Acute and long-term hypotensive effects and plasma concentrations of nifedipine in patients with essential hypertension

The acute and long-term hypotensive effects of low doses of nifedipine, and the correlation between the fall in the blood pressure (BP) and the plasma nifedipine concentration, were investigated in patients with essential hypertension. The oral administration of nifedipine 5 mg rapidly decreased BP from 163 +/- 22/101 +/- 10 to 127 +/- 12/82 +/- 9 mmHg (mean +/- SD; p less than 0.001), and increased heart rate from 72 +/- 8 to 76 +/- 6 beats/min (p less than 0.05), plasma renin activity rose from 1.2 +/- 0.6 to 1.4 +/- 0.8 ng/ml/h (p less than 0.05), and plasma nifedipine concentration was 75.6 +/- 22.0 ng/ml 30 min after administration (n = 7). The nifedipine concentration was significantly correlated both with the fall in BP (r = 0.410, p less than 0.02, n = 31) and the rise in the heart rate (r = 0.412, p less than 0.02, n = 31). Treatment with nifedipine 5 mg t.d.s. alone or in combination either with propranolol 10 mg t.d.s., or thiazide 1 tablet daily, or propranolol and thiazide, controlled BP in 36 patients during the 22 week study period. During the long-term nifedipine therapy, the plasma nifedipine level was significantly correlated with the fall in systolic (r = 0.577, p less than 0.01, n = 20) and diastolic (r = 0.595, p less than 0.01, n = 20) BP. It was concluded that the plasma nifedipine concentration could be correlated with the fall in BP, and that low doses of nifedipine, either as monotherapy or in combination, were effective in the acute and long-term treatment of patients with essential hypertension.

Primary myelofibrosis with myeloid metaplasia and cytogenetically abnormal clones in 2 children with Down's syndrome

2 children with Down's syndrome showed severe anaemia, leucocytosis with blastic cells, thrombocytopenia and hepatosplenomegaly. Bone marrow aspirations were near-dry tap and marrow biopsy revealed primary myelofibrosis with myeloid metaplasia (MMM). Their course was short with a blood picture similar to that of leukaemia. They expired 2 months and 21/2 months after diagnosis, respectively. The cases were thought to represent an acute childhood variant of MMM. Cytogenetic study of circulating white cells by 24 h culture without phytophaemagglutinin stimulation revealed aneuploidy in both cases, the first case showing marked aneuploidy with a predominant karyotype of 50,XX,+8,+19,+19,+21 and the second case a mosaic of 47,XX,+G/48,XX+G,+G. The karyotype of phytohaemagglutinin stimulated lymphocytes was 47,XX,+G in both cases. These findings suggest that the abnormal karyotypes are those of circulating blastic cells which are abnormal clones of haematopoietic cells responsible for MMM. In Down's syndrome, MMM might not be so rare as reported.

Cloning in Escherichia coli of the structural gene of prorennin, the precursor of calf milk-clotting enzyme renin

Double-stranded cDNA was prepared from prorennin-specific mRNA by sequential actions of reverse transcriptase, DNA polymerase and S1 nuclease, and inserted into the Sa/I site of pBR322 by the poly(dG)-(dC) annealing method. Transformation of Escherichia coli C600 r- m- by the hybrid plasmid yielded transformants containing prorennin cDNA. The presence of the cDNA sequence in these clones was confirmed by both colony hybridization and hybrid-arrested translation of the mRNA in vitro. The largest size of the cloned cDNA was 1,020 bp.

Hypotensive action of nifedipine (Ca2+-antagonist) and propranolol in acute trials and its long-term therapy of hypertensive coronary heart disease patients

The hypotensive effect of nifedipine (a Ca2+-antagonist) was studied in acute tests and during the long-term administration of the drug together with propranolol. Nifedipine (10 mg, sublingually) decreased blood pressure from 174/102 to 136/82 mmHg with increase in heart rate and plasma renin activity. The combination of nifedipine (10 mg, sublingually) and propranolol (0.2 mg/Kg body weight, intravenously) decreased blood pressure from 168/104 to 131/86 mmHg with decrease in heart rate and plasma renin activity. Twenty-five hypertensive patients were treated with nifedipine and propranolol (10 mg x 3 to 4/day) together with or without diuretic for long-term. With the combination therapy, blood pressure of Group I (11 hypertensive patients with coronary heart disease) fell from 211/129 to 140/85 mmHg, blood pressure of Group II (9 severe hypertensive patients without coronary heart disease) from 230/137 to 139/84 mmHg, and blood pressure of Group III (5 established hypertension) from 182/107 to 134/83 mmHg. With this treatment regimen, heart rate and plasma renin activity decreased, and abnormal electrocardiographic findings, hypertensive retinopathy, and renal dysfunction were improved. Nifedipine, in combination with propranolol and a diuretic, is considered an effective treatment of hypertension either with or without coronary heart disease.

[A case of intracranial mesenchymal chondrosarcoma--changes observed by computed tomography before and after radiotherapy (author's transl)]

Intracranial mesenchymal chondrosarcoma is very rare, only 14 cases being reported in Europe and in the United States of America. Recently we experienced a case in which the follow-up indicating computed tomograms (CT) demonstrated interesting data on the radiosensitivity of this tumor. The patient, a 14-year-old female was admitted to out hospital with the complaint of left hemiplegia which had gradually progressed. CT revealed an area spreading upward from the right median base of the skull and consisted of two components showing (A) a density as high as that of calcium and (B) a density higher than that of surrounding brain tissue, but much lower than that of calcium. Temporoparietal craniotomy was performed to react approximately one-half of the tumor. Histological finding revealed mesenchymal chondrosarcoma. The component-A was though to be a cartilaginous tissue, and-B to be an undifferentiated mesenchymal tissue. Postoperative irradiation of 7,000 rad was initiated. The effect of radiotherapy as seen on computed tomograms is as follows, (1) decrease in the volume of the tumor by 26%, (2) decrease in density and enhancement of the area which is considered to be the undifferentiated mesenchymal cells, (3) mild reduction of the area which is considered to be the cartilaginous tissue, and (4) a very high density of the entire tumor similar in degree to that of the bone one year later. These results suggested that radiotherapy is effective for this tumor.

Evidence of a collateralized climbing fiber projection from the inferior olive to the flocculus and vestibular nuclei in rabbits

In albino rabbits, horseradish peroxidase injections confined to vestibular nuclei retrogradely labeled neurons in the dorsal cap of the contralateral inferior olive. Mapping with stimulating electrodes revealed that stimulation of the lateral aspect of the medial vestibular nucleus and the medial aspect of the inferior vestibular nucleus evoked field potentials representing antidromic activation of contralateral dorsal cap neurons. These responses interfered with the antidromic response evoked from the contralateral flocculus and orthodromic responses evoked from the contralateral retina, suggesting that dorsal cap neurons which both receive retinal input and project to the flocculus send collaterals to vestibular nuclei.

Studies on the metabolism of 1-(2-tetrahydrofuryl)-5-fluorouracil and uracil co-administered orally to tumor-bearing rats

The metabolism of 1-(2-tetrahydrofuryl)-5-fluorouracil (FT) plus uracil (1:4, UFT) was compared with that of FT alone and that of uracil alone in tumor-bearing rats by using 3H-tracer. After oral administration of UFT, both FT and uracil were rapidly absorbed and no interaction of their absorptions was observed. The levels of 5-fluorouracil (5-FU) in the blood and tissues and the excretion of 5-FU in the urine of rats given UFT were temporarily higher, and the levels of alpha-fluoro-beta-ureidopropionic acid (a catabolic metabolite of 5-FU) in almost all tissues were lower than in rats given FT. The levels of 5-FU, 5-fluorouridine, and fluoronucleotides increased more in the tumors than in normal tissues of rats given UFT, but not in those given FT. The metabolism of uracil administered exogenously as UFT was not influenced by 5-FU or its metabolites derived from FT.

Type III glycogenosis with deposition of urate and amyloid

A case of a 44-year-old man with hepatic form of glycogenosis was presented. The patient had abdominal distension and muscular weakness. The glucose tolerance test showed a diabetic pattern, though he had hypoglycemia in fasting state. The fructose tolerance test showed an ability of conversion from fructose to glucose. The double glucagon test showed no rise of blood glucose in fasting state but a rise 2 hours after meal. These symptoms and laboratory data supported the clinical diagnosis of type III glycogenosis. At autopsy, glycogen was markedly deposited in the liver, and slightly in the kidneys and heart. The glycogen pooled in the hepatic cells histochemically showed a normal reaction to several glycogen stainings. Electron microscopy by using Thiéry's method revealed that the pooled glycogen particles were clearly arranged as rosettes measuring 1,000A in largest diameter composed of clustered monoparticulates. There were marked hyalinization of the islets of Langerhans containing amyloid. As to its pathogenesis, this change can be interpreted as a morphological expression of the hypofunction of beta-cells ascribed to long-standing hypoglycemia.

[Study of lymphocytes blast transformation method by a small amount of whole blood cultivation with 125I-UdR (author's transl)]

Lymphocytes blast transformation method by a small amount of whole blood cultivation with 125I-UdR was studied. 1) It is suitable to take for 4 or 5 days as culture days. 2) It is suitable to add PHA-P in the concentration of 7.5 micrograms per ml of medium. 3) Addition of fetal calf serum in medium is not required. 4) The mean value of SI was 35.62 for the healthy persons, 31.23 for the patients of lung tuberculosis and 16.31 for the patients of lung cancer. The difference of SI between the healthy persons and the lung cancer was significant statistically.

Metabolism, antitumor activity, and acute toxicity of 5-fluoro-1,3-bis(tetrahydro-2-furanyl)-2,4-pyrimidinedione by oral administration to animals

The metabolism, antitumor activity, and acute toxicity of 5-fluoro-1,3-bis-(tetrahydro-2-furanyl)-2,4-pyrimidinedione (FD-1) were investigated in animals, compared with 5-fluoro-1-(tetrahydro-2-furanyl)-2,4-pyrimidinedione (FT). It was found that after oral administration of FD-1, the level of 5-fluorouracil (5-FU) was maintained higher and longer than after administration of FT, and that a large amount of 5-FU was released from FD-1 by liver microsomal drug-metabolizing enzymes or spontaneous hydrolysis via 5-fluoro-3-(tetrahydro-2-furanyl)-2,4-pyrimidinedione (3-FT) and FT. FD-1 had a significant activity against the solid form of Ehrlich carcinoma, sarcoma-180, hepatoma AH130, Yoshida sarcoma, Walker carcinosarcoma-256, and leukemia L1210 and P388, but not the ascitic forms, and it produced greater inhibition of tumor growth than FT. The acute toxicity of FD-1 was less than that of FT.

Pathogenicity of cultivated murine leprosy bacilli of Hawaiian-Ogawa strain in mice. 4) Visceral lesions in mice produced by intraperitoneal infection

The pathogenicity of two substrains (HO-R and HO-S) of cultivated murine leprosy bacilli was examined by intraperitoneal inoculation to various strains of mice (C3H, KK, BALA/c, DDD and C57BL/6). HO-R (Rough Form) was first isolated on 1% Ogawa's egg yolk medium from the leprous lesions produced by original Hawaiian strain (H bacilli). HO-S (Smooth Form) was dissociated in vitro during the 9th to 15th subculture of HO-R on the same kind of medium. In all the mice tested, intraperitoneal inoculation with HO-R bacilli produced progressively severe visceral lesions in the manner similar to H bacilli harvested from subcutaneous leproma. The only exception was, however in DDD strain of mice H bacilli produced only slight visceral lesions even in the later stage of infection. HO-S was much lower in the pathogenicity than the above two strains of murine leprosy bacilli. Visceral lesions produced by intraperitoneal inoculation with HO-S used to be very slight in all the strains of mice except BALB/c. BALB/c strain mice were highly susceptible to intraperitoneal as well as subcutaneous infection with HO-S. From the above observations, it is concluded that the characteristic features of pathogenicity of cultivated murine leprosy bacilli, such as mouse strain differences, are all the same regardless of infection route.

Effect of 1 alpha-hydroxyvitamin D3 in rats with experimental renal osteodystrophy

A model of experimental renal osteodystrophy was established in the rats with chronic renal failure induced by partial nephrectomy and therapeutic effects of 1 alpha-hydroxyvitamin D3 (1 alpha-OH-D3) were studied. Male Wistar rats weighing 180 g were 5/6 nephrectomized and fed a normal diet (Ca and P : 1%) for 6 months. After the surgery, serum creatinine levels increased 60% and thereafter continued to rise gradually with their growth for 4 to 5 months, followed by rapid increase. The serum phosphorus levels were also elevated concomitantly and the serum calcium concentrations were normal. Marked bone resorption accompanied with hypertrophy of parathyroid glands was observed by histological examinations (Tetrachrome-Fuchsin stain, contact microradiography and H-E stain). The bone resorption seemed to be due to secondary hyperparathyroidism. Treatment with 0.25 micrograms/kg/day p.o. of 1 alpha-OH-D3 for 10 days in the uremic state resulted in remarkable new bone formation which was confirmed by histological examinations. These results clearly demonstrated that the reduction of nephron mass play a critical clue of renal osteodystrophy and 1 alpha-OH-D3 appears to have a good potential for clinical use in patients with renal failure and metabolic bone diseases.

Widespread eczema vaccinatum acquired by contacts. A report of an autopsy case

A 4-month-old male infant predisposed to allergic dermatitis acquired wide-spread eczema vaccinatum by contacts with a recently vaccinated sibling. He died of acute purulent peritonitis following a perforation of multiple duodenal ulcers. Fluorescence immunocytochemical and electron microscopic studies on the skin lesions revealed the presence of viral antigens and numerous virus particles compatible morphologically with those of the mature form from the same batch of smallpox vaccine given to the sibling. A large number of virus particles in the developmental form were also predominantly scattered in the cytoplasm of cells at the stratum malpighii of the epidermis as well as in neutrophils and macrophages in the skin lesions. The virus isolation from the skin lesions was done by using the HeLa cells and the human embryonic lung fibroblasts. No abnormal laboratory data were noted in immunoglobulins. On the basis of atrophy of the thymus and other lymphatic tissues and an appearance of large pyroninophilic cells in association with blastoid transformation, the authors discussed a possible participation of the disturbance of cellular immunity secondary to the virus infection in the development of the disease.

Pathogenicity of cultivated murine leprosy bacilli Hawaiian-Ogawa strain in mice. 1. The pathogenicity of bacilli from rough colonies

This paper deals with the pathogenicity of cultivated murine leprosy bacilli from rough colonies of Hawaiian-Ogawa strain in mice. This strain was isolated by Ogawa, in 1970, on Ogawa's 1% egg yolk medium [1], from mice previously inoculated with Hawaiian strain of murine leprosy bacilli which has been maintained by passages from mice to mice. The pathogenicity of Hawaiian-Ogawa strain was found to belong to the same pattern as Hawaiian strain when the subcutaneous inoculation test was carried out in C57BL/6 and C3H mice, the former being representative of the benign type and the latter being representative of the malignant type. In KK mice of the intermediate type with Hawaiian bacilli, however, Hawaiian-Ogawa bacilli produced the lesions with malignant features in almost all the male mice, while the female mice were divided into two groups roughly half showing the intermediate or malignant type. In DDD mice of the benign type with Hawaiian bacilli, some cases of the male mice showed the malignant features, whereas almost all the female mice were of the benign type in the same experimental conditions. The pathogenicity of Hawaiian-Ogawa bacilli in mice did not revert into that of Hawaiian bacilli even after serial mouse passage. There are slight but definite differences in the mouse pathogenicity between Hawaiian-Ogawa and Hawaiian strains.

Familial medullary carcinoma of the thyroid through 3 generations

A family with high genetic penetrance of medullary carcinoma of the thyroid was reported. Seven proven (6 patients and one autopsy case) and 2 probable cases of medullary carcinoma were present in 25 members through 3 generations. An endogemy had intervened in the prior generation of these cases. Preliminary results in clinicopathological examinations of 7 proven cases were as follows; clinically, all of the cases showed B type blood group. Glycosuria was found in 2 cases, and diarrhea in one case. Serum thyrocalcitonin being estimated in two cases showed high levels. The autopsy cases coexisted with medullary carcinoma of the thyroid and pheochromocytoma of the right adrenal. Pathologically, the majority of tumors occurred in both thyroid lobes, and were present from the middle to upper portion of the thyroid. The tumor showed a variety of histological features even in the same tumor. In the tumor cell, numerous membrane-limited granules were seen with an electron microscope. Amyloid was demonstrated only in the tumor tissue.

Some factors related to obesity in the Japanese sumo wrestler

Sumo is an ancient sport in Japan and there are at present over 800 professional sumo wrestlers (rikishis). After entrance into the wrestler society a wrestler takes strenuous daily training together with a very high calorie diet (more than 5,000 cal). Frequency of food intake is twice a day. The average diet of Japanese people contains of 2,279 calories and the meal frequency is generally three times a day. In 96 wrestlers average actual body weight and modified Broca index was 100.4 kg and 143.5%, respectively. In this group the prevalence of overweight with obesity, overweight without obesity, nonoverweight with obesity, and nonoverweight without obesity was 53.4, 39.1, 1.0, and 6.5%, respectively. Also mean serum levels of triglyceride, phospholipid, uric acid, and total protein were significantly higher than those obtained in 89 age-matched healthy males. The incidence of diabetes mellitus, gout, and hypertension in wrestlers was 5.2, 6.3, and 8.3%, respectively, all values being considerably higher than in controls. Weight correlated significantly with skinfold thickness, diastolic blood pressure, total cholesterol, and uric acid in each group. Multiple regression analyses were made treating weight or uric acid as dependent variables in both groups. Obesity, hyperlipidemia, and hyperuricemia in wrestlers were presumed to be caused chiefly by the high calorie diet and partially by the infrequent meal intake.

Susceptibility to murine leprosy bacilli of nude mice

Comparative observations were made on the development of experimental murine leprosy in various inbred strains of mice, including nude mice of congenital thymic aplasia. The susceptibility of these strains of mice to murine leprosy bacilli was evaluated by the development of leproma at the subcutaneous infection site and also by the involvement of visceral organs. Nude mice developed a much more severe disease than C3H mice which is the representative of the malignant type. Their high sensitivity was also demonstrated in the case of intraperitoneal infection. The observations in nude mice and other mouse strains confirmed our concept that experimental mouse leprosy can be classified into three clinical types, benign, intermediate and malignant, and suggested that such mouse strain differences are related with their cell-mediated immunity.