Measuring body composition in pediatric patients with complex diagnoses: Acceptability, practicality, and validation of different techniques.

BACKGROUND: Body composition could help identify malnutrition in pediatric patients, but there is uncertainty over which techniques are most suitable and prevailing opinion that measurements are difficult to obtain in practice. This study examined the acceptability, practicality, reliability, and validity of different anthropometric and body composition measurements in patients with complex diagnoses in a tertiary pediatric hospital. METHODS: A total of 152 children aged 5-18 years had weight, height, body mass index (BMI), mid-upper arm circumference (MUAC), 4-site skinfold thicknesses (SFT), bioelectrical impedance analysis (BIA), and dual-energy x-ray absorptiometry (DXA) assessed on admission and discharge. Acceptability was assessed in a continuous scale, practicality with number/percentage of successful measurements, reliability with intraclass correlation coefficients and coefficients of repeatability, and validity between "simpler" techniques and DXA with Bland-Altman analysis of agreement and Cohen kappa. RESULTS: Techniques were overall acceptable. Measurements were successful in >50%, with patient refusal uncommon. Coefficients of repeatability were good (0.3 cm MUAC and height, 0.2 kg weight, and 1.0 mm SFTs). All techniques significantly overestimated DXA fat mass, but BMI and triceps SFT better identified abnormal fat mass (κ = 0.46 and 0.49). BIA fat-free mass was not significantly different from DXA, with substantial agreement between techniques (κ = 0.65). CONCLUSION: Body composition by a range of techniques is acceptable, practical, and reliable in a diverse group of children with complex diagnoses. BIA seems a good alternative to DXA for assessing fat-free mass, triceps SFT, and BMI for fat mass but should be used with care as it could overestimate total fat mass in individuals.

Use of standardized body composition measurements and malnutrition screening tools to detect malnutrition risk and predict clinical outcomes in children with chronic conditions.

BACKGROUND: Better tools are needed to diagnose and identify children at risk of clinical malnutrition. OBJECTIVES: We aimed to compare body composition (BC) and malnutrition screening tools (MSTs) for detecting malnutrition on admission; and examine their ability to predict adverse clinical outcomes [increased length of stay (LOS) and complications] in complex pediatric patients. METHODS: This was a prospective study in children 5-18 y old admitted to a tertiary pediatric hospital (n = 152). MSTs [Pediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONGkids)] were completed on admission. Weight, height, and BC [fat mass (FM) and lean mass (LM) by DXA] were measured (n = 118). Anthropometry/BC and MSTs were compared with each other and with clinical outcomes. RESULTS: Subjects were significantly shorter with low LM compared to reference data. Depending on the diagnostic criteria used, 3%-17% were classified as malnourished. Agreement between BC/anthropometric parameters and MSTs was poor. STAMP and STRONGkids identified children with low weight, LM, and height. PYMS, and to a lesser degree STRONGkids, identified children with increased LOS, as did LM compared with weight or height. Patients with complications had lower mean ± SD LM SD scores (-1.38 ± 1.03 compared with -0.74 ± 1.40, P < 0.05). In multivariable models, PYMS high risk and low LM were independent predictors of increased LOS (OR: 3.76; 95% CI: 1.36, 10.35 and OR: 3.69; 95% CI: 1.24, 10.98, respectively). BMI did not predict increased LOS or complications. CONCLUSIONS: LM appears better than weight and height for predicting adverse clinical outcomes in this population. BMI was a poor diagnostic parameter. MSTs performed differently in associations to BC/anthropometry and clinical outcomes. PYMS and LM provided complementary information regarding LOS. Studies on specific patient populations may further clarify the use of these tools and measurements.

Similar influence of stabilized alkaline and neutral sodium hypochlorite solutions on the fracture resistance of root canal-treated bovine teeth.

INTRODUCTION: Stabilizing sodium hypochlorite (NaOCl) at an alkaline pH is proposed to increase solution stability and tissue dissolution ability; however, a reduction on the flexural strength of dentin discs has been found to be a side effect. This study sought to determine whether a stabilized alkaline NaOCl reduces the fracture resistance of root canal-treated bovine teeth after root canal preparation compared with a neutral solution counterpart. METHODS: The 4 anterior incisors were removed from 20 mandibular bovine jaws, and each 1 was randomly assigned to 1 of 4 groups (20 teeth each). Teeth were prepared with a sequence of 6 K-type files. The following experimental groups received a different irrigation regimen: G1: distilled water (negative control), G2: 5% NaOCl at a pH of 7.2, and G3: 5% NaOCl at a pH of 12.8; in the positive control group (G4), teeth remained untreated. The time of contact and volume of solution were carefully standardized. After bone and periodontal ligament simulation, teeth were subjected to a fracture resistance test. RESULTS: A significant difference was observed among the 4 groups tested (analysis of variance, P < .05). The 5% NaOCl groups (G2 and G3) presented significantly lower resistance to fracture than the control (G1 and G4) (Tukey test, P < .05). Both NaOCl solutions similarly reduced the fracture resistance at approximately 30% (Tukey test, P > .05). No differences were observed between positive and negative control groups (Tukey test, P > .05). CONCLUSIONS: Stabilized alkaline and neutral NaOCl solutions similarly reduced the fracture resistance of root canal-treated bovine teeth by about 30%.

Caracterización de cepas de Leishmania, por medio de la técnica de PCR-RFLP de la región del Spliced Leader Miniexon (SLME), aisladas de humanos y caninos en Paraguay / Characterization of Leishmania strains using PCR-RFLP of Spliced Leader Miniexon (SLME) in human and canine isolates in Paraguay

La leishmaniosis es una enfermedad parasitaria con varias formas clínicas, desde lesiones cutáneas leves hasta enfermedades fatales con comprometimiento visceral. Existen varias técnicas moleculares como por ejemplo la reacción en cadena de la polimerasa (PCR) que amplifica diferentes secuencias blanco, una de ellas es la región SLME (spliced leader miniexon), el producto se corta con enzimas de restricción (PCR-RFLP), permitiendo la identificación de las especies de Leishmania. Este trabajo fue realizado con el objetivo de caracterizar las cepas de Leishmania, empleando una PCR-RFLP de la región SLME, aisladas de humanos y caninos, provenientes de distintas zonas del país. Se analizaron 12 aislados de humanos y 40 de caninos debidamente codificados. Se empleó un par de cebadores para la región SLME, los productos amplificados fueron cortados con las enzimas Hae III y Nco I (RFLP) y los patrones de bandas analizados. Se detectó en un primer paso la presencia de parásitos del subgénero Viannia en 7 aislados de humanos y correspondientes al subgénero Leishmania en 5 aislados de humanos y 40 de caninos. La RFLP según los patrones de bandas permitió identificar a L. braziliensis en aislados de leishmaniosis tegumentaria y L. chagasi en los casos de leishmaniosis visceral. Es importante resaltar que este trabajo es el primero en el país en realizar la caracterización molecular a nivel de especies de Leishmania y los hallazgos descritos tienen una implicación a nivel epidemiológico, contribuyendo con las estrategias de vigilancia y control de la enfermedad. Adicionalmente, se sugiere el uso de otros marcadores genéticos para identificar genotipos o perfiles genéticos diferentes, entre cepas de estas especies

Azteca barbifex Forel (Hymenoptera: Formicidae): potential pest of citrus crops in eastern Amazon

Damage caused by the ant Azteca barbifex (Forel) was identified in orange trees (Citrus sinensis), in Capitão Poço County, Guamá microregion, Pará State. The damage caused by the scraping of stems and branches lead to reduction in yield with subsequent death of the plant. These characteristics indicate A. barbifex as a potential pest of citrus crops in the eastern region of Amazon.

Detección del virus influenza pandémica A (H1N1) en Paraguay 2009, y amplificación de genes hemaglutinina y neuraminidasa / Detection of pandemic influenza A (H1N1) virus in Paraguay in 2009, and amplification of the hemagglutinin and neuraminidase genes

Introducción: El virus de influenza pandémica A (H1N1), cuya circulación se inició en abril del año 2009 en México y Estados Unidos, se constituyó en el último virus pandémico desde los casos detectados en Hong Kong en 1968. El genoma del virus de influenza A está formado por 8 segmentos ARN de cadena simple (polaridad negativa), que codifican para 10 proteínas. Los genes hemaglutinina y neuraminidasa codifican para dos proteínas de superficie y son los utilizados en los análisis de variabilidad genética. Objetivos: a) Detectar la circulación del virus pandémico en pacientes con sospecha clínica de infección por influenza, y b) Diseñar una estrategia para amplificar de forma completa los genes hemaglutinina y neuraminidasa. Materiales y Métodos: Fueron analizados por Real-Time RT-PCR (transcripción reversa y reacción en cadena de la polimerasa en tiempo real) un total de 181 muestras de hisopado faríngeo, colectadas o remitidas al Hospital de Clínicas, del 6 de agosto al 11 de octubre de 2009. Para el diseño de amplificación de los genes hemaglutinina y neuraminidasa, se han utilizado herramientas bioinformáticas y reacción en cadena de la polimerasa. Resultados: Del total de muestras analizadas, 27 (14.9 %) dieron resultado positivo para el nuevo virus pandémico. Por otra parte, la amplificación completa de ambos genes proporcionó los resultados esperados: 1678-pares de bases (pb) para la hemaglutinina, y 1427-pb para la neuraminidasa. Conclusiones: La implementación de esta tecnología de amplificación permitirá posteriormente la secuenciación de estos genes a fin de determinar las variaciones genéticas del virus que podrían tener un impacto en la salud humana.

Introduction: The pandemic influenza A (H1N1) virus, whose circulation was detected in April 2009 in Mexico and the United States, is the latest pandemic virus since the cases reported in Hong Kong in 1968. The genome of the influenza A virus consists of 8 segments of single-stranded RNA of negative polarity, coding for 10 proteins. The hemagglutinin and neuraminidase genes encode for two surface proteins and are used in the analysis of genetic variability. Objectives: a) to detect circulation of the pandemic virus in patients with clinical suspicion of influenza infection and b) design a strategy to fully amplify the hemagglutinin and neuraminidase genes.Materials and Methods: A total of 181 pharyngeal swabs were collected and sent to the Hospital de Clínicas for analysis using Real-Time RT-PCR (reverse transcription and polymerase chain reaction in real time) between 6 August and 11 October 2009. To design the amplification of hemagglutinin and neuraminidase genes, we used bioinformatic tools and polimerase chain reaction. Results: Of the samples analyzed, 27 (14.9%) were positive for the new pandemic virus. Moreover, the complete amplification of both genes provided the expected results: 1678-base pairs (bp) for the hemagglutinin, and 1427-bp for neuraminidase. Conclusions: The use of this technology for amplification will eventually allow sequencing to identify genetic variations of the virus that could have an impact on human health.

Azteca barbifex Forel (Hymenoptera: Formicidae): potential pest of citrus crops in eastern Amazon.

Damage caused by the ant Azteca barbifex (Forel) was identified in orange trees (Citrus sinensis), in Capitão Poço County, Guamá microregion, Pará State. The damage caused by the scraping of stems and branches lead to reduction in yield with subsequent death of the plant. These characteristics indicate A. barbifex as a potential pest of citrus crops in the eastern region of Amazon.

Mantenimiento y titulación del virus de dengue para obtención de antígeno viral / Maintenance and titration of dengue virus for the obtainment of viral antigens

El dengue es un grave problema de salud pública que no posee vacuna ni tratamiento específico. El método de diagnóstico más utilizado es el serológico, específicamente, la detección de anticuerpos IgM anti-dengue. Los antígenos virales utilizados en este método pueden ser preparados en cultivo de células de Aedes albopictus (C6/36). El objetivo de este trabajo fue el mantenimiento de los cuatro serotipos virales (D1 (RIO), D2 (RIO), D3 (H-87), D4 (BV)) en células C6/36 para la futura preparación de antígenos virales. Las células C6/36 fueron cultivadas en medio L-15 con 10% de SFB a 28ºC, e infectadas con 50 ml de cada uno de los serotipos virales por 5 a 7 días. Una vez confirmada la infección por inmunoflurescencia indirecta, los virus fueron titulados por la técnica de placa de lisis. Los títulos de los serotipos fueron D1 (RIO) (2,9 x 106 PFU/ml), D2 (RIO) (4,4 x107 PFU/ml), D3 (H87) (6,4 x 107 PFU/ml) y D4 (BV) (5,1 x106 PFU/ml). La producción de antígenos virales es de gran importancia dado que los mismos pueden ser utilizados en diversos métodos diagnósticos.

Dengue is a serious public health problem that has neither vaccine nor specific treatment. Serology is the most frequently used diagnosis method, specifically the anti-dengue IgM detection. The viral antigens employed in this method could be prepared from Aedes albopictus cell cultures (C6/36). The objective of this study was to maintain the four viral serotypes (D1 (RIO), D2 (RIO), D3 (H-87), D4 (BV)) on C6/36 cells for the preparation of viral antigen in the future. The C6/36 cells were cultured in L-15 medium supplemented with 10% FCS, infected with 50 µl of each viral serotype and then incubated for 5-7 days at 28°C. After confirmation of the infection by indirect immunofluorescence (IIF), viral titration was performed by lysis plaque assay. The serotypes titres obtained were as follows: [2.9 x 106 PFU/ml] for D1 (RIO), (4.4 x107 PFU/ml) for D2 (RIO), (6.4 x 10 7 PFU/ml) for D3 (H87) and (5.1 x106 PFU/ml) for D4 (BV). The production of viral antigens is very important because they could be used in several diagnosis methods.

Carotenoids affect proliferation of human prostate cancer cells.

We investigated whether various carotenoids present in foodstuffs were potentially involved in cancer-preventing action on human prostate cancer. The effects of 15 kinds of carotenoids on the viability of three lines of human prostate cancer cells, PC-3, DU 145 and LNCaP, were evaluated. When the prostate cancer cells were cultured in a carotenoid-supplemented medium for 72 h at 20 micromol/L, 5,6-monoepoxy carotenoids, namely, neoxanthin from spinach and fucoxanthin from brown algae, significantly reduced cell viability to 10.9 and 14.9% for PC-3, 15.0 and 5.0% for DU 145, and nearly zero and 9.8% for LNCaP, respectively. Acyclic carotenoids such as phytofluene, zeta-carotene and lycopene, all of which are present in tomato, also significantly reduced cell viability. On the other hand, phytoene, canthaxanthin, beta-cryptoxanthin and zeaxanthin did not affect the growth of the prostate cancer cells. DNA fragmentation of nuclei in neoxanthin- and fucoxanthin-treated cells was detected by in situ TdT-mediated dUTP nick end labeling (TUNEL) assay. Neoxanthin and fucoxanthin were found to reduce cell viability through apoptosis induction in the human prostate cancer cells. These results suggest that ingestion of leafy green vegetables and edible brown algae rich in neoxanthin and fucoxanthin might have the potential to reduce the risk of prostate cancer.

Lysophosphatidylcholine enhances carotenoid uptake from mixed micelles by Caco-2 human intestinal cells.

Despite the interest in the beneficial roles of dietary carotenoids in human health, little is known about their solubilization from foods to mixed bile micelles during digestion and the intestinal uptake from the micelles. We investigated the absorption of carotenoids solubilized in mixed micelles by differentiated Caco-2 human intestinal cells, which is a useful model for studying the absorption of dietary compounds by intestinal cells. The micelles were composed of 1 micromol/L carotenoids, 2 mmol/L sodium taurocholate, 100 micromol/L monoacylglycerol, 33.3 micromol/L fatty acid and phospholipid (0-200 micromol/L). The phospholipid content of micelles had profound effects on the cellular uptake of carotenoids. Uptake of micellar beta-carotene and lutein was greatly suppressed by phosphatidylcholine (PC) in a dose-dependent manner, whereas lysophosphatidylcholine (lysoPC), the lipolysis product of PC by phospholipase A2 (PLA2), markedly enhanced both beta-carotene and lutein uptake. The addition of PLA2 from porcine pancreas to the medium also enhanced the uptake of carotenoids from micelles containing PC. Caco-2 cells could take up 15 dietary carotenoids, including epoxy carotenoids, such as violaxanthin, neoxanthin and fucoxanthin, from micellar carotenoids, and the uptakes showed a linear correlation with their lipophilicity, defined as the distribution coefficient in 1-octanol/water (log P(ow)). These results suggest that pancreatic PLA2 and lysoPC are important in regulating the absorption of carotenoids in the digestive tract and support a simple diffusion mechanism for carotenoid absorption by the intestinal epithelium.

Formation of cleavage products by autoxidation of lycopene.

The cleavage products formed by autoxidation of lycopene were evaluated in order to elucidate possible oxidation products of lycopene in biological tissues. Lycopene solubilized at 50 microM in toluene, aqueous Tween 40, or liposomal suspension was oxidized by incubating at 37 degrees C for 72 h. Among a number of oxidation products formed, eight products in the carbonyl compound fraction were identified as 3,7,11 -trimethyl-2,4,6,10-dodecatetraen-1-al, 6,10,14-trimethyl-3,5,7,9,13-pentadecapentaen-2-one, acycloretinal, apo-14'-lycopenal, apo-12'-lycopenal, apo-10'-lycopenal, apo-8'-lycopenal, and apo-6'-lycopenal. These correspond to a series of products formed by cleavage in the respective 11 conjugated double bonds of lycopene. The maximal formation of acycloretinal was 135 nM in toluene, 49 nM in aqueous Tween 40, and 64 nM in liposomal suspension. Acycloretinoic acid was also formed by autoxidation of lycopene, although its formation was lower in the aqueous media than in toluene. The pig liver homogenate had the ability to convert acycloretinal to acycloretinoic acid, comparable to the conversion of all-transretinal to all-trans-retinoic acid. These results suggest that lycopene might be cleaved to a series of apolycopenals and short-chain carbonyl compounds under the oxidative conditions in biological tissues and that acycloretinal is further enzymatically converted to acycloretinoic acid.

Acyclic carotenoids and their oxidation mixtures inhibit the growth of HL-60 human promyelocytic leukemia cells.

Lycopene has been known as a potential food component for cancer prevention, since tomato consumption was shown to be associated with reduced risk of certain cancers. We used HL-60 cells as a model of cancer cells to investigate whether acyclic carotenoids, such as phytoene, phytofluene, and zeta-carotene present in tomatoes, other than lycopene, as well as oxidation mixtures of these carotenoids, are potentially involved in the cancer-preventive action of tomatoes. When HL-60 cells were grown in the carotenoid-supplemented medium for 120 hours, zeta-carotene and phytofluene at 10 microM inhibited cell growth to 3.7% and 22.6% of the growth in control culture, respectively, although they were extremely unstable in the culture medium. The oxidation mixture of each carotenoid, which was prepared by incubation in toluene at 37 degrees C for 24 hours, more strongly inhibited cell growth than each intact carotenoid. The growth inhibition by lycopene was remarkably enhanced by its oxidation before supplementation to the medium. Phytofluene, zeta-carotene, and the oxidation mixture of lycopene induced apoptosis in HL-60 cells during incubation for 24 hours. The addition of alpha-tocopherol to the medium did not eliminate growth inhibition by the oxidation mixture of lycopene. These results suggest that the acyclic carotenoids inhibit cell growth through apoptosis induction and that oxidation products of the carotenoids participate in the growth inhibition.

Enzyme-histochemical demonstration of lymphatic vessels in the golden hamster periodontium: an attempt to reactivate the 5'-nucleotidase activity with Mg++ ion supply.

Enzyme-histochemical demonstration of lymphatic vessels in the golden hamster periodontium was performed on cryostat sections using the 5'-nucleotidase (5'-Nase) staining method by light microscopy and backscattered electron imaging of scanning electron microscopy. The inhibition of the 5'-Nase activity by decalcification was cancelled by the Mg++ ion supply. The reaction products of 5'-Nase activity were produced on the lymphatic endothelial cells and the tubular structures of lymphatic vessels were seen as highlights by backscattered electron imaging. The invasion of 5'-Nase-positive lymphatic vessels into the alveolar bone from the periodontium was found in the present study.

Preferential recognition of zwitterionic dipeptides as transportable substrates by the high-affinity peptide transporter PEPT2.

We investigated the interaction of rat PEPT2, a high-affinity peptide transporter, with neutral, anionic, and cationic dipeptides using electrophysiological approaches as well as tracer uptake methods. D-Phe-L-Gln (neutral), D-Phe-L-Glu (anionic), and D-Phe-L-Lys (cationic) were used as representative, non-hydrolyzable, dipeptides. All three dipeptides induced H+-dependent inward currents in Xenopus laevis oocytes heterologously expressing rat PEPT2. The H+:peptide stoichiometry was 1:1 in each case. A simultaneous measurement of radiolabeled dipeptide influx and charge transfer in the same oocyte indicated a transfer of one net positive charge into the oocyte per transfer of one peptide molecule irrespective of the charged nature of the peptide. We conclude that the zwitterionic peptides are preferentially recognized by PEPT2 as transportable substrates and that the proton/peptide stoichiometry is 1 for the transport process.

Evaluation of oral mucoadhesive microspheres in man on the basis of the pharmacokinetics of furosemide and riboflavin, compounds with limited gastrointestinal absorption sites.

When sustained-release adhesive and non-adhesive microspheres which release the same drugs at similar rates are administered orally, drug absorption after administration of adhesive microspheres should, if the gastrointestinal residence of adhesive microspheres is prolonged as a result of mucoadhesion, be higher than that after administration of non-adhesive microspheres. The gastrointestinal transit of oral adhesive microspheres in man has been evaluated pharmacokinetically using furosemide and riboflavin, compounds with limited absorption sites in the upper small intestine. In a preliminary experiment with fasted rats it was confirmed that a higher percentage of the drug remained in the stomach and that plasma drug levels were higher when furosemide was administered in the form of adhesive rather than non-adhesive microspheres. Two kinds of sustained-release microsphere, adhesive and non-adhesive, containing furosemide and riboflavin in hard gelatin capsules were prepared and orally administered to 10 healthy fasted volunteers in a cross-over design. Areas under the plasma concentration-time curves (AUC) were 1.8 times larger for furosemide and urinary recovery was 2.4 times higher for riboflavin when adhesive microspheres rather than when non-adhesive microspheres were used. When adhesive microspheres containing riboflavin were administered to fed volunteers, urinary recovery was 2.1 times higher and mean residence time (MRT) was more prolonged than when the microspheres were administered to fasted volunteers. Adhesive microspheres were found to adhere to the gastric or intestinal mucosa with high affinity in man and rats, resulting in prolonged gastrointestinal residence.

Bifid ribs observed in the third and the fourth ribs.

Three cases of bifid ribs were found in two cadavers during routine dissections at the Iwate Medical University School of Dentistry. All of the cases were found in the third or the fourth rib. The distal parts of the osseous rib bifurcated with an angle of 60 degrees and both of the branches had their own costal cartilage. The costal cartilage fused again to form the trunk which was connected to the sternum. The space between the two branches was filled with presumably normal intercostal muscles. Blood supply was maintained by a small branch from the interthoracic artery to the upper branches. However, the intercostal nerves did not branch toward the upper branch but only ran along the lower margins of the lower branches of the bifid ribs.

Oxidative stability of liposomes prepared from soybean PC, chicken egg PC, and salmon egg PC.

The oxidative stability of phosphatidylcholines (PCs) from soybean, chicken egg, and salmon egg in liposomes was compared with that in aqueous micelles. When each PC was oxidized in aqueous micelles, salmon egg PC was the most oxidatively stable, followed by chicken egg PC and soybean PC, however, no significant difference in the oxidative stability was apparent between chicken egg PC and salmon egg PC in liposomes. The main molecular species of soybean PC was 1,2-dilinoleoyl-PC, while most of the PUFAs in chicken egg PC and salmon egg PC were not esterified at the sn-1 position but at the sn-2 position. Therefore, it is suggested that the oxidative stability of PC liposomes would be strongly influenced by the positional distribution of PUFAs in the PC molecule. Further studies on the oxidation of PC liposomes showed that chicken egg albumin and soybean protein protected PC bilayers against attack by free radicals generated in the aqueous phase.

Effect of chronic administration of phenobarbital on the hepatobiliary transport of phenol red: assessment by statistical moment analysis.

The effect of enzyme induction on the hepatobiliary transport of phenol red (PR) in rats was investigated by application of a new analytical system to determine local drug disposition based on statistical moment theory (T. Kakutani et al., J. Pharmacokin. Biopharm. 13:609-631, 1985). Employing the moment parameters obtained from the time courses of plasma and biliary concentrations of PR and its metabolite after intravenous injection, the hepatobiliary transport of PR was theoretically assessed by separating it into component subprocesses such as hepatic uptake, hepatobiliary transfer, and intrahepatic metabolism. The results demonstrated that the acceleration of plasma disappearance of PR caused by pretreatment with phenobarbital (PB), known to induce hepatic enzyme systems, could be attributed to elevation of both hepatic and extrahepatic clearances. While PB did cause bile flow elevation (choleresis) and increased metabolism, these effects were shown to make little contribution to accelerated plasma disappearance of PR, since it was shown that the hepatobiliary excretion of PR was rate-limited by the intrahepatic transfer process, which was unaffected by PB treatment. From the results of this study, this experimental/analysis methodology seems to be useful in obtaining detailed information about hepatobiliary transport of the drug from in vivo data.

Contribution of interstitial diffusion in drug absorption from perfused rabbit muscle: effect of hyaluronidase on absorption.

[3H]Water and [14C]inulin were injected into perfused rabbit muscle with or without hyaluronidase (300 units/ml) and their absorption into venous effluent from muscle was determined. Hyaluronidase accelerated the absorption of both compounds but the enhancement of [14C]inulin was much larger than that for [3H]water. The pharmacokinetic analysis of venous appearance curves based on a physiological diffusion model elucidated that interstitial diffusion of [14C]inulin was remarkably increased by hyaluronidase treatment, suggesting the existence of steric hindrance for it by the polysaccharide network under normal conditions. Enhancement of [3H]water diffusion was also detected although enhancement ratio was about one-half of that of [14C]inulin. Mean time necessary for each process was calculated using the statistical moment concepts. The results suggested predominant contribution of the interstitial diffusion process and secondary and little contribution of local perfusion flow and permeation process across the capillary wall, respectively, in total absorption of [14C]inulin. Effect of hyaluronidase on transcapillary movement of [14C]inulin was studied using an in vitro diffusion experiment with cultured endothelial cell monolayer and no enhancing effect was shown on [14C]inulin transport across the cell monolayer. The contribution of the local perfusion flow, on the other hand, was shown to be almost equivalent to that of the diffusion process in the total absorption of [3H]water.