Prediction of human pharmacokinetics of panipenem, a new carbapenem antibiotic, from animal data.

The prediction of human pharmacokinetics of Panipenem (PAPM), which is a new carbapenem antibiotic, was investigated using animal data. The plasma concentration-time curve after intravenous administration of PAPM in each animal showed biexponential elimination. There were good allometric correlations between pharmacokinetic parameters (CLtotal and Vd,ss) calculated from the plasma concentration in animal species and body weight of experimental animals. Predicted human pharmacokinetic parameters calculated by these allometric equations agreed with the values observed in humans.     

Primary actinomycosis in the liver

We present a case of a 71-year-old female with actinomycosis in the liver, which is a rare region to be primarily affected with actinomycosis. The diagnosis was done histopathologically with a partially resected liver specimen taken during surgery for choledocholithiasis. There were no clinical signs of Actinomyces infection before surgery. The hepatic lesion was a 2 cm sized nodule with histological appearances of abscess-forming suppurative inflammation with fibrosis, in which eosinophilic radiate granules with peripheral clubs were found. The Brown-Brenn stain showed Gram-positive branched filamentous bacilli, which were revealed as acid-fastness by the Ziehl-Neelsen method of Putt's modification. These findings were considered to be consistent with actinomycosis of the liver.     

Ultrasonographic Measurement of Intima-Media Thickness of the Carotid Artery Before Coronary Artery Bypass Grafting

Purpose We evaluated the usefulness of measuring intima-media thickness (IMT) of the carotid artery by ultrasonography before coronary artery bypass grafting (CABG).Methods Seventy-three patients who underwent carotid ultrasonography before CABG were selected for this study. The maximum IMT (max IMT) in the bilateral common carotid artery was used as the index of carotid ultrasonography. As a quantitative measure of coronary atherosclerosis, we calculated Gensinis coronary score (GCS) from the preoperative coronary angiography.Results There was a positive correlation between the max IMT and the GCS. Furthermore, the max IMT of the patients with myocardial infarction was significantly greater than that of the patients with angina pectoris.Conclusions Carotid ultrasonography before CABG is useful, not only for the morphological evaluation of the stenotic lesions of the neck vessels, but also for the quantitative prediction of atherosclerosis in the native coronary artery. The max IMT may predict the progression of atherosclerotic change of the native coronary artery from angina pectoris to myocardial infarction.     

Juvenile Granulosa Cell Tumor in a Three-year-old Infant An Immunohistochemical and Ultrastructural Study

A three-year-old female infant with a juvenile granulosa cell tumor of the ovary and precocious pseudopuberty is presented. Laboratory tests revealed elevated levels of serum and urinary estrogen. Histological examinations showed an immature follicular pattern surrounded by theca-like stromal tissue. The immunohistochemical localization of estradiol, estriol, progesterone and testosterone was studied by indirect immunoperoxidase staining of cryostat sections. All of these steroid hormones were localized mainly in stromal cells and in some follicular cells. Electron microscopic examination revealed three types of tumor cell, i.e. polygonal cells, spindle cells and transitional cells. Well developed smooth endoplasmic reticulum, mitochondria with tubulovesicular cristae, and lipid droplets in the cytoplasm, which are typical features of steroid synthesis, were conspicuous mainly in the last type of cell. Such transitional cells almost corresponded to steroid-positive cells. These cells were considered to have a close relationship to theca gland cells of developed ovarian follicles and to have mainly participated in steroid synthesis in the present tumor. In addition, some spindle cells showed features of myofibroblasts, such as intracyto-plasmic filaments, dense body-like structures, and pinocytotic vesicles. These features suggest that the cells might all be derived from the same progenitor of ovarian mesenchyme.