AIMS: To develop a novel warfarin-dosing algorithm based on a previous population pharmacokinetic/pharmacodynamic (PK/PD) model with Bayesian forecasting to facilitate warfarin therapy. MATERIALS & METHODS: Using information on CYP2C9 and VKORC1 genotypes, S-warfarin level, dose and international normalized ratio (INR) of prothrombin time, individual PK (apparent clearance of S-warfarin [CLs]) and PD (concentration resulting in 50% of E(max)[EC(50)]) parameters were determined by Bayesian forecasting for 45 Japanese patients. Maintenance doses were described by multiple linear regression using individually estimated PK/PD parameters and INR values. The validity of the model and a comparison with other dosing methods were evaluated by bootstrap resampling and a cross-validation method. RESULTS: The plasma concentration of S-warfarin and INR were accurately predicted from individual PK/PD parameters. The following final regression model for maintenance dose was obtained; maintenance dose = 11.2 x CLs + 0.91 x EC(50)+ 2.36 x INR - 9.67, giving a strong correlation between actual and predicted maintenance doses (r(2)= 0.944). Bootstrap resampling and cross-validation showed robustness and a superior predictive performance compared with other dosing methods. On the other hand, the predictability without actual measurements (S-warfarin and INR values) and Bayesian inference was comparable to other dosing methods. CONCLUSION: A novel algorithm, based on the population PK/PD model combined with Bayesian forecasting, gave precise predictions of maintenance dose, leading to individualized warfarin therapy.

The number of bacterial cells adhered on a glass surface was counted over a wide range of ionic strengths. The counted number increased linearly with the square root of time. The rate of attachment increased with the increase in ionic strength and then plateaued. The rate of attachment was analyzed on the basis of the potential barrier between the surface of the bacterial cell and that of the substratum. An equation for formulating the dependence of the attachment rate on the ionic strength was proposed, which seems to be useful for the systematic understanding of bacterial attachment in various environments, from terrestrial to marine.

The role of breast cancer resistance protein (BCRP), an efflux ABC transporter, in the pharmacokinetics of substrate drugs in humans is unknown. We investigated the impact of genetic polymorphisms of ABCG2 (421C>A) and NAT2 on the pharmacokinetics of sulfasalazine (SASP), a dual substrate, in 37 healthy volunteers, taking 2,000 mg of conventional SASP tablets. In ABCG2, SASP AUC(0-48) of C/C, C/A, and A/A subjects was 171 +/- 85, 330 +/- 194, and 592 +/- 275 mug h/ml, respectively, with significant differences among groups. In contrast, AUC(0-48) of sulfapyridine (SP) tended to be lower in subjects with the ABCG2-A allele as homozygosity. In NAT2, AUC(AcSP)/AUC(SP) was significantly higher in rapid than in intermediate and slow acetylator (SA) genotypes. We successfully described the pharmacokinetics of SASP, SP, and N -acetylsulfapyridine (AcSP) simultaneously by nonlinear mixed-effects modeling (NONMEM) analysis with regard to both gene polymorphisms. The data indicate that SASP is a candidate probe of BCRP, particularly in its role in intestinal absorption.Clinical Pharmacology & Therapeutics (2008) doi:10.1038/sj.clpt.6100459.

We report the case of a 39-year-old female with non-herpetic subacute encephalitis. Aphasia occured after a slight fever, and severe epilepsy followed 3 months later. Wernicke's aphasia was noted at the recovery stage, but the patient showed almost complete recovery. Head MRI revealed a lesion from the left parietal to the left posterior temporal lobe. Improvement in the left hemisphere noted on the encephalograms was consistent with that of aphasia. While amnesia was not found, aphasia, ideomotor apraxia and limb-kinetic apraxia were noted. There was no involvement of herpes simplex types 1 and 2 the tubercle bacillus was found, and the disease virus was not detected either. In several respects, it was similar to non-herpetic acute limbic encephalitis (NHALE) and acute juvenile female non-herpetic encephalitis (AJFNHE) the latter develops particularly in young females as stated by Kamei. The characterisitic of the present case differs from NHALE and AJFNHE and is unique in that the lesion was detected in the unilateral cortex.

5-Fluorouracil (FU) is a chemotherapeutic agent commonly used against esophageal cancer. Recently, interferons (IFNs) have been administered together with cytotoxic chemotherapy to patients with this cancer, although the mechanisms of synergy are unknown. We reconsidered the mechanisms for the effects of 5-FU in this context, aiming to refine combination therapy. After three cell lines (T.T, TE-2, and TE-6), derived from human esophageal squamous cell carcinoma (SCC), were exposed to 5-FU, the expression profiles were analyzed using high-density oligonucleotide microarrays representing about 12,000 genes. Among them, three IFN-related genes, an IFN receptor gene (IFNAR2) and two IFN-stimulated genes (ISG15K, ISG-54K), that were up-regulated following addition of 5-FU, were investigated. Up-regulation was confirmed by RT-PCR. Based on these results, the antitumor effects of exposure to 5-FU simultaneously with IFN-alpha,-beta and -gamma were investigated. The growth of esophageal SCC cells with 5-FU was suppressed synergistically or semi-additively by IFN-alpha and -beta, but not by IFN-gamma. These findings indicated that 5-FU stimulated IFN pathways in esophageal SCC cells following up-regulation of the IFN type I receptor. A combination of 5-FU and an IFN, therefore, may be particularly efficacious in esophageal cancer.

The gene expression profiles of 33 renal cell carcinomas (RCCs) and nine normal kidney samples were examined using high-density oligonucleotide microarrays in an attempt to identify biomolecular markers for the diagnosis of tumour subtypes and also for prediction of prognosis. Hierarchical clustering demonstrated that clear-cell RCC, chromophobe RCC, and normal kidney tissue showed distinctive gene expression profiles. The mean expression levels of 149 of 12 500 genes were more than three times higher in clear-cell RCC than in chromophobe RCC and normal kidney tissue. Among the genes whose expression was upregulated in clear-cell RCC, adipose differentiation-related protein (ADFP) and nicotinamide N-methyltransferase (NNMT) were selected for further analysis. Consistent with the results of the microarray, increased levels of ADFP and NNMT mRNA were found more frequently in clear-cell RCCs than in other non-clear-cell tumour subtypes using real-time quantitative PCR. Immunohistochemistry for ADFP showed strong and unique tumour cell staining patterns in the majority of clear-cell RCCs. More importantly, patients bearing tumours with higher AFDP mRNA levels showed significantly better survival in both univariate and multivariate analyses. ADFP is a lipid storage droplet-associated protein and its transcription is considered to be regulated by the von Hippel-Lindau/hypoxia-inducible factor pathway. It is known that clear-cell RCC contains abundant lipids and cholesterols. Thus it is likely that sustained upregulation of ADFP following VHL inactivation is involved in the morphological appearance of clear-cell RCC. Moreover ADFP expression status may provide useful prognostic information as a biomolecular marker in patients with clear-cell RCC.

A 7-year-old male Golden Retriever with swelling of the rostral bridge and right wing of the nasal areas, sneezing, and inspiratory difficulty was referred to a neighbor veterinarian. Except for those in the nasal area, no lesions were noted during routine physical examination. The mass occupying the nasal cavity was not observed radiographically. Punch biopsy of the affected lesions revealed nonepitheliotropic lymphoma. Immunohistochemical staining for CD3 antigen was positive. The dog was diagnosed with solitary nonepitheliotropic T-cell lymphoma. Local radiotherapy and systemic chemotherapy with doxorubicin were instituted and resulted in total clinical remission. The dog has remained disease free for 30 months.

Chiral recognition in the host-guest complexation systems of chiral crown ether hosts and amino ester guests was thoroughly examined using the electrospray ionization (ESI) mass spectrometry/enantiomer labeled (EL)-guest method. In this method, the mass spectra of a mixture of three components in a solution, a chiral host (H), an equal amount of an (S)-enantiomer guest labeled with deuterium atoms (G(S-dn)(+)) and an unlabeled (R)-enantiomer guest (G(R)+), were measured and the relative peak intensity value [I(H + G(R))(+)/ I(H + G(S-dn))(+)= IRIS] of the host-guest complex ions, observed with an excess guest concentration, was taken to provide the chiral recognition ability of the host. In our earlier report (1996), we demonstrated that the apparent chiral recognition abilities using a mass spectrometer with a homemade ESI interface were depressed by about one tenth compared with the corresponding abilities obtained by fast-atom bombardment (FAB) MS. In the present study, the enantioselective complexation behaviors of various combinations of chiral crown hosts with chiral guests were further investigated in detail mainly using a modern commercial ESI/ion trap (IT) mass spectrometer. Consequently, it was found that the apparent IRIS values from the ESI-MS/EL-guest method changed significantly, depending upon the instrument used, and in particular, upon the ESI interfaces. Moreover, under the specific measuring conditions in ESI-IT-MS, the degrees of depression of the apparent chiral recognition abilities are roughly grouped into three classes, depending upon the number (or probably the type) of the hydrophobic substituents of the hosts. Representing the degrees by the slopes when plotting the apparent IRIS values in ESI-MS versus those in FAB-MS, the slopes for the three classes are (1) 1.0,(2) 0.7 and (3) 0.3; the higher the hydrophobicity of the hosts (and then, the host-guest complex ions), the lower the slope (the apparent enantioselectivity). Strengthening the degree of depression may be caused by an increase in the local concentration of the host close to the surface of the droplets produced during the electrospary ionization process. The chiral recognition ability (K(R )/ K(S)) in an equilibrated solution agrees quite well with the IRIS value in FAB-MS rather than that in ESI-MS.

BACKGROUND. N-Biphenyl sulfonyl-phenylalanine hydroxamic acid (BPHA), a synthetic, selective matrix metalloproteinase (MMP)-2,-9,-14 inhibitor, has been reported to show significant antiangiogenic activity without unpleasant adverse effects. After film in situ zymography (FIZ) and conventional zymography were performed to detect MMP in experimental choroidal neovascularizations (CNVs), we studied the reducible effect of BPHA on CNVs. METHODS. Using FIZ, the gelatinolytic activity of MMPand BPHA-reduction on gelatinolysis were examined in diode-laser-induced CNV lesions in a total of 22 male Brown Norway rats. The MMP subtypes were studied in the CNV lesions of three rats using conventional zymography. Vehicle solution only or 25-, 50-, or 100 mg/kg-body-weight of BPHA was administered orally twice daily for 14 days after the laser photocoagulation in 18 rats, respectively. Fluorescein angiograms were taken, and the late hyperfluorescence of CNVs was given scores by three researchers using four grades. The thickness of CNV lesions was studied histologically. RESULTS. In laser-induced CNVs, the gelatinolytic activity of MMP and reduction of gelatinolysis by BPHA were observed on FIZ, and MMP-2 and proMMP-2 were identified by conventional zymography. The scores given to the late dye leakage and staining on angiograms were lower in the BPHA-treated groups ( p<0.01) than in the controls, and the effect appeared to be dose-dependent. Similarly, the CNV lesions in the BPHA-treated groups were less thick than in the controls ( p<0.01). CONCLUSIONS. MMP-2 played a role in laser-induced CNV development, and administration of BPHA reduced the experimental CNVs.

Loss of the von Hippel-Lindau gene (VHL) expression ca-uses deregulation of contact inhibition of cell growth, which might be one of the bases of the tumor suppressor function of VHL. Here we show that this function of the VHL gene product (pVHL) depends on cell autonomous events. To identify the target gene of pVHL, which is directly involved in the contact inhibition, we compared the gene expression profile between VHL-deficient renal carcinoma 786-O cells and those infected with an adenovirus vector encoding VHL. In addition to known pVHL-regulated genes, such as vascular endothelial growth factor and carbonic anhydrase, we found cyclinD1 as a new target of pVHL at a high cell density. In VHL-expressing cells (VHL (+) cells), the cyclinD1 mRNA expression level diminishes at a high cell density, while it remains at a relatively high level in VHL-deficient cells (VHL (-) cells). The cyclinD1 expression level was also abnormally high in VHL (-) cells at a high cell density. Consequently, the phosporylation level of the retinoblastoma (Rb) protein remained high in these cells, whereas there was no phosporylated Rb in VHL (+) cells under the contact inhibition. The abnormal expression of cyclinD1 at a high cell density was observed even in VHL (+) cells under the hypoxic state. Moreover, ectopic expression of a HIF mutant resistant to pVHL-mediated proteolysis causes the abnormal cyclinD1 expression in VHL (+) cells. Taken together, these observations indicate that VHL is required for the downregulation of cyclinD1 at a high cell density through HIF.