Organic calcium channel antagonists provoke acetylcholine receptor autodesensitization on train stimulation of motor nerve

The effects of nicardipine and other organic Ca2(+)-channel antagonists on the responses induced by indirect train stimulation (3 s, 50-100 Hz) were studied in mouse phrenic nerve diaphragm preparations. Nicardipine at 1-10 microM, which alone did not affect single or tetanic contractions or the amplitude of evoked endplate potentials and spontaneous miniature endplate potentials, caused tetanic contraction to fade completely in the presence of 0.3 microM neostigmine or 50 microM diisopropylfluorophosphate. In combination with these anticholinesterases, nicardipine caused a severe run-down and shortening of endplate potentials in 1-2 s. This effect on endplate potentials was dependent on stimulus frequency and on extracellular Ca2+. The effect was accelerated by intracellular injection of Ca2+, but retarded by injection of EGTA. The amplitudes of miniature endplate potentials and the evoked endplate depolarization were also depressed during repetitive stimulation. On termination of repetitive stimulation, all postsynaptic responses, including evoked endplate potentials, miniature endplate potentials and single twitches, recovered to pre-train level in 3-10 s. These results suggest that the postsynaptic nicotinic receptors had lost the functional activity during repetitive stimulation. The time-courses of the aforementioned changes initiated by repetitive stimulation were similar to the fast phase of desensitization induced by acetylcholine. The irreversible action of alpha-bungarotoxin on acetylcholine receptor was attenuated in the presence of nicardipine and neostigmine if repetitive stimulation was applied. The same effects were observed with other organic Ca2(+)-channel antagonists (diltiazem, verapamil and nifedipine) as well as agonist (methyl-1,4-dihydro-2,6-dimethyl-3-nitro-4-(2-trifluoromethylphenyl)-pyr idine- 5-carboxylate, BAY K8644), but not with Mn2+, theophylline or caffeine. It is inferred that organic Ca2(+)-channel antagonists interact directly with acetylcholine receptor ion channel, enhance its autodesensitization liability and thus cause extinction of endplate potentials on repetitive stimulation.

Fibroblast-mediated acceleration of human epithelial tumor growth in vivo

Transformed fibroblasts coinoculated with epithelial cells accelerated the growth and shortened the latency period of human epithelial tumors in athymic mice. Addition of NbF-1 fibroblasts caused epithelial tumors to grow from five marginally tumorigenic or "nontumorigenic" (nontumor-forming) human tumor cell lines or strains: PC-3 (prostate), WH (bladder), MDA-436 (breast), and cells derived from the ascites fluids of patients with metastatic renal pelvic or prostate cancers. Evidence for the human and epithelial nature of these experimental tumors was provided by histologic, immunohistochemical, Southern and dot-blot hybridization, and cytogenetic analyses. Transformed fibroblasts induced predominantly carcinosarcomas, whereas nontumorigenic fibroblasts (NIH 3T3) and lethally irradiated transformed fibroblasts induced exclusively carcinomas. The fibroblast-epithelial interaction appears to occur bidirectionally and does not result from cell fusion. Because coculture experiments in vitro did not demonstrate an increased cell proliferation, it appears that undefined host factors can influence tumor growth. This tumor model may be useful in drug-screening programs and in mechanistic studies of factors regulating human tumor growth and progression.

Identification of Stictodora lari (Heterophyidae) metacercariae encysted in the brackish water fish, Acanthogobius flavimanus

Metacercariae of the genus Stictodora encysted in the head tissue of Acanthogobius flavimanus (the gobies) caught at Sachun-gun, Kyongnam Province, were identified to be Stictodora lari Yamaguti, 1939 (Trematoda: Heterophyidae), a new parasite fauna in Korea. The metacercariae were 0.39-0.43 mm by 0.32-0.35 mm in size, long elliptical, and with a thin and transparent cyst wall. Total 200 metacercariae were collected from 50 gobies. In order to obtain adult worms two kittens and a puppy were infected each with 34-100 metacercariae, and total 33 adults were recovered between the day 4 and day 8 post-infection. The S. lari adults measured 0.95-1.18 mm long and 0.26-0.32 mm wide and the eggs in uteri 0.028-0.033 mm by 0.017-0.020 mm. The most characteristic morphological feature of these flukes was the presence of a gonotyl and gonotyl spines arranged in two groups; densely crowded group of 30-40 spines and linearly-arranged one of 30-40 spines, together of which made a comma (or reversed comma) shape along the lateral margin of the gonotyl. It has been proved by this study that S. lari is distributed in southern coasts of Korea.

Nicardipine inhibits axon conduction but causes dual changes of acetylcholine release in the mouse motor nerve

The effects of nicardipine, a dihydropyridine Ca2(+)-channel antagonist, on neuromuscular transmission and impulse-evoked release of acetylcholine were compared with those of nifedipine. In the isolated mouse phrenic nerve diaphragm, nicardipine (50 microM), but not nifedipine (100 microM), induced neuromuscular block, fade of tetanic contraction, and dropout or all-or-none block of end-plate potentials. Nicardipine had no significant effect on the resting membrane potential and the amplitude of miniature end-plate potentials but increased the frequency and caused the appearance of large size miniature potentials. The quantal contents of evoked end-plate potentials were increased. In the presence of tubocurarine, however, nicardipine depressed the amplitude of end-plate potentials. The compound nerve action potential was also decreased. It is concluded that nicardipine blocks neuromuscular transmission by acting on Na+ channels and inhibits axonal conduction. Nicardipine appeared to affect the evoked release of acetylcholine by dual mechanisms, i.e., an enhancement presumably by an agonist action on Ca2+ channels, like Bay K 8644 and nifedipine, and inhibition by an effect on Na+ channels, like verapamil and diltiazem. In contrast with its inactivity on the amplitude of miniature end-plate potentials, depolarization of the end plate in response to succinylcholine was greatly depressed. The contractile response of baby chick biventer cervicis muscle to exogenous acetylcholine was noncompetitively antagonized by nicardipine (10 microM), but was unaffected by nifedipine (30 microM). These results may implicate that nicardipine blocks the postsynaptic acetylcholine receptor channel by enhancing receptor desensitization or by a use-dependent effect.

Use of geographutoxin II (mu-conotoxin) for the study of neuromuscular transmission in mouse

1. Endplate potentials (e.p.ps) were investigated in the presence of geographutoxin II (GTXII) in the mouse phrenic nerve diaphragm preparation. This toxin preferentially blocks muscle Na+ channels which allows the study of e.p.ps in the absence of nicotinic receptor antagonists or substances to depress acetylcholine release. 2. GTXII abolished muscle action potentials and antagonized the depolarization of the muscle membrane produced by the crotamine-induced opening of Na+ channels. 3. E.p.ps as large as 19-25 mV were observed after 2-4 micrograms ml-1 GTXII. These concentrations of GTXII did not cause discernible changes of resting membrane potential and frequency and amplitude of miniature e.p.ps. 4. Lower concentrations (1-2 micrograms ml-1) of GTXII caused incomplete blockade of the muscle Na+ channel resulting in exaggerated 'e.p.ps', while higher concentrations of GTXII (8 micrograms ml-1) abolished e.p.ps by a prejunctional effect. 5. Trains of e.p.ps on repetitive stimulation after GTXII neither ran down, as in tubocurarine-treated preparations, nor facilitated, as in low Ca2+ and/or high Mg2+-treated preparations, and were indistinguishable from those of untreated cut muscle preparation. 6. In cut muscle preparations, GTXII did not affect the rise and decay times, amplitude or rundown of e.p.ps. 7. It is concluded that GTXII is a useful agent for studying neuromuscular transmission. This method provides e.p.ps which are neither attenuated nor modified because manipulations that alter transmitter release and postjunctional receptor responses are avoided.

Antagonism by tubocurarine and verapamil of the regenerative acetylcholine release from mouse motor nerve

The role of presynaptic acetylcholine receptors and Ca2+ channels in the regenerative acetylcholine release was studied in the cut muscle preparation of mouse phrenic nerve hemidiaphragm. The regenerative release shown as a prolonged endplate depolarization was evoked by stimulation of the nerve with a train of pulse at 75-300 Hz when acetylcholinesterase activity was depressed with neostigmine or by lowering temperature. Tubocurarine, cobratoxin, verapamil, diltiazem and nifedipine at low concentrations, which had a negligible effect on the endplate potential, shortened the duration of regenerative depolarization while leaving the amplitude unaffected. In contrast, Mn2+ at concentrations that markedly reduced the amplitude of single endplate potentials caused little suppression of the regenerative depolarization though intensive stimulation was needed to trigger the response. On the other hand, atropine inhibited the regenerative depolarization only at high concentrations which also depressed endplate potentials. These results indicate that the mechanism for evoking the regenerative release involves the activation of acetylcholine receptors and Ca2+ channels which are sensitive to tubocurarine and Ca2+ channel blockers. The Ca2+ channel concerned, however, appears to differ from that involved in the normal quantal release of acetylcholine.

[A human case of tick bite by Ixodes nipponensis on the scalp]

A human case of tick bite on the scalp was found at a local hospital on June, 1984. The patient, 63-year old female, was attacked by a tick while working in a farm forest which located in the suburbs of Seoul. The clinical complaint was a (worm) mass on the scalp which she thought as a tumor. On admission the patient complained of facial edema and general malaise. After removal of the mass (tick), small bleeding and discoloration were observed around the biting site. The tick was morphologically examined and identified as Ixodes nipponensis. This is the 4th human case of tick bite reported in the literature of Korea.

Study on Centrocestus armatus in Korea. II. Recovery rate, growth and development of worms in albino rats

Some biological characteristics of Centrocestus armatus were studied using albino rats as its experimental host. The metacercariae were collected from Zacco platypus by artificial digestion method. Laboratory rats (Wistar) were fed each 100 or 200 metacercariae and sacrificed on 1, 2, 3, 4, 5, 6, 8, 14 and 28 days after infection to recover worms of various ages. The average recovery rate was 10.7% from 82 rats. The rate decreased rather slowly for the first 8 days but showed a steep decrease thereafter. Of the worms, 35.5% were recovered from the duodenum and 62.5% from the jejunum. At metacercarial stage, body length was 293 microns and body width 144 microns. At adult stage, the length and width reached 382 microns and 214 microns respectively at 14 days after infection. The testes and Mehlis' gland were recognized at metacercarial stage, whereas the ovarian analage appeared on the 1st day of infection, seminal vesicle and vitellaria on the 2nd day, and seminal receptacle and uterine eggs on the 3rd day. Until 8 days after infection the genital organs developed continuously and the number of uterine eggs increased. The above results show that albino rats are one of useful experimental hosts for C. armatus and the worms can develop to adults in 3 days after infection.

[Study on Centrocestus armatus in Korea. I. Infection status of Zacco platypus and Z. temminckii with the metacercariae of C. armatus]

This study was performed to observe the infection rate and infection intensity of fresh water fish such as pale chub (Z. platypus) and dark chub (Z. temminckii) with the metacercariae of C. armatus. The fish were caught in several rivers and streams from June to September, 1988 and examined by artificial digestion technique. Total 370 fish were caught at 19 rivers. The metacercarial (C. armatus) infection rate and average burden in Z. platypus were 86.8% and 224, and those in Z. temminckii were 78.5% and 131. The infection rate and burden per fish were 73.4% and 32 in the fish caught from the Han river, and 88.0% and 44 from the Youngsan river. All fish caught from the Keum and the Tamjin river were infected and their mean metacercarial density was 45 and 59 respectively. The infection rate and density in fish caught from the Seomjin and Nagdong rivers were 100% and 119, and 81.0% and 348 respectively. From this study, it is confirmed that C. armatus is widely distributed along 5 major rivers in Korea.

Reversals of the neostigmine-induced tetanic fade and endplate potential run-down with respect to the autoregulation of transmitter release

1. In order to shed more light on the role of presynaptic cholinoceptors in the modulation of transmitter release, the effects of tubocurarine, choline and hexamethonium on neostigmine-induced tetanic fade and run-down of endplate potentials (e.p.ps) in response to indirect stimulation with trains of pulses were studied in the intact and cut isolated phrenic nerve-diaphragm preparation of the mouse, respectively. 2. Tubocurarine, choline and hexamethonium reduced both the tetanic fade and e.p.p. run-down caused by neostigmine, despite the fact that they themselves also induced these two effects. 3. At a given degree of postsynaptic inhibition, choline and hexamethonium caused less e.p.p. run-down and reversed the neostigmine-induced tetanic fade and e.p.p. run-down better than tubocurarine. Moreover, the e.p.p. run-down caused by choline or hexamethonium, but not that induced by tubocurarine, was reciprocally reversed by neostigmine. 4. Tubocurarine, choline and hexamethonium significantly decreased the endplate depolarization induced by repetitive nerve stimulation in the presence of neostigmine. The remaining depolarization continued to grow during repetitive stimulation in the presence of choline or hexamethonium, but not, however, in the presence of tubocurarine; a finding which suggests that choline and hexamethonium but not tubocurarine may be displaced from the receptor by the accumulated acetylcholine. 5. The mutual reversal by neostigmine and cholinoceptor antagonists of e.p.p. run-down may implicate the presence of a positive (physiological) and a negative (pharmacological) feedback regulation for evoked transmitter release via nicotinic cholinoceptors in the mammalian motor nerve, depending on the concentration of acetylcholine within the synaptic cleft.

Somatostatin modulation of neurally mediated pepsinogen secretion from frog esophageal mucosa

Frog esophageal mucosa contains peptic glands which are innervated by cholinergic neurons. When incubated in a medium containing 1.5 mM CaCl2, pepsinogen release from esophageal mucosa was increased by a high potassium concentration (55 mM KCl), 1,1-dimethyl-4-phenylpiperazinium (DMPP) or bethanechol. Whereas the response to bethanechol remained little changed, the response to high KCl concentrations or DMPP was abolished in the absence of Ca2+. The stimulatory effects of high KCl concentrations and DMPP were also eliminated by the presence of atropine or somatostatin. Furthermore, pepsinogen release in response to bethanechol was dose-dependently inhibited by somatostatin. Frog esophagus was found to contain somatostatin-like immunoreactivity, with a higher density at the end adjacent to the stomach. Chromatography of mucosa extract on Sephadex G-50 revealed a single peak of somatostatin-like immunoreactivity that coeluted with somatostatin-14. Immunohistochemical staining of the mucosa with peroxidase antiperoxidase technique demonstrated the presence of two varieties of somatostatin-like immunoreactivity-containing cells, one individually dispersed within the intercalated septa and the other in groups within the interlobular septa of the peptic glands. These results seem to indicate that somatostatin or somatostatin-like immunoreactivity may play a modulatory role in neurally mediated pepsinogen secretion in the frog esophagus.

Dissociation of the end-plate potential run-down and the tetanic fade from the postsynaptic inhibition of acetylcholine receptor by alpha-neurotoxins

The effects of so-called postsynaptic snake alpha-neurotoxins (alpha-bungarotoxin, cobratoxin, erabutoxin b) on the wanings of tetanic contraction (tetanic fade) and the run-down of end-plate potentials during stimulation at 100 Hz were studied, respectively, in intact and cut mouse phrenic nerve-diaphragm preparations. No tetanic fade was evident with high concentrations of toxins until the complete failure of contractile response whereas the tetanic fade was evident after prolonged incubation with lower concentrations of toxins. The proportion of junctions exhibiting end-plate potential run-down increased progressively during toxin incubation. However, depression of end-plate potential amplitude by the toxins was not necessarily accompanied by run-down. The tetanic fade and the run-down became more pronounced for a time shortly after washout of toxins despite the restoration of single twitches and end-plate potential amplitudes, indicating the presynaptic origin of these effects induced by alpha-neurotoxins. We demonstrated that the functions of the pre- and postsynaptic acetylcholine receptors can be dissociated by using the different kinetics of toxin-receptor interactions. The results also implicate that a positive feedback enhancement of transmitter release operates via the presynaptic acetylcholine receptor in the neuromuscular junction in normal physiological conditions during repetitive pulses.

The frequency distribution of cardiovascular diseases in 13 hospital admitted patients in Korea. Korean Society of Circulation

The frequency distribution of cardiovascular disease are changing recently due to the development of living environment. Unfortunately there are few epidemiological studies of cardiovascular diseases in general population, we tried to estimate the recent trend of cardiovascular diseases studying hospitalized patients in nationwide 13 large hospitals during a year of 1985. The hypertensive disease (24.1%) was the most common cardiovascular disease and the next were cerebrovascular disease (15.8%), arrhythmias (12.2%), ischemic heart disease (9.7%), congenital heart disease (9.1%), and rheumatic heart disease (5.4%) in order. This results showed that hypertensive disease and cerebrovascular disease are still the major cardiovascular disease and ischemic heart disease and arrhythmias are increased. But chronic rheumatic heart disease is declined compared with previous studies in hospitalized patients.

Does endogenous adenosine modulate the release of acetylcholine from motor nerve during single and repetitive stimulations in the mouse diaphragm?

In order to elucidate the physiological role of endogenous adenosine in regulating the release of acetylcholine, the effects of 8-phenyltheophylline, an antagonist of adenosine receptors and dipyridamole, an uptake inhibitor of adenosine, on the contractile response and quantal release of acetylcholine during single and repetitive stimulations of isolated mouse phrenic nerve-diaphragm preparations were studied. The curves relating the concentration vs. inhibition of contractile response to added adenosine and ATP were shifted parallel to the left by dipyridamole, but were shifted to the right by 8-phenyltheophylline at concentrations with little Ca2+-mobilization or phosphodiesterase inhibition. In the absence of exogenously added adenosine, 8-phenyltheophylline increased the quantal content of end-plate potentials (1 Hz), whereas dipyridamole decreased the quantal content. Successive decrease of the amplitude of end-plate potentials (e.p.p. run-down) evoked at 50 Hz was not changed either by 8-phenyltheophylline or by dipyridamole, suggesting that adenosine or ATP released from the motor nerve does not accumulate to an effective concentration even after repetitive stimulation for a feed-back regulation of the transmitter release. It is concluded that endogenous adenosine does inhibit the release of acetylcholine from motor nerve. However, the source of adenosine may be mostly from the muscle and is probably not involved in the feedback autoregulation.

Pre- and postsynaptic effects of nicotine on the mouse phrenic nerve-diaphragm preparation

Nicotine at less than or equal to 33 microM enhanced the single twitch response to indirect stimulation but potentiated the blocking effect of tubocurarine. Failure of tetanic contraction (tetanic fade) occurred on stimulation at 100 Hz. At 76 microM, nicotine induced a first phase rapid (10 min) inhibition of twitch response followed later (60-90 min) by a second phase complete block. Neostigmine partially restored the response at either phase of block whereas diaminopyridine completely antagonized the blockade. The end-plate was depolarized maximally by only 10-15 mV within 30 min with 43 microM nicotine. The depolarization was maintained but was antagonized by tubocurarine. The twitch response induced by direct stimulation was unchanged indicating no depolarization block ensued. The amplitudes of both EPP (0.7 Hz) and MEPP were markedly depressed in parallel indicating a curare-like postsynaptic inhibition without an effect on the release of transmitter. It is concluded that nicotine blocks the neuromuscular transmission by a dual mechanism by its partial agonist action. At higher frequencies of transmission, nicotine (greater than or equal to 22 microM) also produced a remarkable run-down of EPP just like other receptor antagonists suggesting that the nerve terminal acetylcholine receptors are not particularly sensitive to nicotine as those on the autonomic ganglia.

A regenerating release of acetylcholine from mouse motor nerve terminals treated with anticholinesterase agents

It was found by intracellular recording with glass microelectrodes that train stimulation (50-200 Hz) of the phrenic nerve of intact or cut mouse diaphragm induced an accumulative depolarization of the endplate and triggered after a few pulses an 'all-or-none' regenerative depolarization lasting for 300-900 ms when acetylcholinesterase was inhibited by neostigmine or diisopropylfluorophosphate. This depolarization was associated with a noise of the membrane potential and a failure of the end plate potential. Low Ca2+ prolonged whereas high Ca2+ shortened the duration of regenerative depolarization which needed no further stimulation once triggered. d-Tubocurarine abolished the depolarization while restoring the end plate potential. A regenerative release of acetylcholine due to an activation of presynaptic cholinoceptors is speculated.

Mechanisms of the inhibition by neostigmine of tetanic contraction in the mouse diaphragm

Neostigmine (0.5-2 microM) caused fade of tetanic contractions (Wedensky inhibition) evoked by repetitive nerve stimulation. The mechanism underlying this action was studied in intact and cut isolated phrenic nerve-diaphragm preparations of mice. The fade was brought about by failure to elicit muscle action potentials. During fade, the muscle was unable to conduct directly evoked action potentials across the central endplate zone. Recovery of excitability occurred in 5 s with continued stimulation. In the presence of neostigmine, the resting membrane potential at endplate areas during repetitive stimulation decreased from -80 mV to less than -50 mV within the first 10 pulses at 75-200 Hz and thereafter recovered gradually to about -60 mV in the following 5 s during continuous stimulation. The quantal content of endplate potentials evoked by single stimulation was not reduced by neostigmine whereas that evoked by high frequency stimuli (75 Hz) was reduced to about 1/3 in 10 pulses. It is concluded that the fade of tetanic contraction caused by inhibition of acetylcholinesterase is induced by the inactivation of sodium channels in the area surrounding the endplates and that the sustained fade is due to a decrease of transmitter release. Both effects are the result of acetylcholine accumulation.

A comparison of the antagonisms by neostigmine and diaminopyridine against the neuromuscular block caused by cobrotoxin and (+)-tubocurarine

Cobrotoxin was about 11-fold more potent than (+)-tubocurarine on a weight basis in blocking neuromuscular transmission in mouse isolated phrenic nerve-diaphragm preparations. Neostigmine and diaminopyridine increased the concentrations of cobrotoxin for 70% inhibition of indirect contraction by 290 and 320%, and increased those of (+)-tubocurarine by 180 and 230%, respectively. More than additive increases were obtained when neostigmine and diaminopyridine were used simultaneously. Cobrotoxin, however, was only 6-fold more toxic than (+)-tubocurarine after intraperitoneal injection in mice. The lethal dose of (+)-tubocurarine was increased by 80% when both antidotes were used together, but only by 15-20% when used alone. In contrast, the lethality of cobrotoxin was not decreased by these drugs. Unexpectedly, the time to death after treatment with cobrotoxin was shortened when mice were pretreated with these antidotes.

Pharmacological identification of saxitoxin-like toxins in the cultured purple clam, Hiatula diphos

An outbreak of poisoning from ingestion of purple clam (Hiatula diphos), obtained from a brackish fish-culture pond, occurred in southern Taiwan in early January 1986. The extract blocked the twitch responses and generation of the action potential of the mouse diaphragm without an effect on the resting membrane potential or the miniature endplate potential. The depolarizations and spontaneous firings of the diaphragm induced by veratridine and crotamine were effectively antagonized by the toxic clam extract, indicating the presence of saxitoxin-like substances, which may have amounted to 0.013% tetrodotoxin equivalent.

Electrophysiological studies of myotoxin a, isolated from prairie rattlesnake (Crotalus viridis viridis) venom, on murine skeletal muscles

Myotoxin a reduced the resting membrane potential of mouse and rat diaphragms from about -80 mV to -60 mV, induced spontaneous repetitive firing and enhanced the contractile force in response to single stimulations. The depolarizing effect was reversed noncompetitively by tetrodotoxin, local anesthetics or low Na+ solution, but was augmented by ouabain or low Cl-solution while being unaffected by high K+ solution or electrical stimulation of the muscle. The duration of muscle action potential was prolonged by only 20-30%, whereas the rate of rise (dV/dt) was unaffected. About a 40% increase of membrane conductance was observed, be abolished by the Na+-channel blocker tetrodotoxin. By contrast, K+ conductance was unaffected. Effects on caffeine-induced contracture, quantal release of neurotransmitter and the amplitude of miniature endplate potential were not appreciably affected. These effects of myotoxin a indicate that the toxin affects the muscle, but not the nerve, by acting specifically on the Na+-channel of the sarcolemma or T-tubule, like crotamine, rather than on the sarcoplasmic reticulum. The effects of sea anemone toxin II on the Na+-channel (marked depolarization and prolongation of action potential) could not be prevented by saturating the muscle with myotoxin a. On the other hand, the effect of veratridine, a member of another group of toxins acting on the Na+-channel, was enhanced. These results suggest that myotoxin a acts on the Na+-channel at a site which is discrete from those of tetrodotoxin, veratridine and sea anemone toxin II.

Potentiation between neostigmine and 3,4-diaminopyridine in antagonizing the neuromuscular block induced by D-tubocurarine

The antagonisms to the d-tubocurarine-induced neuromuscular blockade by neostigmine and 3,4-diaminopyridine (DAP) were studied quantitatively in the isolated phrenic nerve-diaphragm preparation of mice in vitro and in lethality of mice in vivo by assaying concentrations of d-tubocurarine needed to produce 70% block of indirect muscle contraction and LD50, respectively. The "antagonist efficacies", defined as the ratio of d-tubocurarine concentration (dose) after pretreatment with antagonistic agents over that of control, were 1.87, 2.24 and 14.7, respectively, for neostigmine, DAP and both agents combined when the stimulus pulses were at 0.1 Hz. Under 50 Hz train stimulation, the antagonist efficacies were lower, being 1.85, 1.64 and 5.33, respectively. For the lethality to d-tubocurarine, the values were still lower, being only 1.21, 1.33 and 1.84, respectively. The synergism between neostigmine and DAP, as evident from the marked increase of antagonist efficacy in vitro, is more than expected from the possible interaction of the major pharmacological actions of these two agents.

A study on the membrane depolarization of skeletal muscles caused by a scorpion toxin, sea anemone toxin II and crotamine and the interaction between toxins

Quinquestriatus toxin (QTX) isolated from the venom of a scorpion (Leiurus quinquestriatus) and sea anemone (Anemonia sulcata) toxin II enhanced the twitch response of the rat and mouse diaphragms and like crotamine (isolated from the venom of Crotalus durissus terrificus) caused spontaneous fasciculation of the muscle. Trains of action potentials in muscles at 70-250 Hz, which could not be antagonized by (+)-tubocurarine, were triggered by single stimulation or occurred spontaneously after treatment with these toxins. QTX and toxin II prolonged the rat muscle action potential 3 to 4 fold whereas crotamine prolonged the action potential by only 30%. The membrane potential was depolarized from about -82 mV to -55 mV by crotamine 2 micrograms ml-1, -41 mV by toxin II 5 micrograms ml-1 and to -50 mV by QTX 1 microgram ml-1. The concentrations to induce 50% maximal depolarization (K0.5) were 0.07, 0.15 and greater than 0.4 microgram ml-1, respectively, for QTX, crotamine and toxin II, whereas the rates of depolarization were in the order toxin II greater than or equal to crotamine greater than QTX. The depolarizing effects of crotamine and QTX, but not of toxin II, were saturable. The depolarizing effects of all three toxins were irreversible whereas the membrane potential could be restored by tetrodotoxin non-competitively. Simultaneous treatment with crotamine and QTX or crotamine and toxin II at concentrations below K0.5 caused only additive effects on depolarization. When the muscle was depolarized by pretreating with a saturating concentration of crotamine, the onset of depolarization by QTX was greatly retarded whereas that by toxin II was unaffected. Action potentials were further prolonged in both cases. 8 It is inferred that all three peptide toxins act at sites on the sodium channel and the binding sites for QTX and crotamine overlap to a considerable extent. On the other hand, the site for toxin II appears not to overlap with that of crotamine but may overlap with that of QTX.

Potentiation by crotamine of the depolarizing effects of batrachotoxin, protoveratrine A and grayanotoxin I on the rat diaphragm

The interactions between crotamine and tetrodotoxin and group II sodium channel toxins, including batrachotoxin, protoveratrine A and grayanotoxin I, were studied on the rat diaphragm muscle. When the diaphragm was pretreated with 0.1 micrograms crotamine/ml for 45 min (a condition known to depolarize the muscle by less than 3 mV, which is only 20% of the maximal depolarization induced by a saturating concentration of crotamine), the rate of depolarization by group II toxins was markedly enhanced and the time to reach the steady state depolarization was greatly shortened. The maximal depolarizations induced by each of the group II toxins, however, were not increased. Pretreatment with saturating concentrations of crotamine also caused no change of the steady state depolarization induced by batrachotoxin or grayanotoxin I. Moreover, pretreatment of the diaphragm with a high concentration of grayanotoxin I, whose effect is reversible, did not impede the depolarizing effect of crotamine. Tetrodotoxin restored the membrane potential, depolarized by crotamine, with 50% restoration at a concentration of 16 ng/ml, no matter whether a high (20 micrograms/ml) or a low (2 micrograms/ml) concentration of crotamine were used. The above results indicate that there is no competition between crotamine and group II toxins or between crotamine and tetrodotoxin. However, crotamine may affect the binding of group II toxins allosterically, increasing their affinity although the intrinsic activity may not be changed.

Cystadenocarcinoma of the ovary in a 4-year-old: benign transformation during therapy

Ovarian tumors comprise only 1% of all tumors in females below the age of 17 years. Of these, the epithelial tumors are the least common, being particularly rare before puberty and then increasing in frequency with advancing age after puberty. The youngest girl previously reported in the literature with an epithelial ovarian tumor was a 9-year-old child with an ovarian papillary cystadenocarcinoma. This is the only case thus far reported of a malignant ovarian epithelial tumor occurring before puberty. Only histologically benign appearing glands were detected in the resected tumor masses, on a second-look laparotomy following the use of multiagent chemotherapy.