a dose dependent manner, while having no effect on resting tension and glyceryl trinitrate induced relaxations. Bradykinin, another endothelium dependent relaxant, induced a biphasic Ca2+ transient in BAEC. Pretreatment of BAEC with palmitoyl-L-carnitine (5-10 microM) inhibited bradykinin induced Ca2+ transients.

CONCLUSIONS

The inhibitory effect of palmitoyl-L-carnitine on endothelium dependent relaxation results from the suppression of the intracellular calcium signal transduction in endothelial cells. We speculate that palmitoyl-L-carnitine may be an important mediator of the impaired vascular endothelial function in myocardial ischaemia.

Preventive administration of bovine colostral immunoglobulins for foal diarrhea with rotavirus

Foal diarrhea due to serotype 3 rotavirus broke out on a foal-raising farm in the years 1987 and 1989. In 1989, all of the foals, regardless of whether or not they suffered from diarrhea, received bovine colostral immunoglobulin (Ig) powder orally for 3 to 5 days during the epidemic. The morbidity of the diarrhea was lower than that observed in 1987, when the Ig powder was not administered to foals. These data suggested that the administration of Ig powder might partially prevent foal diarrhea with rotavirus infection.