Predicting difficulty in extending the ileal pouch to the anus in restorative proctocolectomy: investigation of a simple predictive method using computed tomography.

AIM: This study aimed to assess the ability of preoperative axial computed tomography (CT) to predict surgical difficulty in bringing the ileal pouch to the level of the anus during restorative proctocolectomy (RPC). METHOD: Patients who underwent RPC with an ileal pouch-anal anastomosis (or ileal pouch-anal canal anastomosis) in our institution between January 2008 and April 2014 were enrolled. The patients were divided into two groups, including those in whom CT indicated potential difficulty in extending the pouch downwards (extension difficult (ED) group) and patients with no CT evidence of potential difficulty (normal group). The groups were compared for clinical factors and the thickness of the slices of CT showing the root of the superior mesenteric artery, the point of communication of the ileocaecal artery with the marginal artery (tICA) and the anal verge (AV). Receiver-operating characteristic analysis was performed, and a cut-off value was calculated for predicting the degree of difficulty in bringing the ileal pouch down to the anal canal. RESULTS: Thirty-four patients were entered in the study. The ED group included significantly taller patients and more with familial adenomatous polyposis than the normal group. The distance between tICA and AV was significantly longer in the ED group, with a cut-off of 21 cm giving a sensitivity of 100% and a specificity of 83.3%. CONCLUSION: The distance between tICA and AV measured by axial CT can be a useful predictor for the difficulty in bringing the ileal pouch down to the anus during RPC.

Purification and characterization of carbaryl hydrolase from Arthrobacter sp. RC100.

A carbaryl hydrolase was purified to homogeneity from Arthrobacter sp. strain RC100 by protamine sulfate treatment, ammonium sulfate precipitation, and hydrophobic, anion-exchange, and gel filtration chromatographies. The native enzyme had a molecular mass of 100 kDa and was composed of two identical subunits with molecular masses of 51 kDa. The hydrolase activity was strongly inhibited by DIFP, PMSF, Hg(2+) and paraoxon but not by EDTA. The optimum pH and temperature for the enzyme activity were 9.0 and 50 degrees C, respectively. The enzyme hydrolyzed four N-methylcarbamate insecticides (carbaryl, xylylcarb, metolcarb and XMC), but was not able to hydrolyze fenobucarb, propoxur, and isoprocarb.

Liquefaction tests of toyoura sand measuring change of quasi-elastic deformation properties

Undrained cyclic torsional and triaxial shear tests were perfomed on hollow cylindrical specimens of dense Toyoura sand, which were consolidated isotropically after preparation by airpluviation. At several stress states, quasi-elastic deformation properties were measured by applying very small amplitude cyclic torsional and vertical loads. Some of the results could be explained by considering inhewrent and stress state-induced anisotropy in modeling of elastic deformation characteristics and by correcting for the effects of membrane penetration. Degradation in the values of elastic shear modulus and Young's modulus was observed during liquefaction when compared to those measured during isotropic consolidation.(AU)

Dihydropyridine type calcium channel blocker-induced turbid dialysate in patients undergoing peritoneal dialysis.

We previously reported that manidipine, a new dihydropyridine type calcium channel blocker, produced chylous peritoneal dialysate being visually indistinguishable from infective peritonitis in 5 patients undergoing continuous ambulatory peritoneal dialysis (CAPD) [Yoshimoto et al. 1993]. To study whether such an adverse drug reaction would also be elicited by other commonly prescribed calcium channel blockers in CAPD patients, we have conducted postal inquiry to 15 collaborating hospitals and an institutional survey in International Medical Center of Japan as to the possible occurrence of calcium channel blocker-associated non-infective, turbid peritoneal dialysate in CAPD patients. Our diagnostic criteria for drug-induced turbidity of dialysate as a) it developed within 48 h after the administration of a newly introduced calcium channel blocker to the therapeutic regimen, b) absence of clinical symptoms of peritoneal inflammation (i.e., pyrexia, abdominal pain, nausea or vomiting), c) the fluid containing normal leukocyte counts and being negative for bacterial and fungal culture of the fluid, and d) it disappeared shortly after the withdrawal of the assumed causative agent. Results showed that 19 out of 251 CAPD patients given one of the calcium channel blockers developed non-infective turbid peritoneal dialysis that fulfilled all the above criteria. Four calcium channel blockers were suspected to be associated with the events: benidipine [2 out of 2 (100%) patients given the drug], manidipine [15 out of 36 (42%) patients], nisoldipine [1 out of 11 (9%) patients] and nifedipine [1 out of 159 (0.6%)] in descending order of frequency. None of the patients who received nicardipine, nilvadipine, nitrendipine, barnidipine and diltiazem (25, 7, 2, 1 and 8 patients, respectively) exhibited turbid dialysate. In conclusion, we consider that certain dihydropyridine type calcium channel blockers would cause turbid peritoneal dialysate being similar to that observed in patients developing infective peritonitis. To avoid unnecessary antibiotic therapy the possibility of this adverse reaction should be ruled out whenever a CAPD patient receiving a dihydropyridine type calcium channel blocker develops turbid dialysate.

Base specificity and primary structure of poly U-preferential ribonuclease from chicken liver.

The primary structure and base specificity of chicken liver RNase CL1 which has been reported by Miura et al. [Chem. Pharm. Bull., 32, 4053-4060 (1984)] as poly U-preferential RNase, were extensively studied. The sequence study of this enzyme and comparison of the amino acid sequence of the enzyme with homologous RNases from oyster and Drosophila melanogaster suggested that RNase CL1 consists of three peptides with 17, 19, and 163 amino acid residues. The amino acid sequence of these three peptides were identified. The two small peptides are joined to the large peptide by disulfide bridges. The amino acid sequence of RNase CL1 had 62 (31.2%) and 63 residues (31.6%) identical with oyster RNase and D. melanogaster RNase, respectively, and belongs to the RNase T2 family RNase. Reassessment of the base specificity of RNase CL1 found that it is guanylic acid, then uridylic acid-preferential, and not poly U preferential.

Distribution and identification of proteolytic Bacillus spp. in paddy field soil under rice cultivation.

Proteolytic bacteria in paddy field soils under rice cultivation were characterized and enumerated using azocoll agar plates. Bacillus spp. were the proteolytic bacteria that were most frequently present, comprising 59% of the isolates. They were always the numerically dominant proteolytic bacteria isolated from three kinds of fertilizer treatments (yearly application of rice-straw compost and chemical fertilizer, yearly application of chemical fertilizer, and no fertilizer application) and at three different stages of rice development (vegetative growth stage, maximal tillering stage, and harvest stage). Of the 411 proteolytic bacteria isolated, 124 isolates had stronger proteolytic activity than others on the basis of gelatin liquefaction tests and most of them were Bacillus spp. (100% in 1989 and 92.4% in 1991). Bacillus subtilis and Bacillus cereus were the main bacteria of this group and Bacillus mycoides, Bacillus licheniformis, and Bacillus megaterium were also present. We conclude that these Bacillus spp. are the primary source of soil protease in these paddy fields.

Characterization of poly C preferential ribonuclease from chicken liver.

Poly C preferential RNase previously reported by Levy and Karpetsky [J. Biol. Chem. 255, 2153-2159 (1980)] and Miura et al. [Chem. Pharm. Bull. 32, 4053-4060 (1984)] was extensively purified from chicken liver to homogeneity as determined by SDS-PAGE (RNase CL2). The poly C preference over poly U was slightly higher than that of bovine pancreatic RNase A. However, the kinetic constants for 8 dinucleoside phosphates, CpY and UpY (Y = one of A, G, U, and C) as substrates showed that RNase CL2 was preferential for cytidylic acid, but less so than RNase A, and the influence of Y base on the rate of hydrolysis of CpY or UpY was less marked than in the case of RNase A. The primary structure of RNase CL2 was determined. The molecular weight calculated from the sequence was 13,420. Comparison of the amino acid sequence of RNase CL2 with those of other vertebrate RNases showed that RNase CL2 is a member of the RNase A family, but is not a non-secretory RNase. It retains 3 disulfide bridges of RNase A, but Cys65-Cys72 of RNase A is missing. As for the active site, the amino acid residues of the P0 and P1 sites of RNase A are completely conserved. Among the B1 site components, Thr45 (RNase A numbering) is conserved, but Phe120 and Ser123 are substituted by Leu and Thr, respectively. Among the B2 site residues, Gln69, Asn71, and Glu111 are substituted by other amino acids.

A case of minimal change nephrotic syndrome associated with acute renal failure after excessive exercise.

A case of minimal change nephrotic syndrome associated with acute oliguric renal failure after exercise is reported. Renal function returned to normal after the patient underwent hemodialysis, and the nephrotic state was improved by administration of prednisolone. Adequate supportive management of the renal failure and early administration of corticosteroids for nephrotic syndrome are important therapeutic procedures in such a situation.

[A case of anti-GBM nephritis (crescentic glomerulonephritis) associated with membranous nephropathy].

We report a case of endstage renal disease due to simultaneous occurrence of membranous nephropathy and crescentic glomerulonephritis associated with anti-GBM antibodies. The patient was a 60-year-old male and was hospitalized for prolonged anorexia and general malaise. On admission, his body temperature was 38.5 degrees C. Urinalysis revealed 3+ proteinuria and the sediment contained abundant erythrocytes. The urea nitrogen was 142.4 mg/dl, the creatinine 19.5 mg/dl, the potassium 6.47 mEq/dl and CRP 10.1 mg/dl. Anti-GBM antibodies were 1000EU/ml. Immediately after initiating hemodialysis, pulse steroid therapy, plasma exchange and continuous heparinization were performed. However, renal function had been impaired and maintenance hemodialysis was required. Histological examination of the renal specimen revealed marked epithelial crescent formation, whereas thickening of basement membrane and mesangial proliferation were not observed. By immunofluorescent staining, both bright linear and fine granular fixation of IgG and fine granular fixations of C3 along the glomerular capillary walls were observed. Electron microscopy showed subepithelial electron lucent deposits and thickening of the glomerular basement membrane, diagnostic of the advanced membranous nephropathy (stage IV).

Potential neuroleptic agents, N-[(2-pyrrolidinyl)methyl]-2,3-dihydrobenzofuran-7-carboxamide derivatives.

A series of 2,3-dihydrobenzofuran-7-carboxamides, presenting a stabilized intramolecular hydrogen bond, was synthesized and evaluated in pharmacological models for antipsychotic activity. Among them, N-[(1-butyl-2-pyrrolidinyl)methyl]-2-methyl-5-sulfamoyl-2, 3-dihydrobenzofuran-7-carboxamide (15) showed an atypical neuroleptic profile similar to that of sulpiride (1) and more lipophilic properties than 1. Compound 15 was 11 times more potent in antagonistic activity on apomorphine-induced hyperactivity in mice (ED50 = 30 mg/kg, p.o.) and stronger in potentiation of methamphetamine lethality in rats than 1, while it was as weak in inhibitory activity of apomorphine-induced stereotype in rats (ED50 greater than 500 mg/kg, p.o.) as 1. On the other hand, N-[(1-ethyl-2-pyrrolidinyl)methyl]-2-methyl-5-methylthio-2, 3-dihydrobenzofuran-7-carboxamide (30) showed a classical neuroleptic profile with a potency comparable to haloperidol in antagonistic activity on apomorphine-induced hyperactivity in mice (ED50 = 0.65 mg/kg, p.o.). The structure-activity relationships were also discussed.

[A case report of rhinocerebral mucormycosis in hemodialysis patient receiving deferoxamine].

Deferoxamine (DFO) has been widely used in the treatment of aluminum toxicity in patients on chronic dialysis. Mucormycosis is an opportunistic infection caused by fungi of the Mucorales order and some reports suggested a role for DFO in the precipitation of this infection. A 50-year-old man had been on hemodialysis for 16 years. 6 weeks before admission, he was begun on DFO because of aluminum toxicity. 2 weeks before admission, general fatigue and fever developed and followed by headache and loss of vision. He was admitted to this hospital with disturbed consciousness. His clinical course and a CT scan of the head suggested cerebral infarction. Within 24 hours he required ventilatory support and died 5 days after the admission. On autopsy, rhino-cerebral mucormycosis was demonstrated with a mycotic thrombus involving the left middle cerebral artery. Dialysis-related mucormycosis has recently appeared in the literature. We feel that hemodialysis patients on DFO may be at risk for potentially fatal mucormycosis infections. With a possible relationship between DFO treatment and this fatal opportunistic infection, caution should be given before using this drug and the indications should be definitive.

[Comparative toxicity study of rokitamycin and josamycin in rats].

A comparative toxicity study on macrolide antibiotics, rokitamycin (TMS-19-Q) and josamycin, was performed in male rats. These drugs were given orally for 1 month at daily doses of 250, 500, 1,000, and 2,000 mg/kg. No animals died in the study. No abnormal symptoms or changes in body weights and food consumption were observed. Results of urinalysis, hematological analysis and biochemical analysis of serum and organ weights were normal except that a dose-dependent hypertrophy of caecum was observed in all dosage groups. Necropsy revealed no notable drug related abnormalities except in caecum of all test groups. Pathological examination found no significant drug-related abnormalities in the test groups. No toxicological signs were detected in the group administered with 2,000 mg/kg of either drug and no difference was found between the 2 drugs.

[Reproduction study of rokitamycin. Teratological study in rabbits].

A teratological study was performed on rokitamycin (TMS-19-Q), a new macrolide antibiotic, using rabbits. TMS-19-Q, at dose levels of 100, 300 and 600 mg/kg, was orally administered from the day 6 to the day 18 of gestation to dams. Diarrhea and decrease in body weight gain and food consumption were observed in dams at or above 300 mg/kg. Decrease in numbers of live fetuses was observed at dose levels of 300 and 600 mg/kg but there was no teratogenicity at any dose levels. The maximum non-toxic dose level for TMS-19-Q in this study was 100 mg/kg.

[Antigenicity study of rokitamycin].

The antigenicity of rokitamycin (TMS-19-Q, TMS) was studied. Rabbits and mice were repeatedly challenged with TMS emulsified with adjuvant to be strongly immunized. Neither IgG nor IgE antibodies were, however, detected in serum from these animals when assayed by PCA and PHA reactions. Furthermore, guinea pigs immunized with TMS together with Freund's complete adjuvant did not exhibit any systemic anaphylactic reactions when elicited with TMS alone. In contrast, specific antibody production against TMS was confirmed in animals immunized with chemically introduced antigen of TMS-carrier protein conjugate, where TMS had antigenic nature as hapten.

The acetylation of 6'-amino group of amikacin by a new enzyme prepared from serratia sp.

It was found that Serratia marcescens 43, Serratia proteamaculans 48 and Serratia sp. 45, all of which were clinically isolated, produced a new type of aminoglycoside acetyltransferase which acetylated amikacin at the 6'-amino group. 1-N-[(S)-3-Amino-2-hydroxypropionyl]-gentamicin B (HAPA-B, SCH 21420) and gentamicin C2 were hardly inactivated by the enzymes and had effective antimicrobial activities against these strains both in vitro and in vivo. This kind of aminoglycoside acetyltransferase should be classified into a new group other than previously reported AAC(6') enzymes.

[Subacute toxicity and recovery tests of mequitazine in beagle dogs (author's transl)].

Subacute toxicity and recovery tests of Mequitazine, a new phenothiazine ;type anti-histamine agent, were carried out using each 20 male and female dogs. The drugs was administered orally in doses of 0, 1, 5 and 25 mg/kg day for 14 weeks. Recovery test was carried out for following 4 weeks. As a result, transient decrease of the body weights and somnolences were observed in both male and female dogs given 25 mg/kg. In a female dog given 25 mg/kg, extrapyramidal reaction accompanied with tremors and muscle stiffenings was observed. But no dead animals were observed throughout experimental period. Vomitings, mydriasis and loss of appetite were observed with the dose-responsiveness, but these symptoms were reduced after 1-2 weeks administration. No abnormal changes were observed in hematological, serum biochemical, and other examinations. In histopathological examinations, slights changes were observed in liver, kidneys, mesenteric lymph nodes, palpebra and conjunctival membrane. But these changes were reversible in recovery period. From these results, it was suggested that the maximum non-effective and maximum safety doses were 1 mg/kg/day and 5 mg/kg/day, respectively.

[Mutagenicity tests on mequitazine (author's transl)].

Microbial backward mutation test, Ames Salmonella/microsome plate assay, on six bacterial strains (Salmonella typhimurium TA 98, 100, 1535, 1537, 1538 and E. coli WP 2uvrA) and micronucleus test in mice were carried out to detect mutagenic activity of mequitazine. Mequitazine caused no increases of revertants at doses from 1 to 1000 microgram/plate in every bacterial strains irrespective of metabolic activation. Similarly, mequitazine induced no significant increases of micronucleated polychromatic erythrocytes in mice over the control level at doses from 0.12 (clinical dose) to 48 mg/kg (approx. LD 50). From above results, we concluded that mequitazine has no mutagenic activity per se.

[Comparative biochemical studies of placental alkaline phosphatase in animals (author's transl)].

Biochemical properties of alkaline phosphatase (ALP) from placenta were compared between man, dog, cat, rabbit and cattle. 1) Optimum pH of the enzyme was essentially identical through the species of the animals but the inhibition of L-phenylalanine was clearly demonstrable with human ALP but little with that of other animals. 2) ALP of human placenta was not inactivated by heating at 65 degrees C for 15 min. but one of the other animals was thermolabile. Such thermostability of human placental ALP almost disappeared after treatment with EDTA, suggesting that the divalent metal ions were required for the thermostability. 3) Activities of placental ALP were inhibited by cationsurfactants in human and rat but not in the other animals, while the inhibition by DOC-Na, an anion-surfactant, was seen only in human. 4) The affinity to beta-glycerophosphae of placental ALP was seen only in human.

On the mode of action of a new antifungal antibiotic, aculeacin A: inhibition of cell wall synthesis in Saccharomyces cerevisiae.

The mode of action of a new antifungal antibiotic, aculeacin A, was studied with the cells of Saccharomyces cerevisiae. In the presence of aculeacin A, the distinct decrease of viable cells was observed. The most of cells treated with aculeacin A lysed with releasing intracellular substances at the tips of their buds. This lysis was considered to be due to the inhibition of cell wall synthesis, because the incorporation of glucose into the cell wall glucan was significantly reduced. Aculeacin A also had a weak activity to burst the protoplasts of S. cerevisiae at a relatively high concentration.