Refractoriness of eucapnic hyperventilation-induced bronchoconstriction in rabbits

The mechanism of refractoriness in bronchoconstriction after repeated hyperventilation was investigated in 18 sensitized rabbits. Rabbits were separated into three groups: an untreated control group (n = 7), a cimetidine-treated group (n = 6), and an indomethacin-treated group (n = 5). After anesthetization, hyperventilation was performed for 15 min (120 breaths/min, 7 ml/kg tidal volume) with dry air containing 5% CO2. Total lung resistance (RL) and dynamic compliance (Cdyn) were measured before (baseline) and after hyperventilation challenge. After RL and Cdyn had returned to baseline values, the hyperventilation challenge was repeated. In the control group maximal increase in percent RL (max %RL) was 49 +/- 9% after the first challenge, but 16 +/- 4% after the second challenge, indicating refractoriness. A similar tendency was observed in percent Cdyn. In the cimetidine- and indomethacin-treated groups, max %RL were 42 +/- 3% and 60 +/- 15% after the first challenge, and 35 +/- 8% and 60 +/- 7% after the second challenge, respectively, indicating no refractoriness. These results suggest that the H2-receptor and bronchodilating prostanoids play an important role in producing the refractoriness to bronchoconstriction observed in sensitized rabbits after repeated hyperventilation.

[Massive skeletal invasion in Hodgkin's disease observed by MRI]

A 35-year-old female developed cervical adenopathy and mediastinal tumor in 1988. A lymph node biopsy specimen showed nodular sclerosing Hodgkin's disease. She received combination chemotherapy with cyclophosphamide, vincristine, adriamycin and prednisolone, and radiotherapy for mediastinal tumor. She had a complete remission (CR). In September 1990, she developed swelling of the left hip and felt pain in the left hip and thigh. She also noticed swelling of the left inguinal lymph nodes. MRI T2-weighted images showed enlargement and destruction of the fascia and hyperintense signal of the left iliac and gluteus muscle. A biopsy specimen of the inguinal lymph node showed recurrence of Hodgkin's disease of mixed cellularity. She received salvage therapy with ifosfamide, methotrexate, etoposide and procarbazine, and achieved a second CR. The clinical appearance of the skeletal muscle involvement by lymphoma is uncommon, especially in Hodgkin's disease.

[Evaluation of gastric motility using vector analysis of electrogastrography]

The validity of amplitude analysis was studied by means of vector analysis of cutaneous electrogastrography (EGG) recorded from two sets of bipolar electrodes placed at the upper abdomen. In a basic study on the dog, it was found that the vector locus area obtained by vector analysis of EGG expresses contractile activity in the stomach, and that the extreme ellipsoid's long axis of EGG corresponds well to the electrical axis of the stomach. In a clinical study on the healthy male volunteers, vector analysis of EGG in response to gastroprokinetic and cold stress showed potential utility. In summary, vector analysis of cutaneous EGG enables the measurement of gastric motor activity and the location of electrical axis, and is valuable in the evaluation of gastric motor activity together with the analysis of EGG frequency. In is concluded that cutaneous EGG is a simple, and clinically relevant technique for the measurement of functional abnormalities of the stomach.

Immunosuppressive effect of shedding intercellular adhesion molecule 1 antigen on cell-mediated cytotoxicity against tumor cells

We have examined whether shedding intercellular adhesion molecule-1 (ICAM-1) antigen from cultured tumors is able to inhibit the leukocyte function-associated antigen-1 (LFA-1)/ICAM-1 interaction between cytotoxic effector cells and ICAM-1+ target tumor cells. The cytotoxic activity of lymphokine-activated killer (LAK) cells incubated with spent media from ICAM-1+ tumor cells, especially interferon-gamma-stimulated tumor cells, was significantly decreased as compared with that of LAK cells treated with fresh culture medium without ICAM-1 antigen. Treatment of LAK cells with spent media from ICAM-1- tumor cells did not cause a significant decrease of the cytolytic activity towards ICAM-1+ tumor cells. These findings suggest that shedding of ICAM-1 antigen could be involved in binding of LFA-1 to LAK cells, resulting in reduced cytolytic activity.

Application to cows and horses of Spotchem, a dry-chemistry blood analyzer for use in veterinary clinics

The usefulness of a dry-chemistry blood analyzer, Spotchem SP-4410 (SP-4410) in a veterinary clinic for analysis of bovine and equine blood chemistry was studied. We quantitated total protein (TP), albumin (Alb), total bilirubin (T-Bil), blood urea nitrogen (BUN), total cholesterol (T-Cho), glucose (Glu), calcium (Ca), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), creatinine phosphokinase (CPK), and alkaline phosphatase (ALP) in bovine sera. Each sample was assayed with both the SP-4410 and an automated blood analyzer which served as a wet-chemistry reference system, and the data were analyzed with regression analysis. The correlation coefficient for AST was 0.997 being the highest for all the parameters, and all the correlation coefficients were 0.93 or higher. The coefficients of variation were lower than 5.0 except in the case of bovine T-Bil where it was 5,756. The ranges of normal reference values measured by SP-4410 were the same as those reported by other investigators in most cases, but those for GGT and CPK were slightly higher. The strongest interference was observed with hemoglobin. It seems that dry-chemical-analysis of blood serum using the SP-4410 is useful for analysis of bovine and equine blood.

Phenotypic analysis of nylon-wool-adherent suppressor cells that inhibit the effector process of tumour cell lysis by lymphokine-activated killer cells in patients with advanced gastric carcinoma

The causes of down-regulation of cytotoxic immune responses in cancer patients have not been fully evaluated. We previously demonstrated that T-cell-growth-factor-activated peripheral blood lymphocytes (PBL) with the surface phenotype CD8+ CD11b-, from patients with widespread metastasis of gastric carcinoma, inhibited the effector process of lymphokine-activated-killer(LAK)-cell-mediated cytolysis. In this study, we examined suppressor cell activity in freshly prepared PBL from 18 patients with advanced gastric carcinoma, and 10 normal healthy individuals. The suppressor cell activity was assayed by recording whether or not PBL inhibited directly the effector process of LAK cell cytotoxicity. Most of the PBL suspensions from cancer patients showed that they contained a population of cells that can directly inhibit the effector phase of tumor cell lysis of the cytotoxic cells. To analyze further the PBL responsible for the suppression, the cells were passed over a nylon-wool column. Nylon-wool-adherent cells significantly augmented the suppression, while the cells passing through abrogated the suppressive effect. Most nylon-wool-adherent cells from 10 normal healthy controls did not inhibit the cytotoxic reaction. To determine further the suppressor-effector population in nylon-wool-adherent cells, negative-selection studies using CD8-, CD4- or CD11b-coated magnetic beads, and positive-selection studies using CD8- or CD4-coated magnetic beads were performed. Finally the results suggest that the suppressor-effector cells comprise at least two different surface phenotypes: CD8+ T and CD8-CD11b+ cells. The possible role of CD4+ T cells and HLA-DR+ LeuM3+ macrophages as suppressor cells was ruled out in nylon-wool-adherent cells. CD8+ T and possibly CD8-CD11b+ cells apparently suppressed the efferent limb of the antitumor immunity. The selective immune suppression mediated by these cells may partly be concerned with escape mechanisms of gastric carcinoma from the host immune surveillance system.

A new surgical approach to apical segment lung diseases, including carcinomas and inflammatory diseases

A new surgical approach to lung cancer and inflammatory pulmonary diseases has been developed. This approach focuses on diseases located in the apical segments of the lung and showing invasion or severe adhesion to the apical thoracic wall or to vital organs near the thoracic dome (including superior sulcus tumors). The conventional posterolateral approach leaves the surgeon "blind" because it forces the surgeon to perform the operation looking up through a tube from the bottom. This limited view makes accurate assessment of the surrounding vital organs involved in these diseases almost impossible and also increases the risk of injury to adjacent vital organs. The incision in this new approach allows extensive retraction of the scapula to provide easier access to the posterior chest wall. Because the incision curves upward anteriorly, rather than downward as usual, it gives excellent exposure of the apical anterior thoracic region. In the few cases in which we have used this approach, we have found that the surgical field is in plain view and that the operation is consequently safer and easier. So far we have not encountered any complications, and we can recommend this approach with confidence.

Major hepatectomy and pancreatoduodenectomy for advanced carcinoma of the biliary tract

Seven patients with advanced carcinoma of the extrahepatic biliary tract, including two with cancer of the gallbladder, underwent major hepatectomy with concomitant pancreatoduodenectomy. The mean hepatic volume resected was 64 (range 35-81) per cent. Postoperative complications occurred in all patients and accounted for two hospital deaths. Two patients with gallbladder carcinoma survived without recurrence for 22 and 58 months. Three of five patients with bile duct cancer survived operation, although all three subsequently died from recurrent disease at 8, 10 and 27 months. Combined major hepatectomy and pancreatoduodenectomy may be appropriate in selected patients with advanced cancer of the gallbladder. Further evaluation is necessary before this approach can be recommended for those with advanced bile duct carcinoma.

Roles of neutrophil elastase and superoxide anion in leukotriene B4-induced lung injury in rabbit

The effects of a competitive neutrophil elastase (NE) inhibitor, ONO-5046, and a recombinant human superoxide dismutase on leukotriene B4 (LTB4)-induced polymorphonuclear leukocyte (PMN)-mediated increase in microvascular permeability in isolated non-blood-perfused rabbit lungs were studied. Pulmonary microvascular permeability and lung edema were evaluated by use of the fluid filtration coefficient (Kf) and the wet-to-dry lung weight ratio (W/D), respectively. Pulmonary capillary pressure was estimated by the double occlusion technique. NE activity in the perfusate was determined using a spectrophotometric method. The PMNs (2-3 x 10(8) cells) were added into the perfusate in all groups of lungs. Injection of LTB4 (5 micrograms) increased Kf and W/D without affecting pulmonary arterial or capillary pressure. The LTB4-induced lung injury was closely associated with the increase in NE activity in the perfusate. Infusion of ONO-5046 (1 or 10 mg.kg-1 x h-1) inhibited the LTB4-induced increases in Kf, W/D, and perfusate NE activity in a dose-dependent fashion. Infusion of recombinant human superoxide dismutase (80,000 U.kg-1 x h-1) attenuated the LTB4-induced increases in Kf and W/D, although it did not influence the elevation of perfusate NE activity induced by LTB4. These results suggest that both NE and superoxide anion play important roles in the LTB4-induced PMN-mediated increase in pulmonary microvascular permeability.

Renal vascular and sympathetic nerve responses to hypotension induced by platelet-activating factor in anesthetized dogs

This experiment was designed to determine renal sympathetic and renal vascular responses to platelet-activating factor (PAF)-induced hypotension in anesthetized dogs with and without systemic baroreceptor denervation. The left kidney was perfused at a constant flow, and renal perfusion pressure and efferent left renal sympathetic nerve activity were measured simultaneously. Intrarenal injection of PAF (1.25-5.0 x 10(-2) micrograms/kg, n = 6) produced a dose-dependent increase in renal perfusion pressure without any change in systemic blood pressure. An intravenous injection of PAF (10 micrograms/kg) to intact animals (n = 7) caused an initial increase in renal nerve activity (157 +/- 14%) followed by a gradual reduction below baseline (72 +/- 7%) with concomitant systemic hypotension (from 116 +/- 7 to 46 +/- 6 mmHg). Renal perfusion pressure increased significantly from 84 +/- 2 to 161 +/- 33 mmHg concomitant with an increase in renal nerve activity at 1 min and was maintained at this elevated level throughout the experiment. Similar responses of renal nerve activity and renal perfusion pressure were found in animals with complete systemic baroreceptor denervation (n = 7). These results suggest that renal vascular response during PAF-induced hypotension may presumably be mediated by a direct vasoconstrictor effect of PAF on the renal vasculature and that baroreceptor reflex is not involved in either renal sympathetic or renal vascular changes.

FK506 therapy of experimental autoimmune myocarditis after onset of the disease

Preventive effects of FK506 on autoimmune myocarditis have been demonstrated, but the therapeutic efficacy of the agent in established myocarditis yet remains to be assessed. In this study, effects of FK506 on experimental autoimmune myocarditis were investigated by the use of the agent after the onset of the disease. Lewis rats were immunized with either cardiac myosin or bovine serum albumin (BSA) in complete Freund's adjuvant. The onset of the disease was ascertained by examining randomly chosen cardiac myosin-immunized rats. Animals were divided into four groups: the BSA-immunized saline-treated group (group A, n = 6); the BSA-immunized FK506-treated group (group B, n = 6); the myosin-immunized saline-treated group (group C, n = 6); and the myosin-immunized FK506-treated group (group D, n = 11). Saline or 1.0 mg/kg/day of FK506 were intramuscularly injected from day 16 to day 27. All the rats were put to death on day 28. Rats of group C became severely ill by the third week, while in contrast, rats of group D remained active, as did rats of groups A and B. The heart weight/body weight ratio was significantly lower in group D than in group C rats. Group mean values were 3.48 +/- 0.10 gm/kg for group A, 3.48 +/- 0.16 gm/kg for group B, 4.94 +/- 0.66 gm/kg for group C, and 3.88 +/- 0.43 gm/kg for group D. Rats of group C showed severe myocarditis with mononuclear cell infiltration, myocardial necrosis, and interstitial edema.(ABSTRACT TRUNCATED AT 250 WORDS)

Efficacy of amlodipine besilate therapy for variant angina: evaluation by 24-hour Holter monitoring

The efficacy of amlodipine, a calcium antagonist, was investigated in 12 patients with variant angina. Amlodipine was administered at a dose of 5 mg once daily, and efficacy was assessed from the frequency of anginal attacks, the frequency of ST elevation or depression, and the extent of ST segment changes [ST segment elevation or depression (mm) x duration (seconds)] on the Holter ECG before and after treatment. The frequency of ST elevation during the observation period was 1.67 +/- 0.33 times/day (symptomatic attacks: 1.17 +/- 0.21/day; asymptomatic attacks: 0.50 +/- 0.19/day), and this significantly decreased to zero per day (both symptomatic and asymptomatic attacks) after treatment (p < 0.05). The extent of ST segment elevation during the observation period was 507.5 +/- 156.6 mm.sec/day (symptomatic: 382.5 +/- 102.9 mm.sec/day; asymptomatic: 125.0 +/- 62.0 mm.sec/day), and such changes were completely suppressed (both symptomatic and asymptomatic) by treatment (p < 0.05). The frequency of ST depression was 2.08 +/- 0.42 times/day (symptomatic: 0.25 +/- 0.13/day; asymptomatic: 1.83 +/- 0.37/day) during the observation period, while it was 1.50 +/- 0.36 times/day (symptomatic: 0.25 +/- 0.13/day; asymptomatic: 1.25 +/- 0.30/day) after treatment. Although anginal attacks remained unchanged, asymptomatic attacks tended to decrease (p = 0.07).(ABSTRACT TRUNCATED AT 250 WORDS)

Further study of nebulisation chemotherapy, a new chemotherapeutic method in the treatment of lung carcinomas: fundamental and clinical

Nebulisation chemotherapy, a chemotherapeutic method for the treatment of lung cancer that involves the administration of anticancer agents through the inhalation of nebulised aerosols, has been found to be highly effective (Tatsumura et al., 1983a,b). We confirmed that 5-FU administered by this method accumulates in the trachea, bronchi and regional lymph nodes of patients treated before surgery, along with 5-FU metabolites, FUR and FUdR, indicating that 5-FU is directly incorporated and metabolised in the respiratory tract. Parallel result were obtained using mongrel dogs. The 5-FU levels in other organs, such as the heart and liver, were found to be extremely low. Only a trace of 5-FU was found in the serum of both the patients and the dogs. We further investigated the anti-tumour effect of this therapy in ten selected patients and observed a satisfactory anti-tumour response of 60.0%. These results, along with our previous finding that the retention time of isotope tracers inhaled as aerosol is considerably longer in tumour tissues than in normal parts (Tatsumura et al., 1983a) explain the high antitumour action of this therapy and the absence of adverse effects of administered 5-FU.

Orthodromic capture of the atrial electrogram during transient entrainment of atrioventricular nodal reentrant tachycardia

BACKGROUND

The reentry circuit of atrioventricular nodal reentrant tachycardia (AVNRT) has not been fully demonstrated. We hypothesized that if an upper common pathway was present, the atrial electrogram could not be captured orthodromically during transient entrainment of AVNRT by rapid atrial pacing. Based on this hypothesis, the presence of an upper common pathway was investigated.

METHODS AND RESULTS

The atrial electrogram at the recording site of the His bundle potential was identified during induced AVNRT in 9 patients. To entrain AVNRT transiently, rapid pacing from the high right atrium and coronary sinus was applied at a cycle length 10 milliseconds shorter than that of AVNRT and repeated after a decrement of the paced cycle length in steps of 5 milliseconds until AVNRT was interrupted. In 5 of 7 patients, orthodromic capture of the atrial electrogram at the recording site of the His bundle potential was observed during transient entrainment of AVNRT by coronary sinus pacing, ie, the first postpacing interval of the atrial electrogram at the recording site of the His bundle potential was the same as the paced cycle length. In these 5 patients, the mean minimum paced cycle length capable of orthodromic atrial capture was 349 milliseconds, and the mean difference from the cycle length of AVNRT was only 16 milliseconds. During transient entrainment of AVNRT by high right atrial pacing, the atrial electrogram could not be captured orthodromically.

CONCLUSIONS

Observation of orthodromic capture of the atrial electrogram at the recording site of the His bundle potential by coronary sinus pacing ruled out the presence of an upper common pathway in AVNRT, and the concept that perinodal atrial tissue is involved in the reentry circuit of AVNRT was supported.

Superficial and protruding type of esophageal adenocarcinoma mucocellulare and muconodulare confined mostly to the lamina propria mucosa and partly in the submucosal layer

We report a case with an adenocarcinoma mucocellulare and muconodulare of the esophagus which is limited to the lamina propria mucosa and the submucosal layer. The patient, a 74-year-old man had the chief complaints of hematemesis and melena. A superficial and protruding (0-I) type of lesion was found at the lower thoracic portion of the esophagus by X-ray and endoscopic examination. The surgically resected esophageal specimen showed 0-I and predominantly subepithelial (Sep) type. The tumor is presumed to have arisen from the cardiac glands in the lamina propria mucosa of the lowermost region of the esophagus.

HLA associations with Menière's disease

In order to investigate the genetic background of Menière's disease, histocompatibility (HLA) antigens in Japanese patients were studied. HLA-class I: HLA-A, -B and -C were typed by the classical microcytotoxicity technique, and HLA-class II: HLA-DR, DQ, and DP were typed by PCR-DNA typing methods. Twenty patient samples tested were selected very strictly following clinical data and classical criteria. Most of the patients had been suffering from typical symptoms during a considerably long period of time (16 +/- 7 years). Normal controls were based on the gene frequency in the Japanese population. Compared with the normal controls, a higher frequency of the DRB1*1602 subtype of HLA-DR2 was found in the patient group (chi 2 = 9,21, p < 0.04). P-values were corrected by multiplying by the total number of antigens. Additionally, HLA-Cw4 was increased, although the p-value was not significant after multiple antigen correction. There was no obvious relationship between the HLA-DRB1*1602 patients and the clinical data that included severity, age at time of onset, etc.

[Influence of airway temperature and humidity of hyperventilation induced bronchoconstriction in rabbits]

It has been suggested that humidity and temperature of inspired air is important in determining the severity of hyperventilation induced bronchoconstriction (HIB). To investigate whether water loss or heat loss from airway plays more important role to induce HIB, we compared the effect of temperature and humidity of inspired air on HIB, in sensitized and non-sensitized rabbits. Inspired air containing 5% CO2 was conditioned to dry or humidified and to temperature of 9 degrees C or 25 degrees C during isocapnic hyperventilation. In sensitized rabbits, marked bronchoconstriction was observed when inspired air dry regardless of temperature. We conclude that 1) HIB is produced in sensitized rabbits and 2) humidity rather than temperature of inspired air is more important to induce HIB.

Dystrophin negative skeletal and myocardial muscle cells in a carrier of Duchenne's muscular dystrophy

A 47-year-old woman whose elder son had typical Duchenne's muscular dystrophy (DMD) was diagnosed as the manifesting carrier of the disease. She had developed congestive heart failure but had no evidence of skeletal muscular atrophy. Histological observation of the cardiac muscle revealed a mosaic pattern of dystrophin negative fibres detected by immunofluorescence analysis.

Granulocyte colony-stimulating factor does not exacerbate endotoxin-induced lung injury in sheep

Because it has been suggested that neutrophils play a role in endotoxin-induced lung injury, we examined the effects of increased peripheral blood-neutrophils induced by recombinant human granulocyte-colony-stimulating factor (rhG-CSF) on the lung dysfunction when induced by endotoxin in awake sheep. We prepared chronically instrumented awake sheep with lung lymph fistulae and catheters for hemodynamic monitoring. We compared alterations of pulmonary hemodynamics, lung lymph balance, circulating leukocytes, plasma and lung lymph concentrations of thromboxane B2 and 6-keto-prostaglandin F1 alpha, and arterial blood gases in sheep that received Escherichia coli endotoxin infusion intravenously (1 microgram/kg) in the following two groups: Group 1 (n = 6) received endotoxin alone, and Group 2 (n = 7) received rhG-CSF (125 micrograms/day) intravenously for 3 days before endotoxin was administered in the same manner as in Group 1. The rhG-CSF remarkably increased circulating neutrophils to 24,600 +/- 2,500/microliters in Group 2 sheep at baseline when compared with the level in Group 1 (5,700 +/- 550 microliters). After endotoxin infusion, we observed significant decreases in circulating neutrophils in both groups. There were no differences between the two groups in the time course of changes in pulmonary hemodynamics, arterial blood gases, or arachidonate products after endotoxemia. However, lung lymph flow and lung lymph protein clearance during the late phase were lower in rhG-CSF-treated sheep than in those that received only endotoxin.(ABSTRACT TRUNCATED AT 250 WORDS)

1H and 15N assignments and secondary structure of the PI3K SH3 domain

The sequential 1H and 15N assignments of the SH3 domain of human phosphatidyl inositol 3'-kinase (PI3K) were determined by a combination of homonuclear and heteronuclear NMR experiments. With the exception of several protons belonging to lysine and proline residues, all proton and proton-bearing amide nitrogen resonances were assigned. Based on the sequential nuclear Overhauser effects (NOEs), 3JNH-C alpha H coupling constants and locations of slowly exchanging amide protons, we determined that the secondary structures of the protein consists of six beta-strands, two beta-turns and four short helices. Additional long range NOEs indicate that these beta-strands form two antiparallel beta-sheets. The topology of secondary structural elements of the PI3K SH3 domain is similar to those of the SH3 domains from c-Src and alpha-spectrin, suggesting that the SH3 family has a common tertiary structural motif.

[Analysis of bronchoalveolar lavage fluid in a case of high altitude pulmonary edema]

A 29-year-old male climber developed high altitude pulmonary edema (HAPE), progressing from headache and dyspnea to disturbance of consciousness in the Japan Alps. He was admitted to Shinshu University Hospital. Physical examination on admission revealed a cyanotic patient with coarse crackles and wheezes in bilateral lungs. Chest X-ray film showed bilateral patchy infiltrates. Arterial blood gases indicated severe hypoxemia, and respiratory alkalosis; pH 7.452, PO2 35.5 Torr, PCO2 31.6 Torr. Right heart catheterization showed noncardiogenic pulmonary edema, analysis of bronchoalveolar lavage (BAL) fluid was as follows; cells 2.05 x 10(5)/ml (alveolar macrophages 61.5%, neutrophils 25.5%, lymphocytes 13.0%), protein concentration 91 mg/dl. Cellular and protein analysis of BAL has been shown to be of value to clarify the pathogenesis of the permeability edema in patients with HAPE.

Thalamic neuronal hyperactivity following transection of the spinothalamic tract in the cat: involvement of N-methyl-D-aspartate receptor

Single neuron activities responding to peripheral stimuli with short latencies were recorded within the thalamic nucleus ventralis posterolateralis (VPL) after transection of the spinothalamic tract (STT) in the cat under alpha-chloralose anesthesia. The VPL neurons showed spontaneous and evoked hyperactivity after STT transection, which was revealed at 1-2 weeks. The spontaneous hyperactivity further progressed until 3-4 weeks. These hyperactivities were observed in core-area neurons as well as neurons found in the shell area, suggesting that some, if not many, of the N-methyl-D-aspartate (NMDA) receptor antagonist (MK-801, 4-16 mg; i.v.) attenuated both the spontaneous and evoked hyperactivity observed after STT transection. No such effects were demonstrated in sham-operated animals. These findings suggest that VPL neurons become hyperactive after STT transection through recruitment of NMDA receptors. The hyperactivity of VPL neurons may represent an important background process in the production of deafferentation pain induced by lesions involving the STT.