Inhibitory effect of amiloride on glucose transport in isolated rat adipocytes

The effect of amiloride on 3-O-methylglucose (3-O-MG) uptake was studied in isolated rat adipocytes to define to what extent amiloride inhibited the process of insulin action or glucose transport. Amiloride (1 mM), which did not change the intracellular water space of adipocytes, inhibited by 43.3% the insulin-stimulated uptake of 3-O-MG, while it did not appear to inhibit the basal uptake. To distinguish the inhibitory effect on glucose transport activity from that on the process of insulin action, the effect of amiloride was evaluated in the transport system using adipocytes deprived of ATP, in which glucose transporters were considered immobile. Amiloride (1 mM) inhibited this transport by 32.8% in an insulin-stimulated state, which was obtained using adipocytes that had been treated with 20 nM insulin and exposed to 2 mM KCN, whereas it did not inhibit the transport system at the basal state. In the inhibitory effect, 76% was thus attributable to the inhibition of glucose transport activity recruited by insulin and 24% to the inhibition of the action of 20 nM insulin itself. These results indicate that amiloride can not be used as a specific inhibitor of the insulin action itself.

Developmental studies on the interparietal part of the human occipital squama

The development of ossification centres in the membranous occipital squama is described, based on observations on human fetal skulls. The interparietal part develops basically from 3 pairs, 1 primary pair and 2 secondary pairs; an additional 4th pair is occasionally observed. The so-called separated interparietal bones (Inca bones) are formed by a failure of fusion between the primary and secondary centres, not between the supraoccipital and interparietal parts. The preinterparietal bones, which are developed from the additional 4th pair of interparietal ossification centres, are clearly differentiated from other anomalies in the lambda region by the shape of their territory and by their location. The issue still remains as to how to establish their identity in skulls from individuals of advanced age.

Serum secretory leukoprotease inhibitor levels to diagnose pneumonia in the elderly

In pneumonia in the elderly, one occasionally encounters difficulties in evaluation with respect to both clinical observation and treatment. Thus a simple serum indicator is indicated. We measured secretory leukoprotease inhibitor (SLPI) concentrations in sera to see whether this can provide a useful indicator for pneumonia, especially in the elderly. Serum samples from patients over 65 yr of age, with (n = 54) or without (n = 87) pneumonia, and from healthy, young (n = 16) and aged (n = 188) control subjects were assayed using ELISA for human SLPI. Comparisons were made between groups with clinical diagnoses of either definite or probable pneumonia and among cases with various other respiratory diseases, including bronchial asthma, chronic obstructive pulmonary disease, and lung cancer. The mean SLPI concentration in patients with pneumonia was significantly higher than in patients without pneumonia or in healthy controls. The data suggest that the measurement of SLPI can provide a useful indicator for pneumonia to be used in clinical evaluation.

[Basic and clinical studies on cefprozil in pediatrics]

1. Serum levels of cefprozil (CFPZ, BMY-28100) after single oral administration of 7.5 mg/kg were 2.9-5.5 micrograms/ml at 1 hour and trace at 6 hours. 2. Urinary excretion rates of CFPZ were 45.7-102.3% within 6 hours (HPLC). 3. CFPZ was administered at doses ranging 19-47.3 mg/kg/day to 17 cases of pediatric infections including 16 cases with respiratory infections and 1 case with external otitis. Good clinical and bacteriological responses were obtained in all cases. 4. As side effect, diarrhea was observed in 1 case. As abnormal laboratory test results, eosinophilia was observed in 5 cases.

Point mutations in the tyrosine aminotransferase gene in tyrosinemia type II

Tyrosinemia type II (Richner-Hanhart syndrome, RHS) is a disease of autosomal recessive inheritance characterized by keratitis, palmoplantar hyperkeratosis, mental retardation, and elevated blood tyrosine levels. The disease results from deficiency in hepatic tyrosine aminotransferase (TAT; L-tyrosine:2-oxoglutarate aminotransferase, EC 2.6.1.5), a 454-amino acid protein encoded by a gene with 12 exons. To identify the causative mutations in five TAT alleles cloned from three RHS patients, chimeric genes constructed from normal and mutant TAT alleles were tested in directing TAT activity in a transient expression assay. DNA sequence analysis of the regions identified as nonfunctional revealed six different point mutations. Three RHS alleles have nonsense mutations at codons 57, 223, and 417, respectively. One "complex" RHS allele carries a GT----GG splice donor mutation in intron 8 together with a Gly----Val substitution at amino acid 362. A new splice acceptor site in intron 2 of the fifth RHS allele leads to a shift in reading frame.

DNA synthesis and related enzymes altered in compensatory lung growth in rats

Left pneumonectomy was performed on 4 week-old male Fischer-344 rats. Changes in DNA biosynthesis and the activities of related enzymes were studied in the contralateral lungs of the pneumonectomized animals (n = 55) and compared with sham-operated (n = 55) and untreated control animals (n = 40) The wet weight of the contralateral lung of the pneumonectomized rats reached that of both lungs of the untreated and sham-operated rats 14 days after the operation. The activities of thymidine kinase and DNA polymerase from the regenerating lungs were elevated on Days 1 and 7. To determine the molecular forms of DNA polymerase in the crude extract, phosphocellulose column chromatography was performed. The type of DNA polymerase with the highest activity was alpha in regenerating lung on Days 1, 3, and 7. These results suggest that DNA replication for cellular proliferation was elevated in the remaining lung after pneumonectomy. In addition, an interlobar difference in DNA biosynthesis was observed in the remaining lung. The increase was especially marked in the cardiac lobe, followed by increases in the DNA content of the remaining lobes on Day 7. From these observations we conclude (1) that increased activity of DNA polymerase alpha is likely to be an initial change in compensatory lung growth, and may be caused by some unknown stimulator in lung tissue, and (2) that DNA biosynthesis may differ among the lobes of the lung, at least until 3 days post-pneumonectomy.

An immunopotentiator of beta-1,6;1,3 D-glucan prevents diabetes and insulitis in BB rats

The preventive effect of an immunopotentiator, beta-1,6;1,3 D-glucan, on the development of diabetes and insulitis was studied in BB rats. The intravenous administration of 1 mg kg-1 week-1 of beta-1,6;1,3 D-glucan from the age of 4 weeks decreased the cumulative incidence of diabetes from 43.3% (13/30) to 6.7% (2/30) (P less than 0.005) and also the incidence of insulitis from 82.4% (14/17) to 26.3% (5/19) at the age of 20 weeks (P less than 0.002). Eight of nine rats were free from diabetes for 5 weeks after stopping beta-1,6;1,3 D-glucan at the age of 20 weeks. The total numbers of leukocytes in the peripheral blood and spleen of the rats were increased by beta-1,6;1,3 D-glucan treatment (P less than 0.05), whereas their T lymphocytes subsets were not changed. These data indicate that immunopotentiators could modulate the autoimmune mechanisms directed to pancreatic islets and inhibit the development of diabetes in BB rats.

Synergism in insulin-like effects of molybdate plus H2O2 or tungstate plus H2O2 on glucose transport by isolated rat adipocytes

The effect of molybdate, tungstate, molybdate plus H2O2 or tungstate plus H2O2 on 3-O-methylglucose (3-O-MG) uptake was studied in isolated rat adipocytes to investigate whether these agents possess an insulin-like action. High concentrations (10-30 mM) of molybdate or tungstate significantly stimulated the uptake of 3-O-MG while 1 mM of the metaloxides did not. The combination of 1 mM molybdate and 1 mM H2O2, or 1 mM tungstate and 1 mM H2O2 induced striking stimulation of the uptake of 3-O-MG in a synergistic manner, whereas 1 mM H2O2 alone showed only a small effect. The effect of metaloxides plus H2O2 (1 mM) and the effect of insulin (20 nM) were not additive, and both effects were ATP or energy dependent based on experiments using KCN. These results indicate that a weak insulin-like effect of molybdate or tungstate is potentiated synergistically with H2O2, presumably by producing peroxocompounds. Based on the present findings, these new agents may be useful for investigating the mechanism of insulin action and may indicate a new class of drugs for diabetes mellitus.

[Pharmacokinetics and clinical studies of panipenem/betamipron in the pediatric field]

Panipenem/betamipron (PAPM/BP) is a mixture of panipenem (PAPM), carbapenem antibiotic, and betamipron (BP), N-benzoyl-beta-alanine. The adverse reaction to PAPM of the kidney is reduced by the addition of BP to PAPM which inhibits the anion transport in the kidney tubules. We studied the pharmacokinetics and the clinical efficacies of PAPM/BP in children and we evaluated the antibacterial activities of PAPM by determining MIC values of PAPM in vitro against organisms isolated in our children's hospital from January to December, 1990. 1. Pharmacokinetics 10 mg/kg of PAPM/BP (10 mg PAPM/10 mg BP) was administered intravenously by drip infusion to 7 children. The mean blood concentration of PAPM was 14.8 micrograms/ml at the peak, and the mean half life was 0.9 hours in blood. PAPM was not detected in blood 3 hours after the time when the peak values were attained. 2. Clinical studies 10 mg/kg of PAPM/BP was administered intravenously 3 times a day to 18 cases including 15 of respiratory infections, 2 of otitis media and 1 of sepsis. The clinical efficacies of PAPM/BP were excellent or good in 17 out of the 18 cases. All causative organisms isolated in 5 cases, Methicillin-sensitive Staphylococcus aureus (MSSA) (1 case), Streptococcus pneumoniae (1), Haemophilus influenzae (2) and Branhamella catarrhalis (1) were eradicated in a few days upon the administrations of PAPM/BP. No adverse reactions due to PAPM/BP were observed, but a slight elevation of platelet counts in blood was observed in 1 case, which was normalized soon after the end of the treatment. 3. Antibacterial activities in vitro(ABSTRACT TRUNCATED AT 250 WORDS)

In vivo and in vitro effects of cyclosporin A on glucose transport by soleus muscles of mice

The effect of cyclosporin A (CyA) on 2-deoxyglucose (2DG) uptake by soleus muscles of ICR mice was studied in vivo and in vitro. The basal and insulin-stimulated uptakes of 2DG by the muscles as well as the plasma insulin level were significantly decreased by the in vivo treatment of mice with 20 mg/kg/day of CyA for 6 weeks (P less than 0.01 and P less than 0.05), whereas the insulin binding was increased inversely in the muscles from 20 mg/kg/day CyA-treated mice. The insulin-stimulated uptake of 2DG by the muscles was significantly decreased by the in vitro treatment of the muscles with 1, 10 and 100 micrograms/mL of CyA (P less than 0.05 and P less than 0.01, respectively), while the basal uptake of 2DG was not changed by the in vitro treatment of the muscles with CyA. The insulin binding to the muscles was not altered by the in vitro treatment of the muscles with CyA. These findings suggest that CyA affects not only the insulin secretion from the pancreatic islets but also the postbinding mechanisms of insulin action on the glucose transport by the muscles, which may account for a part of the diabetogenic effect of CyA.

Factors influencing the clinical type and course of myasthenia gravis

Myasthenia gravis is considered to be an autoimmune disease in which several factors reciprocally influence the clinical type and course. We investigated the relative importance of the following factors: anti-acetylcholine receptor antibody (AChR Ab), HLA, age at onset, autoimmunity, thymic abnormality, duration of treatment, change in AChR Ab titer and immunosuppressive therapy. The pretreatment-AChR Ab titer and HLA were shown to significantly influence the clinical type. On the other hand, the age at onset significantly influenced the clinical course. The finding that with an onset at less than 5-year-old there was a tendency for a good prognosis suggests an association between the immaturity of the muscle and immune systems, and the clinical course.

Alterations in DNA Synthesis and Cellular Constituents in Mouse Lung following Bleomycin Injections

Changes in the DNA synthesis and cellular constituents of mouse lung following repeated bleomycin (BLM) injections were studied. ICR mice were administered BLM subdermally for 10 days. Wet lung weight was increased 1.36 times on day 5 after the final administration compared with control mice receiving an identical volume of saline only for 10 days. The total number of cells in the bronchoalveolar lavage fluid of the BLM group reached a maximum on day 14, and histologic investigation of the lungs revealed marked cellular infiltrations. The labeling index obtained by the antibromodeoxyuridine monoclonal antibody method for cells was increased from days 5 to 14 in the BLM group. By day 28, these inflammatory changes had subsided and fibrotic remodeling had occurred. DNA polymerase activity in the lung tissue reached its maximal level on day 5 and remained unchanged until day 14. This phenomenon occurred in parallel with increases in DNA content and synthesis. During this period, an increase in DNA polymerase-beta activity and new induction of DNA polymerase-alpha activity were observed by phosphocellulose column chromatography. From these observations, it is concluded that: (1) repeated injections of BLM cause DNA injury in lung cells; (2) there is a subsequent increase in the DNA repair function as supported by the finding of an increase in DNA polymerase-beta activity; and (3) these lead further to cell proliferation as supported by the increase in both DNA polymerase-alpha activity and DNA content. Thus, a close relationship between morphologic changes and altered DNA synthesis was observed in the lungs of mice after BLM injections.

Urinary excretion of human growth hormone in children with short stature: correlation with pituitary secretion of human growth hormone

Thirty-five children with short-stature underwent insulin-loading and sleep tests for assessment of secretion of human growth hormone. Correlations between the levels of human growth hormone in the serum and urine during the tests were examined to elucidate the clinical significance of urinary human growth hormone levels in short children. The concentration and total amount of human growth hormone in the urine correlated significantly with the peak concentration of serum human growth hormone (r = 0.81, p less than 0.001 and r = 0.80, p less than 0.001, respectively) and the integrated concentration of human growth hormone (r = 0.85, p less than 0.001 and r = 0.85, p less than 0.001, respectively) in the insulin-loading test. The concentration and total amount of human growth hormone in the morning urine also correlated significantly with the peak concentration of serum human growth hormone (r = 0.80, p less than 0.001 and r = 0.70, p less than 0.001, respectively) and the integrated concentration of serum human growth hormone (r = 0.80, p less than 0.001 and r = 0.72, p less than 0.001, respectively) in the sleep test. The concentration or total amount of human growth hormone in the urine differed significantly among children with human growth hormone deficiency, those with nonendocrine short stature, and those with normal stature (p less than 0.05). These data suggest that measurement of human growth hormone in the urine may be used to assess secretion of human growth hormone, serving as a screening test for human growth hormone deficiency in children.

[Pterion and epipteric bones in Japanese adults and fetuses, with special reference to their formation and variations]

The formation and variations of the pterion and epipteric bones were examined in total of 614 Japanese skulls. The materials used consisted of 258 skulls of Japanese fetuses ranging from the fourth to the ninth month, 20 skulls of Japanese juveniles from the third month to 17 years of age, and 336 skulls of Japanese adults from 20 to 89 years of age. For the skulls examined the incidence of ossification in the fetal sphenoidal fontanelle was 3.6% on each side, whereas epipteric bones were observed in more than 10% of the juvenile and adult pteria. Great variation was seen in the form of the adult pterion. The most common form was a sphenoparietal contact in which the pteria were classified into usual (306 pteria), high (119), low (21), and narrow (32) types Another form of this type, a frontal process of the temporal bone without contact with frontal bone, was found in five pteria. The form of frontotemporal contact is classified into two types: One is with a frontal process of the temporal bone (17 pteria), and another is a K-shaped contact referred to as "stellate" (four). The two types were observable in adult skulls of all ages, although the fused pteria and fusing epipteric bones were most often seen in cases over 40 years of age. The results suggest that the pterion formation has two phases, the first occurring before the occlusion of sphenoidal fontanelle, and the second starting after 40 years of age.

Evidence that polymyxin B is a glucose transport inhibitor

The effect of polymyxin B on 3-O-methylglucose transport was studied in isolated rat adipocytes and erythrocytes. Polymyxin B (300 micrograms/mL) inhibited basal transport and insulin-stimulated transport of 3-O-methylglucose in adipocytes by 26.1 and 40.1%, respectively. Polymyxin B at concentrations of 300 and 3000 micrograms/mL inhibited transport of 3-O-methylglucose in erythrocytes by 20.0 and 40.8%, respectively. Polymyxin E at a concentration of 3000 micrograms/mL also inhibited, by 40.6%, the transport of 3-O-methylglucose in erythrocytes but 300 micrograms/mL of polymyxin E did not inhibit it significantly. These results indicate that polymyxin B inhibits glucose transport per se, as well as the insulin-dependent stimulation of glucose transport.

Lack of correlation between P pulmonale and right atrial overload in chronic obstructive airways disease

The correlation between P pulmonale and right atrial overload in chronic lung disease was studied. Right atrial pressure, pulmonary artery pressure, and cardiac output were measured with a Swan-Ganz catheter in nine patients with chronic lung disease and P pulmonale on the electrocardiogram (P wave amplitude of greater than or equal to 2.5 mm (0.25 mV) in leads II, III, and a VF. The results were compared with those in six patients with an atrial septal defect (left to right shunt greater than or equal to 50%) and six patients with pulmonary hypertension (mean pressure greater than or equal to 30 mm Hg without left sided heart disease). Right atrial volume and wall thickness were measured in 10 cases of P pulmonale among 1000 necropsy cases and compared with 141 normal hearts from the same series. The patients with P pulmonale did not show a significant increase in right atrial or pulmonary artery pressures. None of the patients with an atrial septal defect or pulmonary hypertension had P pulmonale on the electrocardiogram. In the necropsy cases of P pulmonale mean (1 SD) in right atrial volume (32 (12) ml) and wall thickness (1.5 (0.7) mm) were not significantly increased (40 (14) ml and 1.4 (0.5) mm in the normal hearts). There was a significant inverse relation between the presence of P pulmonale and the cardiothoracic ratio. In all the patients with P pulmonale chest x ray showed a low cardiothoracic ratio, a considerably depressed diaphragm, and a pendulous heart. This study showed no correlation between P pulmonale and right atrial overload in chronic lung disease. A more vertical anatomical position of the heart, particularly of the right atrium, seems to be the major factor responsible for generation of P pulmonale in chronic airways disease.

[Pharmacokinetical and clinical study of cefpirome in children]

This study describes the pharmacokinetic characteristics and clinical usefulness of cefpirome (CPR) in children. Mean half-lives of 20 mg/kg and 40 mg/kg of CPR injected intravenously in one shot were 1.18 and 1.34 hours, respectively, and their mean recovery rates into urine were 69.8 and 72.2%, respectively. Minimum inhibitory concentrations of CPR against Staphylococcus aureus, Streptococcus pneumoniae, Klebsiella pneumoniae, Escherichia coli and Haemophilus influenzae were the same as or lower than those of ceftazidime. CPR was clinically effective in 14/15 of patients with bacterial infections; 8/9 of pneumonia, 2/2 of bronchitis, 1/1 of pharyngitis, 1/1 of tonsillitis, 1/1 of osteomyelitis, 1/1 of urinary tract infection. No clinically overt side effects of CPR were found, while an increase of eosinophils in blood was observed in 2 cases, and an increase of platelet in blood in 1 case and an elevation of serum GPT activity in 1 case were also observed. These findings indicate that CPR is useful for the treatment of bacterial infections in children.

[An autopsy case of chronic germanium intoxication presenting peripheral neuropathy, spinal ataxia, and chronic renal failure]

We report here an autopsy case of chronic germanium intoxication with major pathological changes in the central and peripheral sensory nervous systems. The patient was a 4-year-old girl who had suffered from gait disturbance and generalized muscle weakness for 22 months. She had been given orally germanium compounds (containing germanium dioxide, 225-450 mg/day) for the previous 28 months. In addition to the findings of chronic renal failure and anemia, she presented characteristic neurological symptoms exemplified by diffuse muscle atrophy, tongue fasciculation, sensory impairment and truncal ataxia as well as areflexia. Median and ulnar sensory nerve conduction velocities were also reduced. On the 17th hospital day, she died of renal failure. In addition to conspicuous degeneration of renal tubular cells, pathological studies revealed marked nerve fiber loss, degeneration and gliosis in the dorsal column of the spinal cord, which were most conspicuous in the thoracic and cervical cord. Axonal degenerative changes were also conspicuous in the sural and sciatic nerves. High concentration of germanium was detected in the brain, cerebellum, spinal cord, sciatic nerve, liver and kidney. It was suggested that the neural involvement in the current case was caused by chronic toxicity of germanium.

[A case of primary hypothyroidism with repeated episodes of respiratory failure]

A case of repeated episodes of hypoventilatory respiratory failure accompanied with primary hypothyroidism was reported. A 76-year-old woman was admitted to our hospital due to both disturbance of consciousness and respiratory failure. A diagnosis of primary hypothyroidism complicated with hypoventilatory respiratory failure deterioration due to respiratory infection was made. Supplemental therapy of thyroid hormones improved her general condition, but respiratory failure recurred after interruption of a replacement drug. Cases of unexplained respiratory failure should be differentiated from respiratory failure induced by hypothyroidism.

[Early changes of postpneumonectomy lung growth in premature rats]

Following pneumonectomy in animals, the contralateral lung increases in volume, weight, collagen content, protein, and cell number, reaching levels approximate to those of both lungs of control animals. The volume and weight response in quicker and more complete in young animals compared to old animals. The increase in the amount of DNA was found to be greater in young rats compared to old ones. However, little is known about the effects of pneumonectomy in immature animals, in which combined effects of normal and the compensatory lung growth may be expected. The present studies were aimed at elucidating early changes in terms of morphology and biochemistry in the contralateral lung following pneumonectomy in premature rats. Male Sprague-Dawley rats (2 week-old) were subdivided into 3 groups. Group P, underwent left pneumonectomy, group S was sham operated, which group C was matched by age, sex, and weight with group P. Morphological studies consisted of light microscopic morphometry and immunohistochemistry using anti-bromodeoxyuridine (BrdU) were performed. Biochemical studies included measurement of DNA polymerase activity, DNA and RNA content, collagen and elastin content. The wet lung weight in group P after one week reached approximately the same as that of bilateral lungs of groups S and C. The fixed lung volume of group P reached that of group S or group C at three weeks. The activity of DNA polymerase and BrdU positive alveoli were increased only during the early period following pneumonectomy. DNA content in group P reached the same range as group S and C at 4 weeks, suggesting the occurrence of cellular hyperplasia.(ABSTRACT TRUNCATED AT 250 WORDS)

Chronological observations of histological changes, cytochrome oxidase activity and copper level in the brain of the postnatal brindled mouse

Neuropathological and enzyme-histochemical studies were performed on brindled mouse hemizygotes (BMs) and normal littermates at the age of 2 days, 7 days, 11 days and 14 days, together with an investigation of their tissue copper levels. A greatly increased copper concentration was confirmed in the kidney and intestine and a greatly reduced concentration in the liver and brain of BMs. The copper concentration in the brain increased gradually with age in the normal littermates, whereas this did not occur in BMs. There was no significant difference in the tissue copper concentration between the cerebrum and the cerebellum-brainstem in BMs or in normal littermates. Light and electron microscopy of the BM brain revealed progressive neuronal degeneration in association with increased mitochondrial changes (ballooning and crista disintegration). Enzyme histochemical examinations demonstrated a progressive comparative decrease (i.e., an increased difference from normal) of cytochrome oxidase activity in the BM brain. These data suggest that progressive degeneration of the brain in Menkes' disease is attributable to mitochondrial degeneration caused by a comparative decrease of both copper concentration and cytochrome oxidase activity in the brain.

[The spinal monosynaptic reflexes elicited from the tibialis anterior muscle--standardization of the reflexes and diagnostic use in L5 radiculopathy]

The spinal monosynaptic reflexes evoked in the tibialis anterior muscle were investigated to establish a practical method for assessing L5 radiculopathy. Voluntary contraction and averaging technique made it possible to consistently obtain the H-and T-reflexes from the muscle in which these reflexes are normally unelicitable at rest. Based on the study of fifty normal subjects, formulae were produced by an analysis of the simultaneous regression of the latencies of these reflexes on height and age, because these latencies were highly correlated with them. A side-to-side latency difference of the H-and T-waves greater than 1.5 msec. and 2.3 msec. respectively, and/or low amplitude less than 26% and 39% of the amplitude of the contralateral side respectively, could be considered abnormal. According to these criteria, eight out of twelve patients (67%) with unilateral compressive L5 radiculopathy showed abnormalities.