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Ligand effects on the structures and redox reactivities of copper complexes have been examined using (2-pyridyl)alkylamine derivatives as the supporting ligands, where particular attention has been focused on the effects of the alkyl linker chain length connecting the tertiary amine nitrogen atom and the pyridine nucleus: N[bond]CH(2)[bond]Py (Pym) vs N[bond]CH(2)CH(2)[bond]Py (Pye). X-ray crystallographic analysis of the copper(I) complex of tridentate ligand (Phe)L(Pym2) [N,N-di(2-pyridylmethyl)-2-phenylethylamine] (complex 1) has demonstrated that it possesses a trigonal pyramidal geometry in which a d[bond]pi interaction with an eta(1)-binding mode exists between the metal ion and one of the ortho carbons of the phenyl ring of the ligand side arm (phenethyl). The result shows sharp contrast to the d[bond]pi interaction with an eta(2)-binding mode existing in the copper(I) complex of (Phe)L(Pye2) [N,N-di[2-(2-pyridyl)ethyl]-2-phenethylamine] (complex 2). Such a d-pi interaction has been shown to affect the stability of the copper(I) complex in CH(2)Cl(2). Oxygenation of copper(I) complex 1 supported by (Phe)L(Pym2) produces a bis(mu-oxo)dicopper(III) complex, also being in sharp contrast to the case of the copper(I) complex 2 with ligand (Phe)L(Pye2), which preferentially affords a (micro-eta(2):eta(2)-peroxo)dicopper(II) complex in the reaction with O(2). Such an effect of the alkyl linker chain length of the metal binding site has also been found to operate in the RSSR (disulfide)/2RS(-) (thiolate) redox system. Namely, ligand (S2,R)L(Pym1) (di[2-[(alkyl)(2-pyridinylmethyl)amino]ethyl] disulfide) with the methylene linker group (Pym) induced the reductive disulfide bond cleavage in the reaction with copper(I) ion to give a bis(micro-thiolato)dicopper(II) complex, while the ligand with the ethylene linker group (Pye), (S2,Bn)L(Pye1) (di[2-[(benzyl)(2-(2-pyridinyl)ethyl)amino]ethyl] disulfide), gave a disulfide-dicopper(I) complex. These ligand effects in the Cu(2)[bond]O(2) and Cu(2)[bond]S(2) systems have been discussed by taking into account the difference in electron-donor ability of the pyridine nucleus between the Pym and Pye ligand systems.

Chronic periodontitis (CP) is caused by enhanced resorption of the alveolar bone supporting the teeth and is associated with intraoral inflammation after infection with certain bacteria. The VDR gene polymorphism was reported recently to be deeply related to the occurrence of tuberculosis and infection of chronic hepatitis B virus. This may be interpreted to indicate a close relationship between VDR gene polymorphism and the immunological action, because vitamin D activates monocytes, stimulates cell-mediated immunity, and suppresses lymphocyte proliferation. The purpose of the present study was to clarify whether polymorphisms in VDR gene exons are associated with the incidence of CP. A case-controlled study was performed on a group of 168 unrelated Japanese subjects whose ages ranged from 35 to 65 years. The Taq I polymorphism in the VDR gene was found to be associated significantly with CP (X2=4.48, P=0.034). We performed multiple logistic regression analyses on the TT genotype, which was found to be associated with CP, and on well-recognized risk factors, smoking and diabetes. The odds ratio (OR) for the genotype (TT/Tt) was 2.73 (95% CI 1.11-6.68, P=0.028), being larger than the unadjusted value. This indicates that the VDR gene polymorphism (TT genotype) is a risk factor for CP, independently of smoking and diabetes.

We designed and synthesized N(3)-substituted 5-fluorodeoxyuridines as radiation-activated prodrugs of the antitumor agent, 5-fluorodeoxyuridine (5-FdUrd). A series of 5-FdUrd derivatives possessing a 2-oxoalkyl group at the N(3)-position released 5-FdUrd in good yield via one-electron reduction initiated by hypoxic irradiation. Cytotoxicity of the 5-FdUrd derivative possessing the 2-oxocyclopentyl group (3d) was low, but was enhanced by hypoxic irradiation resulting in 5-FdUrd release.

The first systematic studies on the oxidation of neutral phenols (ArOH) by the mu-eta(2):eta(2)-peroxo)dicopper(II) complex (A) and the bis(mu-oxo)dicopper(III) complex (B) supported by the 2-(2-pyridyl)ethylamine tridentate and didentate ligands L(Py2) and L(Py1), respectively, have been carried out in order to get insight into the phenolic O-H bond activation mechanism by metal-oxo species. In both cases (A and B), the C-C coupling dimer was obtained as a solely isolable product in approximately 50% yield base on the dicopper-dioxygen (Cu(2)/O(2)) complexes, suggesting that both A and B act as electron-transfer oxidants for the phenol oxidation. The rate-dependence in the oxidation of phenols by the Cu(2)/O(2) complexes on the one-electron oxidation potentials of the phenol substrates as well as the kinetic deuterium isotope effects obtained using ArOD have indicated that the reaction involves a proton-coupled electron transfer (PCET) mechanism. The reactivity of phenols for net hydrogen atom transfer reactions to cumylperoxyl radical (C) has also been investigated to demonstrate that the rate-dependence of the reaction on the one-electron oxidation potentials of the phenols is significantly smaller than that of the reaction with the Cu(2)O(2) complexes, indicative of the direct hydrogen atom transfer mechanism (HAT). Thus, the results unambiguously confirmed that the oxidation of phenols by the Cu(2)O(2) complex proceeds via the PCET mechanism rather than the HAT mechanism involved in the cumylperoxyl radical system. The reactivity difference between A and B has also been discussed by taking account of the existed fast equilibrium between A and B.

Dental implant surgery commonly proceeds in two stages. It is generally accepted that bone loss around implants does not occur at stage-II surgery because implants do not receive mechanical loading. However, early marginal bone loss around implants occasionally does occur during the healing period. Genetic polymorphisms in the interleukin-1 (IL-1) gene have been reported to be important for bone homeostasis and susceptibility to bone disease. We therefore investigated whether the idiopathic early marginal bone loss around implants is related to polymorphisms in the IL-1 gene. We performed a case-control study. Patients demonstrating marginal bone loss around implants at stage-II surgery were designated as the 'marginal bone loss (+)' group and those without bone loss as the 'marginal bone loss (-)' group. Polymorphisms of the IL-1alpha and IL-1beta genes (IL-1A-889, IL-1B-511 and IL-1B+3954) were detected by restriction fragment length polymorphism using NcoI, AvaI and TaqI after polymerase chain reactions. A total of 251 implants were placed in 39 patients. Marginal bone loss was observed in 36 implants. The patients with IL-1B-511 2/2 genotype exhibited a significantly higher occurrence of marginal bone loss than those with IL-1B-511 1/1 or 1/2 genotypes (OR=5.63; 95% CI=1.20-26.42; P=0.033). Multiple logistic regression analyses showed a markedly increased odds ratio (OR=10.86; 95% CI=1.64-71.90) in IL-1B-511 2/2 genotype carriers, while ORs of the other risk factors for bone loss, such as age, smoking status, post-menopausal women and bone quality, remained between 0.44 and 6.20. There was no significant difference in the distributions of the IL-1B+3954 and IL-1 A-889 genotypes between cases and controls. These data suggest that the IL-1B-511 2/2 genotype has a significant association with the incidence of early marginal bone loss around endosseous implants.

Purpose: At stage II surgery during dental implant treatment, early marginal bone loss around the implant occasionally occurs despite a lack of apparent causal events, and the etiology of this bone loss is unclear. This study was designed to investigate whether the bone morphogenetic protein-4 (BMP-4) genetic polymorphism is associated with early marginal bone loss around implants., Materials and Methods: The BMP-4 polymorphism was detected by restriction fragment length analysis using HphI digestion after polymerase chain reaction. A total of 262 implants were placed in 41 patients, and early marginal bone loss was observed in 25 of the 109 maxillary implants and 14 of the 153 mandibular implants., Results: In the mandible, the patients with the BMP-4 AV genotype had a significantly higher rate of occurrence of marginal bone loss than those with the BMP-4 W genotype (P = .012). According to multiple logistic regression analyses, the odds ratio of the AV versus the W BMP-4 genotype was 8.106 between patients with and those without bone loss in the mandible (95% CI = 1.30 to 50.51; P = .025)., Discussion: These results suggest that the BMP-4 genetic polymorphism influences early marginal bone loss around implants., Conclusion: While perhaps premature in recommendation, genetic screening before implant surgery may prove to be a very useful aid to consider the risk of implant treatment.

Structures of Cu(I) and Cu(II) complexes of sterically hindered tripyridine ligands RL = tris(6-methyl-2-pyridyl)methane (HL), 1,1,1-tris(6-methyl-2-pyridyl)ethane (MeL), and 1,1,1-tris(6-methyl-2-pyridyl)propane (EtL), [Cu(RL)(MeCN)]PF(6) (1-3), [Cu(RL)(SO(4))] (4-6), and [Cu(RL)(NO(3))(2)] (7-9), have been explored in the solid state and in solution to gain some insights into modulation of the copper coordination structures by bridgehead alkyl groups (CH, CMe, and CEt). The crystal structures of 1-9 show that RL binds a copper ion in a tridentate facial-capping mode, except for 3, where EtL chelates in a bidentate mode with two pyridyl nitrogen atoms. To avoid the steric repulsion between the bridgehead alkyl group and the 3-H(py) atoms, the pyridine rings in Cu(I) and Cu(II) complexes of MeL and EtL shift toward the Cu side as compared to those in Cu(I) and Cu(II) complexes of HL, leading to the significant differences in the nonbonding interatomic distances, H.H (between the 3-H(py) atoms), N.N (between the N(py) atoms), and C.C (between the 6-Me carbon atoms), the Cu-N(py), Cu-N(MeCN), and Cu-O bond distances, and the tilt of the pyridine rings. The copper coordination geometries in 4-6, where a SO(4) ligand chelates in a bidentate mode, are varied from a square pyramid of 4 to distorted trigonal bipyramids of 5 and 6. Such structural differences are not observed for 7-9, where two NO(3) ligands coordinate in a monodentate mode. The structures of 1-9 in solution are investigated by means of the electronic, (1)H NMR, and ESR spectroscopy. The (1)H NMR spectra show that the structures of 1-3 in the solid state are kept in solution with rapid coordination exchange of the pyridine rings. The electronic and the ESR spectra reveal the structural changes of 5 and 6 in solution. The bridgehead alkyl groups and 6-Me groups in the sterically hindered tripyridine ligand play important roles in modulating the copper coordination structures.

Fourteen pediatric patients diagnosed as bacterial meningitis between August 1997 and April 2002 were enrolled in this study. Both rapid antigen detection test, Slidex Meningite 5 Kit (Biomerieux) and culture were performed using cerebrospinal fluids (CSF). H. influenzae was isolated from 11 samples and was the most frequently isolated bacteria, followed by S. pneumoniae from 4 samples and enteric bacteriae from 2 samples. Five out of six samples with positive result by culture were also positive by the rapid antigen test. Gram-negative rod was identified in smear specimens of CSF from all these 5 samples. Significance of the rapid antigen test should be recognized under drug resistance of those bacteriae are increasing.

A series of Cu(I) and Cu(II) complexes of a variety of beta-diketiminate ligands (L(-)) with a range of substitution patterns were prepared and characterized by spectroscopic, electrochemical, and, in several cases, X-ray crystallographic methods. Specifically, complexes of the general formula [LCuCl](2) were structurally characterized and their magnetic properties assessed through EPR spectroscopy of solutions and, in one instance, by variable-temperature SQUID magnetization measurements on a powder sample. UV-vis spectra indicated reversible dissociation to 3-coordinate monomers LCuCl in solution at temperatures above -55 degrees C. The Cu(I) complexes LCu(MeCN) exhibited reversible Cu(I)/Cu(II) redox couples with E(1/2) values between +300 and +520 mV versus NHE (cyclic voltammetry, MeCN solutions). These complexes were highly reactive with O(2), yielding intermediates that were identified as rare examples of neutral bis(mu-oxo)dicopper complexes on the basis of their EPR silence, diagnostic UV-vis absorption data, and O-isotope-sensitive resonance Raman spectroscopic features. The structural features of the compounds [LCuCl](2) and LCu(MeCN) as well as the proclivity to form bis(mu-oxo)dicopper products upon oxygenation of the Cu(I) complexes are compared to data previously reported for complexes of more sterically hindered beta-diketiminate ligands (Aboelella, N. W.; Lewis, E. A.; Reynolds, A. M.; Brennessel, W. W.; Cramer, C. J.; Tolman, W. B. J. Am. Chem. Soc. 2002, 124, 10600. Spencer, D. J. E.; Aboelella, N. W.; Reynolds, A. M.; Holland, P. L.; Tolman, W. B. J. Am. Chem. Soc. 2002, 124, 2108. Holland, P. L.; Tolman, W. B. J. Am. Chem. Soc. 1999, 121, 7270). The observed structural and reactivity differences are rationalized by considering the steric influences of both the substituents on the flanking aromatic rings and those present on the beta-diketiminate backbone.

A 40-year-old man was admitted to our hospital for further evaluation of a pulmonary nodule in chest radiographs. The 8-mm nodular lesion was located in the right anterior basal lobe on a plain chest radiograph, and showed 1) spiculation, 2) pleural indentation and 3) a converging vessel formation in high-resolution computed tomography of the chest. The radiographic findings were highly suggestive of primary pulmonary adenocarcinoma and the patient underwent video-assisted thoracoscopic surgery (VATS) to obtain a precise diagnosis. The nodule was diagnosed histopathologically as an intrapulmonary lymph node. In cases with such radiographic findings, careful attention should be paid in the differential diagnosis to distinguish intrapulmonary lymph nodes from primary pulmonary adenocarcinoma.

An unprecedented clean interconversion between a novel bis(mu-thiolato)dicopper(II) complex (1) and a disulfide-bridged dicopper(I) complex (3) through a disulfide-bridged (mu-chloro)dicopper(I) complex (2) mediated by chloride ion has been established for the first time, providing a new redox chemistry of the transition metal-sulfur complexes. Crystal structures of 1 and 3 as well as spectroscopic features of the compounds are reported.

Copper(I)-dioxygen reactivity has been examined using a series of 2-(2-pyridyl)ethylamine bidentate ligands (R1)Py1(R2,R3). The bidentate ligand with the methyl substituent on the pyridine nucleus (Me)Py1(Et,Bz) (N-benzyl-N-ethyl-2-(6-methylpyridin-2-yl)ethylamine) predominantly provided a (mu-eta(2):eta(2)-peroxo)dicopper(II) complex, while the bidentate ligand without the 6-methyl group (H)Py1(Et,Bz) (N-benzyl-N-ethyl-2-(2-pyridyl)ethylamine) afforded a bis(mu-oxo)dicopper(III) complex under the same experimental conditions. Both Cu(2)O(2) complexes gradually decompose, leading to oxidative N-dealkylation reaction of the benzyl group. Detailed kinetic analysis has revealed that the bis(mu-oxo)dicopper(III) complex is the common reactive intermediate in both cases and that O[bond]O bond homolysis of the peroxo complex is the rate-determining step in the former case with (Me)Py1(Et,Bz). On the other hand, the copper(I) complex supported by the bidentate ligand with the smallest N-alkyl group ((H)Py1(Me,Me), N,N-dimethyl-2-(2-pyridyl)ethylamine) reacts with molecular oxygen in a 3:1 ratio in acetone at a low temperature to give a mixed-valence trinuclear copper(II, II, III) complex with two mu(3)-oxo bridges, the UV-vis spectrum of which is very close to that of an active oxygen intermediate of lacase. Detailed spectroscopic analysis on the oxygenation reaction at different concentrations has indicated that a bis(mu-oxo)dicopper(III) complex is the precursor for the formation of trinuclear copper complex. In the reaction with 2,4-di-tert-butylphenol (DBP), the trinuclear copper(II, II, III) complex acts as a two-electron oxidant to produce an equimolar amount of the C[bond]C coupling dimer of DBP (3,5,3',5'-tetra-tert-butyl-biphenyl-2,2'-diol) and a bis(mu-hydroxo)dicopper(II) complex. Kinetic analysis has shown that the reaction consists of two distinct steps, where the first step involves a binding of DBP to the trinuclear complex to give a certain intermediate that further reacts with the second molecule of DBP to give another intermediate, from which the final products are released. Steric and/or electronic effects of the 6-methyl group and the N-alkyl substituents of the bidentate ligands on the copper(I)-dioxygen reactivity have been discussed.

Purpose: This study investigated the relationship between calcitonin receptor (CTR) genotype and buccal marginal bone loss observed at stage II surgery for endosseous implants., Materials and Methods: A total of 237 implants were placed in 35 patients; 89 implants were placed in maxillae and 148 implants in mandibles. The CTR genetic polymorphism was examined by the polymerase chain reaction restriction fragment length polymorphism method., Results: Patients with the TC genotype were 20 times more likely to suffer buccal marginal bone loss in the mandible than patients with the CC genotype. Furthermore, there were no significant differences in the distribution of age, smoking status, postmenopausal women, and bone quality between patients with and without bone loss in either jaw., Discussion: These results suggest that the known risk factor for bone loss cannot explain the early marginal bone loss around the implants., Conclusion: Although further genetic research should be conducted, it is suggested that the CTR genetic test could become a useful tool in the planning of treatment before implant surgery and lead to more predictable implant treatment.

Structure and physicochemical properties of copper(I) complexes of the tridentate ligands L(2) (N,N-bis[2-(6-methylpyridin-2-yl)ethyl]phenethylamine) and L(3) (N,N-bis[2-(2-pyridyl)ethyl]-beta-methylphenethylamine) have been examined to obtain deeper insights into modulation of the coordination chemistry of copper(I) complexes. [Cu(I)(L(2))(CH(3)CN)](ClO(4)) (2.CH(3)CN) has a distorted tetrahedral geometry, which consists of three nitrogen atoms of the ligand and one nitrogen atom of the bound CH(3)CN. Steric repulsion between the 6-methyl group on the pyridine nucleus of L(2) and the metal ion of the complex prevents the cuprous complex from adaptation to a three-coordinate geometry which must have a shorter Cu-N(pyridine) distance ( approximately 1.88 A). Thus, the four-coordinate copper(I) complex (2.CH(3)CN) with a longer Cu-N bond (1.98 approximately 2.13 A) becomes favorable, resulting in rather strong binding of CH(3)CN to the metal ion. In [Cu(I)(L(3))](ClO(4)) (3), there is a Cu(I)-pi interaction between the cuprous ion and the phenyl group of the ligand sidearm. Such a copper(I)-arene interaction is essentially weak, but is significantly stabilized in complex 3. The methyl group at the benzylic position of L(3)() reduces the degree of freedom of sidearm rotation to make the phenyl group stick on the cuprous ion. Thus, the reactivity of the copper(I) complexes of L(2) and L(3) toward dioxygen is significantly diminished, showing sharp contrast to the high reactivity of the copper(I) complex supported by a similar tridentate ligand L(1) (N,N-bis[2-(2-pyridiyl)ethyl]phenethylamine).

We examined whether polymorphisms in the vitamin D receptor (VDR) gene are associated with the incidence of adult periodontitis (AP) and early-onset periodontitis (EOP) in case-controlled studies of Japanese and Chinese subjects. Restriction fragment length polymorphisms in the VDR gene detected by digestion with Taq I were found to be significantly associated with the occurrence of AP or EOP, suggesting that the VDR genotype a risk factor for periodontitis.

Vitamin E reacts with radicals such as lipid peroxyl radical (LOO*) and singlet oxygen ((1)O2), and plays a role in inhibiting lipid peroxidation in cell membranes and preventing the oxidation of low-density lipoproteins (LDL). However, only a few studies have investigated the effect of vitamin E on the degradation of hydrogen peroxide (H2O2). Therefore, we examined the effect of vitamin E on glutathione redox cycle-dependent H2O2 degradation activity in human umbilical vein endothelial cells (HUVEC). Confluent HUVEC were cultured for seven days in media containing various concentrations of vitamin E (alpha-tocopherol). The level of glutathione redox cycle-dependent H2O2 degradation activity and the intracellular glutathione level were determined. HUVEC that had been cultured in the presence of higher concentrations of vitamin E had a higher level of H2O2 degradation activity and a higher intracellular content of the reduced form of glutathione (GSH). Therefore, it is suggested that the vitamin E-induced increase in H2O2 degradation activity in HUVEC results from an increase in intracellular GSH level.

Two sterically hindered tris-pyridyl methane ligands, tris(6-methyl-2-pyridyl)methane (L1) and bis(6-methyl-2-pyridyl)pyridylmethane (L2), are newly synthesized. Under aerobic conditions, Ln (n = 1 or 2) reacts with CuX2 (X = Cl or Br), oxygenated at the methine position to LnOH or LnOMe. The former alcoholate ligand creates trinuclear Cu(II) complexes [Cu3(X)(LnO)3](PF6)2 [(X, n) = (Br, 1) 1, (C1, 1) 2, (Br, 2) 3, or (C1, 2) 4] in which the alkoxide oxygen atoms bridge copper centers. The crystal structures of 1-4 are presented along with their magnetic susceptibility data. The weak antiferromagnetic coupling between the Cu(II) centers in this trinuclear arrangement is due to weak interaction of the magnetic orbitals (dz2) which are oriented along three alternate sides in a hexagon of the Cu3O3 core in 1-4. Under anaerobic conditions, L1 reacts with CuBr2 to form a square pyramidal complex [CuL1Br2] (9) with the ligand facially capping. [Cu(Br)2(L1OMe)] (10) was obtained after the suspension of 9 in MeOH was stirred under air for 48 h. In the presence of cyclohexene, 9 is converted to [Cu(Br)(L1)]m (m = 1 or 2) 5 quantitatively to give trans- 1,2-dibromocyclohexane, indicating that Br2 is generated during the reaction. The FAB MS spectrum of [18O]-1 prepared by the reaction of L1 with CuBr2 under 18O2 shows that the ligand of [18O]-1 is L1(18O-.) L1(18OH), L1OCD3, and bis(6-methyl-2-pyridyl) ketone were obtained from reaction of L1 with CuBr2 in CD3OD under 18O2. These results indicate that the origins of the O atom in L1OH and L1OMe are O2 and MeOH, respectively. On the basis of these results, a mechanism of the oxygenation of L1 in the present system will be proposed.

To elucidate the biological functions of poly(ADP-ribose) polymerase (PARP, [EC 2.4.2.30]) in DNA damage responses, genetic and biochemical approaches were undertaken. By disrupting exon 1 of the mouse PARP gene by a homologous recombination, PARP-deficient mouse embryonic stem (ES) cell lines and mice could be produced without demonstrating lethality. PARP-/- ES cells showed complete loss of PARP activity and increased sensitivity to gamma-irradiation and an alkylating agents, indicating a physiological role for PARP in the response to DNA damage. p53, a key molecule in cellular DNA damage response, was found to stimulate PARP activity and became poly(ADP-ribosyl)ated in the presence of damaged DNA. However, PARP-/- ES cells showed p21 and Mdm-2 mRNA induction following gamma-irradiation, indicating that PARP activity is not indispensable for p21 and Mdm-2 mRNA induction in the established p53-cascade. On the other hand, in a reconstituted reaction system, purified PARP from human placenta suppressed the pRB-phosphorylation activity in the presence of NAD and damaged DNA. Human PARP expressed in E. coli showed a similar effect on pRB-phosphorylation activity of cdk2. These findings suggest a direct involvement of PARP in the regulation of cdk activity for cell-cycle arrest.

We demonstrated that high glucose reduced H2O2 scavenge activity in human vascular smooth muscle cells. In the cells exposed to high glucose, the intracellular glutathione content decreased, although the NADPH content was unchanged. The rate of uptake of cystine, which is a rate-limiting precursor of the glutathione synthesis, decreased in the high glucose group compared with the control group. These decreases were shown to be dependent on glucose concentration. It was suggested that high glucose causes impairment of the function of the glutathione redox cycle in human vascular smooth muscle cells, resulting in reduced H2O2 scavenge activity.

Serum paraoxonase/arylesterase (PONA) is associated with high-density lipoprotein and may prevent oxidation of low-density lipoprotein by hydrolyzing lipid peroxides. A recent report suggested an association of glutamine (A type)/arginine (B type) polymorphism at position 192 of PONA gene with coronary heart disease (CHD) among Caucasian patients with noninsulin-dependent diabetes mellitus (NIDDM). However, conflicting results have also been reported. To investigate the significance of this polymorphism in the pathogenesis of CHD, we performed an association study of this polymorphism with CHD in Japanese NIDDM patients. We genotyped 164 patients with NIDDM, 42 with CHD, and 122 without CHD. Other known risk factors for CHD were matched between the 2 groups. AB+BB isoforms were detected in 41 of 42 diabetic patients with CHD. The proportion of B allele carriers (AB+BB) was significantly higher than that of AA carriers among diabetic patients with CHD compared with those without CHD (chi 2 = 7.68, P = 0.003). Multivariate logistic regression analyses showed a markedly increased odds ratio (OR: 8.823, CI, 1.13-68.7) in B allele carriers, while ORs of other risk factors remained between 1.01 and 1.92. Carriers of the B allele of the Gln192Arg polymorphism in the PONA gene proved to be at increased risk for developing CHD in Japanese NIDDM patients. This association was independent of other known risk factors for CHD, suggesting an important role of the paraoxonase B isoform in the pathogenesis of CHD.

The effects of elevated glucose and aldose reductase inhibitor (ARI:ONO-2235) on nitric oxide (NO) production in cultured human umbilical endothelial cells (HUVEC) were evaluated. Aldose reductase and nitric oxide synthase(NOS) share NADPH as an obligate cofactor, therefore it is suggested that the enhanced of glucose flux (27.5 mM) by aldose reductase inhibited NO production by blunting NOS activity. However, the addition of ONO-2235 (100 microM) prevented the inhibition of [NO2-] production. Since ARI decreases glucose-mediated inhibition of NO production in HUVEC. this agent might ameliorate endothelial function associated with diabetes.

We investigated whether a G123-->A mutation causing a Gly40-->Ser substitution in exon 2 of the human glucagon receptor gene, which has been reported to be associated with non-insulin-dependent diabetes mellitus (NIDDM) and impaired glucose tolerance (IGT) in France and Sardinia with a prevalences as high as 4.6% and 8.3%, respectively, is associated with Japanese patients with glucose intolerance. This mutation was not found in 242 unrelated Japanese patients with NIDDM or 23 with IGT by screening by the polymerase chain reaction-restriction fragment length polymorphism method. We also performed single-stranded conformational polymorphism analysis to search for new mutations in this gene associated with glucose intolerance. We found no mutations by examining all the 13 exons from 30 selected patients with NIDDM who had at least 2 diabetic first-degree relatives. These patients were also screened for the common polymorphism at codon 155 reported previously, but none were found to carry it. The absence of the mutation and polymorphism, which are common in French and Sardinian NIDDM or IGT patients, in Japanese indicates the existence of marked ethnic differences.

The mechanisms responsible for the abnormalities in the vascular wall associated with long standing diabetes mellitus are incompletely understood. The aim of this investigation was to assess the effects of angiotensin II and high glucose on the production of platelet-derived growth factor (PDGF) in human endothelial cells. For this purpose, a primary culture was obtained from fresh human umbilical cords by collagenase digestion of the vein interior. A high glucose medium increased the production of PDGF and a similar effect was observed by the addition of mannitol. These data are consistent with a stimulatory effect of glucose on PDGF that is mediated by the osmotic effect of this substance. Angiotensin II significantly increased PDGF in human endothelial cells and the effect was accompanied by a transient increase in cytosolic calcium. The angiotensin II-induced intracellular Ca2+ increases, PDGF production were completely abolished by saralasin and neomycin, respectively. We postulate that the increased production of PDGF by the vascular endothelium in response to high glucose and angiotensin II may participate in the development of the diabetic angiopathy.

A 64-year-old male presented with a large decubitus ulcer of the sacrum which had not healed for thirteen years in spite of various conservative treatments. His primary disease was paraplegia following spondylitis. Although he was not ambulatory, he was able to manage a wheelchair. The decubitus, which had a 8 x 13 cm dead space, was successfully closed with a single operation using two fasciocutaneous flaps. The patient was discharged two months postoperatively. The medical cost of his treatment before and after the surgery was investigated. The expense including the surgery and postoperative care until discharge was five times more than the monthly cost of the preoperative period. These findings suggest that a decubitus ulcer which does not respond to conservative treatments for more than several months should be considered for a surgical management, as long as the patient's general condition permits an operation.

A double-blind comparative study of S6472 and cefaclor (CCL) was conducted to evaluate the therapeutic efficacy, safety and usefulness in the treatment of skin and soft tissue infections. Either 750 mg b.i.d. of S6472 or 750 mg t.i.d. of CCL was administered orally to patients for a period of 7 consecutive days. Of the 250 cases (123 cases of S6472 group and 127 cases of CCL group) recruited in this trial, 228 cases (114 cases of S6472 and 114 cases of CCL) were adopted by the committee members for the evaluation of therapeutic efficacy, 238 cases (118 cases of S6472 group and 120 cases of CCL group) for usefulness, and 245 cases (121 cases of S6472 group and 124 cases of CCL group) were adopted for the evaluation of side effects. The backgrounds of both patients group were almost similar. The results obtained were as follows: Overall clinical effectiveness Of the 114 patients treated with S6472, excellent clinical responses were obtained in 11 patients, good in 79, fair in 19, poor in 5 (efficacy rate 78.9%), and of the 114 patients treated with CCL, excellent were in 16, good in 78, fair in 13, poor in 7 (efficacy rate 82.5%). There was no statistically significant difference between the 2 groups. Clinical effectiveness classified by initial severity and bacteriological efficacy There was no significant difference between the 2 groups in the clinical effectiveness classified by initial severity and in the bacteriological efficacy. Side effects were noticed in 5 patients of 121 treated with S6472 (4.1%) and in 2 patients of 124 treated with CCL (1.6%), and other 13 patients developed some abnormal laboratory findings. But these undesirable reactions were mild, and developed no significant difference between the 2 groups in the incidence of side effects. There was no significant difference between the 2 groups in the usefulness of the drugs. Conclusively, 750 mg b.i.d. of S6472 is anticipative of the same clinical efficacy, safety and usefulness as compared with that of 750 mg t.i.d. of CCL in the treatment of skin and soft tissue infections.

Fundamental and clinical studies of S6472 (sustained release preparation of cefaclor (CCL] were conducted in the surgical field and it was confirmed that the preparation is a useful drug. The following is the summary of the results from the fundamental and clinical studies: In vitro antibacterial activity. CCL showed MICs of 0.78 to 6.25 micrograms/ml against almost strains of S. aureus, E. coli and Klebsiella isolated from surgical wound regions, and the antibacterial activities were stronger than those of cephalexin (CEX). Clinical efficacy. S6472 was orally administered to 33 patients with skin and soft tissue infections in 2 divided doses. As a result, excellent clinical response was observed in 13 patients, good response observed in 14 patients, fair in 4 and poor in 1. The clinical efficacy in 1 of the 33 patients was unknown. Overall clinical effective rate was 84.4%. Adverse reaction. In 2 patients, mild gastrointestinal symptoms were observed.

Cefotiam, a second generation cephalosporin and cefoperazone, a third generation cephalosporin have a broad spectrum of activity against a majority of organisms commonly found in the bile. Although cefoperazone is excreted into the human bile to a greater extent than is cefotiam, there are no comparative data available that cefoperazone prophylaxis is safer and more effective than cefotiam for patients undergoing biliary tract surgery. A prospective randomized study was performed to compare the safety and efficacy of cefotiam with those of cefoperazone for prophylaxis in patients undergoing elective biliary tract surgery. The incidence of postoperative infection was not significantly different between the cefotiam group (n = 86) and the cefoperazone group (n = 86). The rate of side effects, however, was significantly different. In the cefotiam group, only one patient had diarrhea whereas in the cefoperazone group, eight had diarrhea and one skin eruption. Clostridium difficile cytotoxin was nil in those with diarrhea. Diarrhea in all patients was mild and recovery was rapid. Cefotiam is thus safer and as effective as cefoperazone in preventing postoperative infections following biliary tract surgery. We suggest that cefotiam is the first choice antibiotic for prophylaxis in biliary tract surgery.