Disposition of the Highly Fat Distributed Compound 1-(4-Methoxyphenyl)-4-(2,2,4,6,7-Pentamethyl -2,3-Dihydro-1-Benzofuran-5-yl)Piperazine (TAK-357) in Rats and Dogs

The non-clinical pharmacokinetics (PK) of TAK-357, a highly lipophilic (clogP>6) potential agent for the amelioration of Alzheimer's disease, was investigated in rats and dogs. A long half-life (t_1/2) in plasma was observed in animals and a low total body clearance with high distribution volume was consistent with the long t_1/2. The absorption, distribution, metabolism and excretion (ADME) studies using radiolabeled TAK-357 revealed that the total radioactivity was highly distributed to the adipose tissues and sustained with high concentration for over 4 weeks after oral administration. The metabolite analysis also revealed that the main component in the plasma and adipose tissues was unchanged TAK-357. The major elimination route of absorbed TAK-357 was suggested to be by metabolism. An ADME study indicated that the adipose tissue is the main depot of remaining TAK-357 in the body and slow release from the adipose tissues contributes to the long t_1/2. The PK of highly lipophilic compounds have a tendency to be affected by body weight changes especially changes in the adipose tissues. Therefore, it is considered that the relationship between the plasma levels of TAK-357 and the body weight should be evaluated carefully during the clinical trials.

Pharmacokinetics and Urinary Excretion Mechanism of Orteronel (TAK-700), A Novel 17,20-Lyase Inhibitor, in Animals

Orteronel is newly identified as a selective 17,20-lyase inhibitor for an agent for castration resistant prostate cancer. The absorption and disposition of [(14)C]orteronel were investigated in rats and monkeys. Orteronel was extensively excreted into rat and monkey urine in an unchanged form after oral administration. The unbound based renal clearances in rats and monkeys were greater than the respective glomerular filtration rates (GFR), suggesting that urinary tubular secretion plays an important role in the renal excretion of orteronel. Therefore, the uptake of [(14)C]orteronel was investigated using rat kidney slices to estimate the contribution of carrier-mediated transport on the urinary tubular secretion. The uptake study using rat kidney slices suggested that the transport of orteronel from the blood circulation to the kidney was mediated by a digoxin sensitive transport system represented by Oatp4c1 and non-saturable components. Furthermore, the saturable component accounted for a limited fraction of the total renal uptake by rat kidney slices. These results suggested that non-saturable uptake mainly contributed to the renal excretion of orteronel in rats.

Main metabolic pathways of TAK-802, a novel drug candidate for voiding dysfunction, in humans: the involvement of carbonyl reduction by 11β-hydroxysteroid dehydrogenase 1

To investigate species differences in the metabolism of TAK-802, in vitro and in vivo metabolic profiles were compared between humans and animals. TAK-802 was mainly metabolized to M-I, M-II, M-III and M-IV in human and animal liver microsomes. Especially the M-IV formation in humans was greater than that in animals. Likewise, M-IV was detected to a lower extent in the plasma and excreta of animals administered with TAK-802, whereas the AUC0-48 h of M-IV was approximately five-fold higher than that of TAK-802 in human plasma. These results indicate that the in vitro metabolic profile reflects the in vivo condition. Thus, to identify the metabolic pathway of TAK-802 in humans, the responsible enzyme to form M-IV was elucidated in vitro. Since M-IV is a reductive metabolite formed in microsomes, the possibility of involvement of 11β-hydroxysteroid dehydrogenase (11β-HSD), a carbonyl reductase located in microsomes, was first investigated. Consequently, M-IV formation was confirmed by incubation with human 11β-HSD1-expressing microsomes and was concentration-dependently inhibited by glycyrrhetinic acid, an inhibitor for 11β-HSD enzymes, indicating the involvement of 11β-HSD1 in the M-IV formation. In contrast, little M-IV formation was observed using rat 11β-HSD1, suggesting species differences between humans and rats. In addition, M-II was formed via M-IV, not via M-I and the CYP identification studies revealed that both M-I formation from TAK-802 and M-II formation from M-IV were mainly catalyzed by CYP3A4. In conclusion, 11β-HSD1 and CYP3A4 are principally responsible for the metabolism of TAK-802 in humans and 11β-HSD1 may be responsible for the observed species difference.

Disposition of the new potent acetylcholinesterase inhibitor 8-[3-[1-[(3-fluorophenyl)methyl]-4-piperidiny]-1-oxopropyl]-1, 2, 5, 6-tetrahydro-4H-pyrrolo [3, 2, 1-ij] quinolin-4-one (TAK-802) in rats, dogs and monkeys

The pharmacokinetics of TAK-802, a potential agent of amelioration for voiding dysfunction, were investigated in rats, dogs and monkeys after a single oral administration of 14C-labeled TAK-802. The values of the bioavailability for the compound ranged from 10.2 to 19.9% and the extent of absorption of 14C were higher than the values for the bioavailability in the tested animals. TAK-802 and its related compounds distributed widely in the tissues including the target organ, the urinary bladder, in rats. TAK-802 was highly bound to the plasma proteins and the protein-binding % was independent of the spiked concentrations in all the species tested. Meanwhile, the erythrocyte distribution decreased significantly with the increase in the TAK-802 concentrations. After oral dosing, the dosed 14C was predominantly excreted into the feces of the test animals and the hepato-biliary route mainly contributed to the excretion of 14C in rats. The major components of 14C in the plasma and excreta were unidentified polar metabolites in the test animals. These results indicated that TAK-802 was extensively metabolized by first-pass metabolism during the absorption process and its related metabolites were excreted predominantly into the feces via the bile in the test animals. The concentration-dependent erythrocyte distribution was characterized as the most influential property on the pharmacokinetics of TAK-802. For the clinical safety in the development of TAK-802, the effect of the concentration-dependent erythrocyte distribution on the pharmacokinetics of TAK-802 in animals and humans should be addressed.

Video-assisted parathyroidectomy

A parathyroid tumor is not larger than other tumors, so minimally invasive surgery has long been a major focus of parathyroid surgeons. Improving endoscopic instruments has facilitated the recent changes in approaches to parathyroid surgery. Endoscopic parathyroidectomy is developed in a totally closed space with CO2 gas insufflation. This method has a risk of complications, such as extensive emphysema or hypercarbia. Minimally invasive video-assisted parathyroidectomy (MIVAP) has greater safety, low cost, easy procedure and flexibility in changing the working space including conversion to open method when compared with endoscopic parathyroidectomy. MIVAP can be performed with only a 1-1.5-cm small incision on the neck. MIVAP is indicated in the patient with parathyroid adenoma or renal hyperplasia that is defined preoperatively using ultrasonography and 99mTc-methoxyisobutylisonitrile (MIBI) scan. Furthermore, the radio-guided technique using nuclear navigation after preoperative administered MIBI is being developed. This method is so useful during MIVAP that we combined MIVAP and radio-guided surgery to develop minimally invasive radio-guided and video-assisted parathyroidectomy (MIRVAP). After injection of 600 MBq of MIBI, intraoperative nuclear mapping was performed using a hand-held gamma probe. Then we expected to find swollen parathyroid tumor at surgery when radioactivity at a level relatively higher than background was found. Following this mapping result, MIVAP was started and succeeded. The radio-guided technique is also indicated for open parathyroidectomy (radio-guided open parathyroidectomy, RGOP) in multiglandular disease (MGD) when it was not possible to identify those lesions completely, for instance in asymmetric hyperplasia, such as multiple endocrine neoplasia (MEN) 1. In conclusion, MIVAP is beneficial for minimal invasiveness and cosmesis. Furthermore, radio-guided parathyroidectomy (MIRVAP and RGOP) is more useful and feasible. Improvement of endoscopic instruments and modification of the dose of MIBI administered might facilitate treating more cases by MIRVAP instead of RGOP.

Active life expectancy for people over 65 years old in a local city in the northern part of Tohoku district

Life expectancy does not necessarily match quality of life (QOL). A cohort study involving a population of 10,107 in a certain city of Japan was conducted to evaluate active life expectancy (ALE), which has a direct relationship with QOL. The ALE that took functional recovery rates into account was 17.20 and 19.08 years for males and females respectively, at the age of 65. These values increased by 2.98 and 3.87 years for men and women, respectively, compared with when functional recovery rates were not considered. ALE may serve as an indicator for the objective evaluation of various public health services provided by local governments.

Establishment of the transformants expressing human cytochrome P450 subtypes in HepG2, and their applications on drug metabolism and toxicology

Transformants with stable expression of a series of human cytochrome P450 (CYP) subtypes in the human hepatic cell line, HepG2, were established. These transformants are designated Hepc/1A1.4, Hepc/1A2.9, Hepc/2A6L.14, Hepc/2B6.68, Hepc/2C8.46, Hepc/2C9.1, Hepc/2C19.12, Hepc/2D6.39, Hepc/2E1.3-8 and Hepc/3A4.2-30, which stably expressed human CYP1A1, CYP1A2, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP2E1 and CYP3A4, respectively. The expression of the CYP subtypes in the transformants was confirmed by both determination of enzyme activities and the reverse transcriptase polymerase chain reaction (RT-PCR) procedure. The apparent K(m) values of the expressed CYP subtypes for their specific substrates were close to those of human liver microsomes. In addition to their CYP activities, these transformants retained glucuronide- and sulfate-conjugating activities. Furthermore, the activities of CYP2C9, CYP2D6 and CYP3A4 were inhibited by their specific inhibitors. The cytotoxicity of acetaminophen (APAP), cyclophosphamide (CPA) and benz[a]anthracene (BA) were analyzed by CYP-expressing transformants. The cytotoxicity depended on the expression of CYP subtypes and increased in a dose-dependent manner. These results show the metabolic activation of APAP, CPA and BA by the specific CYP subtypes expressed in the transformants and demonstrate the usefulness of these transformants for in vitro metabolic and toxicological studies in human liver.

Establishment of a human hepatocyte line (OUMS-29) having CYP 1A1 and 1A2 activities from fetal liver tissue by transfection of SV40 LT

Immortalized human hepatocytes that can retain functions of drug-metabolizing enzymes would be useful for medical and pharmacological studies and for constructing an artificial liver. The aim of this study was to establish immortalized human hepatocyte lines having differentiated liver-specific functions. pSVneo deoxyribonucleic acid, which contains large and small T genes in the early region of simian virus 40, was introduced into hepatocytes that had been obtained from the liver of a 21-wk-old fetus. Neomycin-resistant immortalized colonies were cloned and expanded to mass cultures to examine hepatic functions. Cells were cultured in a chemically defined serum-free medium, ASF104, which contains no peptides other than recombinant human transferrin and insulin. As a result, an immortal human hepatocyte cell line (OUMS-29) having liver-specific functions was established from one of the 13 clones. Expression of CYP 1A1 and 1A2 messenger ribonucleic acid by the cells was induced by treatment with benz[a]pyrene, 3-methylcholanthrene, and benz[a]anthracene. OUMS-29 cells had both the polycyclic aromatic hydrocarbon receptor (AhR) and AhR nuclear translocator. Consequently 7-ethoxyresorufin deethylase activity of the cells was induced time- and dose-dependently by these polycyclic aromatic hydrocarbons. This cell line is expected to be instrumental as an alternative method in animal experiments for studying hepatocarcinogenesis, drug metabolisms of liver cells, and hepatic toxicology.

Requirement of intact disulfide bonds in orexin-A-induced stimulation of gastric acid secretion that is mediated by OX1 receptor activation

Orexin-A is a neuropeptide consisting of 33 amino acids with two intrachain disulfide bonds, namely Cys6-Cys12 and Cys7-Cys14, and is a potent stimulator of food consumption and gastric acid secretion. In contrast, orexin-B, a peptide containing 28 amino acids without disulfide bond, which has no stimulatory action of gastric acid. The objective of the present study was to characterize the receptor-mediated mechanism of orexin-A-induced stimulation of gastric acid secretion using orexin-A-related peptides with modification of disulfide bonds. Intracisternal injection of orexin-A, but not orexin-B or orexin-A (15-33), that does not contain both disulfide bonds stimulated gastric acid secretion in pylorus-ligated conscious rats. The ability of the stimulation of gastric acid output was less in three alanine-substituted orexin-A, [Ala(6,12)]orexin-A, [Ala(7,14)]orexin-A, and [Ala(6,7,12,14)]orexin-A, than orexin-A. Orexins-induced calcium increase was measured in CHO-K1 cells expressing OX1R or OX2R. Orexin-A induced a transient increase in [Ca(2+)]i in CHO-K1/OX1R cells in a dose-dependent manner. EC50 values for OX1R of orexin-A, orexin-B, or orexin-A (15-33) was 0.068, 0.69 or 4.1 nM, respectively, suggesting that peptides containing no disulfide bonds have lower potency for the receptor. Agonistic activity for OX1R of the three orexin-A analogues with modification of one or both disulfide bonds was significantly reduced as compared with that of orexin-A. EC50 values for OX2R of orexin-A and orexin-B was almost equal but potency for the receptor of orexin-A (15-33) and three alanine substituted orexin-A was less than that of orexin-A. A significant inverse relationship between gastric acid output and EC50 values for OX1R, but not OX2R, was observed. These results suggested that the orexin-A-induced acid stimulation requires OX1R activation and that disulfide bonds in orexin-A may have a key role in the receptor activation.

Formation of a dihydroxy metabolite of phenytoin in human liver microsomes/cytosol: roles of cytochromes P450 2C9, 2C19, and 3A4

Formation of four oxidative metabolites from the anticonvulsant drug phenytoin (DPH) catalyzed by human liver microsomal cytochrome P450 (P450) enzymes was determined simultaneously. Under the conditions in which linearity for formation of 4'-hydroxylated DPH (4'-HPPH; main metabolite) was observed, human liver cytosol increased microsome-mediated DPH oxidation. 3',4'-Dihydroxylated product (3', 4'-diHPPH) formation was 10 to 40% of total DPH oxidation in the presence of liver cytosol. 3'-Hydroxy DPH formation was catalyzed by only one of the human liver microsomal samples examined and 3', 4'-dihydrodiol formation could not be detected in all samples. In the presence of liver cytosol, 3',4'-diHPPH formation activity from 100 microM 4'-HPPH was correlated with testosterone 6beta-hydroxylation activity and CYP3A4 content. However, 3', 4'-diHPPH formation using 1 or 10 microM 4'-HPPH as a substrate was not correlated with contents of any P450s or marker activities. Of 10 cDNA-expressed human P450 enzymes examined, CYP2C19, CYP2C9, and CYP3A4 catalyzed 3',4'-diHPPH formation from the primary hydroxylated metabolites (3'-hydroxy-DPH and 4'-HPPH). Fluvoxamine and anti-CYP2C antibody inhibited 3',4'-diHPPH formation from 10 microM 4'-HPPH in a human liver sample that contained relatively high levels of CYP2C, whereas ketoconazole and anti-CYP3A antibody showed inhibitory effects on the activities in liver microsomal samples in which CYP3A4 levels were relatively high. These results suggest that CYP2C9, CYP2C19, and CYP3A4 all have catalytic activities in 3',4'-diHPPH formation from primary hydroxylated metabolites in human liver and that the hepatic contents of these three P450 forms determine which P450 enzymes play major roles of DPH oxidation in individual humans.

Retrospective study of porcine circovirus 2 infection in Japan: seven cases in 1989

Retrospectively, we demonstrated that seven pigs necropsied in 1989 had characteristic porcine circovirus 2 (PCV-2) lymphoid tissue lesions of severe lymphoid depletion, syncytial giant cell formation, and intracytoplasmic inclusion bodies in macrophages. Immunohistochemically, PCV-2 antigen was detected in these tissues and the distribution of positive staining corresponded to the distribution of inclusion bodies. Electron microscopy demonstrated viral particles compatible with porcine PCV-2. Therefore, the disease occurred in Japan as early as 1989.

Pre- and postoperative bone metabolism of primary hyperparathyroidism

Primary hyperparathyroidism (PHPT) is a well-known indicator of severe bone loss. However, the recovery process of bone mineral density after surgery in PHPT patients is not sufficiently clear. We examined postoperative bone metabolism in 24 PHPT patients.

PATIENTS AND METHODS

Subjects were 24 patients with PHPT upon whom we performed parathyroidectomy in the Department of Surgery II, Fukushima Medical University. Mean age was 54.2 years and the male-to-female ratio was 10:14; mean time of follow-up was 27.3 months. Patients were divided histopathologically into 16 adenomas and eight hyperplasias, and classified by heredity into seven familial (six, MEN 1; one, MEN 2) and 17 sporadic types. Bone mineral density was measured by dual energy X-ray absorptometry (DXA) and digital image processing (DIP). Age-matched values of these parameters were obtained. Serum bone metabolic parameters; ionized calcium (CaF), phosphorus, intact PTH (iPTH), c-PTH, ALP, osteocalcin (OC) and PTHrP were measured.

RESULTS

PHPT patient preoperative bone mineral densities were significantly lower than those of healthy controls. Those by DIP method were lower than those by DXA. High CaF, iPTH, OC and ALP levels were indicated before surgery, but all parameters immediately became normal. Longitudinal bone mineral density changes of asymptomatic cases increased more than those of patients with renal stone and/or ostitis fibrosa. In adenoma cases, tumor weights were significantly inversely, which correlated with preoperative DIP bone density measurements.

CONCLUSION

Preoperative PHPT patients showed decreased bone density; bone loss in symptomatic cases was especially prominent compared to asymptomatic cases. Most PHPT patients had not completed the BMD recovery after surgery, so even asymptomatic and mild PHPT patients should undergo parathyroidectomy to minimize irreversible bone loss.

Enhancement of cytochrome P-450 3A4 catalytic activities by cytochrome b(5) in bacterial membranes

Activities of testosterone, nifedipine, and midazolam oxidation by recombinant cytochrome P-450 (P-450) 3A4 coexpressed with human NADPH-P-450 reductase (NPR) in bacterial membranes (CYP3A4/NPR membranes) were determined in comparison with those of other recombinant systems and of human liver microsomes with high contents of CYP3A4. Growth conditions for Escherichia coli transformed with the bicistronic construct affected expression levels of CYP3A4 and NPR; an excess of NPR over P-450 in membrane preparations enhanced CYP3A4-dependent testosterone 6beta-hydroxylation activities of the CYP3A4/NPR membranes. Cytochrome b(5) (b(5)) and apolipoprotein b(5) further enhanced the testosterone 6beta-hydroxylation activities of CYP3A4/NPR membranes after addition to either bacterial membranes or purified enzymes. NPR was observed to enhance catalytic activity when added to the CYP3A4/NPR membranes, either in the form of bacterial membranes or as purified NPR (in combination with cholate and b(5)). Apparent maximal activities of testosterone 6beta-hydroxylation in CYP3A4/NPR membranes were obtained when the molar ratio of CYP3A4/NPR/b(5) was adjusted to 1:2:1 by mixing membranes containing each protein. Testosterone 6beta-hydroxylation, nifedipine oxidation, and midazolam 4- and 1'-hydroxylation activities in CYP3A4/NPR membranes plus b(5) systems were similar to those measured with microsomes of insect cells coexpressing CYP3A4 with NPR and/or of human liver microsomes, based on equivalent CYP3A4 contents. These results suggest that CYP3A4/NPR membrane systems containing b(5) are very useful models for prediction of the rates for liver microsomal CYP3A4-dependent drug oxidations.

Bcl-2 protein expression and gut neurohormonal polypeptide/amine production in colorectal carcinomas and tumor-neighboring mucosa, which closely correlate to the occurrence of tumor

To clarify whether advanced colorectal carcinomas and tumor-neighboring mucosa simultaneously produce both Bcl-2 protein and gut neurohormonal polypeptides and/or amines, and the interrelationship of these phenomenon, we studied retrospective analysis of Bcl-2 protein production and neuroendocrine characteristics in 52 cases of advanced colorectal carcinoma and surrounding mucosa. All of the tumor-neighboring mucosa presented hyperplasia. The rates of enhanced immunoreactivity of the tumor-neighboring mucosa and of positive immunoreactivity of the carcinomas against human Bcl-2 protein and against human vasoactive intestinal polypeptide, pancreatic polypeptide and somatostatin were 78.8% and 94.2%, 82.7% and 59.6%, 78.8% and 67.3%, and 88.5% and 84.6% respectively. Double immunostaining for Bcl-2 protein and each peptide hormone revealed simultaneous expression. In contrast, that of tumor-neighboring mucosa and carcinomas to serotonin and chromogranin-A and to argyrophilia were 11.5% and 1.9%, 32.7% and 17.3%, and 26.9% and 21.2%, respectively. We concluded that tumor-neighboring crypt cells displayed not only hyperplasia but also neuroendocrine characteristics and that enhanced Bcl-2 protein immunoreactivity correlated with tumor occurrence in the wall of the colorectum. The production of Bcl-2 protein by tumor cells and tumor-neighboring crypt cells indicates that the bcl-2 protooncogene may act not only as an inhibitor of apoptosis but also as an inducer of neuroendocrine differentiation from the latent characteristics of the endodermal stem cell.

Biosynthesis of archaeosine, a novel derivative of 7-deazaguanosine specific to archaeal tRNA, proceeds via a pathway involving base replacement on the tRNA polynucleotide chain

Archaeosine is a novel derivative of 7-deazaguanosine found in transfer RNAs of most organisms exclusively in the archaeal phylogenetic lineage and is present in the D-loop at position 15. We show that this modification is formed by a posttranscriptional base replacement reaction, catalyzed by a new tRNA-guanine transglycosylase (TGT), which has been isolated from Haloferax volcanii and purified nearly to homogeneity. The molecular weight of the enzyme was estimated to be 78 kDa by SDS-gel electrophoresis. The enzyme can insert free 7-cyano-7-deazaguanine (preQ0 base) in vitro at position 15 of an H. volcanii tRNA T7 transcript, replacing the guanine originally located at that position without breakage of the phosphodiester backbone. Since archaeosine base and 7-aminomethyl-7-deazaguanine (preQ1 base) were not incorporated into tRNA by this enzyme, preQ0 base appears to be the actual substrate for the TGT of H. volcanii, a conclusion supported by characterization of preQ0 base in an acid-soluble extract of H. volcanii cells. Thus, this novel TGT in H. volcanii is a key enzyme for the biosynthetic pathway leading to archaeosine in archaeal tRNAs.

Higher prevalence of Borna disease virus infection in blood donors living near thoroughbred horse farms

It is believed that Borna disease virus (BDV), an etiological agent of progressive polioencephalomyelitis in horses and sheep, is closely associated with psychiatric disorders in humans since the prevalence of BDV is higher in psychiatric patients than in blood donors. We investigated whether or not BDVs in humans are derived from infected domestic animals, by characterizing the BDVs in blood donors and horses derived from the same region of Hokkaido island, Japan. The seroprevalences (2.6 to 14.8%) of BDV were significantly higher in the blood donors from four regions where most horse farms are concentrated, compared with only 1% in the blood donors from Sapporo, the largest city in Hokkaido.BDV RNA was also detected in peripheral blood mononuclear cells from most of the seropositive horses and blood donors by nested reverse transcriptase-polymerase chain reaction. These findings support that BDV may be horizontally transmitted, at least in part, from infected horses to humans.

Impaired left ventricular diastolic filling occurs in diabetic patients without atherosclerotic coronary artery disease

Using left ventriculography, left ventricular diastolic function was studied in 24 diabetic patients who had angina pectoris without atherosclerotic large-vessel coronary artery diseases (group A, 14 patients with exercise-induced ischemic ST-T changes as seen during electrocardiogram; group B, 10 patients without such changes). In groups A and B, the global peak filling rate was significantly less than that in control patients without diabetes or cardiac diseases. The ratio of the global time to the peak filling rate to the diastolic time was higher in both groups A and B than in the control groups. However, the total of time differences, defined as the sum of the time differences between global time to the peak filling rate and each of the three regional time to the peak filling rate, was greater in group A than in either group B or the control patients. Total time difference was similar in group B and the controls. Left ventricular diastolic filling was impaired in diabetic patients without large-vessel coronary artery disease. Impaired diastolic filling was present regionally in patients with ischemic ST-T change but globally in those without such change.

Borna disease virus RNA in peripheral blood mononuclear cells obtained from healthy dairy cattle

We examined natural infection of Borna disease virus (BDV) in 74 healthy dairy cattle in Japan. The seroprevalence determined using recombinant BDV p24 protein was 20.3%. The prevalence of BDV RNA in peripheral blood mononuclear cells (PBMCs) determined by polymerase chain reaction for p24 was 10.8%. Cell fraction of the PBMCs revealed the presence of BDV RNA in the T cell-enriched fraction. Thus, BDV infection is widespread even among healthy cattle.

Potent neuropeptide Y Y1 receptor antagonist, 1229U91: blockade of neuropeptide Y-induced and physiological food intake

Neuropeptide Y (NPY) is thought to increase food intake through the action of Y1 (-like) receptors in the hypothalamus. To confirm the involvement of Y1 receptors in feeding behavior, selective and potent antagonists for Y1 receptors are required. In the present study, we showed that a peptide, 1229U91 [(Ile,Glu,Pro,Dpr,Tyr,Arg,Leu,Arg, Tyr-NH2)2 cyclic (2,4'),(2',4)-diamide], is a potent and selective antagonist for Y1 receptors. 1229U91 displaced [125I]peptide YY (PYY) binding to membranes of human neuroblastoma-derived SK-N-MC cells that predominantly express Y1 receptors with a K1 value 0.10 nM and inhibited the NPY-induced increase in intracellular calcium levels(IC50 = 0.27 nM). In contrast, the K1 values for [125I]PYY binding to Y2 receptors in membranes of human neuroblastoma-derived SK-N-BE2 cells and rat hypothalamus were 700 nM and more than 1 microM, respectively. Although [125I]PYY could not detect Y1 receptors in the rat hypothalamic membranes, [125I]1229U91 revealed binding sites with a high affinity (Kd = 18 pM), indicating the presence of Y1 receptors in the hypothalamus. Intracerebroventricular injection of 1229U91 (30 micrograms) into male Sprague-Dawley rats completely inhibited NPY (5 micrograms)-induced food intake without any other behavioral change. Furthermore, intracerebroventricular injection of 1229U91 significantly suppressed physiological feeding behavior after overnight fasting. These results indicate that Y1 receptors in the rat hypothalamus mediate NPY-induced food intake, and that physiological feeding behavior after overnight fasting may be largely regulated by NPY via Y1 receptors. 1229U91 may be useful for further elucidating the pathophysiological roles of NPY in feeding behavior.

Possible correlation between Borna disease virus infection and Japanese patients with chronic fatigue syndrome

Borna disease virus (BDV) is a neurotropic, as yet unclassified, non-segmented, negative-sense, single-strand RNA virus. Natural infection with this virus has been reported to occur in horses and sheep. In addition, antibodies to BDV in plasma or BDV RNA in peripheral blood mononuclear cells (PBMCs) were also found in patients with neuropsychiatric diseases. We describe here the possible link between the patients with chronic fatigue syndrome (CFS) and infection with BDV.

Detection of turkey rhinotracheitis virus from chickens with swollen head syndrome by reverse transcriptase-polymerase chain reaction (RT-PCR)

We developed a sensitive and specific method, reverse transcriptase-polymerase chain reaction (RT-PCR) method, for detection of turkey rhinotracheitis virus (TRTV). Two sets of primers were designed from F protein gene sequence of TRTV 3B strain. Sensitivity of detection by nested PCR with the primers corresponded to 0.4 TCID50. Applying this method to a field case of swollen head syndrome (SHS), TRTV could be detected directly from chicken trachea and turbinates. It was identified that this method was very useful to examine the relation of TRTV and SHS.

Demonstration of Borna disease virus RNA in peripheral blood mononuclear cells derived from Japanese patients with chronic fatigue syndrome

CFS, a recently named heterogeneous disorder, is an illness of unknown etiology. The association of CFS with viral infections has been suggested. A common association between CFS and several viruses examined has not been confirmed. Here, we centered on the possible link between CFS and BDV infection. By nested RT-PCR followed by hybridization, BDV RNA was demonstrated as a clear signal in PBMCs in 3 out of 25 CFS patients. The amplified cDNA fragments were cloned and sequenced. A total of 16 clones were studied. Intra-patients divergencies of the p24 were 2-9%, 3-20%, and 3-11% in the deduced amino acids. Inter-patient divergencies among the 16 clones were 3-24%. Antibodies to recombinant BDV p24 protein were detected in 6 CFS patients including one carrying BDV RNA. Overall, these gave the prevalence of 32% (8/25) in Japanese CFS patients, suggesting that Japanese CFS is highly associated with active infection of BDV, or a related agent.

Demonstration of borna disease virus RNA in peripheral blood mononuclear cells derived from domestic cats in Japan

Borna disease virus (BDV) naturally infects horses, sheep, and several other species, including humans, and it is believed to be related to neurological disorders. BDV infection in domestic cats has also been demonstrated by serological assays. We demonstrated for the first time BDV RNA in peripheral blood mononuclear cells from 11 of 83 (13.3%) randomly selected domestic cats in Japan by nested reverse transcriptase-PCR. The BDVs from cats were similar to but slightly different from those from horses and humans, as shown by sequencing the reverse transcriptase-PCR products. None of the cats was positive for both BDV RNA and anti-BDV antibodies.

Demonstration of Borna disease virus RNA in peripheral blood mononuclear cells from healthy horses in Japan

Borna disease (BD) is a progressive poliomeningoencephalomyelitis which occurs naturally in horses and sheep. Here, peripheral blood mononuclear cells (PBMC) derived from 57 healthy horses in Japan were examined by a nested reverse transcription-polymerase chain reaction to determine the prevalence of BD virus (BDV) infection. Seventeen (29.8%) of the samples were positive by this examination and the specificity of the amplified product was confirmed by hybridization with authentic oligomer probes. About 60% of the BDV RNA-positive individuals also showed seropositivity by Western blotting. This report is the first for the demonstration of BDV RNA in PBMC of healthy horses, as well as the first on the BDV infection in horses in Japan. Thus, BDV may be more widespread in healthy horses over the world as well as in Japan and the detection of BDV RNA in PBMC at a high rate indicates that the disease might develop in a part of the carriers only after long-incubation period.

A 3-deazauracil-resistant mutant of Bacillus subtilis with increased production of cytidine

Bacillus subtilis No. 344 is a cytidine-producing mutant strain derived from wild type strain No. 122. When 3-deazauracil-resistant mutants were derived from strain No. 344, some of the mutants had higher productivities of cytidine. Among them, strain No. 428 accumulated 14.2 mg/ml cytidine in the culture. Cytidine 5'-triphosphate (CTP) synthetase from strain No. 428 changed to be free from feedback inhibition by CTP, compared with the enzyme from strain No. 344.

QT prolongation and possibility of ventricular arrhythmias after intracoronary papaverine

The incidence of ventricular arrhythmias following the intracoronary injection of papaverine was assessed. A 3F coronary Doppler catheter was placed in the proximal left anterior descending artery and 6-12 mg of papaverine was injected into the left coronary artery in 42 patients. After intracoronary papaverine, the corrected QT interval on the electrocardiogram was prolonged from 0.43 +/- 0.03 to 0.49 +/- 0.07 s (p < 0.001). Occasional premature beats were observed in 2 patients (4.5%) with dilated cardiomyopathy. In 1 patient (2.3%) with 99% stenosis of the left anterior descending artery, polymorphous ventricular tachycardia with marked QT prolongation occurred. This patient also had hypokalemia (2.5 mEq/l) due to primary aldosteronism. In conclusion, careful use of intracoronary papaverine is necessary because of the risk of occasional serious ventricular arrhythmias.

Oxygen demand-supply relationship in peripheral tissues as a therapeutic indicator in acute myocardial infarction with advanced heart failure

Oxygen demand-supply relationships in peripheral tissues were studied in 14 patients who had acute myocardial infarction with advanced pump failure. Seven patients with acute myocardial infarction but without pump failure were studied as a control. In all patients, a Swan-Ganz catheter and a radial arterial cannula were inserted for the purpose of hemodynamic monitoring, and arterial and mixed venous blood were sampled. Initially, oxygen delivery (DO2) (p < 0.01) was lower, and oxygen extraction ratio (OER) (p < 0.001) and oxygen tension at 50% saturation (P50) (p < 0.01) were higher in patients with pump failure than in the controls. During the therapeutic course, with an increase in the cardiac index and DO2, oxygen uptake (VO2) did not change but OER (p < 0.001) and P50 (p < 0.01) significantly decreased in 6 survivors with pump failure. In contrast, an increased VO2 (p < 0.01) and no change of OER and P50 were observed in 8 nonsurvivors with pump failure. These results suggest that reversibility of oxygenokinetics might be an important factor for recovery from critical heart failure.

Saphenous vein graft to the distal vertebral artery between C-1 and C-2 using a lateral-anterior approach. Technical note

The authors present a modified surgical procedure for extracranial vertebral artery reconstruction. The use of the proposed technique results in access to the V3 segment of the vertebral artery between the C-1 and C-2 vertebrae through the retrojugular space without requiring bone rongeuring. A saphenous vein bypass graft was placed between the common carotid artery and the V3 segment of the vertebral artery in three patients with bilateral occlusive lesions of the proximal vertebral arteries.

[A case of angina pectoris with cardiac arrest at treadmill stress test]

We reported a case of angina pectoris with cardiac arrest immediately after treadmill exercise test, and the effect of PTCA in the same case. A 69-year-old Japanese male had chest oppression on exertion. Initial treadmill test showed 2 mm ST-segment depression in leads V4-6. Two minutes after exercise, he had atrio-ventricular (A-V) block and cardiac arrest with episodes of fainting. He was resuscitated by chest thump. Coronary angiography showed 90% stenosis in the right coronary artery (RCA). PTCA for RCA was able to dilate the stenotic lesion. The second treadmill test after PTCA did not induce bradycardia nor A-V block. It was suggested that the RCA lesion may play a critical role.

Analysis of MRI and SPECT in patients with acute head injury

Traumatic lesions defined by magnetic resonance (MR) imaging were divided into two groups according to findings on computed tomography (CT). This classification reflected difference in the regional cerebral blood flow (rCBF). In the contusional lesions which CT could demonstrate, rCBF varied from hyperperfusion to hypoperfusion, while it was almost always decreased in the lesions which CT could not detect. These results suggest that the former may include a mixture of brain oedema and hyperemia and the latter may imply brain oedema. MR imaging can reveal the minor oedema which CT fails to show in patients with acute head injury.

Menaquinone (vitamin K2)-6 production by mutants of Flavobacterium meningosepticum

Flavobacterium meningosepticum IFO 12535, a menaquinone (MK) producer, was mutagenized to improve productivity. A mutant, which was resistant to 1-hydroxy-2-naphthoate (HNA), was found to produce MK more abundantly: 34 mg/liter of culture broth and 5.5 mg/g of dry cells. The mutant was less sensitive to inhibition by HNA on MK biosynthesis than the wild-type strain. MK was isolated from cells of the mutant and identified as MK-6 based on its physicochemical characteristics. Mutants, which were given each KCN resistance, aromatic amino acid auxotrophy and no carotenoid productivity, did not show further increase of productivity.

[Penetration of cefotaxime into human cerebrospinal fluid]

The penetration of cefotaxime (CTX) into the cerebrospinal fluid (CSF) was monitored to evaluate the prophylactic efficacy of the drug against post-craniotomy infections. Doses ranged from 1 to 2 g were administered to patients with subarachnoid hemorrhage due to the rupture of cerebral aneurysm, traumatic cerebral contusion, or subdural edema accompanied by intracerebral hemorrhage, by intravenous drip infusion over a period of 30 or 60 minutes. CTX readily entered the CSF with concentrations exceeding MICs against the major pathogens occurring after craniotomy. CTX proved to be effective in the prevention of post-craniotomy infections in noninflammatory situations, especially after surgery in the case of cerebral traumas or subarachnoid hemorrhage.

[A study of cefoperazone levels in the cerebrospinal fluid of patients with hydrocephalus]

Eleven neurosurgical patients without intracranial infection were given 4 g cefoperazone (CPZ) intravenously for 30 minutes. Ventricular drainage was performed in 10 cases, and 1 case with cisternal drainage. Eight of 11 cases showed moderate to severe ventricular dilatation. Serum and ventricular cerebrospinal fluid (CSF) concentrations of CPZ were measured for 8 hours after injection. Average peak serum concentration of CPZ was 476 micrograms/ml and the half-life was 150 minutes. Patients with obstructive hydrocephalus showed relative good penetration of CPZ in CSF (2.74 approximately 5.29 micrograms/ml). Especially, those who had severe dilatation of ventricles demonstrated sequential increased concentration (5.48 approximately 6.25 micrograms/ml at 8 hours). In poor risk patient and intracerebral hemorrhage with ventricular hemorrhage cases, who had normal range of CSF cell counts and protein, CPZ level was low, less than 2 micrograms/ml. In cases with severe subarachnoid hemorrhage, sufficient concentration (11 micrograms/ml) of CPZ was observed in cisternal CSF. The CPZ concentrations in CSF after 4 g administration did not seem to exceed comparing to 2 g dosing.

[Etiology of water and electrolyte metabolism imbalance following the rupture of cerebral aneurysms--with special reference to preoperative condition]

One hundred fourteen patients with ruptured cerebral aneurysms were reviewed in regard to the incidence and etiological factors of preoperative disturbances of water and electrolyte metabolism. Patients with inadequate salt intake, evidence of renal disease, cardiac failure or excessive diuretic therapy were excluded. Twenty-five (21.9%) patients developed water and electrolyte disturbances. Hyponatremia (less than 130 mEq/l) occurred in 18 (15.8%) of 114 patients. The majority of those patients with hyponatremia showed laboratory findings and/or clinical features suggesting the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). The mean interval between the last subarachnoid hemorrhage (SAH) and the development of hyponatremia was 13.5 days (range 6 to 26 days). No patients developed hypernatremia (more than 155 mEq/l). Preoperative diabetes insipidus (DI) occurred in 7 (6.1%) of 114 patients. The mean interval between the last SAH and the onset of DI was 26.5 days (range 15 to 35 days). When compared with the onset of hyponatremia following SAH, the development of DI was significantly delayed. The present study showed that the following five types of patients significantly related to the development of preoperative water and electrolyte disturbances after SAH due to cerebral aneurysms. The patients with ruptured aneurysms of anterior communicating, anterior cerebral artery or internal carotid artery. The patients in grade III, IV according to Hunt & Hess. The patients with high density in the basal subarachnoid space on the CT scan. The patients with a small hematoma in the region of the basal frontal interhemispheric fissure in cases with aneurysms of the anterior communicating or anterior cerebral artery.(ABSTRACT TRUNCATED AT 250 WORDS)

[Diabetes insipidus following the rupture of cerebral aneurysms--with special reference to preoperative cases]

The authors reported 4 cases with preoperative diabetes insipidus (DI) following the rupture of cerebral aneurysms. In addition, the incidence of preoperative DI and the mechanisms as the cause of DI in cases with the ruptured cerebral aneurysms were also discussed. In the 114 cases underwent clipping of the ruptured cerebral aneurysms more than 14 days after the bleed, only 4 cases (3.5%) developed DI preoperatively. The time period between last subarachnoid hemorrhage and the onset of DI ranged from 23 to 35 days. This delayed onset of DI after subarachnoid hemorrhage was different from previous reports. A few of mechanisms had been suggested through which DI could be brought about in cases with cerebral aneurysm. That is; direct compression to the hypothalamo-hypophysial system by a giant aneurysm. compression and destruction of the hypothalamus by a hematoma or hemorrhage, ischemic changes in the hypothalamo-hypophysial system caused by vasospasm. In the present 4 cases, no had giant aneurysms. Although CT scan revealed subarachnoid clot in all cases, it did not show apparent hypothalamic lesion except case 1 who had small hematoma in the region of the basal frontal interhemispheric fissure. Symptomatic vasospasm was recognized in 3 cases. However, one of them had mild vasospasm restricting in M1 portion and case 3 was free of any vasospasm. Furthermore, the time period from the identification of vasospasm until the onset of DI ranged from 2 to 3 weeks. These results suggest that another mechanism in addition to a hemorrhage, hematoma and/or vasospasm may exist.(ABSTRACT TRUNCATED AT 250 WORDS)

[Cerebral vasospasm following subarachnoid hemorrhage in arteriovenous malformation]

Cerebral vasospasm after SAH from AVMs is rare. Only few reports have been made. Vasospasm was confirmed in 4 out of 13 patients with SAH from AVMs at the Sagamihara National Hospital in the past 5 years. The incidence of vasospasm following rupture of AVM is higher than those in previous reports ranging between 8 and 12 percent. This high incidence (31%) might be attributable to the timing from the last SAH attack until angiography. The existence of massive subarachnoid blood clots around the arteries of the circle of Willis is the most important factor causing vasospasm after SAH from AVMs.