[Ectopic parathyroid adenoma: a case report]

A 69-year-old woman suffered from bilateral renal stones. Laboratory examinations showed primary hyperparathyroidism. Neck exploration including left hemithyroidectomy and partial thymectomy failed to reveal the abnormal parathyroid gland. Localization studies were done for an ectopic parathyroid adenoma. Repeated selective arteriography with digital subtraction technique revealed an ectopic parathyroid adenoma in the upper mediastinum. Computed tomography, ultrasonotomography and selective venous sampling also confirmed this finding. Subsequently, mediastinal exploration with partial sternotomy was performed and the ectopic parathyroid adenoma was removed. We discuss the preoperative localization studies for ectopic parathyroid adenoma.

The role of cGMP in the anti-aggregating properties of BY-1949, a novel dibenzoxazepine derivative

The anti-aggregatory activity of a novel agent, BY-1949, 3-methoxy-11-methyldibenz (b,f) (1,4) oxazepine-8-carboxylic acid, was examined using rabbit platelets. Oral administration of BY-1949 (10 or 30 mg/kg) inhibited platelet aggregation induced by ADP, collagen, and arachidonate in a dose-related fashion. In in vitro studies, however, neither BY-1949 nor its major metabolites inhibited platelet aggregation, even at a concentration similar to that attained in plasma in vivo. With regard to the anti-aggregatory action of BY-1949, biochemical analysis revealed that BY-1949 preferentially augmented cyclic GMP (cGMP) formation, via inhibition of phosphodiesterase activity, without altering cyclic AMP (cAMP) formation. Furthermore, the in vitro anti-aggregatory activity was significantly enhanced when the platelets were concomitantly treated with nitric oxide (NO). Based on these results, it is suggested that the in vivo anti-aggregatory effects of BY-1949 are at least partly elicited via platelet/endothelium interactions, in which cGMP plays a pivotal role.

Phorbol 12,13-diacetate-induced contraction of the canine basilar artery: role of protein kinase C

The pharmacological and biochemical mechanisms of contractile responses to the protein kinase C (PKC) activator phorbol-12,13-diacetate (PDA) were investigated in canine basilar arteries. In the normal medium, PDA elicited a strong, dose-related, and slow-developing sustained contraction. Among the constrictors examined, including serotonin, prostaglandin F2 alpha, and endothelin, only PDA yielded contractions in a Ca2(+)-free medium. In both media, the PDA-induced contractions were virtually inhibited by either staurosporine, H-7, or quinacrine, while neither neurotransmitter blockades nor R24571 (calmidazolium) exerted significant effects. In addition, it was shown that 8-bromocyclic GMP, but not 8-bromocyclic AMP, markedly curtailed the PDA-induced contractions. Biochemical analysis, furthermore, showed that PDA induced increased phosphorylations of 27- and 96-kDa and proteins other than the myosin light chain (MLC) 20-kDa protein. Thus, the present results open up a novel mechanism of sustained cerebral artery contractions, where PKC activation rather than Ca2+/calmodulin/MLC system plays a key role that is regulated both by phospholipase A2 and by cyclic GMP.

Localization of tissue plasminogen activator on experimental microthrombi in rats. Microautoradiographic observations

The localization of tissue plasminogen activator (t-PA) on microthrombi in various organs of disseminated intravascular coagulation rats (DIC rats) was investigated by using microautoradiographic technique. After the injection of [125I]fibrinogen, experimental DIC rats induced by the infusion of thrombin for 1 h were submitted to microautoradiograms (MARGMs) of some major organs. The radioactivity of [125I]fibrin thrombi, which were observed as silver grains, was localized in the glomeruli and parts of small vessels in the kidney. In the liver, microthrombi were seen in sinusoid vessels and on Kupffer cells. In addition, many microthrombi were noted in small vessels in the lung and marginal zones in the spleen. Two min after the intravenous administration of [125I]t-PA to DIC rats, many silver grains were observed on each MARGM of the kidney, lung, liver and spleen showing the formation of microthrombi. From the identical results with the observations of MARGMs after the injection of [125I]fibrinogen, we confirmed that t-PA was highly accumulated to microthrombi formed in small vessels of the organs. The scattered silver grains were widely observed on the hepatocytes. This result suggested that t-PA bound to the parenchymal cell surface might be transported into the hepatocytes by receptor-mediated endocytosis. On the other hand, when [125I]urokinase plasminogen activator [( 125I]u-PA) was administered intravenously to DIC rats, many silver grains were observed on MARGM of the proximal tubules in the kidney but not seen on MARGMs of the glomeruli in the kidney, nor in the lung, liver, and spleen. This observation suggested that u-PA might not have a characteristic to accumulate to thrombi.

Localization of tissue plasminogen activator on experimental thrombi in rats

The localization of tissue plasminogen activator (t-PA) or urokinase plasminogen activator (u-PA) on thrombi was investigated in disseminated intravascular coagulation rats (DIC rats) induced by thrombin. One hour after the intravenous infusion of thrombin to rats, the plasma fibrinogen level decreased, while the plasminogen activator activity in the plasma euglobulin fraction increased. The whole body autoradiography was studied after an injection of [125I]fibrinogen in DIC rats. The high radioactivity which indicated the presence of microthrombi was observed in the renal cortex, liver, spleen and lung. Furthermore, a large venous thrombus with higher radioactivity was observed in the abdominal vena cava. These results show that the thrombin-treated animal is one of the best DIC models. After the intravenous administration of [125I]t-PA, the autoradiograms of DIC rats showed a radioactivity in the blood and much higher radioactivities in the renal cortex, spleen and lung in comparison with the normal rat. However, there was no difference in the distribution of [125I]u-PA between normal and DIC rats at all. The strong radioactivity of [125I]t-PA but not [125I]u-PA was observed on the surface of large thrombus in the vena cava. These results suggest that t-PA localizes more preferentially on microthrombi than u-PA. The ratio of the radioactivity in the tissue to that in the blood was calculated to compare quantitatively the localization of [125I]t-PA and [125I]u-PA on microthrombi formed in organs.(ABSTRACT TRUNCATED AT 250 WORDS)

Urinary crystal surface binding substances on calcium oxalate crystals

In order to study the effect of urinary crystal surface binding substances (CSBS), we extracted the naturally existing CSBS from urine from healthy individuals by conducting homogeneous crystallization of calcium oxalate. CSBS proved not to be promoters but rather strong inhibitors of calcium oxalate crystal growth and aggregation. It is suggested that CSBS exhibited their inhibitory effect by masking the growing sites and aggregating sites on the crystal surface. As for the characteristics of CSBS, we found around 10 peaks of molecular weight, and all of them contained both peptides and saccharides. The findings suggest that CSBS are composed of various kinds of glycoproteins and proteoglycans.

[A case of retroperitoneal Hodgkin's disease with dysuria]

A case of retroperitoneal Hodgkin's disease with dysuria is reported. A 56-year-old man visited our hospital with the complaints of dysuria and lower abdominal mass. On physical examination, an unmovable hard smooth mass of fist size was palpable in the lower abdomen and prostate was slightly swelling by rectal digital examination. Excretory urography demonstrated medial deviation of left lower ureter and bladder deformity. Retrograde urethrocystography showed deviation and compression of prostatic urethra. On CT, tumors were composed of several round masses, which surrounded the left common iliac artery on angiography. Surgical extirpation was carried out and histological examination revealed Hodgkin's disease. As postoperative treatment, chemotherapy with cyclophosphamide, adriamycin, vincristine and prednisolone was performed, and 30 months after the operation the patient was asymptomatic.

[Detection of polyamines by a new enzymatic differential assay. (8) Studies on tissue polyamine concentrations in patients with genitourinary malignant diseases]

Polyamine concentrations of human cancerous and non-cancerous tissues from the kidney, ureter, bladder were measured by a new enzymatic method for isolation and determination of polyamines. In cancerous and non-cancerous tissue of the organs studied, the spermine level was highest followed by the spermidine and diamine levels. The concentrations of diamine, spermidine and spermine in cancerous tissues were significantly higher than those in non-cancerous tissues, but there was no significant difference in the spermidine/spermine ratio between the cancerous and non-cancerous tissues. These data suggest that polyamines are produced above the normal levels in pathological conditions such as renal cell carcinoma, ureteral cancer and bladder cancer.

[Detection of polyamines by a new enzymatic differential assay. (7) Fundamental study on a new enzymatic differential assay of tissue polyamines]

The enzymatic method for isolation and determination of urinary polyamines was modified to measure the polyamines in tissue. High recovery rates of polyamines in tissue by the enzymatic method were obtained, namely, 104.5 +/- 7.4% for diamine, 104.7 +/- 23.3% for spermidine and 104.8 +/- 7.5% for spermine. The results obtained by this method correlated well with those obtained by high performance liquid chromatography, and a close correlation was demonstrated for all fractions: diamine r = 0.8991, y = 0.9916x + 0.0499; spermidine r = 0.8936, y = 1.2073x + 0.1005; spermine r = 0.8921, y = 1.2200x-0.2194, (n = 13).

Assignment of the human gene for histidine-rich glycoprotein to chromosome 3

Histidine-rich glycoprotein (HRG) is a monomeric plasma glycoprotein involved in the modulation of coagulation and fibrinolysis. Using Southern analysis of human-rodent somatic cell hybrid DNA with a human HRG-specific cDNA probe, the HRG gene was assigned to chromosome 3. One hybrid that was known to contain only a segment of chromosome 3 also reacted positively with the HRG probe. Hybridization analysis with a set of chromosome 3-specific probes showed that the segment of chromosome 3 present in this hybrid is missing the region pter-p14, which indicates that HRG is not located in this region. No restriction fragment length polymorphisms were detected for HRG with 10 commonly used restriction enzymes.

Factors participating in blood pressure elevation after discharge from the hospital in patients with essential hypertension

We followed the changes in blood pressure (BP) after discharge from the hospital in 32 patients with essential hypertension whose BP was normalized on a diet containing 7g/day of NaCl during hospitalization. They were divided into two groups on the basis of BP changes: 18 patients whose BP values were elevated by more than 10% after discharge (group I; mean +16.9%, P less than .01) and the remaining 14 patients (group II; -3.6%, P = NS). Urinary Na excretion (UNaV) in Group I patients increased markedly after discharge (83 v 189 mu Eq/min, P less than .001) while it did not change in Group II (122 v 102 mu Eq/min, P = NS), resulting in a greater postdischarge UNaV in group I than in group II (P less than .01). The changes in BP were positively correlated with the overall changes in UNaV (r = 0.45, P less than .01). Plasma epinephrine after discharge was higher in group I than in group II (31 v 18 pg/mL, P less than .05). Thus, increases in NaCl intake seem to play an important role in BP elevation after discharge. Adrenal medullary function may partly contribute also to the BP elevation.

[Vesicorectal fistula associated with Crohn's disease: a case report]

A 41-year-old man was hospitalized, complaining of fecaluria and right lower abdominal pain. He was diagnosed to have vesicorectal fistula. Wedge resection of bladder and rectum, and partial resection of ileocecal legion were performed. Pathological diagnosis was Crohn's disease. Postoperative course was uneventful and no recurrence was observed. Including our case, 32 cases of enterovesical fistula due to Crohn's disease have been reported in the Japanese literature.

A novel dibenzoxazepine derivative (BY-1949) increases regional cerebral blood flow

The effects of BY-1949, a novel dibenzoxazepine derivative, on the regional cerebral blood flow were investigated in conscious cats. Oral administration of BY-1949 (10-50 mg/kg) significantly increased in a dose-related manner the regional cerebral blood flow in all brain regions examined. Vinpocetine (20 mg/kg p.p.) had similar effects that were shorter-lasted than those of BY-1949. From these results, it seems likely that amelioration by BY-1949 of cognitive impairment following cerebral ischemia/hypoxia or that occurs on ageing is at least partly explainable in terms of its effects on the cerebral circulation.

Cobb's syndrome and its treatment with embolization. Case report

A case of Cobb's syndrome, which is characterized by spinal and vertebral angiomas and a skin nevus at the same metameric level, is reported. The spinal angiomas were treated with liquid embolization using ethylene vinyl alcohol.

[Retroperitoneal lymph node dissection for testicular tumor with renal autotransplantation: a case report]

A case of testicular tumor (embryonal cell carcinoma with choriocarcinoma) in a 42-year-old man treated with renal autotransplantation is presented. After four courses of chemotherapy (carboplatin, vinblastine and bleomycin), we performed retroperitoneal lymph node dissection. At the operation, one of the swelling lymph nodes involved left renal artery completely, so we performed left renal autotransplantation and promoted more effective lymph node dissection. After the operation, renal function was impaired but returned completely in a short time. Autotransplantation provides excellent bench visualization of renal lesions and stable graft function. Therefore, this procedure should be taken into consideration when nephrectomy cannot be avoided.

Amplification of a long sequence that includes a processed pseudogene for elongation factor 2 in the mouse

Quantitative Southern blotting analysis has demonstrated that mouse cells contain about 70 copies per haploid genome of a DNA sequence related to the gene for elongation factor 2. The restriction maps of seven cosmids that each carry one copy of the EF2-related sequence (MER) and nucleotide sequences of MERs were highly conserved among the cosmids. Data obtained by such analyses suggest that MERs were produced by the integration of one copy of MER derived from poly(A)+ mRNA for EF2 into a specific site in the mouse genome, with subsequent amplification of MER together with its large flanking sequences during the evolution of the mouse. Furthermore, it appears that the size of each repeating unit is more than 60 kb. Analysis by pulse-field gel electrophoresis suggested that multiple copies of a repeating unit of more than 400 kb (or two units) are clustered at a specific site (or each specific site) in the mouse genome.

A case of Fabry's disease in a patient with no alpha-galactosidase A activity caused by a single amino acid substitution of Pro-40 by Ser

We analyzed a male patient with Fabry's disease who had no activity of the lysosomal hydrolase alpha-galactosidase A (alpha-GalA) and female members of his family. We cloned a cDNA that encoded the mutant alpha-GalA, determined its nucleotide sequence, and found two nucleotide differences between the mutant and the wild-type cDNAs. Although one difference was silent, the other difference, a C-to-T transition at nucleotide number 118, resulted in an amino acid substitution of Pro-40 by Ser. A transient expression assay demonstrated that this missense mutation was the cause of the deficiency of alpha-GalA activity in the patient. In vitro mutagenesis experiments demonstrated that Pro-40 is critical for the appearance of alpha-GalA activity.

[Urolithiasis--changes in its treatment in the traditional surgical management]

Surgical treatments for urolithiasis in the upper urinary tract are reviewed on the basis of operation statistics at the Department of Urology, Osaka University Hospital for the past 30 years from 1957 to 1986. Open surgery was applied for 1,624 patients with urolithiasis in the kidney and ureter during this period. These operations accounted for 14.4% of the 11,300 cases of urological surgery at our department. Types and frequency of operations for urolithiasis were as follows: ureterolithotomies 697 cases (6.2%), pyelolithotomies including extended pyelotomy 376 cases (3.3%), nephrolithotomies 294 cases (2.6%), partial nephrectomies 132 cases (1.2%) and nephrectomies 125 cases (1.1%).

Possible role of Tamm-Horsfall glycoprotein in calcium oxalate crystallisation

The role of Tamm-Horsfall glycoprotein (THGP) in the crystallisation of calcium oxalate was investigated. The results showed THGP to have a weak inhibitory effect on crystal growth. In contrast, urinary macromolecules showed a strong inhibitory effect. THGP should, therefore, not be considered the main component of urinary macromolecules which have a strong inhibitory effect on crystal growth. However, THGP did enhance crystal production in the early phase of crystallisation. It appears that THGP should be viewed as a promoter rather than an inhibitor of calcium oxalate crystallisation at physiological concentrations.

[Uncommon calcification of a pheochromocytoma: a case report]

A 62-year-old man with a 2-year history of hypertension was referred for evaluation of severe back pain, but his blood pressure was normal during his hospital stay. Plain radiography and excretory urography demonstrated central and eggshell-like calcification in the left suprarenal area. Computed tomographic scan confirmed similar shapes for the left adrenal calcifications. Laboratory examination revealed that the urinary normetanephrine was elevated. Left adrenal venography showed that the mass was in the middle to lower portion of the left adrenal gland. The most likely diagnosis was, calcified pheochromocytoma. The left adrenal tumor was removed surgically through a thoracolumbar incision on September 19, 1985. The blood pressure rose to 186/102 mmHg at the time of tumor manipulation. The tumor was a markedly hard mass, which was 3.5 x 3.5 x 3.0 cm and weighed 20 g. The histopathologic diagnosis was calcified pheochromocytoma. The patient remained symptomless after the operation.

Pyruvate dehydrogenase activity in the rat cerebral cortex following cerebral ischemia

The effect of cerebral ischemia on the activity of pyruvate dehydrogenase (PDH) enzyme complex (PDHC) was investigated in homogenates of frozen rat cerebral cortex following 15 min of bilateral common carotid occlusion ischemia and following 15 min, 60 min, and 6 h of recirculation after 15 min of ischemia. In frozen cortical tissue from the same animals, the levels of labile phosphate compounds, glucose, glycogen, lactate, and pyruvate was determined. In cortex from control animals, the rate of [1(-14)C]pyruvate decarboxylation was 9.6 +/- 0.5 nmol CO2/(min-mg protein) or 40% of the total PDHC activity. This fraction increased to 89% at the end of 15 min of ischemia. At 15 min of recirculation following 15 min of ischemia, the PDHC activity decreased to 50% of control levels and was depressed for up to 6 h post ischemia. This decrease in activity was not due to a decrease in total PDHC activity. Apart from a reduction in ATP levels, the acute changes in the levels of energy metabolites were essentially normalized at 6 h of recovery. Dichloroacetate (DCA), an inhibitor of PDH kinase, given to rats at 250 mg/kg i.p. four times over 2 h, significantly decreased blood glucose levels from 7.4 +/- 0.6 to 5.1 +/- 0.3 mmol/L and fully activated PDHC. In animals in which the plasma glucose level was maintained at control levels of 8.3 +/- 0.5 mumol/g by intravenous infusion of glucose, the active portion of PDHC increased to 95 +/- 4%. In contrast, the depressed PDHC activity at 15 min following ischemia was not affected by the DCA treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Rat heart fatty acid-binding protein. Evidence that supports the amino acid sequence predicted from the cDNA

The amino acid sequence of rat heart fatty acid-binding protein was re-examined by analysing the tryptic and the chymotryptic peptides, since some discrepancies have been reported between the sequences determined by protein analyses and that deduced from the cDNA analyses. Our result completely agreed with the amino acid sequence predicted from the cDNA analyses, providing evidence for the actual existence of the molecular species predicted from the cDNA.

Decrease of atrial natriuretic peptide content in rat superior cervical sympathetic ganglion after denervation and axotomy

We found atrial natriuretic peptide (ANP), known as a humoral factor in regulating body fluid volume and blood pressure, in considerable quantities in rat superior cervical sympathetic ganglion (SCG) by radioimmunoassay after separation with reverse-phase HPLC. Although the ANP content of the immature rat 1 week after birth was low, it doubled at 2 weeks and then increased gradually, until it reached the adult level. Denervation caused a rapid decrease in the ANP content to half of the intact SCG level after 3 h, which then fell to 10% of the control value on day 2 after operation. The time course of ANP content reduction after denervation was similar but rather faster than that of activity of the acetylcholine-synthesizing enzyme, choline acetyltransferase, an observation suggesting that ANP may partly contribute to cholinergic synaptic transmission. On the other hand, axotomy produced a rather slower decrease in the ANP content than did denervation. Enucleation and sialoadenectomy also caused a considerable reduction of the ANP content. Thus, part of the ANP found in the ganglion is apparently transported from sympathetically innervated extraganglionic organs via retrograde axoplasmic flow.