Fluoxetine and norfluoxetine concentrations in nursing infants and breast milk.

BACKGROUND: This study's goal was to characterize nursing infants' exposure to fluoxetine through breast milk and to identify variables for minimizing such exposure. METHODS: Nursing women on stable daily doses of fluoxetine were recruited into the study. Breast milk, maternal and infant serum concentrations of fluoxetine and norfluoxetine were determined with high-performance liquid chromatography. RESULTS: Nineteen nursing women one with a pair of dizygotic twins participated in the study. The women were on stable daily doses of fluoxetine (10-60 mg/day) and all but two took the medication during the last trimester of pregnancy. Fluoxetine was detectable in 30% (n = 6) of the nursing infant sera (< 1-84 ng/mL), whereas norfluoxetine was found in 85% (N = 17) (< 1-265 ng/mL). Peak breast milk concentrations occurred approximately 8 hours after maternal dosing and predicted norfluoxetine concentrations in infant serum. Maternal serum fluoxetine and norfluoxetine concentrations correlated highly with infant norfluoxetine concentrations. A daily maternal fluoxetine dosage of 20 mg or lower was significantly less likely to produce detectable concentrations of either fluoxetine or norfluoxetine in infants compared to higher daily dosages. No adverse effects were reported in any infant. CONCLUSIONS: Our findings demonstrate that maternal serum and peak breast milk concentrations of fluoxetine and norfluoxetine predict nursing infant serum norfluoxetine concentrations. In nursing women taking 20 mg/day or less of fluoxetine, infant serum concentrations were typically low.

Use of sertraline, paroxetine and fluvoxamine by nursing women.

BACKGROUND: The pharmacological treatment of depression in nursing women requires information on the magnitude of medication exposure to the infant that may occur through breast milk. AIMS: To examine serum concentrations of antidepressants in infants exposed to these medications through breast-feeding. METHOD: Maternal and infant serum concentrations of sertraline, paroxetine and fluvoxamine were determined with high-performance liquid chromatography (limit of detection=1 ng/ml). RESULTS: No detectable medication was present in any infant exposed to paroxetine (n=16) or fluvoxamine (n=4). Among infants exposed to sertraline (n=30), detectable medication was present in 24% of serum samples. A significant negative correlation was found between infant age and infant serum concentration. Sertraline was significantly more likely to be detected in an infant if the mother's daily dose was 100 mg or higher. No adverse sequelae occurred in any infant. CONCLUSIONS: This study shows that paroxetine, fluvoxamine and sertraline produce minimal exposure to infants when taken by nursing mothers.

[Anesthetic management of heart transplantation].

We anesthetized a 47-yr-old man with end-stage hypertrophic cardiomyopathy for heart transplantation. This is the first case of heart transplantation from a patient with brain death, since the organ transplantation law had become valid in Japan. Anesthesia was induced and maintained with fentanyl and diazepam. Aseptic technique was used in inserting and securing all catheters. The patient was assisted by left ventricular assist system, and hemodynamic suppression at anesthetic induction was trivial. Since complete AV block was present at the termination of cardiopulmonary bypass (CPB), VVI pacing and infusion of isoproterenol were started. In addition, nitroglycerin was given for pulmonary vasodilation. The cardiovascular support used for weaning from CPB included dobutamine, isoprote-renol, dopamine and milrinone. Following weaning from CPB sinus rhythm appeared spontaneously and function of the transplanted heart was satisfactory. When the patient was transported to ICU reduction in doses of catecholamines was possible, and dopamine and milrinone were infused. The patient was extubated 10 hours after admission to ICU.

Neuroblastoma IV-S. Cual es el mejor tratamiento? Experiencia en 12 casos / Neuroblastoma IV-S. Which is the best treatment?

El neuroblastoma IV-S tiene muy buen pronostico. Sin embargo puede haber una evolucion mortal debido al curso natural de la enfermedad o, mas frecuentemente, por complicaciones del tratamiento. Decidir cual es el tratamiento de eleccion es una tarea dificil. La cirugia del tumor primario es un punto controvertido

Neuroblastoma IV-S. Cual es el mejor tratamiento? Experiencia en 12 casos / Neuroblastoma IV-S. Which is the best treatment?

El neuroblastoma IV-S tiene muy buen pronostico. Sin embargo puede haber una evolucion mortal debido al curso natural de la enfermedad o, mas frecuentemente, por complicaciones del tratamiento. Decidir cual es el tratamiento de eleccion es una tarea dificil. La cirugia del tumor primario es un punto controvertido

Retrotransposon families in rice.

Three families of retrotransposons of rice (Tos1, Tos2, and Tos3) were isolated by using a method based on the sequence conservation of the primer binding site for reverse transcription. This method should be generally applicable for cloning retrotransposon of other plants. One retrotransposon, Tos3-1, was studied in detail. Tos3-1 is 5.2 kb long, has structures common to retrotransposons, such as long terminal repeats (LTR), a primer binding site complementary to the initiator tRNA, a polypurine tract, and generates target sequence duplications flanking the inserted element. Southern blotting analysis showed that sequences homologous to Tos1, 2 and 3 are found in wild rice species as well as in cultivated rice species, but not in maize and tobacco. The copy number and genomic location of the families vary in different strains of one species of wild rice, suggesting that these elements may still be active. Retrotransposons were also screened for by amplification of the reverse transcriptase coding region using the polymerase chain reaction (PCR). At least two types of copia-like elements (Tos4 and Tos5) were found. The total copy number of retrotransposons in the rice genome was estimated to be about 1000. These results suggest that, as in Drosophila, retrotransposons are the major transposon class in rice.

Phosphatase-inhibitory activity and activation of murine macrophages by new 5'-nucleotidase inhibitors, NPF-86IA, NPF-86IB, NPF-86IIA and NPF-86IIB.

New 5'-nucleotidase-inhibitory polyphenols named NPF-86IA, NPF-86IB, NPF-86IIA and NPF-86IIB were isolated from the seeds of Areca catechu L. The ability of the inhibitors to precipitate gelatin was investigated by microturbidimetry. These inhibitors produced weak turbidity. As 5'-nucleotidase is a kind of phosphatase, we examined the effects of these inhibitors on alkaline and acidic phosphatases. While they showed moderate inhibitory effects on the activity of acidic phosphatases, they did not have any significant effect on the activity of alkaline phosphatase. Therefore, they showed a higher inhibitory effect on the 5'-nucleotidase than the other phosphatases, Murine macrophages were directly stimulated by the 5'-nucleotidase inhibitors.

Effect of 5'-nucleotidase inhibitors on mouse immune system and experimental murine tumors.

Nucleoticidin and melanocidins A and B exhibited potent inhibitory activity against 5'-nucleotidases from rat liver membrane and snake venom. Nucleoticidin retarded growth of Sarcoma 180 solid tumor, and melanocidins A and B prolonged the survival period of mice bearing B16 melanoma. These inhibitors enhanced phagocytic activity, interleukin-1 production and superoxide-generating activity of murine peritoneal macrophages. The tumor necrosis factor was also induced by the inhibitors. These results suggested that 5'-nucleotidase inhibitors inhibit tumor growth by modification of the immune system.

Plasmid-determined cadmium resistance in Pseudomonas putida GAM-1 isolated from soil.

Cadmium-resistant Pseudomonas putida GAM-1, which was able to grow in concentrations of CdCl2 as high as 7 mM, was isolated from soil in a rice paddy. This bacterium harbored a DNA plasmid of about 52 kilobases. The plasmid (pGU100) transformed Escherichia coli C600 to cadmium resistance. A cadmium-resistant transformant of E. coli C600 contained a plasmid corresponding to that seen in P. putida GAM-1. The transformant did not take up cadmium as well as P. putida GAM-1 did.

5'-Nucleotidase inhibitory activity of nucleoticidin, melanocidin A and melanocidin B. Structure-activity relationships.

Nucleoticidin and melanocidins A and B exhibited potent inhibitory activity against 5'-nucleotidases from rat liver membrane and snake venom. These inhibitors are polysaccharides with highly branched side chains having at least disaccharide units. This conclusion was supported by the results with polysaccharides of known chemical structures. The inhibitors showed non-competitive inhibition with respect to AMP, and urea-treatment caused a marked decrease or a disappearance of the 5'-nucleotidase inhibitory activity. Therefore, it is concluded that steric factors also play an important role in their inhibitory activity.

A new 5'-nucleotidase inhibitor, nucleoticidin. II. Physico-chemical properties and structure elucidation.

A novel 5'-nucleotidase inhibitor, named nucleoticidin, was isolated from a fermentation broth of Pseudomonas sp. The molecular weight was estimated by gel filtration to be over 1,000,000. Nucleoticidin is composed of D-glucose and D-mannose at a molar ratio of 1.7 to 1.0. Combined analyses using chemical and physico-chemical methods, such as gas liquid chromatography and mass fragmentography, revealed that nucleoticidin has a structural unit with mannosyl residues at the terminal of a (1----4) linked D-glucosyl main chain with beta-configuration.