[Pharmacokinetic study of sparfloxacin in patients receiving regular hemodialysis].

We investigated the in vivo kinetics of sparfloxacin (SPFX), an oral quinolone, in the hemodialytic patients. SPFX was orally administrated in a single dose of 200 mg to each of five hemodialytic patients, on a day that they were not receiving hemodialysis therapy. After dosing, the blood samples were collected periodically at 2, 4, 6, 8, 12, 24, 25, 27, 29, 48, 72 hours. Concentration of the unchanged SPFX in the plasma samples were measured by HPLC. The peak plasma levels of SPFX in the hemodialytic patients did not differ greatly from patients with renal failure (5 < Ccr<20 ml/min). Average T 1/2 beta of SPFX was 25.7 hours, and it was prolonged compared to the patients with renal failure (who were not receiving hemodialysis) and a group of young healthy volunteers. Based on these results, we believe those hemodialytic patients may be administrated with the drug once every other day, as long as normal doses are used.

Three-dimensional computed tomography image of small pulmonary lesions.

To evaluate diagnostic imaging of small lesions in the peripheral lung, three-dimensional (3D) reconstruction CT images were used to study 36 cases (including which had been 19 resected) of pulmonary nodules less than 3 cm in diameter. Rapid scanning was employed in 17 cases and helical scanning (in which the X-ray tube rotates continuously with simultaneous table sliding) in 19 cases. The rapid scanning could not be evaluated in two cases because respiratory motion resulted in discontinuous image data. We were able to evaluate 34 cases. The addition of 3D images to the conventional images made it possible for us to obtain useful information on visualizing relations between nodules and vascular structures in 32% (11/34) of the cases. The 3D images enabled us to visualize the lesions and pulmonary vessels three-dimensionally. It was, however, difficult to evaluate lesion shape since we were able to obtain useful information in only 3% (1/34) of the cases. In helical scanning, data are acquired from an extensive area within a short time, providing consecutive axial-slice images remain free of any respiratory artifacts. In this regard, helical scanning is suitable for generating 3D images. A diagnostic procedure based on 3D lesion analysis should be developed and standardized.

An electron microscopic study of glomeruli in Japanese patients with non-insulin dependent diabetes mellitus.

Renal biopsy specimens of 29 Japanese non-insulin dependent diabetes mellitus (NIDDM) patients were examined by quantitative electron microscopic morphometry. In NIDDM the relative increase of percent total mesangium and mesangial capillary surface density (S/Vb) and the relative decrease of peripheral capillary surface density (S/Va) were compared with disease controls. However, mesangial-GBM-epithelial surface density (S/Vc) was not different between both groups. These results suggest that the increased mesangial matrix expands directly towards the capillary lumen as well as along the inner surface of GBM, and narrows the capillary lumen and filtration surface. The duration of diabetes mellitus (DM) did not correlate with all morphological parameters. The mesangial expansion correlated with urinary protein excretion and decreased creatinine clearance (CCr). GBM thickening correlated with proteinuria, but not with CCr. The degree of these morphological changes could be the indicators of hypertension of NIDDM patients. Areas of thin GBM were occasionally noticed in glomeruli which revealed thick GBM extensively, although the mechanism of GBM thinning is not known at the present time.

[Surgical treatment of coarctation of the aorta and interrupted aortic arch].

From December, 1984, through April, 1987, ten infants with coarctation of the aorta and six with interrupted aortic arch underwent staged repair of aorta and other cardiac lesions. Simultaneous pulmonary artery banding was performed in six of 8 patients with ventricular septal defect (VSD) and in all of seven patients with complex cardiac lesions. With first operation, there were no operative deaths and two late deaths. Eight of 14 survivors underwent total correction of associated lesions at three to 17 months after initial operation. VSD was closed in five patients with one operative death. One patient required pulmonary artery debanding alone because of decrease of VSD size. The Damus-Kaye-Stansel operation was performed successfully in one patient with Taussig-Bing anomaly and the Jatene operation was done in one with transposition of the great arteries. Based on these results, we prefer staged repair with pulmonary artery banding for coarctation or interruption of the aorta associated with complex cardiac lesions.

[A case of multiple colorectal cancers repeatedly resected 5 times].

A case of successive metachronous colorectal cancers repeatedly resected 5 times during an 8-year period is reported. The 1st cancer was found in the sigmoid colon when the patient (male) was 32 years old. The 2nd was a mucosal carcinoma of the rectum which was locally excised. The 3rd was found in the ascending colon, and there was detected yet another small cancer in the adenoma in the resected specimen. The 4th and 5th cancers were found in the transverse colon and rectum, respectively. This case is considered to be highly associated with genetic factors. Long-term and careful surveillance is mandatory for early detection of recurrent or additional tumors.

Effects of pretreatment with coenzyme Q10 on myocardial preservation during aortic cross clamping.

A protective effect of coenzyme Q10 on the ischemic and reperfused myocardium was investigated in the isolated working rat heart preparation. Rats were treated intraperitoneally with 30 mg/kg coenzyme Q10, daily for 7 days. The controls were given the same dose of the vehicle. After 25 min of equilibration the hearts were made totally ischemic at 35.5 degrees C for 30 min, arrested with high potassium cardioplegic solution immediately after aortic cross clamping. The recovery of cardiac power in the coenzyme Q10 pretreated group was significantly (P less than 0.05) better than that in vehicle pretreated group. Creatine phosphokinase (CPK) release during reperfusion was significantly (P less than 0.05) reduced by the pretreatment of coenzyme Q10. Tissue analysis for high energy phosphate compounds revealed no significant difference between the two groups. Tissue lactate content at 30 min of ischemia was significantly (P less than 0.001) lower in the coenzyme Q10 pretreated group. These results suggest that pretreatment with coenzyme Q10 is effective for reducing ischemic injury caused by aortic cross clamping.