Deterioration of Ebstein disease after closure of atrial septal defect

We treated a 7-year-old girl in whom the clinical evidence of Ebstein disease was manifest after a surgical closure of an atrial septal defect. This manifestation, which was not evident either in the preoperative catheterization studies or during operative investigation of closure of the atrial septal defect, required further hemodynamic and angiographic evaluation. Tricuspid valve replacement with Hall-Kaster prostheses was carried out.

Effects of solution of low pH and taurocholate on release of beta-endorphin-like immunoreactivity from human duodenal mucosa in vitro

The presence of beta-endorphin-like immunoreactivity (beta-EpLI) in human duodenum and its release were studied. beta-EpLI was detected in the duodenum (mucosa, 26.7 +/- 6.3 pmol/g wet weight, mean +/- SEM; remaining tissue 23.1 +/- 5.3 pmol/g wet weight) and the stomach (7.1 pmol/g wet weight). The two activities gave similar curves for inhibition of beta-Ep radioimmunoassay of synthetic beta-Ep. On gel-filtration chromatography of a duodenal extract, two components of beta-EpLI were separated. When human duodenal mucosa was perfused with a solution of pH2 or 1mM or 5mM taurocholate, the release of beta-EpLI from mucosa into the perfusate increased 2-4 fold. These results indicate that beta-EpLI present in human duodenal is released by the direct action of low pH or taurocholate on the duodenal mucosa and suggest that it may have a physiological role.

Retinal degeneration in celestial goldfish. Developmental study

The celestial goldfish were systematically reared from fertilization for life, revealing developmental processes of retinal degeneration. The eyes began to protrude laterally at the age of 90 days, rotated antero-dorsally at 120 days, and thus the 'celestial eye' was completed. The retina developed to normal mature structure by the age of 50 days. No degenerative findings were revealed before the start of eye extrusion. The first morphological change, irregular distribution of melanin granules in the pigment epithelial layer and disorientation of the outer segments of photoreceptors, was detected at the age of 90 days. At 120 days, the pigment epithelial layer lost melanin granules at places and was occupied by phagocytes. Photoreceptor cells were destroyed, and phagocytes, containing melanin granules, appeared in the inner retina and/or choroid. The retinal degeneration started simultaneously with eye protrusion. The regular telescopic-eye goldfish have large, extended eyes as those of celestial goldfish, but they develop no retinal degeneration. Celestial goldfish seems to be an interesting new type of hereditary retinal degeneration in vertebrates.

In vivo and in vitro effects of substance P on the release of beta-endorphin-like immunoreactivity

The effect of substance P (SP) on the release of beta-endorphin-like immunoreactivity (beta-EpLI) in rats was studied in vivo and in vitro. Intravenous injection of 5 micrograms/100 g BW of SP resulted in significant increase in the plasma beta-EpLI level after 15 and 30 min. SP at concentrations of 10(-9) to 10(-6) M also caused dose-dependent stimulation of beta-EpLI release from dispersed cells of rat anterior pituitary. On gel-chromatography, the beta-EpLI released by incubation of the cells with 10(-7) M SP separated into two components, eluted in the same positions as human beta-lipotropin and human beta-Ep, respectively. Release of beta-EpLI from the cells was increased by the addition of K+ at high concentration (53 mM) in a Ca++-dependent manner. Addition of 10(-3) M verapamil to the incubation medium inhibited SP-induced beta-EpLI release from the cells. Ouabain (10(-5) M) had a stimulatory effect on beta-EpLI release which was not additive with that of SP. These results indicate that SP acts directly on the anterior pituitary cells to stimulate beta-EpLI release and that calcium ion is involved in the mechanism of this effect.

Molecular heterogeneity and biological activity of immunoreactive somatostatin in medullary carcinoma of the thyroid

Two cases of somatostatin (SRIF)-producing medullary carcinoma of the thyroid are presented. The plasma levels of SRIF and calcitonin changed in accordance with the clinical course before and after resection of the tumor. On chromatographic analysis of tumor extracts derived from primary and metastatic tumors of medullary thyroid carcinoma, at least two components of immunoreactive SRIF (IR-SRIF) of large molecular size were found, besides a component corresponding to the tetradecapeptide (SRIF 14); one of these seemed to have almost the same molecular weight as the octacosapeptide (SRIF 28). Most of the IR-SRIF in one patient's plasma was eluted in the same position as tetradecapeptide SRIF. The biological activity of SRIF recovered from the tumor extract was assessed by measuring activity for inhibiting GH release using dispersed rat anterior pituitary cells. GH release from the cells into the incubation medium tended to decrease at a concentration of 1 x 10(-9) M IR-SRIF derived from the tumor (3000 +/- 482 ng/10(5) cells . 3 h) compared with the control value (4288 +/- 567 ng/10(5) cells . 3 h). A significant decrease was observed at concentrations of 1 x 10(-8) M (1880 +/- 403 ng/10(5) cells . 3 h) and 5 x 10(-8) M (938 +/- 262 ng/10(5) cells . 3 h). Responses to equivalent amounts of synthetic SRIF 14 were similar. This suggests that IR-SRIF in the tumor has almost the same biological activity as synthetic tetradecapeptide SRIF.

Freeze-fractured replica of Schlemm's canal and the trabecular meshwork in the primate

Using a freeze-fracture technique, the fine structure of the Schlemm's canal and trabecular meshwork in the monkey was studied with special reference to intercellular junctions. Gap junctions were observed between the endothelial cells of Schlemm's canal and between the trabecular meshwork cells. Maculae occludentes were rarely observed between the endothelial cells of the inner wall of Schlemm's canal. The trabecular meshwork cells appeared to act in an electrotonic and metabolic syncytium.

Effects of thermal load on ion release of the rabbit vitreous body

Ion-release of the rabbit vitreous body through a dialysis membrane against water was studied. To evaluate one of thermal changes in the vitreous properties, the vitreous was heated or cooled before dialysis. The average wet weight of the normal vitreous was 1.61 +/- 0.20 g and dry to wet weight ratio was 1.33 +/- 0.04%. The dry weight, sodium, potassium, and chloride concentrations of the vitreous were decreased as an exponential function curve by dialysis. A decreasing ratio was prominent in the heated vitreous, the frozen vitreous and the non-thermo-treated (control) vitreous in turn. Calcium and magnesium release from the rabbit vitreous body was slow and differences among the heated, frozen and non-thermo-treated vitreous bodies were not significant, suggesting some different capture-mechanisms between the monovalent and bivalent ions.

Histopathologic study of congenital aural atresia in the human embryo

We studied the histopathologic features of the temporal bones in a human embryo with unilateral aural atresia. The developmental stage of the embryo was at stage 22 in the Carnegie system, and the estimated ovulation age was 8 weeks. There were severe hypoplastic changes in Meckel's and Reichert's arch cartilages without differentiation of the auditory ossicles, hypoplasia of the tubotympanic recess, and resultant abnormal passing of the facial nerve in the affected ear. Abnormal lateral extension of the cartilaginous otic capsule replaced a posterior half of the middle ear region and seemed to form the so-called atresia plate. The external and middle ears of the unaffected side and the bilateral inner ears were morphologically normal. These findings might explain some parts of the complicated mechanism in the development of middle ear anomalies encountered in surgery for congenital aural atresia.

Synaptic vesicle exocytosis in goldfish photoreceptor cells

The photoreceptor cell endings of goldfish retinas were examined using ultrathin and freeze-fracture techniques. The synaptic vesicles could be seen lying closely packed in rows on each side of the synaptic ribbon, and the vesicles nearest to the end of the ribbon could be seen to be in direct contact with the presynaptic membrane. The openings of the synaptic vesicles to the synaptic cleft could also be observed at the presynaptic membrane nearest to the end of the ribbon, that is, 100 nm distant from the center of the apex. In the freeze-fractured replicas of the presynaptic membrane, the band-shaped membrane particle aggregation was seen at the apex and a row of the crater-like or circular protuberances were observed at each side of the apex. These structures were considered to be changes of the presynaptic membrane organizations according to the synaptic vesicle exocytosis. It may be possible that the synaptic vesicle exocytosis in the photoreceptor cells occurs at the sites of the presynaptic membrane nearest to the apical end of the synaptic ribbon, and that the exocytotic sites form a line on each side of the apex.

Effects of somatostatin on gastrointestinal hormone-induced glycogenolysis and gluconeogenesis in cultured liver cells

When isolated rat liver cells were incubated for 15 min in the presence of vasoactive intestinal peptide, gastric inhibitory polypeptide, secretin or glucagon at a concentration of 2.0 micrograms/ml, glycogenolysis was stimulated by 30%-67% above the control. Slight but significant increase on gluconeogenesis was also observed by the addition vasoactive intestinal peptide, gastric inhibitory polypeptide or secretin. Somatostatin inhibited both glycogenolysis and gluconeogenesis induced by these hormones, but the degrees of inhibition are clearly much higher in the hormone-induced gluconeogenesis than glycogenolysis, and no significant inhibition of glycogenolysis was observed in case of glucagon and VIP. These results suggest the possibility that the so-called enterohepatic axis may play a part of roles in the regulation of serum glucose levels through gastrointestinal hormones belonging to the secretin family, and that it may be further regulated by somatostatin through gluconeogenesis.

Differential effects of propranolol on vasoactive intestinal peptide-, and epinephrine-induced glycogenolysis in cultured liver cells

When isolated rat liver cells were incubated in the presence of epinephrine and dopamine at concentrations ranging from 0.2 ug to 2.0 ug per ml, glycogenoloysis was maximally stimulated within 15 min. The combined addition to incubation medium showed that somatostatin did not inhibit the stimulated glycogenolysis induced by epinephrine and dopamine. On the other hand, the combined addition to the incubation medium showed that propranolol inhibited the stimulated glycogenolysis induced by epinephrine, while propranolol did not inhibit the stimulated glycogenolysis induced by vasoactive intestinal peptide. These results suggest that the receptor site for vasoactive intestinal peptide may be different from that of epinephrine.

Effects of secretin on glycogenolysis in cultured liver cells

Upon incubation of hepatocyte isolated from rats with secretin at concentration ranging from 0.1 unit to 1.0 unit per ml, glycogenolysis was maximally stimulated after 15 min. Somatostatin inhibited liver glycogenolysis. The combined addition to the incubation medium showed that somatostatin inhibited the stimulated glycogenolysis induced by secretin, while secretin plus vasoactive intestinal peptide showed no additive effects on glycogenolysis, as compared with single addition of secretin. However, the addition of glucagon to secretin showed additive effects on glycogenolysis. These results suggest that the receptor site for secretin might be different from that for glucagon, but the same as that for vasoactive intestinal peptide. Moreover, the calcium ion was shown to be a prerequisite for the inducible effects of the hormones so far tested.

Caffeine contracture in frog cardiac muscle after exposure to high concentrations of calcium

Caffeine induced contracture in frog auricular muscle at room temperature when the muscle was exposed to a Ca-rich solution. The initial transient tension lasted 10-30 sec, and it was inhibited by procaine. It was dependent on caffeine concentration and the time of exposure to a Ca-rich solution prior to caffeine attack, but was little dependent on Ca concentration during caffeine contracture.

Specialized intramembrane organizations of the cone presynaptic membrane in the pigeon retina. Freeze-fracture study

The presynaptic membranes of the cone cell endings of the pigeon retina were investigated using the freeze-fracture technique. En face views of the cytoplasmic leaflet (P-face) of the split presynaptic membrane revealed several specialized membrane organizations, 1. membrane particle aggregates composed of 10-20 particles which were larger than the usual ones seen in the cell membrane, 2. fenestration-like circular structures of 30-50 nm in diameter which were not surrounded by membrane particles. 3. similiar circular structures as described above but which were accompanied by a few membrane particles on the circular margin and were considered to be an intermediate form of the first and second membrane structures. These three structures appeared simultaneously in one fracture plane of the presynaptic membrane; were situated at the same intervals from one another and were approximately equal in size to synaptic vesicles (30-50 nm). These findings strongly suggested that these three structures were serial events in presynaptic membrane organization. When fortuitous cross fractures exposed both the P-face of the presynaptic membrane and the adjacent cytoplasm of the cone ending, fusion of the synaptic vesicles to the presynaptic membrane was observed, and was considered to be the opening of the synaptic vesicle to the synaptic cleft. These openings were also situated at the same distance as the structures described above. These findings demonstrate the process of exocytosis of the synaptic vesicles by which the chemical transmitter is probably released to the synaptic cleft.

Malignant fibrous histiocytoma of the maxillary sinus

A case of malignant fibrous histiocytoma arising primarily in the left maxillary sinus is described. The patient, a 39-year-old male, who had suffered from sinusitis for 20 years, began to have paresthesia or sharp pain of the left side of the face and toothaches of the left maxilla. At operation a white fibrous tumor developing extensively from the lateral wall to the upper and medial walls of the left maxillary sinus and into the ethmoidal sinus was noted. Following a gradual progression of dyspnea, he died approximately one year after the onset in spite of radiation therapy and anticancer chemotherapy. An autopsy revealed recurrence of the tumor in the left maxillary sinus with wide-spread metastases to the lungs, pleurae, pancreas, kidneys and bone marrows. The direct cause of death was respiratory failure due to extensive growths of the pulmonary and pleural metastases.

Effects of vasoactive intestinal peptide on glycogenolysis in cultured liver cells

When isolated rat liver cells were incubated in the presence of vasoactive intestinal peptide at the concentrations ranging from 0.2 microgram to 2 micrograms per ml, glycogenolysis was maximally stimulated within 15 min. However, somatostatin inhibited the liver glycogenolysis. The combined addition to the incubation medium showed that insulin and somatostatin inhibited the stimulated glycogenolysis induced by vasoactive intestinal peptide, while vasoactive intestinal peptide plus secretin showed no additive effect on glycogenolysis, as compared with single the addition of vasoactive intestinal peptide. On the other hand, the additon of glucagon to vasoactive intestinal peptide showed additive effects on glycogenolysis. These results suggest that the receptor site for vasoactive intestinal peptide may be distinguishable from that for glucagon. Extracellular calcium ions were demonstrated to play an important role in the modulation of vasoactive intestinal peptide-induced glycogenolysis. The evidence presented in this paper indicates that glucose metabolism may be partly regulated by the direct action of vasoactive intestinal peptide on hepatocytes, which is referred to as an enterohepatic axis and that the axis is inhibited by insulin and somatostatin.

Intracellular synaptic potentials of primate motor cortex neurons during voluntary movement

An intracellular recording technique was applied to the precentral motor cortex of the unanesthetized, chronically behaving monkey. Postsynaptic potentials, responsible for an initiation of the voluntary movement, were recorded. In total, 22 pyramidal tract neurons (PTNs) and 40 non-pyramidal tract neurons (non-PTNs) were successfully penetrated in 5 monkeys while the monkey was performing a flexion-extension wrist movement after a visual cue (reaction time, 200--350 msec). The neurons showed a negative membrane potential shift of at least 30 mV for more than 30 sec. A slowly rising PSP appeared 80--180 msec after the visual cue, and was 70--180 msec prior to an onset of the movement. Spike activities were superimposed upon this slow PSP with 20--80 msec rise time and 2--6 mV depolarization (8 PTNs and 6 non-PTNs). Since these depolarizations were variable in magnitude and latency, these were considered to be summated potentials of small EPSPs and hidden IPSPs. Membrane resistance was measured from an IR drop by a hyperpolarizing current (1.2 X 10(-9) A) passed through a recording electrode, and was 3.5 +/- 1.7 Momega in 18 PTNs and 4.5 +/- 2.5 Momega in 28 non-PTNs. There was a linear relationship in PTNs between membrane resistance and antidromic latency from the pontine pyramid. Because of the time course of PSPs, their possible dendritic origins were discussed.

Cortical projection to hand-arm motor area from post-arcuate area in macaque monkeys: a histological study of retrograde transport of horseradish peroxidase

In four macaque monkeys horseradish peroxidase (HRP) was injected into physiologically defined hand-arm motor area. Ipsilaterally, HRP labeled neurons were found in both upper and lower limbs of the posterior bank of the arcuate sulcus and in an area surrounding the arcuate spur. Contralaterally, labeled neurons were found in the same areas, though less dense in concentration. Labeled neurons were found mostly in layer III of the cortex.

Factors influencing survival and successful weaning from clinical ventricular bypass with local heparinization and blood filtration: an analysis in 21 consecutive patients

A simple circulatory support of transapical ventricular bypass type with nonpulsatile pumping and regional heparinization in 21 patients has revealed that several factors contribute to the patient's outcome. The duration of the bypass was not an essential determinant of prognosis and patients supported for 5--8 days could be weaned from TALVB. Those patients who could maintain steady hemodynamics with flow rates of 30--40% of cardiac output, were usually successfully weaned. Patients who required longer support with high flow rates (60--80% or over) had less probability of being weaned. Persistent or preexistent dysfunction of vital organs, as manifested by renal failure, brain damage, respiratory failure and infection, were main factors determining unsuccessful weaning. The complications related to pumping itself, thromboembolization, bleeding, infection and blood damage, were much less frequently observed with this type of support. The simplicity and less time consuming surgical technique for cannulation and, in addition, less harmful procedure of decannulation and avoidance of thrombus formation were directly related to the improved prognosis.

[Effects of vitamin B complex in functional changes of the peripheral nerves of alloxan-induced diabetic rats (author's transl)]

Neurophysiological properties of the peripheral nerves of alloxan-induced diabetic rats and effects of vitamin B complex (V) were studied. Alloxan monohydrate was administered to Wistar (38 mg/kg, i.v.) and Sprague-Dawley (SD, 45 mg/kg, i.v.) rats. In Wistar diabetic rats (blood sugar level: more than 400 mg/dl for 6--8 weeks), nerve potentials with 2 peaks were recorded from the tibial and peroneal nerves. The late component had a higher threshold, longer time of recovery from excitation and slower conduction velocities. Large doses of V (B1: 100, B6: 100 and B12: 1 mg/kg, i.p.) administered daily until the experiment inhibited the appearance of the late component. In SD diabetic rats(the same blood sugar content for 6 approximately 8 months), the ventral root potentials had a longer duration, higher threshold and longer time of recovery from excitation. In V administered rats, particularly along with insulin, these changes were prevented. Most efferent fibers of non-treated rats had a refractory period of less than 3.0 msec. The number of fibers with this refractory period was greatly reduced in the diabetic rats. Although rats administered each component of V 100 and V 50 had efferent fibers with similar refractory periods to that of rats in A-S group, those administered V 100 had efferent fibers with significantly shorter refractory periods. Thus, efferent fibers seem to be more sensitive than the afferent ones at the early stages of the long term diabetic state and a large dose of V, particularly along with insulin, depressed these changes.

[Effects of a new psychotropic agent, CS-430, on the central nervous system of experimental animals (author's transl)]

In rats and rabbits with chronically implanted electrodes CS-430(10-bromo-2, 3, 7, 11b-tetrahydro--11b-(2-fluorophenyl)-oxazolo(3, 2d) [1, 4]benzodiazepine-6(5H)-one) (3 mg/kg, .o.) decreased the slightly awake period and increased the slow-wave sleep period. The onset time of sleep was significantly shortened. In the rat pre-treated with p-chlorophenylalaine (500 mg/kg, p.o.), the awake period was remarkable increased and the slow wave sleep period was considerably decreased at 48 hours after the pre-treatment. In these rats CS-430 given in the same dose decreased significantly the awake peiod and the onset time of sleep and increased the slow wave sleep period. CS-430 raised the threshold of the arousal response with stimulation of the posterior hypothalamus, but not of the mesencephalic reticular formation. These effects of CS-430 were almost as potent as those of nitrazepam (NZP). CS-430 reduced duration of after-discharges following stimulation of the hippocampus, depressed the decerebrate rigidity and inhibited activity of lumbar gamma-motoneurons in anesthetized cats. CS-430 (10 mg/kg, p.o.) inhibited the evoked responses recorded from the proreus gyrus following stimulation of either the baso-magnocellularis of the amygdaloid nuclear or the ventral hippocampus, although such did not inhibit the responses between the olfactory bulb and the pyriform cortex, the thalamus and the sensory-motor cortex. Thus CS-430 has a sleep-inducing effect in animals of almost the same potency as is seen with NZP, and site(s) of the action in the limbic system appear to be specific.

Ketamine-diazepam anaesthesia for abdominal surgery. A review of 1000 cases with continuous "Micro-Mini" drip administration technique

During a twenty-one month period, over 1000 patients who underwent various types of intra-abdominal operations were anaesthetized with a combination of diazepam and ketamine using a continuous "Micro-Mini" drip administration technique. The results obtained from 1000 cases were eminently satisfactory. This paper also reviews all the previous literature on ketamine anaesthesia related to abdominal surgery. All the undesirable adverse side effects associated with ketamine anaesthesia in adult patients have been almost completely eliminated using this technique. Overall, the excellent results clearly indicate that ketamine has a definite place in anaesthesia for intra-abdominal operations.