[Intrathecal gentamicin in the treatment of meningitis--clinical case study (author's transl)]

The authors report 33 cases of meningitis treated with intrathecally administered gentamicin (GM) and examine it's effectiveness for meningitis side effects and optimum dose. Of 33 cases 15 cases (group I1 were treated with GM alone 7 cases (group IIa) with GM combined with SB--PC or CP. In 8 cases of the other 11 cases (group IIb) GM was changed for SB--PC or CP because of it's inefficiency and side effects (6 cases) and other reasons (2 cases). In the remaining three cases of group IIb SB--PC or CP was changed for GM due to their inefficiecy. Maximum intrathecal dose is shown below : 4 mg--7 cases, 8 mg--5 cases, 10 mg--15 cases, 20 mg--4cases, 40 mg--2 cases. In all cases GM was not administered systemically, but each of CP, CB--PC, SB--PC and TC was administereed systemically. In group I, only one case did not G--I tract bleeding but the others were cured. In group IIa all but one case was cured. In group IIb one case of cyptococcosis was dead. Total effective cases of intrathecal GM were 17 of 24 cases excluding group IIa (7 cases) and 3 cases of group IIb. There was no side effect in cases of which maximum dose was 4--20 mg, but in one of 40 mg administered cases in which GM was injected from cisternal puncture hearing, vestibular and visual function were disturbed permanently. Therefore GM should not be injected into the cistern. In our conclusion intrathecal GM is thought to be effective in the treatment of meningitis without systemic GM. Effective optimum dose in 4--8 mg/day day in adult and if ineffective after 7--10 days GM should be changed for other antibiotics.

Polypoid carcinoma of the esophagus. A unifying term for "carcinosarcoma" and "pseudosarcoma"

Polypoid carcinomas with spindle-cell sarcomatous features have been designated either as carcinosarcoma or pseudosarcoma. The distinction between these two tumors has depended on the presence of "intermingling" of the carcinomatous and sarcomatous components in so-called carcinosarcoma. But unlike the carcinosarcoma, the sarcomatous component in pseudosarcoma has been considered benign. A polypoid tumor of the esophagus in a 57-year-old male was predominantly composed of spindle cell, sarcomatous cells. The presence of adjacent intraepithelial epidermoid carcinoma with transitional and ultrastructural features confirmed the epithelial origin of this tumor. Because of the absence of "intermingling," the primary tumor was considered to be a pseudosarcoma. However, our postmortem examination showed metastases composed of both carcinomatous and sarcomatous features. A review of the literature on carcinosarcomas and pseudosarcomas shows that only one case of pseudosarcoma reported by Hughes and Cruickshank showed a similar situation and indicates that the sarcomatous component in pseudosarcomas has the same metastatic potentiality as has been reported in carcinosarcomas. We conclude from these studies a basic similarity of the carcinosarcoma and pseudosarcoma. The term polypoid carcinoma is proposed for both these lesions.

[A case of colloid cyst of the third ventricle (author's transl)]

The authors report a case of colloid cyst of the third ventricle diagnosed preoperatively through CT scan, pneumoencephalography and carotid angiography. The patient was a twenty-six year old housewife with a history of two repeated episodic headaches followed by gait disturbance, vomiting and cold sweating. At operation, the colloid cyst which completely occluded the right foramen of Monro, was reached by anterior transcallosal approach and was partially removed with subsequent cure of her symptoms. The cyst fluid contained cholesterin crystals, cholesterol, protein (12.8 g/dl), and sugar (16 mg/dl). Histologically, the cyst wall consisted of a single layered cuboidal or columnar epithelium with many cilias internally and loose connective tissue rich in vascluar channels externally. Cytoplasm and cellular surface was partly positive at mucicarmine, PAS and alusian blue staining. The fact would confirm that there is mucin secreting function among the epithelial cells of the cyst.

Carp connectin: amino acid composition

An elastic protein, connectin, was prepared from carp skeletal muscle by the alkaline method with some modifications; collagen contaminations were exhaustively extracted with 1 N acetic acid and hot phenol treatment was omitted. This connectin preparation contained a considerable amount of tryptophan, but almost completely lacked hydroxyproline.

Scanning electron microscopy of the bile ductule

Scanning electron microscopy of a liver biopsy specimen from a patient 6 months after the onset of acute hepatitis revealed a normal appearing bile ductule. The bile ductule was 13 micron in outer diameter and 1.5-2.7 micron in inner diameter. The ductular lumen was surrounded by two ductular cells and ampullary dilated at the canalicular side. In the lumen, intracytoplasmic diverticles were observed with an orifice diameter of 0.9 micron. About 15 microvilli 0.4-0.6 micron in length and 0.1 micron in thickness were observed on 1 micron2 of luminal surface. The number of microvilli was calculated to be approximately 1,500 per ductular cell. A single cilium 0.15 micron in diameter at the base and 0.10 micron at the trunk, and 7-15 micron in length was found on each ductular cell. The cilium arose from a recess at the canalicular side of the ductular cell, and the free-end was on the bile-duct side. The cilia seemed to play an important role in bile flow to the duct. Sometimes between the ductular cells at the edge of the basal portion a cell was intercalated with thin processes. Such thin processes were not observed on ductular cells.

Synthesis of phenolic group containing analogues of porcine secretin and their immunological properties

Syntheses by the conventional method are described of Nalpha-tyrosylsecretin, [Tyr1]secretin, and Nalpha-beta-(4-hydroxyphenyl)propionylsecretin. Secretin and [Tyr6]secretin were also prepared by the synthetic route identical with those employed for construction of the above analogues. Purification of secretin and the analogues was conducted by ion-exchange column chromatography on CM-Sephadex and gel filtration. Immunological reactivities of these analogues were examined in the radioimmunoassay system for secretin using two different antisera raised against synthetic secretin in rabbits. The tracers used in this study were [125I]-[Tyr1]secretin and [125I]-[Tyr6]secretin. The dose-response curves of Nalpha-tyrosylsecretin, [Tyr1]secretin, and Nalpha-beta-(4-hydroxphenyl)propionylsecretion were essentially superimposable upon those of natural and synthetic preparations of porcine secretin in the systems used, while [Tyr6]secretin showed discrepancy in the curve. In addition, biological activities of the synthetic polypeptides were compared with that of natural porcine secretin in term of exocrine pancreatic secretory response in anesthetized dogs.

Structure-activity relationships of gastrointestinal hormones: motilin, GIP, and [27-TYR]CCK-PZ

The docosapeptide and the tritetracontapeptide corresponding to the entire amino acid sequence of porcine motilin and gastric inhibitory peptide were synthesized, and in addition, an unsulfated form of cholecystokinin-pancreozymin (CCK-PZ) was prepared to cast some light on the structure-activity relationships of these gastrointestinal hormones. In a series of motilin peptides, elimination of the pentapeptide from the amino terminus decreased the activity (in vitro contraction of rabbit duodenal muscle) to 1/250 of the whole molecule, and subsequent removal of the tripeptide Thr-Tyr-Gly resulted in the complete loss of its effects, In a series of gastric inhibitory peptides, two fragments corresponding to positions 1 to 28 and 26 to 43 were both inactive. However, the nonacosapeptide (15 to 43) retained one-fourth of the activity of the tritetracontapeptide (suppression of the gastric acid secretion stimulated by tetragastrin in Heidenhain pouch dogs). Synthetic [27-Tyr]CCK-PZ exhibited 1/250 of the activity of natural CCK-PZ (amylase release from rat pancreas). This compound was smoothly and efficiently labeled with 125I (specific activity 200 to 250 muc per mug).

Tyramine oxidase activity in needle biopsy of normal livers and diseased livers

Tyramine oxidase and UDP-glucuronyl transferase activities were determined in 52 diseased livers obtained by needle biopsy. 14 liver specimens were also subjected to acetyl CoA carboxylase determination. Tyramine oxidase level was elevated in livers with nonalcoholic fatty change or toxic hepatitis, and reduced in livers with fibrosis or chronic alcoholic injury. UDP-glucuronyl transferase activity was reduced in livers with severe parenchymal damage or hyperbilirubinemia. Acetyl CoA carboxylase activity decreased markedly in an active alcoholic cirrhotic liver, and was elevated in alcoholic fatty livers as well as in a liver with acute venous stasis.

[A case of the lateral ventricular tumor (subependymal glomerate astrocytoma) with preceding Parkinsonian symptoms due to normal pressure hydrocephalus (author's transl)]

Authors report a patient with a subependymal glomerate astrocytoma in the right lateral ventricle. He maifested parkinsonian symptoms and dementia related to the preceding normal pressure hydrocephalus which was proved by an infusion test, and then advanced an akinetic mutism. Soon after a shunting operation was carried out he showed a full recovery from the symptoms, which may suggest that an incomplete block of the ventricular system is one cause of the normal pressure hydrocephalus. From pathology it was revealed that the tumor is an intraventricular astrocytoma with a fibrous stalk and was totally removed with an ease. The findings seem to accord with "Subependymal glomerate astrocytoma" (Boykin.) Further corroboration would be necessary to establish this entity.

Peritoneoscopic diagnosis of liver surface--using a new code number system--

A new peritoneoscopic classification of liver surface using a three digit code was developed. The first digit represents the lobular change from normal structure to nodules. The second digit represents the size of the nodule and the internodular distance. The third digit represents the pathological findings, such as inflammation, degeneration, necrosis or regeneration. Furthermore, peritoneoscopic findings of necrosis of lobular size around the portal vein and patchy markings of the liver were presented. These findings were the most prominent in the course of hepatitis progression to cirrhosis.

[On-line, high-speeded data analysis of cardiovascular function using hybrid systems (author's transl)]

In recent years application of computer techniques to various problems in biology has increased. In the field of anesthesia, where rapid changes appearing in a short time must be followed, the conventional, mannual methods are not applicable. So we have developed on-line computer analytical methods of cardiovascular function. Hybrid systems are the preferred methods in many biological problems, either because of efficiency and lower cost, or because of real time, on-line, closed-loop capabilities for direct use during experiments. As a computer output we used a graphic display computer and cathod ray tube devices. We applied these systems to analize and calculate cardiac work with other circulatory parameters. We got a ventricular function curve in visible form on CRT within 30 seconds after introducing the signals of left ventricular work and ventricular end-diastolic pressure into the analog computer. It was also useful to calculate vascular input impedence and myocardial maximal velocity of shortening. Finally causes of input errors in these analytical methods were discussed.

Radioimmunoassay for secretin using Nalpha-tyrosylsecretin and [Tyr1]-secretin

Sensitive radioimmunoassay for secretin was developed by using synthetic preparation of porcine secretin and its related analogs. The secretin-specific antisera with titers ranging 1: 20,000-1 : 150,000 were generated in rabbits against highly purified synthetic secretin. The labeled antigen was prepared by radioiodinating by the chloramine-T method synthetic secretin analog, Nalpha-tyrosylsecretin or [Tyr1]-secretin, both of which were proved to have almost identical immunoreactivities with that of secretin itself. The immunoassay was performed by the double-antibody method using synthetic secretin as standard. The lowest detectable amount of secretin in the present assays was 5-10pg/tube. Human duodenum extract with hot water contained secretin or secretin-like material that shows a parallel displacement curve to the standard in the immunoassay system used. Serum levels of secretin immunoreactivity in man rose up to 250 pg/ml by intraduodenal infusion of HCl and to 800-1,000 pg/ml by i.v. injection of 1 cu/kg of Boots natural secretin.