Neurohormonal characteristics of cardiovascular response due to intraventricular hypertonic NaCl

In morphine-pentobarbital anesthetized dogs (n = 25) we measured the effect of cerebroventricular administration of hypertonic sodium chloride (NaCl) on mean arterial pressure (MAP), heart rate (HR), and integrated renal nerve activity (RNA); in separate experiments (n = 9) we also evaluated the effect of hypertonic NaCl on the osmolarity and electrolyte and catecholamine concentrations of both the blood and the cerebrospinal fluid (CSF); plasma arginine vasopressin (AVP), cortisol, and renin activity were also measured. The intraventricular (ivt) injection of 1.5 M NaCl caused a hypertensive response associated with tachycardia and a significant decrease in RNA (P less than 0.001). Intravenous hexamethonium chloride prevented the changes in HR and RNA, whereas the increases in MAP were markedly reduced but not abolished. The neurohormonal effects of ivt hypertonic NaCl consisted of activation of the sympathoadrenal pituitary axis as reflected by significant increases in the plasma levels of norepinephrine (NE), epinephrine, AVP, and cortisol. On the other hand, there was a significant decrease in plasma renin activity not associated with any significant changes in plasma osmolarity and serum electrolytes. These hormonal changes coincided with an increase in the concentration of CSF NE, CSF Na+, and CSF osmolarity obtained from the cisterna magna. Altogether the results indicate that central administration of hypertonic NaCl in dogs with intact baroreflexes causes a preferential activation of the sympathetic nervous system to vascular systems other than those of the kidneys. In addition, a part of the pressor response may be due to the activation of nonneurogenic mechanisms.

Structure of blood flow through a curved vessel with an aneurysm

A fine structure of blood flow through a curved vessel with an aneurysm was studied in in vitro experiments in relation to rheological factors of arterial diseases such as arteriosclerosis or thrombosis. On the basis of the in vivo data related to cerebral circulation, red blood cell suspension was flowed through curved vessel models with an asymmetrical aneurysm. Flow visualization was made with a microscope 16 mm cinecamera-TV monitor system, and the velocity profile was measured using the laser Doppler velocimeter. Vortices induced in aneurysm influenced flow structure and velocity at the presence of the secondary flow due to the vessel curvature. This suggests strongly that blood flow in curved arteries with an aneurysm must be understood under the influence of the secondary flow.

The renin-angiotensin-aldosterone system and circadian rhythm of urine variables in normotensive and hypertensive subjects

Forty-two middle-age male subjects, aged from 47 to 54 years old, were divided into three groups; 14 normotensives (NT), 16 borderline hypertensives (BHT) and 12 hypertensives (HT). The environmental effects were neutralized as much as possible by keeping their activities synchronized and their plasma and urine variables simultaneously investigated using the same protocol as under normal physiologic conditions. The circadian rhythms of urinary excretions of Na, K, Cl, creatinine, aldosterone, adrenaline and noradrenaline were analyzed by a multivariate method (cosinor method). Both systolic and diastolic blood pressure were statistically significantly different among the three groups and body weight was greater in HT than in NT. Other plasma and urine variables examined, however, were not significantly different among the three groups. A statistically significant circadian rhythm was detected in the urine variables. The rhythm characteristics, such as the mesor, amplitude and acrophase, of the urine variables except for the acrophase of urinary Na excretion were not significantly different among the three groups; the circadian acrophase of urinary Na in HT and BHT appeared significantly earlier than in NT. The pathophysiological and clinical significance of the earlier appearance of the circadian acrophase of urinary Na in hypertensive subjects still remains a unique characteristic requiring further investigation.

Catecholamines, angiotensin II and sodium concentrations in cerebrospinal fluid in young men with borderline hypertension

To evaluate the role of central nervous mechanisms and their relationships to the peripheral sympathetic nervous system in borderline hypertension, we measured catecholamines, angiotensin II (AII) and sodium (Na) concentrations in cerebrospinal fluid (CSF) with plasma catecholamines concomitantly in 12 young men with borderline hypertension and 7 age-matched healthy normotensive men on ordinary salt intake. Plasma norepinephrine (NE) and epinephrine (E) were higher in the borderline hypertensives than in the normotensives (NE: 239 +/- 15 vs 190 +/- 11 pg/ml, p less than 0.05, E: 83 +/- 9 vs 43 +/- 6 pg/ml, p less than 0.01). NE levels in CSF were also higher in the borderline hypertensives than in the normotensives (200 +/- 15 vs 150 +/- 18 pg/ml, p less than 0.05). In most of the subjects, CSF E and plasma and CSF dopamine levels were below the sensitivity of the assay. CSF NE correlated positively with both plasma NE (p less than 0.01) and mean blood pressure (p less than 0.05) in all subjects. Immunoreactive AII and Na concentrations in CSF did not differ between the borderline hypertensives and normotensives. These results suggest that peripheral sympathoadrenal overactivity in young subjects with borderline hypertension may be related to an altered function of central noradrenergic neurons. AII and Na in the central nervous system do not appear to have an important role in borderline hypertension.

Anion transport activity in the human erythrocyte membrane modulated by proteolytic digestion of the 38,000-dalton fragment in Band 3

Extracellular treatment of human erythrocytes with papain completely converted the chymotryptic 38,000-dalton fragment of Band 3 to the 29,000-dalton fragment and inhibited the transport of inorganic phosphate in the cells. The inhibition, however, was not complete, indicating the presence of two components in the anion-transport system: the one resistant to papain digestion and the other sensitive to the digestion. The latter activity is well correlated with the degradation of the 38,000-dalton fragment. The activity remaining in the cells treated with papain was markedly different from that of the control cells. The remaining activity was not inhibited by pyridoxal phosphate and dinitrostilbene-2,2'-disulfonic acid, potent inhibitors to the anion transport, whereas phenyl phosphate inhibited the activities of both papain-treated and control cells. The results indicate that the anion-transport system consists of multiple anion-binding sites and a part of the system which is sensitive to pyridoxal phosphate and dinitrostilbene-2,2'-disulfonic acid was located in the papain-sensitive portion of 38,000-dalton fragment. A possible model of the anion-transport system was presented.

Localization of hepatitis B surface antigen in hepatocellular carcinoma

The author respectively examined the localization of hepatitis B surface antigen (HBsAg) in 150 autopsy cases of hepatocellular carcinoma (HCC) with particular attention to growth pattern of HCC. Varying numbers of orcein-positive cells were observed in 42 cases (28.0%) with various distribution patterns, and all the 42 cases were confirmed with immunoperoxidase technique for HBsAg. HBsAg-positive cells were detected in HCC tissue in 10 cases (6.6%) among the 150 cases. Regarding the growth pattern of HCC in the 10 cases, many HBsAg-positive cells were seen in HCCs of the sinusoidal and replacing types, in which the hepatocytes were frequently retained in the cancerous tissue, particularly around the tumor-nontumor boundary. On the other hand, there was no HBsAg-positive cell in the encapsulated type HCC which was the most common (approximately 50%) in the present study and in which the retained hepatocytes were hardly seen. Meticulous histological observation after decoloration of the positive reaction to HBsAg in the sections treated with immunoperoxidase technique and subsequent eosin stain disclosed that HBsAg-positive cells in HCC tissue were retained hepatocytes in 9 cases, and the possibility of HCC cell was not denied in one case. Moreover, HBsAg-positive cells were never detected in tumor thrombi of the portal vein branches and pulmonary metastases.

Activation of renin-angiotensin system in maintenance of high blood pressure in uncomplicated pheochromocytoma--a case report

In a patient with an uncomplicated pheochromocytoma, we observed high basal value of plasma renin activity (PRA), 16.2 ng/ml/h, and a remarkable elevation in PRA from 18.2 to 90.4 ng/ml/h and concomitant blood pressure reduction following a single oral administration of 25 mg of captopril. The response was same as that observed in renovascular hypertensives, and disappeared during the period of alpha-, beta-blocker administration or after the surgery. Basal PRA also returned to low normal level. The renin-angiotensin (R-A) system probably had a role in the maintenance of high blood pressure. The mechanism of the activation of the R-A system was thought to be renal vasoconstriction due to excessive circulating catecholamines.

Recurrent pheochromocytoma associated with glucagonoma. A case report

We treated a hypertensive patient with recurrent pheochromocytoma (paraganglioma) associated with glucagonoma. No clinical symptom of glucagonoma was found and it could be detected only by a slight elevation of plasma immunoreactive glucagon (IRG) while the extirpated pancreatic tumor contained much IRG. This case could not be classified as either multiple endocrine neoplasia (MEN) type I or type II.

Elevated plasma catecholamines without alteration in cardiovascular responsiveness in young men with borderline hypertension

Plasma catecholamines and cardiovascular responses to upright posture, exogenous noradrenaline (NA), and isoproterenol (IP) were examined in 20 young men with borderline hypertension and in 10 age-matched normotensive volunteers. Resting plasma NA and adrenaline (Ad) levels were higher in the borderline hypertensive patients. Significant correlations were found among plasma NA and mean blood pressure (MBP) or heart rate (HR), and between plasma Ad and HR in all individuals in the supine position. The increases in plasma NA were similar between groups for orthostatic positions. Pressor response to exogenous NA and chronotropic response to exogenous IP were not augmented in borderline hypertensives. A negative correlation was found between plasma NA before infusion and the increases of MBP produced by NA or the increases of HR produced by IP in all the individuals. Our observations suggest that there is hyperactivity of the sympathoadrenal system without enhancement in cardiovascular reactivity to catecholamines in young men with borderline hypertension.

Hepatocellular carcinoma presenting as intrabile duct tumor growth: a clinicopathologic study of 24 cases

We describe the features of 24 cases of hepatocellular carcinoma (HCC) with prominent intrabile duct tumor growth seen among 238 autopsy and 21 surgical cases of HCC. Progressive obstructive jaundice occurred during the course of most cases and was the presenting sign in nine. A fluctuating rise and fall of the total bilirubin was seen in two cases. The average survival time of the cases was significantly shorter than that of HCC patients without intrabile duct tumor growth (Mann-Whitney's U-test, one-tailed, P less than 0.05). The average survival time after the development of severe jaundice (total bilirubin over 10 mg/dl) was only 16 days. Intrabile duct tumor casts were located in the hepatic and/or the common bile ducts in 19 cases (79%) and in five cases were seen in the peripheral (medium to small-sized) bile ducts. Hemobilia developed in five cases (21%) and was regarded as the immediate cause of death in one. Grossly all the cases presented infiltrative or mixed (infiltrative and nodular) growth pattern. Intrabile duct tumor growth and associated marked obstructive jaundice may frequently herald the terminal phase of HCC in certain patients. In our series, approximately 40% of patients with HCC and significant jaundice had gross evidence of extensive intraductal tumor growth. In the absence of intraductal tumor growth, jaundice in HCC usually was seen in a setting of progressive terminal hepatic failure.

Histologic growth pattern of hepatocellular carcinoma: relationship to orcein (hepatitis B surface antigen)-positive cells in cancer tissue

The histologic pattern of tumor growth at tumor-nontumor boundaries was studied in 60 livers bearing hepatocellular carcinoma. Three growth patterns, arbitrarily described as "sinusoidal," "replacing," and "encapsulated," were distinguished. Cancer cells growing in the sinusoids between liver cell cords (sinusoidal pattern) were anaplastic; those growing in an expansile fashion and acquiring a fibrous capsule (encapsulated pattern) were most differentiated; and those growing into the cord of liver cells and replacing them (replacing pattern) were differentiated to an intermediate degree. There was certain relation between the histologic growth patterns and gross morphologic features of the tumors. Test results for 20 of the 60 cases were positive for serum hepatitis B surface antigen (HBsAg), and the livers also contained orcein-positive cells. Orcein-positive cells were frequently seen at the border between tumor and parenchyma. Cells containing HBsAg as an orcein-positive inclusion were present in cancer tissue in three cases. When serial sections were made from such areas and stained alternately with hematoxylin and eosin and orcein, it was found that these cells were hepatocytes blended with cancer cells. This phenomenon was related to the growth pattern of tumor cells. Orcein-positive cells were never found in metastatic lesions.

Hepatocellular carcinoma presenting as intrabile duct tumor growth: a clinicopathologic study of 24 cases

We describe the features of 24 cases of hepatocellular carcinoma (HCC) with prominent intrabile duct tumor growth seen among 238 autopsy and 21 surgical cases of HCC. Progressive obstructive jaundice occurred during the course of most cases and was the presenting sign in nine. A fluctuating rise and fall of the total bilirubin was seen in two cases. The average survival time of the cases was significantly shorter than that of HCC patients without intrabile duct tumor growth (Mann-Whitney's U-test, one-tailed, P less than 0.05). The average survival time after the development of severe jaundice (total bilirubin over 10 mg/dl) was only 16 days. Intrabile duct tumor casts were located in the hepatic and/or the common bile ducts in 19 cases (79%) and in five cases were seen in the peripheral (medium to small-sized) bile ducts. Hemobilia developed in five cases (21%) and was regarded as the immediate cause of death in one. Grossly all the cases presented infiltrative or mixed (infiltrative and nodular) growth pattern. Intrabile duct tumor growth and associated marked obstructive jaundice may frequently herald the terminal phase of HCC in certain patients. In our series, approximately 40% of patients with HCC and significant jaundice had gross evidence of extensive intraductal tumor growth. In the absence of intraductal tumor growth, jaundice in HCC usually was seen in a setting of progressive terminal hepatic failure.

Thorotrast-induced hepatic angiosarcoma, and combined hepatocellular and cholangiocarcinoma in a single patient

A 64-year-old man developed hepatic angiosarcoma, and combined hepatocellular and cholangiocarcinoma, 36 years after Thorotrast administration. The patient presented with a large mass in the right upper quadrant. His serum alpha-fetoprotein increased from 800 ng/ml to 51.2 micrograms/ml, and liver biopsy disclosed hepatocellular carcinoma. At autopsy, the liver had two different malignant neoplasms; angiosarcoma and combined hepatocellular and cholangiocarcinoma. Metastases of angiosarcoma to both lungs and of cholangiocarcinoma to periaortic lymph nodes were also seen. Interestingly, some neoplastic cells of angiosarcoma exhibited globular hyaline inclusions, which were Periodic-Acid-Schiff reaction positive and diastase-resistant.

Augmented sympathetic nervous function in young subjects with borderline hypertension

In order to elucidate the mechanism of blood pressure elevation in the patients with borderline hypertension, the sympathetic nervous activity was investigated and the following results were obtained: 1) Plasma catecholamine (CA) levels were elevated in young men but not in middle-aged men with borderline hypertension in comparison with age-matched normal men. 2) Cardiovascular responsiveness to exogenous CA was not augmented in young men with borderline hypertension. 3) Cerebrospinal fluid noradrenaline levels were elevated in young men with borderline hypertension. They correlated positively with plasma NA or blood pressure. 4) In young men with borderline hypertension, plasma and urinary CAs were not altered by hypertonic saline loading. These results suggest that increased activity of the central and peripheral sympathetic nervous system is an important mechanism of blood pressure elevation in young subjects with borderline hypertension.

High Pressure Liquid Chromatographic Analysis of Chlorpyrifos Containing Insecticidal Formulations: Collaborative Study

A high pressure liquid chromatographic method for determining chlorpyrifos was collaboratively studied. Three liquid and 2 solid formulations were analyzed by 12 collaborators. Samples were weighed and diluted with acetonitrile containing the internal standard, 1,4-dibromonaphthalene. Chlorpyriphos is separated on a Zorbax ODS column with acetonitrile- water-acetic acid (82 ± 17.5 ± 0.5) at 2 mL/min and monitored at 300 nm. Clay samples are extracted with the internal standard solution by agitation for 5 min. Coefficients of variation ranged from 1.28 to 2.40%. Results of all 12 collaborators fell within the 5% two-tail limits. The method has been adopted official first action.

Nuclear magnetic resonance study on the microenvironments of histidine residues of ribonuclease T1 and carboxymethylated ribonuclease T1

The 270-MHz 1H NMR spectra and fluorescence of ribonuclease T1 and carboxymethylated ribonuclease T1 were measured in aqueous solution. Histidine C4 proton resonances were assigned to individual residues. From the pH dependences of the chemical shifts of histidine C2 and C4 protons, the pKa values of histidine residues were obtained by the non-linear least-squares method. The hydrogen leads to deuterium exchange rates of histidine C2 protons were determined as a measure of the accessibility of histidine residues to the solvent. Each histidine residue of ribonuclease T1 was found to interact with a carboxylate group of an aspartic or glutamic acid residue; in particular, His-40 was shown to interact with Glu-58. Upon carboxymethylation of Glu-58, His-92 and His-27 are more shielded from the solvent while His-40 remains exposed to the solvent. The 67.9-MHz 13C NMR spectra were measured for the 13C-enriched preparation of carboxymethylated ribonuclease T1. From the pH dependence of 13C chemical shift, the pKa value of the carboxymethylated Glu-58 was found to be unusually low, suggesting the formation of an ionic or hydrogen bond between this carboxymethyl group and a positively charged group, possibly of Arg-77.

Distribution of albumin- and/or alpha-fetoprotein-positive cells in hepatocellular carcinoma

Albumin (ALB)-positive cells were identified by an immunoperoxidase technique in 52 of 53 autopsy cases and in all of 13 surgical cases of hepatocellular carcinoma (HCC). The distribution pattern of ALB-positive cells could be classified into three groups: diffuse, localized, and sparse. The diffuse type was the most common pattern and was usually seen in well or moderately differentiated HCC, showing a trabecular growth pattern. The localized or sparse patterns were more frequent in poorly differentiated HCC showing a compact growth pattern. alpha-Fetoprotein (AFP)-positive cells were detected in 37 of the 53 autopsy cases of HCC and 11 of the 13 surgical cases. The number of AFP-positive cells and the intensity of the immunoperoxidase reaction were roughly proportional to serum AFP levels in most cases. In most regions of HCC, there seemed to be an inverse relationship between the number of ALB- and AFP-positive cells, suggesting tht most HCC cells synthesized only one of the two antigens studied. ALB-positive hepatocytes were found in all of the normal or cirrhotic livers examined and in the tumor-free regions of the HCC-containing livers. In contrast, AFP was not detected in nonneoplastic hepatocytes.

Influence of unilateral adrenalectomy on renin-angiotensin-aldosterone system in primary aldosteronism

In a study of 14 patients (11 Japanese and 3 white North Americans) with aldosterone-producing tumor carried out within 2 to 4 weeks after unilateral adrenalectomy, both plasma renin activity (PRA) and plasma aldosterone concentration (PAC) increased almost normally with short-term sodium depletion and upright posture. Aldosterone excretion rate (AER) also increased significantly with sodium depletion, and was normally suppressed by sodium loading. Highly significant correlations were observed between PRA and PAC (r=0.89, p < 0.001) or AER (r=0.88, p < 0.001) ater operation, whereas there had been no such correlation before operation. Either physiological or laboratory findings were normalized or markedly improved in all cases although pathohistological diagnosis was made as adenomatous hyperplasia in 10 out of 11. These results indicate that within 4 weeks of operation PRA and the remaining adrenal gland can almost normally respond to stimuli such as sodium depletion and upright posture regardless of the amount of spironolactone given preoperatively.

Influence of unilateral adrenalectomy on renin-angiotensin-aldosterone system in primary aldosteronism

In a study of 14 patients (11 Japanese and 3 white North Americans) with aldosterone-producing tumor carried out within 2 to 4 weeks after unilateral adrenalectomy, both plasma renin activity (PRA) and plasma aldosterone concentration (PAC) increased almost normally with short-term sodium depletion and upright posture. Aldosterone excretion rate (AER) also increased significantly with sodium depletion, and was normally suppressed by sodium loading. Highly significant correlations were observed between PRA and PAC (r=0.89, p < 0.001) or AER (r=0.88, p < 0.001) ater operation, whereas there had been no such correlation before operation. Either physiological or laboratory findings were normalized or markedly improved in all cases although pathohistological diagnosis was made as adenomatous hyperplasia in 10 out of 11. These results indicate that within 4 weeks of operation PRA and the remaining adrenal gland can almost normally respond to stimuli such as sodium depletion and upright posture regardless of the amount of spironolactone given preoperatively.

Small multiple carcinoid tumors occurring in the ileum with a pseuodcystic liver metastasis

A 49-year-old woman was admitted to the hospital with a palpable mass in the right hypochondrium. A laparotomy was performed under the clinical diagnosis of a solitary cyst of the liver. The cystic lesion of the liver was removed. Although the histological finding of the cyst wall showed a similarity to hepatocellular carcinoma of trabecular pattern, the tumor cells with uniform nuclei and little mitotic figure were positive for both argyrophil and argentaffin reaction. The pathological diagnosis was metastatic carcinoid tumor of the liver. There was no carcinoid syndrome nor the other clinical symptoms after the operation and various postoperative examination could not reveal a primary site of the carcinoid tumor. The cystic lesion of the liver recurred ten months after the first operation and a second laparotomy was performed to reveal the primary site in the ileum: three submucosal tumors, 0.8, 0.7, and 0.3 cm. in diameter, two of them, however, extended into the muscle wall or subserosa and conclusively, the small lesion of the ileum metastasized into the liver as a large pseudocystic lesion.