Medial medullary syndrome in a drug abuser

A 28-year-old woman with a long history of drug abuse experienced flaccid quadriplegia and bilateral loss of posterior column sensation a few minutes after an intravenous (IV) injection of methylphenidate hydrochloride. Subsequently, spasticity developed and she showed minimal functional improvement during a period of several months. Necropsy performed 8 1/2 months later showed systemic granulomatosis due to talc and two ischemic infarctions, one involving both medial medullary areas and the other involving the left frontal lobe. Deposits of talc, presumably from a medication prepared for oral use, were demonstrated in the small vessels in the area of the medullary infarction. This case is unique in that the medial medullary syndrome was apparently caused by an embolus of talc following its IV administration.

Effect of polychlorinated biphenyl on viral infections in mice

Mice that were fed a diet containing 400, 200 or 100 microgram of polychlorinated biphenyls (PCB) per g were significantly more susceptible to Herpes simplex virus than mice that were fed a PCB-free diet. The mortality of mice that were fed a diet containing 400 or 200 microgram of PCB per g and infected with ectromelia virus was higher than that of normal control mice infected with virus. There was no significant difference in inducibility of interferon by polyinosinic acid-polycytoidylic acid between PCB-fed mice and control mice.

Parkinson disease, dementia, and Alzheimer disease: clinicopathological correlations

Clinical records and neuropathological specimens from 36 patients with autopsy-demonstrated idiopathic Parkinson disease (PD) were reviewed independently and the results compared. Nine (31%) of the 29 patients with adequate clinical data had severe dementia and 7 (24%) had mild dementia. The cerebral cortex showed senile plaques and fibrillary tangles in 15 of the 36 patients (42%). These changes were found in all 9 patients with severe dementia, in 3 of the 7 with mild dementia, and in 3 of the 13 patients with normal mental status. The prevalence of pathologically established Alzheimer changes and dementia among the patients with PD (33%) was over six times that found in an age-matched population (5.1%). Survival after the onset of PD with Alzheimer disease was shorter than in PD without Alzheimer disease.

An electrographic study on the functional capacity of the coronary collateral circulation in dogs with chronic coronary occlusion

The functional capacity of coronary collaterals was investigated under resting and stress conditions in 15 dogs with chronic occlusion of the anterior descending coronary artery. ST-elevation in epicardial and intramyocardial electrograms was used for assessing the degree of regional myocardial ischemia. In resting condition, epicardial and intramyocardial electrograms from collateral, intermediate and circumflex areas revealed no significant ischemic changes. In 6 of 15 dogs in which atrial pacing was performed, ST-elevation appeared in electrograms from collateral and intermediate areas. In another 9 dogs, pacing tachycardia produced no significant changes in all electrograms. In these dogs more than 50% constriction of the donor coronary artery was necessary to induce ST-elevation in electrogram from collateral area. These findings indicate that the coronary collateral vessels in dog play beneficial role to prevent the myocardium from ischemic injury under stress condition, although their functional capacity is not comparable to that of normal coronary artery.

Decreased activity of proteins adsorbed onto glass surfaces with porous glass as a reference

The biological activity of proteins bound to controlled-pore glass surfaces was studied as a model of denaturation of biologicals upon storage in glass containers. After adsorption onto the glass for 1 week, the activities of alkaline phosphatase, catalase, and horse-radish peroxidase recovered from the glass column were 88, 63, and 97%, respectively. However, the phosphatase activity recovered after adsorption for 3 months was 14% of the total activity loaded onto the column, and the activities recovered of peroxidase and catalase were 48 and 2%, respectively. Insulin had almost full activity after adsorption for 3 months, but calcitonin activity was absent. The scission of peptide bonds of proteins eluted after adsorption for 3 months was not observed, but dissociation to the subunits was found. The proteins were active in the state adsorbed onto glass surfaces.

A study on myocardial ischemia in the left ventricular wall with special reference to electrographic and metabolic changes

Ischemic changes in the left ventricular wall were investigated during graded coronary constriction in 9 dogs. Epicardial and intramyocardial electrograms were recorded and changes in ST-segment voltage were correlated with the changes in intramyocardial gas tensions in outer and inner layers of the myocardium measured using a mass spectrometer. Electrographic and metabolic changes appeared first in inner layer and proceeded to outer layer with increasing severity of coronary constriction. In both layers intramyocardial ST-segment elevation was closely related with the increase in carbon dioxide tension (r = 0.78 in inner layer and r = 0.67 in outer layer). Epicardial electrogram, however, reflected the regional ischemia less sensitively than intramyocardial electrograms and has a limited function to detect myocardial ischemia.

Studies on the ionophorous antibiotics. XXIV. Leuseramycin, a new polyether antibiotic produced by Streptomyces hygroscopicus

A new antibiotic leuseramycin has been isolated from the cultured mycelium of the strain of Streptomyces hygroscopicus TM-531. Physicochemical data, in particular those of 1H- and 13C-NMR spectra, revealed that leuseramycin is closely related to dianemycin in its structure, the former having a methyl group in place of the hydroxymethyl group at C-30. It is active against Gram-positive bacteria, some phytopathogenic fungi and some protozoa.

Studies on the ionophorous antibiotics. XXV. The assignments of the 13C-NMR spectra of dianemycin and lenoremycin

All the resonances observed in the 13C-NMR spectra of polyether antibiotics, dianemycin and lenoremycin (Ro 21-6150) have been assigned by the aid of selective proton decoupling experiments, T1 value measurements and biosynthetic methods as well as comparison to model compounds such as monensin, nigericin, etheromycin and carriomycin.

Antitumor activity of benzaldehyde

Ninety patients with inoperable carcinoma in the terminal stages and 12 patients in serious condition with other tumor types were given benzaldehyde in the form of beta-cyclodextrin benzaldehyde inclusion compound (CDBA) orally or rectally at a daily dose of 10 mg/kg divided in four doses. Toxic effects, including hematologic or biochemical disturbances, were not seen during long-term successive administration of CDBA. Fifty-seven of the patients treated were evaluable; 19 patients responded completely and ten patients responded partially (greater than 50% regression). For all responding patients longer response durations were associated with longer CDBA treatment periods. Treatment of squamous cell carcinoma induced the cancer cells to change into a conglomeration of pearls (the well-known product of differentiation) which consisted of keratinized normal squamous cells.

Effect of intestinal bacteria on incidence of liver tumors in gnotobiotic C3H/He male mice

The effect of intestinal microflora on liver tumorigenesis was studied in gnotobiotic C3H/He male mice monoassociated, diassociated, or polyassociated with the following strains of intestinal bacteria: Escherichia coli, Streptococcus faecalis, Bifidobacterium adolescentis, Bifidobacterium infantis, Clostridium indolis, C. paraputrificum, C. perfringens, C. innocuum, C. nexile, C. ramosum, C. clostridiiforme, Bacteroides multiacidus, Bacteroides fragilis, Veillonella alcalescens, V. parvula, and Lactobacillus acidophilus. The incidence of liver tumors was higher in most of the gnotobiotes (67--100%) and conventionalized mice (82%) derived from the germfree mice than in the germfree mice (39%). The average incidence of tumor nodules in gnotobiotes associated with E. coli, S. faecalis, and C. paraputrificum was 2.9, which was significantly higher than that in the conventionalized animals (1.6). In contrast, the average incidence of tumor nodules in gnotobiotes associated with E. coli, S. faecalis, L. acidophilus, C. perfringens, and Bacteroides fragilis (0.9) was not significantly different from that in germfree animals (0.5). The present study demonstrated that the presence of certain intestinal bacteria is related to liver tumorigenesis in gnotobiotic C3H/He male mice.

Relationship between epicardial and intramyocardial ST-segment voltage and myocardial blood flow during graded coronary constriction in the dog

This study was undertaken to examine the relationship between electrographic ST-elevation and regional myocardial blood flow during graded coronary constriction. Electrograms from the epicardial surface, outer and inner layers of the myocardium were recorded. Regional blood flow to the outer and inner layers of the myocardium was measured by means of a heat-clearance method. With the application of a coronary constriction, myocardial blood flow to the inner layer began to decrease with a 75% coronary constriction, while flow to the outer layer was maintained at near normal up to least an 80% coronary constriction. Non-linear squares curve of between ST-elevation and the decrease in myocardial flow resulted in y = 18.80 exp-0.06x - 0.02 in the outer layer and y = 9.22 exp-0.02x - 1.54 in the inner layer. Also the non-linear squares curve of between epicardial ST-elevation and the decrease in myocardial flow resulted in y = 50.91 exp-0.11 x + 0.04 in the inner layer and y = 10.29 exp-0.07 x + 0.03 in the outer layer. The standard deviations of the coefficients of the latter two equations were higher than those of the former two equations. The higher values indicated larger variations of the parameter coefficients and data points. These results clearly demonstrated that a regional intramyocardial electrogram more closely reflects local ischemia than does an epicardial electrogram.

Coronary collateral circulation as an important factor to modify the ischemic injury of the myocardium in coronary ligated dogs

Effect of coronary ligation on epicardial and intramyocardial ST-segment voltage was investigated in 121 dogs. After ligation of the anterior descending coronary artery, marked ST-elevation, more than 2 mV, was detected in 102 dogs (Group-I) in epicardial lead of the area which was nourished by the ligated coronary artery. In 7 dogs (Group-II), coronary ligation produced negligible changes in ST-segment voltage in epicardial lead, while significant ST-elevation was observed in the leads of middle and inner layers of the myocardium. Systemic hemo-dynamic parameters showed no statistically significant difference between the 2 groups. Coronary collateral indices, however, revealed the significant difference between them. Systolic peripheral coronary pressure was 29.3 +/- 3.1 mmHg in Group-I and 59.2 +/- 10.6 mmHg in Group-II (P less than 0.05). Retrograde flow was also greater in Group-II (14.8 +/- 4.4 ml/min) than in Group-I (1.3 +/- 0.5 ml/min) (p less than 0.01). Diversion of retrograde flow produced a marked ST-elevation in Group-II. Restoration of retrograde flow to the myocardium immediately decreased the ST-segment voltage. These results suggest that spontaneously developed collaterals have an important function for the prevention of the occurrence of ischemic injury after coronary ligation in dogs.

Effect of hypoxia on the sinoatrial node, atrium, and atrioventricular node in the rabbit heart

We used intracellular microelectrodes to study the effects of hypoxia on the isolated, superfused sinoatrial (SA) node, atrium, and atrioventricular (AV) node of the rabbit heart. Hypoxia decreased the rate of spontaneous impulse initiation in SA nodal fibers by decreasing the slope of diastolic depolarization. With gradually decreasing Po2, the sinus rate was reduced; concomitantly, the corrected sinus node recovery time after rapid atrial stimulation was much less affected demonstrating marked prolongation only under severe anoxic conditions. Hypoxia decreased the amplitude of action potentials of the SA node and of the AV node but not of the atrium. SA and AV nodal conduction were slowed by hypoxia; intraatrial conduction was not significantly affected. AV nodal conduction block occurred at lower atrial rates, and the effective refractory period of the AV node was prolonged. Inhomogeneity of SA and AV nodal impulse propagation often was observed in the presence of hypoxia. This was associated with concealed reentry within both nodal areas. The extracellular K+ concentration of the atrial tissue was measured with ion-sensitive microelectrodes. [K+]o remained unchanged even after prolonged periods of severe hypoxia. These results are consistent with the hypothesis that acute hypoxia predominantly inhibits slow response activity but has only little effect on the fast inward sodium current.

Effects of some components of ischemia on electrical activity and reentry in the canine ventricular conducting system

We used intracellular microelectrodes to study the electrophysiological effects of combinations of components of ischemia and their relation to the occurrence of ventricular arrhythmias in the specialized conducting system of isolated canine right ventricles. The middle area of the free wall was exposed to various test solutions in the center compartment of a three-chambered bath; the base and apex of the preparation were superfused with normal Tyrode's solution in the outer control compartments. Hypoxia (Po2 40 mm Hg), lactic acidosis (pH 6.5), and orciprenaline (10(-6) M), either alone or combined, failed to affect the action potential amplitude or the conduction velocity of the subendocardial fibers, and no arrhythmias occurred. The action potential duration and the effective refractory period were markedly prolonged by lactic acidosis. Exposure of the test regions to 15 mM K+ plus orciprenaline resulted in marked decreases in action potential amplitude and conduction velocity. Abnormalities of impulse transmission through the depressed area included high degrees of rate-dependent block, one-way block, warming-up phenomenon, and the Wenckebach phenomenon. Such conditions regularly provoked the appearance of single, sustained, or concealed reentrant depolarizations. The combined effects of hypoxia, 15 mM K+, and orciprenaline resulted in further depression of the already depressed action potential in the depolarized fibers. Our results indicate that regional increases of extracellular K+ may be the predominant factor of the components of ischemia we studied which facilitates the initiation of reentrant arrhythmias.

Superior sensitivity of conjugates of horseradish peroxidase with wheat germ agglutinin for studies of retrograde axonal transport

We have compared the retrograde axonal transport of horseradish peroxidase (HRP), to the retrograde transport of HRP conjugated with wheat germ agglutinin (WGA). Morphometric studies have shown that WGA-HRP conjugates were 40 times more sensitive than free HRP, in the tracing of retrograde connections from the rat submandibular gland to the superior cervical ganglion. Also, WGA-HRP was more sensitive than free HRP in the tracing of retrograde connections from the rat tongue to the hypoglossal nucleus. Our findings with WGA-HRP are consistent with the observations by Schwab et al. who reported (-125I) WGA is a highly sensitive retrograde tracer (Brain Research 152:145, 1978 (22)).

Comparison of elution patterns of proteins chromatographed on controlled-pore glass and carboxymethyl-cellulose

As controlled-pore glass (CPG) has anionic silanol groups, we compared the elution patterns of proteins chromatographed on CPG with those on carboxymethyl (CM)-cellulose using standard proteins and two protein mixtures, rabbit serum and bovine parotid extracts. The results showed that the order of proteins eluted from CPG was similar to that from CM-cellulose, although some differences were found. The adsorption of proteins on CPG was slightly stronger than that on CM-cellulose and the separation of proteins on CPG was slightly better. Some conditions, such as amounts of proteins loaded on the column, pH, temperature and kind of buffer solution for elution, were investigated. The pH of buffer solutions was important in the adsorption chromatography of proteins on CPG and the useful pH range was 7.0-8.5.

An experimental study on the role of coronary collateral development in preservation and improvement of contractile force in the ischemic myocardium

Attempts have been made to demonstrate that the presence of coronary collateral development can preserve and improve the regional contractile force in the ischemic myocardium. Studies were carried out in dogs with developed collaterals and in control dogs. Contractile force was measured with strain-gauge sutured onto the ischemic and the border areas of the myocardium. After ligation of the anterior descending coronary artery, an augmentation of coronary collateral flow via the left circumflex artery was carried out by means of infusion pump up to two and a half fold level. In dogs with developed collaterals, contractile force decreased by 57.6 +/- 11.1% (p less than 0.01) in the ischemic area and 27.2 +/- 5.4% (p less than 0.01) in the border area after coronary ligation. The marked recovery of contractile force up to 63.5 +/- 20.4% (p less than 0.05) of control level in the ischemic area and 70.4 +/- 20.4% (p less than 0.01) in the border area was observed by the augmentation. In control dogs, however, contractile force decreased by 93.2 +/- 17.2% (p less than 0.01) in the ischemic area and 24.6 +/- 5.5% (p less than 0.01) in the border area after the ligation. The augmentation of coronary flow did not recover the depressed contractile force in both areas. These results indicated that the beneficial effect was observed only when the ischemic area was supplied by developed collaterals and closely correlated with the extent of coronary collateral development.

Effects of graded coronary constriction on regional oxygen and carbon dioxide tensions in outer and inner layers of the canine myocardium

This study was undertaken to investigate the effects of graded coronary constriction on regional gas tensions of the myocardium. In 12 open chest dogs, tissue carbon dioxide (PtCO2) and oxygen (PtO2) tensions were measured simultaneously in outer and inner layers of the myocardium using a mass spectrometer. In normal condition, higher PtO2 and lower PtCO2 were observed in outer layer than in inner layer. With application of coronary constriction, increase in PtCO2 and decrease in PtO2 were observed in both layers of the myocardium, but the response to the ischemic stimuli by applying coronary constriction in inner layer was different from that in outer layer. Severe coronary constriction, more than 90% in its diameter, was necessary to produce significant changes in both gas tensions in both layers of the myocardium. Decrease in PtO2 was found in the condition of less severe coronary constriction and to be greater in inner layer than in outer layer of the myocardium. In terms of the changes in PtCO2, inner layer was also more susceptible to the ischemic stimuli than outer layer. The greater and earlier elevation of PtCO2 in inner layer than in outer layer is regarded as one of the possible mechanisms of the reduction of myocardial contraction in the early stage of myocardial ischemia.

A newly designed multipurpose microneurosurgical head frame. Technical note

A new multipurpose head frame has been designed for microneurosurgery. It consists of a head holder with a frame to hold self-retaining brain retractors, hand rests, instrument holders, a plate for cotton patties, and skin-flap retractors. It has been satisfactorily used in 100 operations for 1 year.

Intropic and electrophysiological action of humoral factors released in cardiogenic shock after acute myocardial infarction

The inotropic and electrophysiological effects of plasma obtained from patients and experimental dogs during cardiogenic shock following acute myocardial infarction were studied. Changes in the isometric contraction and the intracellular action potential were determined in isolated papillary muscles of rabbits. Control plasma collected from normal subjects produced no significant changes in the contraction or the electrical parameters. Plasma from shock patients decreased peak force by 42% and the maximum rate of force development by 38% in comparison to control values; the time to peak of contraction, the relaxation time and the action potential parameters were not significantly altered. Corresponding results were obtained with plasma from dogs before and during experimental cardiogenic shock. Biochemical determinations failed to identify a single specific "myocardial depressant factor" in the plasma of patients and dogs with cardiogenic shock. The results suggest that (1) various humoral factors released during cardiogenic shock may depress the contractile function of cardiac muscle and (2) that the observed negative intropic effect is not due to electrical changes in the cell membrane.

A case of demyelinating encephalomyelitis with some resemblance to collagen disease

A woman, aged 26 years, who died of progressively worsening demyelinating encephalomyelitis in the course of 4 years is reported. The neuropathological findings included large subcortical softenings in the cerebral hemispheres, tiny perivenous demyelinated foci in their neighborhood and scattered in the white matter. There was an acute vasculitis with fibrinoid exudation in the affected as well as unaffected areas. Focal perivenous mononuclear cell infiltrations are conspicuous in the white matter. The laboratory and postmortem examinations suggested a collagen disease like SLE. The abnormalities included marked increase of serum gamma-globulin, especially of IgG, and elevation of CRP, RA, and ANA titer, moderate thickening of the basement membranes of the renal glomeruli, onion skin-like periarteriolar fibrosis in the spleen, fibrous pericarditis and periadventitial fibrosis of myocardial arteries. Bilateral degeneration of the spinal posterior columns and dorsal roots was also observed. A probable relationship of the modified features in this example of demyelinating encephalomyelitis with abnormal immune mechanisms in the background is discussed.