[Adrenal ganglioneuroma]

We report a case of adrenal ganglioneuroma. A 29-year-old man was referred to our clinic for further investigation of right abdominal mass incidentally discovered by ultrasonography. Endocrinological study was unremarkable. Abdominal computed tomography revealed well-defined, 6-cm-long oval mass with mottled calcification. Adrenal scintigraphy showed enlarged adrenal gland with low accumulation. T1-image of magnetic resonance depicted hypointensity tumor in comparison with liver. Extirpation of this tumor disclosed yellowish white, homogeneous mass, 101 g in weight and 7 by 7 by 3.5 cm in diameter. Pathological diagnosis was ganglioneuroma. All reported cases of adrenal ganglioneuroma exceeded 5 cm in diameter. This indicates malignancy in computed tomography. Therefore, we should be careful in diagnosing ganglioneuroma.

Failure of blood pressure control by a new combined alpha- and beta-blocking agent (amosulalol) in a patient with pheochromocytoma

A 42-year-old woman with pheochromocytoma received preoperatively a combined alpha- and beta-adrenoceptor blocking agent, amosulalol, exerting some inhibitory action on both receptors. Severe hypertension and remarkable fluctuation of heart rate occurred following this medication. Although it is claimed currently that a combined blocking agent is useful for the management of this disease, it should be administered with caution.

Left preureteral vena cava (retrocaval or circumcaval ureter) associated with partial situs inversus

We present a rare case of left preureteral vena cava associated with partial situs inversus. A 68-year-old woman was referred to our clinic for further study of left hydronephrosis on computerized tomography. The abdominal viscera were in mirror image and the heart was levocardia. The middle portion of the left ureter was dorsal to the left inferior vena cava. The left ureter was reanastomosed ventral to the inferior vena cava. To our knowledge, coexistence of preureteral vena cava and partial situs inversus has not been reported previously in the literature.

Histological analysis of high-grade superficial bladder tumour

Segmental cystectomy or total cystectomy was performed in 26 patients with newly diagnosed stage T1, grade 3 transitional cell carcinoma of the bladder. Their histological specimens were assessed with regard to types of tumour cell spread, small vessel involvement and coexistent carcinoma in situ. Patients were followed for 12 to 141 months. Broad front type and tentacular type spread were seen in 57.7% and 38.5%, respectively. Small vessel involvement was seen in 38.5% of patients. Coexistent carcinoma in situ was found in as many as 65.4%. Urethral recurrence was found in 4 patients out of 26. These data suggest that the high incidence of coexistent carcinoma in situ may be the most important cause of the unsatisfactory prognosis for stage T1, grade 3 bladder cancer.

Enhancement of the actions of smg p21 GDP/GTP exchange protein by the protein kinase A-catalyzed phosphorylation of smg p21

We have previously shown that cyclic AMP-dependent protein kinase (protein kinase A) phosphorylates smg p21A and -B, ras p21-like small GTP-binding proteins. In the present study, we investigated the function(s) of this phosphorylation by use of the smg p21B purified from human platelets. smg p21B bound to plasma membranes and the protein kinase A-catalyzed phosphorylation of smg p21B reduced this binding. Moreover, the phosphorylation of smg p21B enhanced the two actions of its specific GDP/GTP exchange protein, named GDP dissociation stimulator, when tested in a cell-free system: one is the action to stimulate the GDP/GTP exchange reaction of smg p21B, and the other is the action to inhibit the binding of smg p21B to membranes. Consistently, smg p21B was translocated from the membranes to the cytoplasm when it was phosphorylated by protein kinase A in intact platelets in response to prostaglandin E1 or dibutyryl cyclic AMP. The protein kinase A-catalyzed phosphorylation of smg p21B affected neither its basal GDP/GTP exchange reaction, basal GTPase activity, nor the GTPase activity stimulated by its specific GTPase activating protein. On the other hand, we have recently clarified that the structure of the C-terminal region of the post-translationally processed human platelet smg p21B is Lys-Lys-Ser-Ser-all-trans-geranylgeranyl Cys181 methyl ester, and that this modification of the C-terminal region is essential for smg p21B to bind to membranes. We furthermore determined here that protein kinase A phosphorylated Ser179 in this C-terminal region of smg p21B. These results indicate that protein kinase A-catalyzed phosphorylation of smg p21B makes smg p21B sensitive to the actions of smg p21 GDP dissociation stimulator.

The usefulness of cyclophosphamide pretreatment for subrenal capsule assay against human esophageal cancer

In order to suppress the host immune reaction in subrenal capsule assay (SRCA) using normal immunocompetent mice, the effects of cyclophosphamide (CPM) pretreatment were compared to those obtained after cyclosporine A (CSA) treatment. CPM and CSA suppressed the host reaction until day 6 and day 12, respectively, however, the histological evaluation of the tumors on day 6 revealed no differences between the two groups. The cytotoxicity of CPM in mouse serum against P388 cells was measured to evaluate the residual activity of CPM against the implanted tumor. No cytotoxicity was observed in the serum 36 hours after the CPM injection. In the histological analysis of clinical samples, inflammatory infiltration was observed in only 4 of 25 samples and tumor cell preservation recognized in 27 of 28 samples. A persistence of tumor cells was recognized in the samples rich in tumor cells. Adequate growth of the tumor in the control groups was obtained from 30 of 33 tumors (91 per cent), and the response rates of this assay were comparable to those of prior clinical experiences on each of these drugs. These results indicated the feasibility of SRCA with CPM pretreatment as a predictive test of chemotherapeutic agents for esophageal cancer.

Role of the C-terminal region of smg p21, a ras p21-like small GTP-binding protein, in membrane and smg p21 GDP/GTP exchange protein interactions

Limited proteolysis with trypsin of smg p21B, a ras p21-like small GTP-binding protein having the same putative effector domain as ras p21s, produced the N-terminal fragment and the C-terminal tail of Lys-Lys-Ser-Ser-geranylgeranyl-Cys methyl ester. The Mr values of the intact smg p21B, the N-terminal fragment, and the C-terminal tail were estimated to be about 22,000, 20,500, and less than 1,000, respectively, by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Both the GDP- and GTP-bound forms of the intact smg p21B bound to various membranes and phosphatidylserine-linked Affi-Gel. However, both the GDP- and GTP-bound forms of the N-terminal fragment failed to bind to membranes and phosphatidylserine-linked Affi-Gel. In contrast, the C-terminal tail bound to membranes and phosphatidylserine-linked Affi-Gel. The N-terminal fragment contained a GDP/GTP-binding and GTPase domain and exhibited these two activities, but the C-terminal tail did not show any such activity. A GTPase-activating protein for smg p21 stimulated the GTPase activity of both the intact smg p21B and the N-terminal fragment. In contrast, a GDP/GTP exchange protein for smg p21, named GDP dissociation stimulator, stimulated the GDP/GTP exchange reaction of the intact smg p21B but not that of the N-terminal fragment. These results indicate 1) that smg p21B is composed of at least two functionally different domains, the N-terminal GDP/GTP-binding and GTPase domain and the C-terminal membrane-binding domain, 2) that smg p21B binds to membranes through its C-terminal hydrophobic and basic domain, and 3) that this C-terminal domain is also essential for the smg p21 GDP dissociation stimulator action but not for the smg p21 GTPase-activating protein action.

Stoichiometric interaction of smg p21 with its GDP/GTP exchange protein and its novel action to regulate the translocation of smg p21 between membrane and cytoplasm

We have previously purified a GDP/GTP exchange protein for smg p21A and -B, members of a ras p21/ras p21-like small GTP-binding protein superfamily. This regulatory protein, named smg p21 GDP dissociation stimulator (GDS), stimulates the dissociation of both GDP and GTP from and the subsequent binding of both GDP and GTP to smg p21s. We show here that smg p21 GDS forms a complex with both the GDP- and GTP-bound forms of smg p21B at a molar ratio of about 1:1. Both the GDP- and GTP-bound forms of smg p21B bound to membranes. smg p21 GDS inhibited this binding and moreover induced the dissociation of the prebound smg p21B from the membranes. These results indicate that smg p21 GDS stoichiometrically interacts with smg p21B and thereby regulates its GDP/GTP exchange reaction and its translocation between membranes and cytoplasm.

[The study on the function of the intramural portion of the ureter. The motion of the intramural portion of the ureter in dogs]

The present investigation was performed in order to clarify whether the motion of the intramural portion of the ureter is passive or active. In Experiment I, electromyograms of the extravesical and intramural portions of the ureter were recorded using bipolar suspended electrodes and bipolar needle electrodes for 52 ureters in 26 adult mongrel dogs to study the relationship between both portions of the ureters in the nondiuretic and diuretic state. In Experiment II, using 14 ureters in 10 adult mongrel dogs, electromyograms were recorded and the local forces of the ureteral walls of the extravesical and intramural portions were measured with a special needle electrode concurrently.

RESULTS

(1) Experiment I demonstrated in the nondiuretic and diuretic state, 1. no significant differences in the ureteral discharge frequency between the extravesical and intramural portion of the ureters, and 2. a 1:1 correspondence in the extravesical and intramural action potentials. (2) Increases were observed in the local forces of the ureteral walls of the intramural portion of the ureters following action potentials. From these experimental results, it was suggested that the intramural portion of the ureter actively moves due to muscular excitation from the upper ureter and participates in urine transport.

Calcium-dependent regulation of cyclic GMP phosphodiesterase by a protein from frog retinal rods

In vertebrate photoreceptors, light reduces cyclic GMP concentration and closes cGMP-activated channels to induce a hyperpolarizing response. As Ca2+ can permeate the channels and the Na(+)-Ca2+ exchanger continuously extrudes Ca2+, closure of the channel results in a reduction of the inter-rod Ca2+ concentration. This is believed to be one of the mechanisms of light-adaptation produced by activation of guanylate cyclase. Effects of Ca2+ on the cGMP phosphodiesterase (PDE) have been reported, but their physiological significance has remained unclear. We have perfused the inside-out preparation of a frog rod outer segment (I/O ROS, originally termed truncated ROS, and find that Ca2+ in a physiological range regulates the light-activation of PDE. Therefore, PDE regulation by Ca2+ must be involved in light-adaptation in rods. The effect is mediated by a newly found protein which binds to disk membranes at high Ca2+ concentrations and prolongs PDE activation.

Isolation and identification of clostridia from the intestine of laboratory animals

Quantitative and qualitative examination of faecal clostridia from laboratory mice, rats, hamsters and rabbits was carried out by using selective as well as nonselective culture techniques. The 364 isolates were identified where possible, to species level on the basis of physiological and biochemical characteristics. Most isolates from mice and rabbits were identified, i.e. 79.4% and 76.5%, respectively, while only 25.4% and 28.6% of isolates from rats and hamsters were characterized as described species. The most common species of the 16 identified were: C. coccoides, C. cocleatum and C. innocuum from mice; C. cocleatum, C. cochlearium and C. irregularis from rats; C. cocleatum and C. irregularis from hamsters; and C. aminovalericum and C. irregularis from rabbits. Unidentified Clostridium spp. were isolated from each animal species tested and were tentatively classified into 26 groups. None of these groups was found in more than one animal species in this study.

Action potential of the intramural ureter in the dog

In 33 adult mongrel dogs, the function of the intramural ureter was investigated. (A) Bipolar electrodes were placed in both the extravesical ureter and the intramural ureter. Then, an electromyogram (EMG) was recorded from two leads. (B) Cystotomy was performed, needle-type electrodes were inserted into the wall of the ureteral orifice and the extravesical ureter, and the EMG was recorded. (C) A special needle which could record EMG and measure pressure simultaneously was prepared. Then EMG and pressure measurements were recorded from the wall of the intramural ureter. In each experiment, action potentials were recorded from the intramural ureter that were similar to those from the extravesical ureter. The pressure in the wall of the intramural ureter showed variations matching the action potentials. From these results, it was evident that active muscle contraction occurred due to the action potential transmitted from the extravesical ureter even in the intramural ureter.

Attenuated neuropathology by nilvadipine after middle cerebral artery occlusion in rats

We investigated the effects of nilvadipine, a calcium antagonist, on cerebral ischemia in rats. Under halothane anesthesia, 30 rats had a 3-0 nylon suture introduced through the extracranial internal carotid artery to occlude the left middle cerebral artery. Nilvadipine was dissolved in polyethylene glycol 400. Immediately following occlusion, group 1 rats (n = 10) were treated subcutaneously with vehicle and group 2 and 3 rats were treated with 1.0 (n = 10) and 3.2 (n = 10) mg/kg nilvadipine, respectively. Perfusion fixation was performed 24 hours later, and the histopathologic outcomes were quantified. In group 1 infarct volume was 28.2 +/- 11.4% of the total cerebral volume; in groups 2 and 3 infarct volumes were 25.5 +/- 11.6% (NS) and 13.9 +/- 9.2% (p less than 0.05 different from group 1), respectively. Nilvadipine decreased ischemic neuronal injury in a dose-dependent manner and may be of use in the treatment of cerebral ischemia.

Successful repair of huge bladder diverticulum with a transurethral fulguration. Report of a case

We present a 68-year-old man with a huge bladder diverticulum associated with benign prostate hypertrophy treated with transurethral fulguration of the diverticular mucosa in combination with transurethral resection of the prostate. The procedure was well tolerated by the patient and unfavorable symptoms faded after this procedure. Follow-up cystogram demonstrated remarkable reduction of the diverticulum.

Biphasic effects of yohimbine on the ejaculatory response in the dog

The effects of various doses (0.01-1.00 mg/kg) of yohimbine, an alpha-2 adrenoceptor antagonist, on the erectile and ejaculatory response elicited by manual penile stimulation were investigated in male dogs. Systemic administration of yohimbine caused a biphasic effect on ejaculatory response; the amount of ejaculate produced by the genital stimulation (for 5 min) was dose-dependently increased by low doses (0.01-0.10 mg/kg) of yohimbine, whereas it was decreased by the highest dose (1.00 mg/kg) of yohimbine. The erectile potency was attenuated only, by the highest dose of yohimbine. The most effective dose (0.10 mg/kg) of yohimbine on ejaculation did not affect the duration of penile erection after removing the genital stimulation. In a stereoisomer's testing, the stimulatory effect on ejaculation was also observed by rauwolscine, an alpha-2 adrenoceptor antagonist (0.03 and 0.10 mg/kg), but not by corynanthine, an alpha-1 adrenoceptor antagonist (0.10 and 0.30 mg/kg). These results suggest that yohimbine at low doses specifically facilitate the ejaculatory response through the blockade of the alpha-2 adrenoceptors. This study also indicates that the effects of yohimbine on male genital responses vary with its dosage used.

Diminution of ejaculatory capacity induced by frequent ejaculation in dogs: prevention and reversal by yohimbine

The effect of yohimbine, an alpha-2 adrenoceptor antagonist, on diminished ejaculatory capacity induced by frequent ejaculation was investigated in dogs. Ejaculation was elicited by manual penile stimulation (for 5 min) 5-8 times every 30 min. The amount of ejaculate produced by the stimulation was drastically reduced during a period of frequent ejaculation in a frequency-dependent manner. When administered immediately after the first ejaculation, yohimbine (0.1 mg kg-1, i.p.) completely prevented the decrease in the amount of ejaculate produced in the succeeding ejaculation. Moreover, similar treatment with yohimbine immediately after the fifth ejaculation when the dogs displayed a greatly reduced ejaculatory capacity restored the capacity to the initial level. In addition, yohimbine increased the total number of sperm produced during a period of frequent ejaculation. These data corroborate our previous finding that yohimbine at a low dose has a stimulatory effect on ejaculatory function in dogs. The present study also indicates that an alpha-2 adrenergic mechanism may be involved in the diminution of ejaculatory capacity induced by frequent ejaculation.

Effects of a Ca2+ entry blocker (nilvadipine) on acute focal cerebral ischemia in rats

The effects of nilvadipine, a Ca2+ entry blocker, on focal cerebral ischemia were investigated in rats having unilateral middle cerebral artery occlusion. All rats had 24 h ischemia, and were divided into three groups (ten rats per group). Groups 1 and 2 received 1.0 and 3.2 mg/kg nilvadipine s.c. respectively, just after the occlusion. Control rats received an equal volume of the vehicle. Control animals had a % infarct volume of 28.2 +/- 11.4%, and a left/right hemispheric volume ratio of 112 +/- 12%. Group-1 and -2 rats had % infarct volumes of 25.5 +/- 11.6% and 13.9 +/- 9.2% (p less than 0.01) respectively, and left/right hemispheric volume ratios of 111 +/- 9% and 103 +/- 7% (p less than 0.05), respectively. Thus, the drug reduced the infarct size and the brain edema in a dose-dependent manner. The significant decrease in the infarct volume was observed in the periphery of the frontoparietal cortex. This study supports the hypothesis that nilvadipine may be a potential therapeutic agent for cerebral ischemia. Neuropathological findings suggest the possible therapeutic effects of the drug in the ischemic penumbra.

Renal involvement in POEMS syndrome

We describe a patient with POEMS syndrome whose renal biopsy specimen also showed nephropathy. Immunoelectron microscopy of the renal biopsy revealed the localization of immunoglobulin (IgA and lambda light chain) in the subendothelial space of the glomerular capillaries, a previously unrecognized finding. We conclude that the renal pathology in POEMS syndrome is unusual and distinct from microangiopathic glomerular involvement or idiopathic mesangiocapillary glomerulonephritis.

An improved closed cranial window technique for investigation of blood-brain barrier function and cerebral vasomotor control in the rat

A modification of the closed cranial window technique for small laboratory animals is presented. The method facilitates investigation of blood-brain barrier permeability in association with studies of the cerebrovascular response under normal and pathological conditions. Following trephination and preparation of the pia-arachnoid surface, the skull defect is closed again by sealing a cover glass onto a wall of dental cement surrounding the cranial window. The intracranial pressure can then be studied and experimentally manipulated. Care is taken to maintain normal blood-brain barrier function to a small barrier indicator (Na(+)-fluorescein, MW: 376). This is accomplished by opening the skull and dura mater under a column of paraffin oil to avoid exposure of brain tissue to atmospheric pressure. Reactivity of the cerebral surface vessels was assessed during hypercapnia at an arterial PaCO2 of 50.8 +/- 1.1 mm Hg. It was found that small arterioles of 20-50 microns phi had a significantly larger CO2-response than large arterioles of 50-100 microns phi. Pial venules did not respond at all. Superfusion of the cranial window preparation at a rate of 5 ml/h with buffered artificial CSF was tolerated for hours. No alterations of arteriolar or venular diameters nor opening of the blood-brain barrier to Na(+)-fluorescein was observed. These technical modifications enable us to employ a closed cranial window model in small laboratory animals for studies of cerebral microcirculation and blood-brain barrier function under normal as well as under pathological conditions related to brain damage.

Endotoxic activity in faeces of mice from different microbiological environments

Chromogenic Limulus amoebocyte lysate (LAL) tests were evaluated for measuring endotoxic activity in faeces of mice from different microbiological environments. Faeces of BALB/c mice from germ-free (GF), specific-pathogen-free (SPF) and conventional (CV) colonies had no inhibitory activity on the test reaction. GF and SPF faeces had heat-labile non-specific amidase activity which gave false-positive reaction, while CV did not. GF faeces had a heat-stable non-endotoxic effect on the LAL system. Average endotoxin levels in faeces of GF, SPF and CV mice were 0.2, 0.8 and 17 to 24 micrograms/g wet weight, respectively. Results suggest that the microbiological status of mice influences not only the faecal endotoxin level but also the specificity of the test reaction.

Cytophagic histiocytic panniculitis evolving into total lipodystrophy

A 15-year-old boy had persistent fever with severe neutropenia, thrombocytopenia, coagulation disorder, and marked elevation of lactate dehydrogenase values. A diagnosis of cytophagic histiocytic panniculitis was made after repeated skin biopsies. Three years after onset, he gradually lost 20 kg in body weight, and both skin and bone marrow specimens revealed degenerative changes of fatty tissue without any inflammatory cells. These findings suggest that total lipodystrophy syndrome results from the inflammatory destructive process of adipose tissue. To our knowledge, our report is the first to show, in a series of histologic studies, that an inflammatory destructive process may be involved in some cases of total lipodystrophy syndrome.