Effects of diltiazem hydrochloride on the reduction of blood pressure, and cardiac and renal functions in essential hypertensive patients with renal dysfunction

Diltiazem hydrochloride was administered at a dose of 180 mg/day for 12 weeks to 10 essential hypertensive patients with slightly or moderately decreased renal plasma flow (RPF) in order to study its antihypertensive effect as well as the effects on cardiac and renal functions. The administration of diltiazem hydrochloride produced significant decreases in systolic pressure, diastolic pressure, and mean blood pressure. Right and left ventricular ejection fractions, max. dv/dt, and min. dv/dt assessed by cardiac pool scintigraphy were slightly increased, but these changes were not statistically significant. The glomerular filtration rate (GFR) and RPF were slightly increased, while renovascular resistance (RVR) was significantly reduced. No consistent tendency was observed in changes in plasma renin activity (PRA) and plasma aldosterone level. From these results, it was suggested that diltiazem hydrochloride is a potent antihypertensive drug which has no adverse effects on cardiac and renal functions in the treatment of essential hypertensive patients with slightly or moderately decreased RPF.

Electrophoretic separation of proteins on agarose gel--application for direct immunization with a gel piece containing an antigen

An efficient method of separating proteins by electrophoresis with agarose gels containing sodium dodecyl sulfate is described. The separated proteins were then used to make antibodies. The separation of proteins in the molecular weight range 25K to 94K on 4 to 5% agarose gels showed good resolution which was comparable to that obtained by electrophoresis with polyacrylamide gels containing sodium dodecyl sulfate. The subunits of human chorionic gonadotropin were separated by the preparative agarose gel electrophoresis and the gel bands containing the subunits were used directly to raise antibodies against these proteins. The degree of solubilization of the proteins from the gel slices was found to be complete.

[Intrahepatic-artery infusion of cis-diamminedichloroplatinum (II) and 5-fluorouracil in primary or metastatic liver cancer]

Eight hepatocellular cancer patients and eighteen metastatic liver cancer patients were treated with intrahepato-arterial infusion of CDDP (cis-diamminedichloro-platinum II) plus 5-FU (5-fluorouracil); CDDP (0.8-1.0 mg/kg) was given once every 7 or 10-14 days, while 5-FU (250-100 mg/day) was infused daily. A partial response was obtained in 5 of 8 patients with primary liver cancer and in 9 of 14 evaluable patients with metastatic liver cancer. However, severe complications due to bone marrow suppression were observed in 4 patients, 3 of whom died of septicemia and one of enterocolitis. This combined intra-hepato-arterial chemotherapy exerts a synergistic anticancer effect on malignant liver tumors, although the bone marrow suppression associated with it remains to be overcome.

Pathological study on mucosal changes in small intestine of rat by oral administration of ricin. I. Microscopical observation

A histological study on small intestine of Wistar rats after oral administration of ricin, a proteinous toxin from castor bean seeds, was carried out. In Experiment I, the jejunum was examined at 1, 2, 5, 10, 15, 20, 24, and 40 hours after oral administration of ricin 30 mg/kg. In Experiment II, ricin was administered at dose of 1, 3, 5, 10, 15, 30, and 60 mg/kg, and after 5 hours the jejunum, mid-portion, and ileum were examined. For comparison, ricin 0.5 mg/kg was administered intraperitoneally and castor bean hemagglutinin (CBH) 30 mg/kg orally. In both experiments, the changes of mucosa were essentially similar dependent on time-lapse and dose respectively, which were atrophy of villus, elongation of crypt, degeneration of epithelium, decrease of goblet cell, fusion of intervillous epithelia, infiltration of neutrophils and eosinophils, and dissociation between epithelium and lamina propria. These changes were most manifest in the jejunum that was contacted with ricin first in a high concentration. In contrast, intraperitoneal administration of ricin caused only dissociation between epithelium and lamina propria and oral administration of CBH caused only milder atrophic changes. The evidences suggest that the mucosal changes by oral administration were caused by direct contact with ricin.

Growth-enhancing effect of Branhamella catarrhalis culture filtrates on the L-forms of Haemophilus influenzae

Haemophilus influenzae is a common respiratory pathogen and recurrent infection due to H. influenzae is a phenomenon often present in patients with chronic respiratory tract infections. The effects of Neisseria perflava and B. catarrhalis culture filtrates on the growth and reversion of H. influenzae L-forms were determined using the L-forms of H. influenzae induced and subcultured in a medium containing 10% sucrose and these culture filtrates. When each culture filtrate of two strains of N. perflava was added, the viable count of revertants reached a peak of growth after 48 hr and exceeded 10(4) CFU/ml even 48 days after the subculture. Adding each culture filtrate of six strains of B. catarrhalis, the viable count of revertants from the L-forms of H. influenzae was much higher than that in the absence of any filtrate (negative control). The filtrate of a culture prepared from one of the six strains of B. catarrhalis was subjected to biochemical analysis. The molecular weight of the growth-enhancing factor(s) was determined to be approximately 1,000 to 5,000. Some peptide fractions showed growth-enhancing effects on the L-forms of H. influenzae. These findings suggest that culture filtrates may be important clues as to the correlation between recurrent infections due to H. influenzae and the growth of L-forms in the sputum of the patients with chronic respiratory tract infections, during or after the administration of beta-lactam antibiotics.

Intracellular molecular species of human chorionic gonadotropin from normal but non-cultured first trimester placental tissues

Intracellular forms of human chorionic gonadotropin (hCG) were analyzed by SDS-polyacrylamide gel electrophoresis, protein blotting and immunological techniques in normal but non-cultured first trimester placentae. Placental cells were found to contain the major components of the 23K and 19K forms of the beta-subunit and the 21K form of the alpha-subunit of hCG which remained sensitive to endoglycosidase H and Con A-Sepharose 4B and small amounts of mature (urinary) subunits. An unknown molecular species of the alpha-subunit (Mr = 17K) that was not bound to Con A-Sepharose 4B was also detected. These intracellular molecular species accumulated in the placentae mainly during the first trimester. These results suggest that hCG subunits accumulate in placental cells as predominant intermediates containing high-mannose oligosaccharides.

[Intra-arterial infusion of CDDP in advanced gastrointestinal cancer (combination of general chemotherapy)]

We attempted to use CDDP for patients with advanced cancers of the gastrointestinal system by intra-arterial infusion, giving consideration to the side effects of CDDP. Of 19 cases treated with CDDP, 17 cases were evaluable. These 17 cases comprised 10 cases of gastric cancer, 1 of pancreatic cancer and 6 of colon cancer. Therapeutic effects were as follows. According to the criteria for judgement of solid cancers, there were 10 evaluable cases which comprised 1 case of PR, 2 of MR, 4 of NC and 3 of PD. According to the criteria for judgement of malignant ascites, there were 6 evaluable cases which comprised 4 effective and 2 non-effective cases. As to side effects, nausea and vomiting were observed in 10 cases, numbness in 1, fever in 1 and aggravation of diabetes in 2. From the above results, intra-arterial infusion of CDDP is considered to be an effective method for the treatment of advanced cancers of the gastrointestinal system, especially of malignant ascites.

[An autopsy case of triple cancer associated with superior vena cava syndrome]

In recent years, because of advances in diagnostic techniques and therapy for malignant tumors, it is not rare to encounter cases of primary multiple malignant neoplasms. However, triple cancer is still rare. We report a case of triple cancer--gastric cancer, sigmoid colon cancer and malignant fibrous histiocytoma. To our regret, we could not make a diagnosis while the patient was alive. Careful examination of a cancer patient is important because malignant tumors may develop at any time.

Effect of diltiazem hydrochloride in essential hypertension

A number of studies have shown short term hemodynamic and symptomatic improvement in patients with essential hypertension under treatment with diltiazem. The long-term efficacy of the oral calcium antagonist, diltiazem, remain to be established in patient studies. We evaluated this drug in 70 patients with WHO classification 1-3 hypertension. Diltiazem was tested alone in 25 patients, in combination with diuretics in 14 patients and other drugs in 31 patients with essential hypertension. The fall in blood pressure after oral diltiazem was maximum with 24 weeks and then the fall continued steadily with significant improvement as judged by subjective patients impression in each group. The efficacy ratio of diltiazem was 57.1% in remarkably effective cases, 22.9% in effective, 10% in moderately effective and 10% in not effective cases. And this efficacy ratio was most prominent in other drugs concomitant group, followed by the diltiazem monotherapy group and in the diuretic concomitant use group. We concluded the oral calcium antagonist, diltiazem, is effective in patients with essential hypertension, providing significant blood pressure and symptomatic benefit with long-term treatment.

Characterization and comparison of two forms of human chorionic gonadotropin from hydatidiform moles with low and high immunoreactivity

Two glycoproteins (LM-hCG and HM-hCG) with gonadotropic activity were purified from the chorionic tissue of patients with hydatidiform mole with low and high urinary human chorionic gonadotropin levels and were compared to each other. The immunologic, biologic, and physicochemical properties of the two preparations were very similar. Also, the quantities of LM-hCG and HM-hCG recovered from molar tissue from the two types of patients were similar. However, the molar tissue from patients who excreted high levels of human chorionic gonadotropin immunoreactivity also contained other molecular forms with apparent human chorionic gonadotropin immunoreactivity tissues from patients who excreted low levels did not. These latter molecular forms may account for the differences in the levels of human chorionic gonadotropin immunoreactivity excreted by the two types of patients.

[Clinical application of a right ventricular pressure-volume loop determined by gated blood-pool imaging and simultaneously measured right ventricular pressure]

The data obtained by ECG-gated radionuclide angiography were collected simultaneously with right ventricular pressure and thermal cardiac output (CO) obtained by a Swan-Ganz catheter in Scintipac 1200 ( Shimazu Co) in order to create a right ventricular pressure-volume (RV P-V) loop. Subjects consisted of 15 patients with old myocardial infarction (MI group), seven with angina pectoris (AP group), six with congestive cardiomyopathy (CCM group) and five with neurocirculatory asthenia (NCA group). Right ventricular end-diastolic volume ( RVEDV ) was calculated as RVEDV = CO/(EF X HR) (CO = cardiac output; HR = heart rate). Systolic work (Ws), diastolic work (WD) and net work (WN) were calculated from a RV P-V loop by Simpson's method. The measurements were performed before and 5 min after sublingual administration of nitroglycerin (NG) (0.3 mg). The results were as follows: RV P-V loops shifted towards the left lower part of the P-V plane after sublingual administration of nitroglycerin, indicating the reduction of pressure and volume of the right ventricle. Right ventricular ejection fraction (RVEF) in the MI, AP and CCM groups showed smaller values than that of the NCA group. The CCM group presented a significantly smaller value than the NCA group (p less than 0.005). RVEF of each group increased after NG. In the AP and CCM groups, it increased significantly (p less than 0.005). Right ventricular end-diastolic volume index ( RVEDVI ) showed a converse relation with RVEF. The MI and CCM groups demonstrated significantly higher values (p less than 0.05). After NG, RVEDVI of each group decreased significantly (p less than 0.001 in the MI and NCA groups, and p less than 0.005 in the AP and CCM groups). Cardiac index in all groups decreased after NG and a statistical significance was seen in the MI, AP and NCA groups (p less than 0.05). RV Ws, RV WD and RV WN showed no difference among each group in the control state, and significantly decreased after NG. This was due to the reduction of RV pressure and volume. It was indicated that the principal cause was the systemic volume reduction. We conclude that the present method using RV P-V loop might be useful as a noninvasive bedside monitoring and permits the evaluation of RV function in a clinical setting.

Efficacy of hemoperfusion in the therapy of bromvalerylurea (bromural) intoxication

We have found that charcoal hemoperfusion is effective in removing bromvalerylurea (BVU) from circulation. A patient poisoned with BVU showed a marked lightening of coma after 3 h of hemoperfusion. The BVU concentration in the patient's serum was decreased significantly by hemoperfusion. In an experiment with dogs without hemoperfusion, the BVU concentration had its peak at the fourth hour after oral administration and decreased in 24 h. In an experiment with hemoperfusion, BVU concentration in dogs decreased markedly during hemoperfusion. After hemoperfusion a rebound of concentration was observed.