Mortality and causes of deaths of inhabitants with renal dysfunction induced by cadmium exposure of the polluted Jinzu River basin, Toyama, Japan; a 26-year follow-up.

BACKGROUND: We aimed to investigate the mortality and causes of deaths of inhabitants with renal dysfunction induced by cadmium (Cd) exposure caused by heavy environmental contamination. METHODS: We conducted a 26-year follow-up survey targeting 7529 inhabitants of the Cd-polluted Jinzu River basin and 2149 controls from non-polluted areas who participated in urinary examinations for proteinuria and glucosuria conducted in 1979 to 1984. When the residents were divided into 4 groups, no finding group, glucosuria group, proteinuria group, glucoproteinuria group, mortality risk ratios for all and specific causes of these groups in the polluted area were compared with that of controls without glucosuria and/or proteinuria after adjustments for age at baseline, smoking status, and history of hypertension using Cox's proportional hazard model. RESULTS: The mortality risk ratios for all causes of proteinuria and glucoproteinuria in men and glucosuria, proteinuria, and glucoproteinuria in women of the polluted areas significantly increased compared with those of the controls with no urinary findings. Respiratory, renal, and cardiovascular diseases and diabetes in men, and all diseases except cerebrovascular diseases in women contributed toward an increased mortality of exposed glucoproteinuria groups, which involved chronic Cd toxicosis with renal tubular dysfunction. In women, the mortality risks for cancer of the colon and rectum, uterus and kidney and urinary tract were significantly higher in the exposed proteinuria and glucoproteinuria groups, suggesting associations between renal damage and cancer risk. In exposed women, the no finding group and glucoproteinuria group also showed increased mortality from ischemic heart diseases, indicating that all exposed women may be at risk for ischemic heart diseases. Although the control glucosuria and/or proteinuria group also showed high mortality for diabetes and renal diseases, the increased risk ratio for renal disease mortality was much higher in exposed subjects with urinary findings, particularly in women. CONCLUSIONS: These findings indicate that inhabitants with renal effects caused by Cd exposure had a poor life prognosis over long-term observation in both genders. Particularly in women, renal tubular dysfunction indicated by glucoproteinuria may increase mortality from cancer, ischemic heart diseases, and renal diseases.

Evaluation of blood serum, erythrocyte and urine magnesium concentrations in babies with pneumonia or bronchial obstructive bronchitis.

Physiological properties of magnesium (Mg) as a catalyst of enzymatic processes mainly are known quite well. Still unclear, however, are the changes in its concentrations in the body that occur in the course of many diseases, among others in babies with bronchial obstructive bronchitis and pneumonia. Therefore research was undertaken to determine the concentrations of magnesium in blood serum, erythrocytes and urine in babies suffering from pneumonia (54 babies) and bronchial obstructive bronchitis (46 babies). The results found that magnesium concentrations in the blood serum, erythrocytes and urine differ significantly in the groups of sick and healthy babies. Compared to the control group significantly lowest Mg concentrations in the blood serum, erythrocytes and highest in the urine were found both before and after the treatment in the babies suffering from bronchial obstructive bronchitis.

[Clinical evaluation of urinary leukotriene e4 levels in children with respiratory syncytial virus infection].

The levels of leukotriene E4 (LTE4) of the urine were determined in 24 pediatric patients with infectious diseases due to respiratory syncytial virus (RSV), i.e., bronchitis, pneumonia, and bronchiolitis, and compared with those in controls without allergic disease. The level for LTE4 of the acute-phase urine was 620+/-562 pg/mg. cr in the pediatric patients infected with RSV, being significantly higher than 190+/-67 pg/mg. cr in controls (P<0.005). The levels for LTE4 of the urine in the recovery phase showed a tendency toward decrease, as compared to those in the acute phase. However, there was no significant difference in the level for LTE4 of the acute-phase urine between the presence and the absence of each of the following conditions: expiratory wheezing; the association of pneumonia; family history of allergic diseases; the association of atopic dermatitis; and a past history of expiratory wheezing. An allergological study also revealed that there was no significant difference in LTE4 level between the presence and the absence of peripheral eosinophilia or between the presence and the absence of the high total level for IgE of the serum or positivity for the specific IgE level in the serum. These results suggest that LT is involved with the pathological conditions of RSV infection, but there are no direct relation between atopic diathesis or expiratory wheezing and the amounts of LT production.

Clinical pharmacokinetics of meropenem after the first and tenth intramuscular administration.

We investigated the pharmacokinetics of meropenem after the first and tenth i.m. administration in patients with respiratory tract infections. Ten patients (mean age 63.8 +/- 5.2 years) received meropenem 500 mg tds for at least ten doses, and plasma and urine antibiotic concentrations were determined by microbiological assay. After the first injection a mean peak plasma concentration of 7.93 +/- 1.29 mg/L was observed at 1 h. Trough levels at 8 h (0.29 +/- 0.16 mg/L) were detectable in five of ten treated patients. The mean terminal half-life was 1.08 +/- 0.2 h with an area under the curve (AUC) value of 23.8 +/- 4.59 mg/L.h, and a cumulative urinary recovery at 8 h of 48.43 +/- 3.12%. There was no evidence of change in the pharmacokinetics of meropenem after repeated i.m. administration, though the mean peak plasma concentration and AUC value were slightly increased. The accumulation ratio (assessed using AUC values) was 1.18 +/- 0.19 after multiple doses and was considered to be of little kinetic and clinical importance. Moreover, many of the trough concentrations of meropenem were below the limit of detection of the assay. After i.m. administration meropenem concentrations exceeded 0.5 mg/L for longer than previously described following i.v. infusion. No adverse events were reported.

Parental smoking, urinary cotinine, and wheezing bronchitis in children.

We conducted a case-control study to assess the role of exposure to environmental tobacco smoke (ETS) in the development of wheezing bronchitis in children. The study included 199 children age 4 months to 4 years, who were treated in hospital for wheezing bronchitis, and 351 population controls of the same age group. We estimated exposure to ETS from urinary cotinine measurements as well as from questionnaires to parents. The median urinary cotinine concentration was 5.7 micrograms per liter in cases and 4.4 micrograms per liter in controls. Breast-feeding was related to urinary cotinine excretion in children with smoking mothers. The risk of wheezing bronchitis increased in relation to parental smoking and urinary cotinine concentration. This effect was most prominent in children up to 18 months of age, among whom the relative risk was 3.3 in those with a urinary cotinine level exceeding 20 micrograms per liter (95% confidence interval = 1.5-7.6). Our data confirm that ETS is an important risk factor for wheezing bronchitis in children and indicate that a single urinary cotinine measurement offers no major advantages to questionnaire data for assessment of long-term exposure to ETS.

[Amelioration of aminoglycoside nephrotoxicity by Cordyceps sinensis in old patients].

The protective effect on aminoglycoside nephrotoxicity by Cordyceps sinensis in the old patient was observed. 21 old patients were randomly divided into two groups. Each group received amikacin sulfate for 6 days. In addition, group A was administered Cordyceps sinensis for 7 days and group B was given placebo. The results revealed that group A developed less prominent nephrotoxicity compared with group B as evidenced by less urinary nephro-aminoglycosidase (NAGase) and beta-microglobulin in group A than those in Group B. These results suggested that Cordyceps sinensis exerted a protective effect on aminoglycoside nephrotoxicity in the old patients.

[Plasminogen activators in assessing the reaction of patients with chronic obstructive bronchitis to physical loading]. / Aktivatory plazminogena v otsenke reaktsii bol'nykh khronicheskim obstruktivnym bronkhitom na fizicheskuiu nagruzku.

Patients with chronic obstructive bronchitis showed an increased activity of the blood plasminogen activator in a group of patients under 40 years of age and absence of the dynamics of this index an older age group. The urokinase urinary activity did not change in the two groups. The blood activator activity increased in healthy young non-trained and trained young persons under the effect of loads. The urinary urokinase activity reduced only in trained persons.

[Excretion of hydroxyproline in the urine of workers engaged in the production of iron-manganese alloys]. / Wydalanie hydroksyproliny w moczu pracowników zatrudnionych przy wytwarzaniu stopów zelazomanganu.

Statistically significant increase of the excretion of hydroxyproline with urine has been found to occur in workers employed in iron-manganese alloy manufacture, compared with the excretion of hydroxyproline in urine of the control group. Besides, the workers employed for 10 years and longer were characterized by statistically significantly increased excretion of hydroxyproline with urine as compared to the workers employed for shorter periods. No significant differences in excretion of hydroxyproline with urine, however, were detected among workers with chronic bronchitis and among those with smoking factor less than or equal to 10 and smoking factor greater than 10. (Smoking factor = number of packages of cigarettes smoked per day times years of smoking).

Excretion of urinary collagen metabolites correlates to severity of pulmonary disease in cystic fibrosis.

The urinary excretion of collagen metabolites (hydroxylysine, hydroxyproline and proline) was significantly increased in 10 patients with cystic fibrosis and chronic broncho-pulmonary Pseudomonas aeruginosa infection as compared with 14 age matched controls. The increase was significantly correlated to impaired pulmonary function (FVC and FEV1). The results indicate that urinary collagen metabolites reflect degradation of lung connective tissue and may be an indicator of the severity of pulmonary disease in cystic fibrosis. Parts of the excreted hydroxyproline may be degradation products of elastin.

An investigation of renal function in chronic bronchitis.

An investigation has been made into various parameters of renal function in patients with chronic bronchitis and in a group of hypoxic controls. Abnormalities of glomerular filtration rate and of water handling have been demostrated in chronic bronchitic patients but not in hypoxic controls. The abnormalities are related to the arterial Pco2. A hypothesis is presented as to the role of CO2 in causing abnormalities of renal function in chronic bronchitis.