Paracrine function of endothelium-derived nitric oxide

We explored whether endothelium-derived nitric oxide (EDNO) acts in an autocrine or paracrine fashion to activate the soluble guanylate cyclase by measuring the elevations of cGMP levels. Comparisons were made between two culture models in which EDNO can stimulate cGMP synthesis within the same cells (endothelial cells) where it is formed, or in the neighboring cells (smooth muscle cells). The basal amount of EDNO showed no difference in cGMP levels when the endothelial cells (EC) were cultured either alone (iso-culture) or together with the smooth muscle cells (SMC, co-culture). However, cGMP levels were synergistically increased by the BK-stimulated EDNO when EC were co-cultured with SMC. The synergistical increase was significantly inhibited by 3-methyl-1-phenyl-2-pyrazolin-5-one (MCI-186), an extracellular radical scavenger. These findings suggest that the tonic formed basal EDNO has an autocrine effect on cGMP levels of EC themselves. In contrast, BK-stimulated phasic formed EDNO has not only an autocrine effect, but also a paracrine effect on cGMP levels of EC themselves and the adjacent SMC.

[Halothane reduces the inhibition of dorsal horn lamina V type neuronal activity induced by bradykinin injection into the femoral artery contralateral to the recording site]

Effect of halothane (0.2%, 0.5%, and 1.0%) on spinal function were studied in lamina V type cells responding to noxious and light touch applied at their cutaneous receptive field on the foot pad of the left hind paw. Extracellular unit activities of lamina V type cells were recorded at the lumbar level in six cats and thirteen spinal cats. When intra-arterial injection of bradykinin (BK) 10 micrograms into the femoral artery ipsilateral to the recording sites was used as the noxious test stimuli, six of these cells (100%) were found to have inhibitory response in six intact cats and thirteen of these cells (100%) were found to have excitatory response in thirteen spinal cats. On the other hand, when the injection of 10 micrograms into the femoral artery contralateral to the recording sites was used as the noxious test stimuli, six of these cells (100%) were found to have inhibitory response in six intact cats and six of these cells (46%) were found to have inhibitory response in thirteen spinal cats. We studied the effect of halothane on the inhibition induced by BK injection into the femoral artery contralateral to the recording sites in six intact cats and six spinal cats. Halothane 0.2%, 0.5% and 1.0% reduced the inhibition of dorsal horn lamina V type neuronal activity induced by BK injection.

[5-FU concentrations in the blood and tumor tissue after 5'-DFUR or UFT administration in the patients with uterine cervical cancer]

In order to verify the antitumor activity of fluorinated pyrimidine drugs, we conducted an investigation of the clinical pharmacology with two drugs, 5'-DFUR and UFT. Total 21 cases of cervical cancer were alloted randomly into 5'-DFUR group (daily dose 800 mg for 3 days) consisting of 11 patients and UFT group (daily dose 600 mg for 3 days) consisting of 10 patients, the unchanged substances (5'-DFUR in the 5'-DFUR group and tegafur concentrations in the UFT group) and 5-FU concentrations in serum and tissues were measured 6 hours after administration of the drugs. The 5'-DFUR concentration in the 5'-DFUR group was not detected in serum and less than a detectable limit for all of cancerous tissues, normal cervical tissues, and lymph nodes. The tegafur concentrations in the UFT treated group was 13.8 +/- 7.0 micrograms/ml for serum, 10.4 +/- 6.4 micrograms/g for cancerous tissues, 14.1 +/- 7.3 micrograms/g for normal cervical tissues, and 4.5 +/- 4.2 micrograms/g for lymph nodes. The 5-FU concentrations in the 5'-DFUR treated group were 0.018 +/- 0.046 micrograms/g for cancerous tissues, but less than a detectable limit for serum and normal cervical tissues. On the other hand, in the UFT group, 0.271 +/- 0.247 micrograms/g for a cancerous tissue, 0.035 +/- 0.018 micrograms/ml for serum, 0.125 +/- 0.073 micrograms/g for normal cervical tissues, showing significantly high values (p < 0.01, p < 0.001, and p < 0.01, respectively) compared to those in the 5'-DFUR treated group. These results suggest that UFT is a promising drug for the treatment of cancer of the uterine cervix.

Induction of calcium-independent nitric oxide synthase activity in cultured cerebellar granule neurons

Cultured cerebellar granule neurons were assayed for nitric oxide synthase (NOS) activity by measuring the conversion of L-arginine to L-citrulline. Granule neurons expressed constitutive NOS activity which was calcium-dependent. Treatment of neuron cultures for 24 h with the combined stimulation of IFN-gamma plus IL-1 beta, TNF-alpha and LPS induced NOS activity by 87-fold which was calcium-independent. We conclude that cultured cerebellar granule neurons can express both the constitutive and inducible forms of NOS activity.

Evaluation of latex agglutination test for alpha-fetoprotein in diagnosing rupture of fetal membranes

To assess the utility of a latex agglutination test for alpha-fetoprotein in vaginal fluid for diagnosing rupture of the fetal membranes, we tested 91 pregnant women, including 32 with an established rupture, 19 with no evidence of rupture and 40 with a suspected rupture. Results were compared with those of the pH indicator and the fern tests. The latex agglutination test had better sensitivity, specificity, or both, than the pH indicator and the fern tests. We conclude that the latex agglutination test is more accurate than either the pH indicator or the fern test for diagnosing premature rupture of fetal membranes.

Arborization of the inferior laryngeal nerve and internal nerve on the posterior surface of the larynx

The morphological patterns of the inferior laryngeal nerve and internal laryngeal nerve display complex arborizations. This paper attempts to identify and clarify these patterns. Dissections were performed on 105 adult Japanese cadavers, and observations were made on 201 sides. Results showed that the communications between the inferior laryngeal nerve (ILN) and internal laryngeal nerve (ITLN) could be classified into two types and three subtypes. Also, the ITLN displayed three characteristic patterns at the arytenoid cartilage. These communications produce complex arborizations of the ILN as it enters the larynx. This may explain the variety of potential clinical symptoms observed after thyroid surgery or neck dissections.

When is the optimal time for delivery?--Purely from the fetuses' perspective

To determine when the extrauterine environment becomes safer than the intrauterine environment with respect to fetal (neonatal) life, we analyzed all 4,896,505 livebirths, all 21,222 stillbirths, and all 7,513 early neonatal deaths after 26 weeks gestation that were recorded between 1989 and 1992 in Japan. Although the risk of early neonatal death ( < 1 week of age) and of neonatal death ( < 4 weeks of age) greatly exceed the risk of stillbirth at 26 weeks of gestation, those risks declined sharply by 39 weeks of gestation, then increased, while the risk of stillbirth within 1 and 4 weeks exceeded the risks of early neonatal death and of neonatal death at and beyond gestational weeks 40 and 38, respectively, for a singleton pregnancy. A similar reversal occurred at 37 and 35 weeks of gestation for multiple pregnancy. Neonates born at 39 and 37 weeks of gestation for singleton and multiple pregnancies, respectively, had the best outcome. It is concluded that the chance of survival for fetuses reaching 40 and 37 weeks of gestation for singleton and multiple pregnancies, respectively, were higher in the extrauterine than the intrauterine environment in Japan today.

Direct lymphatic drainage from the esophagus into the thoracic duct

The lymphatic vessels from around the esophagus which drain into the thoracic duct were identified macroscopically and histologically in 106 cadavers. Direct lymphatic drainage to the duct was macroscopically demonstrated by 84 vessels in 46 cases (43.4%). In 23 cases (19.8%), large collecting vessels arose from the thoracic esophagus and opened directly into the duct. In most of these cases (15/23) these lymphatic connections were found at the levels of the 1st-3rd or 6th-8th thoracic vertebrae. Histologic study revealed that two vessels originated from the fine lymphatic plexus in the esophageal adventita, which showed monocytic infiltration. In 11 of the 23 cases, an intercalated node was found along the thoracic duct. The results suggest that lymph drains rapidly into the systemic circulation via the thoracic duct. In view of the clinical applications in esophageal carcinoma, previous accounts of the extramural esophageal lymphatics concerned in direct drainage are discussed.

[A new operative technique for pulmonary artery banding: adjustment of pulmonary artery bands by mitral valve flow velocity]

We developed a new technique to adjust the pulmonary artery band at surgery by monitoring the mitral valve flow velocity, which is indirectly indicative of the pulmonary flow. We employed this technique for 10 consecutive patients aged from 5 days to 5 months (mean, 1 months) weighing from 2.7 to 4.4 kg (mean, 3.3 kg). Underlying disease was aortic coarctation or interrupted+ventricular septal defect in 7 patients, single ventricule in 1 patients and miscellaneous defects in 2 patients. The pulmonary artery was exposed through a left lateral thoracotomy and a 3 mm wide Teflon tape was placed around the main pulmonary artery. The transducer of the Doppler echocardiography was placed along the left sternal border. The band was tightened gradually until the maximum velocity of the mitral valve flow decreased to around 70% of the previous level. During banding procedure, arterial oxygen saturation, heart rate and left ventricular contractility were monitored continuously. If bradycardia, unacceptable hypoxemia or ventricular dysfunction occurred, the band was released. The mitral valve flow velocity decreased rapidly by just a little additional tightness of the band between the range of 50% to 80% of the previous level. This technique enabled a very fine adjustment (less than 0.5 mm plication) and postoperative management has become very easy. Although there is a limitation of this technique that monitoring of the mitral valve flow velocity cannot be applied to the patients with significant interatrial shunt or mitral regurgitation, we conclude that this technique is simple and useful to obtain the optimum constriction of the pulmonary artery with excessive pulmonary blood flow.

[Anesthetic management for cesarean section in patients with maternal myotonic dystrophy]

Myotonic dystrophy involves not only voluntary muscles of extremities, pharyngeal muscle and respiratory muscle but also smooth muscle in the gastrointestinal tract. This muscle involvement can cause difficulty in excreting sputa, delayed emptying time of stomach and regurgitation of gastric content, all of which can lead to disastrous complications of anesthetic management. Pregnancy is rare because of ovarian atrophy. We report two cases of cesarean section for patients with myotonic dystrophy. In one case, the newborn baby had dyspnea due to congenital myotonic dystrophy, and in another case, patient experienced postoperative pneumonia. Our cases and other reports suggest that spinal or epidural anesthesia is safely applied for a cesarean section of a patient with myotonic dystrophy.

[Alteration in production of vasomediators associated with in vitro aging in cultured human umbilical vein endothelial cells]

Differences in the secretion of some vascular regulators, endothelin-1 (ET-1), prostacylin (PGI2), thromboxane A2 (TXA2) and nitric oxide (NO) associated with in vitro aging, were investigated in cultured endothelial cells isolated from normal human umbilical veins (HUVECs). HUVECs from different population doubling levels (PDLs) were cultured in a medium MCDB-104 supplemented with FBS and ECGF. Cell saturation density of HUVECs decreased by 5-fold between PDL 7 and 67. PGI2 secretion per cell increased by 6-fold, and TXA2 secretion per cell increased by 18-fold between PDL 7 and 67. The ratio of PGI2 to TXA2 secretion decreased 3-fold between PDL 7 and 40 and remained at the lower level between PDL 40 and 67. The secretion of ET-1 by HUVECs at a young stage of growth (PDL 7) increased linearly with time between 0 and 36 hours of incubation. ET-1 secretion per cell increased between PDL 7 and 67 by 5-fold after 4-hr incubation and by 3-fold after 9-hr incubation. The release of NO was assayed by a newly established, highly sensitive assay system monitoring guanosine 3':5'-cyclic monophosphate (cGMP) formation in a pig kidney epithelial cell line cocultured with HUVECs. The cGMP formation by NO released from HUVECs decreased 3.3-fold between PDL 8 and 50. These results suggest that the vaso-constrictive activity of endothelial cells increases during in vitro aging which may reflect the increased vascular disorders in the aged people.

Enzyme-cytochemistry of human chorion laeve at term: enzyme localization on the chorionic trophoblast

Is the chorion laeve merely a remnant of the chorion frondosum in placental development? Or is it metabolically active, having something to do with maternofetal interactions? In order to answer these questions at least in part, we determined the ultracytochemical localizations of some important enzymes such as nonspecific phosphatase (alkaline phosphatase), specific phosphatase (Ca(++)-ATPase and 5'-nucleotidase) and adenylate cyclase in the human chorion laeve at term. Strong activities of these enzymes were localized by ultracytochemistry on the plasma membrane of the trophoblast in the chorion laeve. These enzyme activities were confirmed by a series of cytochemical-control experiments, i.e., substrate-free control, heat-stability control, and inhibition control by inhibitors of alkaline phosphatase. These observations indicate that the chorionic trophoblast is probably metabolically active and that it might play an important role in the physiology of the fetal membrane.

Complementary improvement of the method for determining cholinergic activities in the small intestine and its application to experiments in vivo

The concentration of acetylcholine (ACh) in rat jejunum that had been homogenized with an ultra-high-speed homogenizer (Biotron) was significantly higher than that in jejunum homogenized with a glass homogenizer. Rats were injected once or repeatedly for 10 days with a muscarinic agonist, pilocarpine (1 mg/kg), or a muscarinic antagonist, scopolamine (5 mg/kg). Animals were killed 20 min or 24 hr after single or consecutive injections, respectively, for determinations of cholinergic activities in the jejunum. Single treatment: Pilocarpine did not cause significant changes in the level of ACh, the activity of acetylcholinesterase (AChE), the binding of [3H]quinuclidinyl benzilate (QNB) or the contractile responses to ACh. Scopolamine reduced the level of ACh and binding of [3H]QNB without inducing significant changes in the activity of AChE and the contractile response. Consecutive treatment: Pilocarpine reduced the binding of [3H]QNB by changing the value of Bmax and reduced the contractile response without affecting the level of ACh or the activity of AChE. Scopolamine increased the binding of [3H]QNB without any effects on the level of ACh, the activity of AChE or the contractile response. In summary, it is possible to determine the level of ACh in a tissue as hard as intestine by homogenization with a Biotron and to assess the cholinergic situation in the intestine of animals that have been poisoned with various agents by estimating cholinergic activities.

Transcription of the MRP RNA gene in frog stage I oocytes requires a novel cis-element

The RNA component of the mitochondrial RNA processing (MRP) enzyme is related to both replication of mitochondrial DNA and processing of 5.8S rRNA, which are accelerated in the frog earliest stage (stage I) of frog oocytes. Microinjection of the deleted genes into the stage I oocytes showed positive cis-elements in the upstream region of the gene. The specific binding of protein(s) to this region was detected in cell extracts from stage I oocytes and liver but not in extracts of stage II-IV oocytes and the concentration of this protein was 40 times higher in the extract of stage I oocytes than that in liver.

Macrophage colony-stimulating factor enhances platelet recovery following cisplatin/carboplatin chemotherapy in ovarian cancer

To assess the effects of macrophage colony-stimulating factor (M-CSF) on platelet recovery in patients given chemotherapy for advanced and recurrent ovarian cancer, we selected 29 cases treated with carboplatin (280 mg/m2, Day 1) and cisplatin (70 mg/m2, Day 2). We evaluated the response and the platelet recovery effects of M-CSF, which was infused intravenously for 7 consecutive days after the second and fourth courses of chemotherapy. For the 54 courses of M-CSF infusion, the platelet nadir averaged 12.8 +/- 6.3 x 10(4)/microliters, with 9% of the courses designated Grade 3 or 4 on the toxicity scale, according to World Health Organization recommendations, both of which were significantly different from the M-CSF noninfused control courses (P < 0.05). The number of periods in which platelets were below 7.5 x 10(4)/microliters was significantly less in the courses of M-CSF infusion (P < 0.01). Response to treatment was pathologic complete in 23% and partial in 41%, for a total response of 64%. Cisplatin combined with carboplatin was effective in treating patients with advanced and recurrent ovarian cancer. M-CSF infusion may enhance the recovery from the thrombocytopenia that accompanies such chemotherapy.

[Effect of isoflurane on spinal dorsal horn WDR neuronal activity in cats]

The effects of isoflurane (0.5% and 1.5%) on the spinal dorsal horn wide dynamic range (WDR) neuronal activity were studied in either spinal cord intact or spinal cord-transected cats. Extracellular activity was recorded in the dorsal horn from single WDR neurons responding to noxious and non-noxious stimuli applied to the cutaneous receptive fields on the left hind foot pads of intact or decerebrate, spinal cord transected (L1-2) cats. When bradykinin (BK) 10 micrograms was injected into the femoral artery ipsilateral to the recording site as the noxious test stimulus in the spinal cat, all of 17 WDR neurons gave excitatory responses which were not depressed by 0.5% isoflurane but were depressed significantly by 1.5%. On the other hand, when the injection of BK 10 micrograms into the femoral artery ipsilateral to the recording site was used in the intact cat, 13 of 24 WDR neurons (54%) gave excitatory responses, which were significantly depressed by 0.5% and 1.5% isoflurane, and 11 of 24 WDR neurons (46%) gave inhibitory responses, which were significantly depressed by 0.5% and 1.5% isoflurane. We have found that isoflurane reduces the excitation as well as the inhibition of dorsal horn WDR neuronal activity induced by BK injection.

Adjustment of pulmonary artery banding by mitral valve flow velocity

In order to determine the tightness of the pulmonary artery band, Doppler echocardiography is used to assess mitral valve flow velocity, which is an indirect indicator of pulmonary blood flow. The band is tightened until the velocity decreases to 70% of the original maximal level. Additional adjustment of the constriction is then made to obtain reasonable arterial oxygen saturation, heart rate and ventricular contractility. Using this method, 12 consecutive patients underwent pulmonary artery banding with satisfactory results. This technique is simple but useful in obtaining optimum constriction of the pulmonary artery in congenital heart disease with excessive pulmonary blood flow.

Enzyme-cytochemistry of human chorion laeve at term: enzyme localization on the chorionic trophoblast

Is the chorion laeve merely a remnant of the chorion frondosum in placental development? Or is it metabolically active, having something to do with maternofetal interactions? In order to answer these questions at least in part, we determined the ultracytochemical localizations of some important enzymes such as nonspecific phosphatase (alkaline phosphatase), specific phosphatase (Ca(++)-ATPase and 5'-nucleotidase) and adenylate cyclase in the human chorion laeve at term. Strong activities of these enzymes were localized by ultracytochemistry on the plasma membrane of the trophoblast in the chorion laeve. These enzyme activities were confirmed by a series of cytochemical-control experiments, i.e., substrate-free control, heat-stability control, and inhibition control by inhibitors of alkaline phosphatase. These observations indicate that the chorionic trophoblast is probably metabolically active and that it might play an important role in the physiology of the fetal membrane.

Venous drainage of the thoracic esophagus toward the pulmonary vein

Venous drainage of the thoracic esophagus toward the pulmonary vein (PV) was investigated in 52 human specimens in which the veins around the esophagus were clearly observed owing to venous blood retention after injection of 10 L of formol solution into the femoral artery. Below the level of the tracheal bifurcation, 43 cases (right, 21; left, 22) of venous drainage toward the PV were observed in 29 of the 52 specimens examined (55.8%). The direct drainage to the PV was observed mainly on the left side (19 of the 22 cases). In contrast, drainage via the bronchial vein toward the PV existed mainly on the right side (18 of the 21 cases). These drainage routes merged into the tributaries of the inferior PV, such as the inferior or superior basal vein. The draining veins often communicated with the azygos vein system on the right side (10 of the 21 cases). The veins passed through the pulmonary ligament, and also often along the vagus nerve or the bronchial artery. No venous valves were found during the course of direct drainage from the esophagus to the PV. Venous drainage toward the PV was considered to be one of the main drainage routes from the thoracic esophagus.

Effects of single or repeated administration of a carbamate, propoxur, and an organophosphate, DDVP, on jejunal cholinergic activities and contractile responses in rats

Wistar rats were injected once or repeatedly for 10 days with dichlorvos (DDVP, 5 mg kg-1), propoxur (10 mg kg-1), oxotremorine (0.1 mg kg-1) or atropine (5 mg kg-1). Animals were killed 20 min or 24 h after single or consecutive injections, respectively, for determinations of cholinergic activities and contractile responses to acetylcholine (ACh) of the jejunum. Single treatments: while DDVP and propoxur decreased acetylcholinesterase (AChE) activity, oxotremorine and atropine did not. Although DDVP, propoxur and oxotremorine increased levels of ACh, atropine decreased them. Contractile responses to ACh were enhanced by DDVP and reduced by oxotremorine and atropine. The Bmax value of binding of [3H]quinuclidinyl benzylate (QNB) to muscarinic ACh receptors was decreased by atropine. Consecutive treatments: DDVP and oxotremorine decreased AChE activity markedly and slightly, respectively. Although DDVP and oxotremorine increased levels of ACh, propoxur decreased them. Without affecting the contractile responses, DDVP caused a reduction and propoxur and atropine caused an increase in the Bmax value for binding of [3H]QNB. Both the contractile responses and the value of Bmax for binding of [3H]-QNB were decreased by oxotremorine. In summary, propoxur and DDVP showed similar effects mainly through their anticholinesterase properties in the case of single injection, but DDVP had similar effects to those of oxotremorine and propoxur had similar effects to those of atropine in the case of repeated injection.

The superior alveolar nerves: their topographical relationship and distribution to the maxillary sinus in human adults

The superior alveolar nerves in human adults were investigated macroscopically using whole-mount silver impregnation, paying special attention to their topographical relationship and distribution to the mucous membrane of the maxillary sinus. In addition, the fiber composition of the alveolar nerves was analysed in order to estimate their contribution to teeth innervation. The posterior superior alveolar nerve (PSAN) ran through canaliculi in the lateral wall of the sinus (23 of 37 cases, 62.2%) or under the mucous membrane of the sinus (14 of 37 cases, 37.8%). Moreover, the PSAN gave off many fine twigs to make complex plexus under the mucous membrane of the sinus before joining the superior dental plexus. The plexus of the maxillary sinus was separated from the superior dental plexus by the bony wall of the sinus. After the above gross observations, the perimeter compositions of myelinated fibers of the plexus, PSAN and the anterior alveolar nerve were analysed in the same specimen. The plexus was composed of myelinated fibers of less than 27 microns in circumference perimeter (mean: 14.3 microns) and numerous unmyelinated fibers. The fiber composition suggested that few fibers in the plexus of the maxillary sinus contribute to the formation of the superior dental plexus. The superior dental plexus, innervating the upper teeth, was located in the thick alveolar process of the maxilla, and not on the maxillary sinus wall. The clinical importance of these results was discussed in relation to nerve injury during antrostomy of the maxillary sinus.