[Clinical evaluation of cardiac function test using scintiview (author's transl)]

Cardiac function was studied with Scintiview in 107 cases, 24 normal and 83 affected cases, and the following results were obtained. 1. Better data were obtained with converging collimeter than with parallel collimeter in cardiac study. (2) Red blood cells were sufficiently labeled with 99mTc using stannous chloride as reductant, and it was proven to be applicable to measurement of circulation blood volume. (3) Pulmonary circulation time and the systemic circulation time calculated from time activity curve, greater than 9.0 seconds and greater than 25 seconds, respectively, were considered abnormal prolongation. (4) Cardiac output index (cardiac output/circulation blood volume), less than 1.10 was considered decreased cardiac output. (5) Stroke volume index ((stroke volume/circulation blood volume)x 100, less than 1.70 was considered decreased stroke volume. (6) Ejection fraction, less than 60% was considered decreased left ventricular wall motion. (7) Cardiac function index (cardiac output index X ejection fraction), less than 80 was considered decreased cardiac performance.

[The echocardiographic study in 13 cases with infective endocarditis (author's transl)]

The echocardiographic study was performed in 13 cases with infective endocarditis including one case with annular subvalvular left ventricular (LV) aneurysm. The echocardiographic findings were compared with clinical as well as anatomical findings obtained by surgery or autopsy. The valvular vegetations were visualized echocardiographically in 6 cases (46%); 2 cases in aortic valve (AV), 2 in mitral valve (MV) and 2 in both valves. In 3 out of 4 cases with AV vegetation, the abnormal echo was seen in the LV outflow tract. Two out of these 3 cases indicated "flail aortic leaflet" with early closure of the MV, and immediate aortic valve replacement was performed. Unfortunately, one died 4 weeks after operation. The echocardiographic findings showed good correlation with anatomical findings in 4 cases with valve replacement. Out of 4 cases with MV vegetation, one developed the progressive growth with subsequent rupture of the chordae tendinae to the anterior mitral leaflet, which paralleled to the clinical deterioration. In another one case, the echocardiographic size of vegetation in the MV reduced significantly shortly after the episode of cerebral embolism. In a case of annular subvalvular LV aneurysm possibly due to infective endocarditis, echo free space was visualized in the interventricular septum, coinciding well with postmortem anatomical findings. It seemed to be reasonable to indicate surgical repair in cases with evident vegetation and considerable destruction of AV, in which congestive heart failure inevitably develops and the prognosis is poor.

Effect of catecholamine on fetal breathing activity in rhesus monkeys

The effect of various catecholamines on fetal breathing movements (FMB) was studied in 10 established chronic fetal rhesus monkey preparations. Norepinephrine, epinephrine, isoproterenol (all 1:10(5) [w/v] in concentration), or saline was infused intravenously to the fetus, each on five separate occasions. The infusion of the catecholamines was started at 0.02 ml/min and increased in a stepwise fashion until the fetus exhibited cardiovascular responses. The infusion rate was then maintained for 30 minutes to observe FBM. The incidence of FBM was determined for each 5-minute period and also expressed as a percentage of preinfusion values. Statistical analysis revealed that the incidence of FBM was significantly increased by isoproterenol and decreased by norepinephrine. Epinephrine did not consistently alter the incidence of the FBM.

Architecture and synaptic relationships in the intermediolateral nucleus of the thoracic spinal cord of the rat: HRP labelling, catecholamine histochemistry and electron microscopic studies

The organization of the intermediolateral nucleus (IML) of the thoracic spinal cord was examined using glyoxylic acid-induced fluorescence histochemistry, retrograde horseradish peroxidase (HRP) labelling and electron microscopy. In serial sections of T2, it was found that the distribution of catecholamine nerve terminals was intimately related to the neuronal perikarya of IML. Potassium permanganate fixation and 5-hydroxydopamine treatment revealed small dense-cored vesicles in axon varicosities with or without synaptic specializations. A gelatinous region, composed of small diameter dendrites and unmyelinated axons, formed a narrow longitudinal bundle in the centre of the nucleus. The population of the axon varicosities in the IML was 0.17 +/- 0.02/micrometer2 in 75 nm sections. The average size of the axon varicosities with flat synaptic vesicles was 1.44 +/- 0.05 micrometers2 and that of varicosities with spherical vesicles was 0.97 +/- 0.02 micrometers2. After HRP injection into the superior cervical ganglion, ipsilateral IML neurons were labelled in T1-T3 segments of the spinal cord. Axon varicosities with flat and others with spherical synaptic vesicles synapsing on the dendrites labelled by HRP. Among axon varicosities synapsing on the preganglionic sympathetic neurons, 74.8 +/- 7.1% at axo-somatic synapses and 46.0 +/- 6.7% at synapses on proximal dendrites contained flat synaptic vesicles.

A cyclic variation in thyroid-stimulating hormone in the fetal rhesus monkey

Morning and evening simultaneous fetal and maternal plasma samples were analyzed for thyroid-stimulating hormone. An a.m.-p.m. variation in fetal concentrations was identified, whereas the majority of the maternal values (28 of 32) were below the sensitivity of the assay. The importance of this cyclic fetal activity is discussed.

[A histopathological study of the brain of patients who died of cerebral vasospasm after rupture of cerebral aneurysm (author's transl)]

It is said that cerebral angiospasm affects very seriously the prognosis of the patient with ruptured aneurysm. Of 44 patients with ruptured aneurysm who died from cerebral ischemia due to cerebral angiospasm, we performed histopathological studies of brains of 18 patients without iatrogenic factors (radical surgical operation, prolonged artificial breathing and so on). In all of the cases, cerebral infarctions were observed in the area fed by the artery with angiospasm. The size and extent of the cerebral infarction were various. In 12 cases who died in the acute stage (within 3 weeks after subarachnoid hemorrhage), those who survived longer showed more severe and wide cerebral infarction, while those who died earlier showed more localized infarction in the basal ganglia and thalamus. In 6 cases who died in the chronic stage (more than 3 weeks after subarachnoid hemorrhage), the cerebral infarction was slight. No ischemic changes were observed in the brain stem, except for secondary petechial hemorrhage due to incisural herniation in cases with extensive cerebral infarction.

Diurnal variations in maternal and fetal steroids in pregnant rhesus monkeys

To examine diurnal changes in maternal and fetal steroids in chronically catheterized pregnant rhesus monkeys, we have measured cortisol (F), progesterone (P4), estone, and estradiol in maternal blood and F, P4, and dehydroepiandrosterone sulphate (DHAS) in simultaneous samples of fetal blood taken in the morning (0700--1000 h) and in the evening (1700--2100 h). In the mother, the concentrations of F, estradiol, and estrone were higher in the morning than in the evening. In contrast, progesterone was higher in evening than in morning samples. In fetal blood, there was no significant morning-evening difference for F; however, the concentrations of P4 and DHAS were higher in the evening than in the morning samples. In three individual monkeys, the concentrations of P4 and DHAS in serial samples of fetal blood were correlated. We conclude 1) that there are marked diurnal changes in the concentration of several steroids in samples of maternal and fetal blood and 2) that the concentration of F in maternal blood shows the opposite pattern to that of possible fetal adrenal steroids in fetal blood.

Cardiac systolic time intervals in fetal monkeys: ventricular ejection time

The VET of the fetal cardiac cycle, measured as the interval between the semilunar valve opening and closing signals of the ultrasound Doppler cardiogram, was studied in chronically catheterized fetal rhesus monkeys. VET varied inversely with FHR between approximately 150 and 250 bpm. Below 150 bpm, however, there was no further prolongation of VET. VET was not related to gestational age. VET, corrected for heart rate, was shortened in the presence of combined hypoxemia and acidosis, but not when either hypoxemia or acidemia was present alone. Corrected VET was shortened by epinephrine, but was not consistently altered by atropine. VET was not affected by changes in the concentration of glucose in fetal blood.

Dictyostelium discoideum fruiting bodies observed by scanning electron microscopy

The fruiting bodies of Dictyostelium discoideum, fixed in a vapor of 25% glutaraldehyde, were observed by scanning electron microscopy. The surface of the basal disk had rootlike ripples, sometimes with concentric rings of riblike striations at its periphery. The surface of the stalk had pleated and twisted ridges along its entire length, but no lateral projections. The spores were randomly orientated and had a crinkled surface. The surface of the lower part of the papilla had flattened ridges running horizontally. A slime coat remained in the region of transition between the stalk and sporangium, but not on the spores.

Diagnosis of fetal death in utero by real-time ultrasound

The efficacy of real-time ultrasound for the diagnosis of fetal death or hydatidiform mole was evaluated during a 1-year period. During this time, 116 patients were referred to the obstetric ultrasound service for the confirmation of clinical diagnoses. In 24 of 46 patients (52%) presenting in the first half of pregnancy, the referring diagnosis was confirmed. In 1 case of an early intrauterine pregnancy with a degenerating myoma, the ultrasound diagnosis of molar pregnancy was in error. In 48 of 70 patients (69%) referred after 20 weeks' gestation, the clinical diagnosis was confirmed. In no instance was either a false-positive or false-negative diagnosis made with real-time ultrasound in the last half of pregnancy. This method should prove to be the method of choice in diagnosing intrauterine fetal death.

Placental diffusing capacity and its relation to fetal growth

The placental diffusing capacity for carbon monoxide was measured in unanaesthetized monkeys (M. Mulatta). Maternal and fetal blood was sampled from chronically placed catheters while the mother breathed 50 or 100 parts per million of CO. Diffusing was calculated from the amount of CO taken up by the fetus divided by the partial pressure difference across the placenta, it averaged 0.646 plus or minus 0.062 (SEM) ml x min(-1) x torr(-1) x kg(-1) of fetal weight. The significance of this index of respiratory gas exchange in the monkey placenta is discussed with respect to previous measurements in other species and with respect to fetal growth.

[Changes of plasma levels of TRH and its target hormones by two hour constant intravenous infusion of TRH tartrate in man (author's transl)]

Constant iv infusion of TRH tartrate for 2 hours was administered to normal men in a dosage of 0.5 (n=4), 1.0 (n=2) and 2 (n=4) mg/120 minutes. Measurements at every 15 minutes were performed for plasma levels of TRH, TSH, Thyroxine (T4) and Triiodothyronine (T3) by radioimmunoassay. Plasma levels of TRH increased promptly and stayed at the same levels until the end of the infusion. The Mean Clearance Rate (MRC), Half-life and Volume of Distribution of TRH were respectively, 4.62 +/- 0.53 L/min. (M +/- SE), 17.8 +/- 3.8 minutes and 112 +/- 15 L in the 0.5 mg administered group and 6.38 +/- 2.50 L/min., 9.0 +/- 1.4 minutes and 82 +/- 30 L in the 2 mg administered group. Plasma levels of TRH increased in two phases, and increments of plasma TSH were dose dependable to the dosage of TRH. Plasma levels of T4 increased gradually in the course of TRH infusion and stayed at high levels even in the withdrawal phase of TRH. Plasma levels of T3 increased markedly during and after the TRH infusion in the 0.5 mg administered group, while increments of plasma T3 were minute in the 2 mg administered group. From the above data, it is suggested that the amount of TRH production in man, which is much more than has previously been reported, may indicate the existence of an extrahypothalamic synthesis of TRH in man.

Breathing movements before death in the primate fetus (Macaca mulatta)

The incidence and character of fetal breathing movements (FBMs) were determined by analysis of continuous tracheal pressure recordings in a 48 hour period preceeding fetal death in utero in 7 chronic pregnant monkey preparations (Macaca mulatta). All fetuses were judged normal by blood gas tensions, pH, and fetal heart rate within 48 hours of death. In the normal fetus breathing movements were periodic and a circadian distribution in the incidence of FBMs was observed. Four distinct patterns of FBMs were observed in the normal fetuses. In five fetuses death occurred in the intrapartum period; all five fetuses were breathing at the onset of labor. A progressive fall in the incidence of FBMs was observed in labor coincident with the development of fetal acidemia. In the remaining two fetuses death occurred before labor. Apnea and gasping were observed in all fetuses before death. The duration of apnea and gasping appeared dependent upon the nature of the lethal insult.

Establishment of cell lines from the wild rodent Millardia meltada and tests for endogenous virus

Four cell lines were established from the wild rodent, Millardia meltada; an untransformed cell line (MM-D), a non-producer (NP) cell line transformed with murine sarcoma virus (MM-CL4), and SV40-transformed cell lines (MM-8 MM-663). MM-D is epithelioid and contact-inhibited, whereas MM-CL4, MM-8, and MM-663 are fibroblastic and grow piling up. No endogenous virus was induced in Millardia cell lines by a long-term culture with various inducers. Millardia cell DNA has no nucleotide sequence homology with cDNA of either murine leukemia virus or rat endogenous virus.

Antepartum determination of pre-ejection period of fetal cardiac cycle: its relation to newborn body weight

Simultaneous recordings of the fetal electrocardiogram and ultrasound Doppler-cardiogram were used for the determination of the pre-ejection period (PEP) of the fetal cardiac cycles. All 50 fetuses selected for the present study experienced uneventful perinatal lives despite maternal antepartum complications which required hospitalization. A significant positive correlation between the PEP and gestational age of the fetuses was again demonstrated. The PEP of the fetus measured within one week prior to delivery was also found to be significantly correlated with the newborn body weights at birth. Statistical analysis demonstrates that fetal body weight was more closely related to the physiologic lengthening of the PEP.

Pre-ejection period of cardiac cycles in fetal lamb

The pre-ejection period (PEP) of the fetal cardiac cycle was studied on 22 chronically instrumented pregnant ewes. The PEP was measured from the onset of the Q wave on fetal electrocardiogram to the onset of the upstroke on the fetal arterial blood pressure curve. Lengthening of the PEP was observed in association with an increase in gestational age, fetal body weight, fetal brow-rump length, and fetal heart weight. Consequently, the PEP values were calculated to those at fetal heart weight of 10 grams. The PEPc (calculated) was prolonged by acidosis but no significant relationship was found between the PEPc and arterial blood pO2. An increase in coronary blood flow was associated with a shortening of the PEPc in the fetuses under normal physiologic conditions. Fetal hypoxemia and respiratory acidosis created by administration of 10 per cent O2 and 20 per cent CO2 with 20 per cent O2 to the mother increased fetal coronary flow and was in general associated with a prolonged pre-ejection period.

Plasma cortisol in the chronic rhesus monkey preparation (Macaca mulatta)

The short- and long-term effects of surgical procedures and chair restraint on total plasma cortisol were assessed in the chronic rhesus monkey preparation. Three nonpregnant and six pregnant animals were sampled daily, morning and evening. Fetal plasma specimens were obtained simultaneously from the pregnant animals. In the nonpregnant rhesus monkey, a circadian rhythm is present the day following venous catheterization and chair restraint, with individual values similar to those in trained, unanesthetized animals. In the pregnant animals, a postoperative rise in cortisol is followed by a gradual decline to a plateau and a return of circadian rhythm. No consistent daily fluctuations are seen in fetal cortisol, and although correlated with maternal cortisol, the exact relationship is uncertain. The data indicate that operation, as expected, is stressful but acclimation to the chair occurs.

Antepartum evaluation of the pre-ejection period of the fetal cardiac cycle

The pre-ejection period (PEP) of the cardiac cycle was studied in 65 antepartum fetuses by means of a noninvasive technique which used simultaneous recordings of abdominal fetal electrocardiogram (FECG) and ultrasound fetal Doppler cardiogram (FDCG). Although most of the fetuses were products of high-risk pregnancies, 45 fetuses had uneventful perinatal courses. The PEP's from these fetuses demonstrated a significant positive relationship with gestational age (p is less than 0.01). Uterine contractions induced for antepartum stress testing of the fetus were founnd to prolong the PEP by approximately 9.1 per cent in five cases (four fetuses). The average PEP of antepartum fetuses between 38 and 40 weeks was shorter than that of intrapartum fetuses by approximately 9.5 per cent. Comparison between clinical outcome and the PEP's of the fetuses who were born within a week after the last determination of PEP revealed a strong correlation between prolonged PEP duration and abnormalities in the perinatal course.

Cardiac systolic time intervals in fetal monkeys: pre-ejection period

The systolic time intervals of the fetal cardiac cycle were studied by means of simultaneous recordings of electrocardiogram (ECG) and ultrasound Doppler cardiogram (DCG) in chronic preparations of fetal rhesus monkeys. Recordings were made under physiologic conditions as well as during various experimental stresses. The pre-ejection period (PEP) showed no significant relationship with heart rate in the unstressed fetuses, but the acceleration of heart rate induced by epinephrine was accompanied by shortening of PEP. The PEP increased with advancing fetal age. The PEP was inversely correlated with left ventricular end-diastolic pressure and arterial pulse pressure, but showed a positive correlation with both systolic and diastolic arterial blood pressure. The PEP also exhibited strong negative correlation with arterial blood pH. the prolongation was essentially the same whether acidosis was of respiratory or metabolic origin. The PEP increased slightly but significantly during nonacidemic hypoxemia; however, there was no correlation between Pao2 and PEP Epinephrine shortened the PEP significantly, whereas the effect of atropine was inconsistent. Alteration of the plasma glucose level by injection of insulin or glucose did not affect PEP. These findings demonstrate that the PEP may be a useful indicator of fetal cardiac performance, reflecting both myocardial contractility and the hemodynamic state of the cardiovascular system.

Ultrastructure of an anaplastic giant-cell carcinoma found 8 years after operation on a papillary carcinoma of the thyroid

Light and electron microscopic studies have been made on an anaplastic giant-cell tumor that developed in a woman 8 years after an operation on the thyroid for papillary carcinoma. Many giant cells were observed in the anaplastic tumor tissue, but no follicles. Numerous tightly-packed mitochondria and abundant ribosomes were present, but there were no desmosomes. The basement membrane was not distinct.

Effect of alpha-benzene hexachloride on 2-fluorenylacetamide carcinogenesis in rats

Studies were made on the effect of 0.06% alpha-benzene hexachloride (alpha-BHC) on hepatic changes, including development of hepatomas, in rats treated with 0.025% 2-fluorenylacetamide (2-FAA) at the same time. alpha-BHC inhibited the induction of hepatocellular carcinomas and oval cells infiltration in rats treated with 2-FAA for 5 months. However, it did not inhibit induction of hyperplastic nodules, it induced liver adenocarcinomas in 4 of 11 rats, and it caused remarkable cyst formation in the liver of rats treated with 2-FAA.

The effect of drugs on fetal heart rate variability

Baseline FHR variability has been quantitated into the mathematical indices of differential index (short-term variability) and interval index (long-term variability). Normal values have been determined. The effect that drugs used during labor have on FHR baseline variability has been evaluated. A clinically meaningful change in variability has been observed following low-dose administration of Demerol, morphine, Nisentil, Phenergan, and Vistaril. A statistically significant increase in variability has been observed following administration of magnesium sulfate.

A simplified method using commercial milk powder for hand-rearing of the Caesarean-derived infant rabbits (author's transl)

An efficient and simplified method for hand-rearing of Caesarean-derived infant rabbits under gnotobiotic condition was devised. The Caesarean-derived infant Dutch or Japanese-White rabbits and their hybrids (F1; Japanese-White female x Dutch male) were reared in sterilized vinyl-isolators by hand-feeding with two kinds of milk diets, A and B, consisted mainly ofa commercial milk powder for dogs and cats (Esbilac) supplemented with several minor components (Table 2) and administered intragastrically once a day through a Nelaton's catheter. Bacteriological examinations revealed that feces and urine were sterile for the first three days. On the third day, Escherichia coli, Staphylococcus epidermidis, Streptococcus faecalis, Bacillus subtilis, Enterococcus, and Bacteroides sp. were given with milk diet and the infant rabbits were reared until 10 to 12 weeks of age. The weaning rate at 5 weeks of age and the raising rate at 3 months of age were approximately 78% and 77%, respectively (Table 3), indicating that feeding once-a-day with a milk diet mainly composed of Esbilac is suitable for the hand-rearing of infant rabbits. There was, however, no significant difference milk diet A and B on the weaning rate.

Effect of thyrotropin-releasing hormone on secretion of thyrotropin, prolactin, thyroxine, and triiodothyronine in pregnant and fetal rhesus monkeys

The effect of thyrotropin-releasing hormone (TRH) on the pituitary-thyroid axis and on prolactin secretion was studied in pregnant Rhesus monkeys during the latter period of gestation and in non-pregnant female controls. The baseline plasma concentrations of TSH, T3, T4, and prolactin (PRL) of pregnant monkeys did not differ from those of non-pregnant monkeys. After administration of TRH, plasma prolactin rose to higher levels in pregnant monkeys than in non-pregnant monkeys whereas there was a similar response of plasma TSH, T4 and T3 in both groups. The baseline plasma TSH was elevated and plasma T3 was decreased in the fetus compared with the mother. Administration of TRH iv to the maternal monkey caused a larger response in the fetal plasma TSH than in that of the mother and was followed by larger increments in plasma T4 and T3 concentrations in the fetuses than in the mothers. The larger increments of plasma TSH and thyroid hormones in the fetus compared with the mother also occurred when TRH was given iv to the fetus. There was a significant rise of plasma prolactin in both mother and fetus after administration of TRH to mother or fetus; the increase of plasma PRL was much higher in the mother than in the fetus. The data show that TRH can cross the primate placenta in either the maternal to fetal or fetal to maternal direction. The fetal thyroid of the Rhesus monkey during the latter period of gestation can release both T4 and T3 in response to TSH.

Angiographical extravasation of contrast medium in hemorrhagic infarction. Case report

Leakage of the contrast medium was noted on angiograms of a patient whose autopsied brain disclosed typical pathological findings of hemorrhagic infarction. The case was a 63-year old woman with mitral valve failure, who suddenly had loss of consciousness and right-sided hemiplegia. The left carotid angiography performed six hours after onset demonstrated middle cerebral arterial axis occlusion, and the second angiography performed three days after onset displayed recanalization of the initially occluded artery as well as extravasation of the contrast medium. Fourteen days after onset the patient died and an autopsy was performed. The brain demonstrated perivascular punctate hemorrhages in the area supplied by the middle cerebral artery, and neither hematoma nor microaneurysm was disclosed pathologically. A short discussion is given on the possible relationship between recanalization and hemorrhagic infarction. The clinical assessment of hemorrhagic infarction has not been established successfully.

Circulatory response to atropine in sheep fetus

Atropine was given to the semichronic sheep fetus intravenously. Fetal heart rate, fetal perfusion pressure, and carotid blood flow increased. Cerebral blood flow was measured with the radioactive microsphere technique. Atropine was capable of increasing the cerebral blood flow. Elevation of carbon dioxide also caused an increase in cerebral blood flow, adding to the effect of atropine.