Endoscopy of mandibular cysts after cystostomy: a preliminary report

PURPOSE

This study evaluated the use of endoscopy to explore mandibular cysts after cystostomy.

MATERIALS AND METHODS

Six mandibular cysts were explored with a fiber endoscope immediately after cystostomy, allowing evaluation of the appearance of the cyst lining and biopsies to be performed.

RESULTS

The lining of the cyst wall had a pearly appearance. It was easy to visualize the interior of large cysts extending from the body into the ramus, as well as to explore lobes and recesses. In no case did biopsies of the cyst lining indicate a neoplasm.

CONCLUSIONS

Fiber endoscopy is a useful technique for the exploration and monitoring of mandibular cysts after cystostomy, particularly in cases in which the cyst extends from the body into the ramus.

Human parvovirus B19 infection and hydrops fetalis in Rio de Janeiro, Brazil

Formalin-fixed paraffin embedded lung and liver tissue from 23 cases of non immune hydrops fetalis and five control cases, in which hydrops were due to syphilis (3) and genetic causes (2), were examined for the presence of human parvovirus B19 by DNA hybridisation. Using in situ hybridisation with a biotynilated probe one positive case was detected. Using 32P-labelled probes in a dot blot assay format, five further positives were obtained. These were all confirmed as positive by a nested polymerase chain reaction assay. Electron microscopy revealed virus in all these five positive cases. The six B19 DNA positive cases of hydrops fetalis were from 1974, 1980, 1982, 1987 and 1988, four of which occurred during the second half of the year, confirming the seasonality of the disease.

Synthesis and structural, conformational, biochemical, and pharmacological study of new compounds derived from tropane-3-spiro-4'(5')-imidazoline as potential 5-HT3 receptor antagonists

A series of tropane-3-spiro-4'(5')-imidazolines was synthesized and studied by 1H and 13C NMR spectroscopy, and the crystal structure of 2'-(1H-indol-3-yl)tropane-3-spiro-4'(5')-imidazoline hydrochloride 5(6)f was determined by X-ray diffraction. In CD3OD solution, compounds 5(6)a-f display the same preferred conformation. The pyrrolidine and piperidine rings adopt an envelope conformation flattened at N8 and a distorted chair conformation puckered at N8 and flattened at C3, respectively, with the N-substituent in the equatorial position with respect to the piperidine ring. This conformation is similar to that observed for compound 5(6)f in the solid state. From binding studies on the compounds synthesized, compound 5(6)d demonstrated the ability to efficiently displace the binding of [3H]GR65630 to bovine brain area postrema membranes to an extent comparable to MDL 72222. In the von Bezold-Jarisch reflex, compound 5(6)d was equipotent with metoclopramide. It is, therefore, likely that the imidazoline ring may provide a useful bioisosteric replacement for the carbonyl group in 5-HT3 antagonists.

Morphology of pulmonary extralobar sequestration in neonatal death by hyaline membrane disease

We present an unusual case of extralobar pulmonary sequestration associated with hyaline membrane disease (HMD) that caused the death of a premature baby in the first day of life. The sequestered parenchyma was nourished by an aberrant aortic vessel. Notable was the presence of typical HMD in all the lung parenchyma perfused by the pulmonary artery; the sequestered lung tissue presented a dysplastic structure compatible with CCAM. A few similar cases have been found in the literature. In all of the reported cases there are morphologic aspects characteristic of HMD in the portions normally receiving blood from the pulmonary artery. These findings suggest the importance of the blood pulmonary circulation in the pathogenesis of HMD, whose exact causes are not fully known.

Morphological and virological studies in six autopsies of children with adenovirus pneumonia

Pulmonary lesions compatible with adenovirus infection were detected by gross and microscopic examination of autopsy tissues from children aged from 5 to 34 months. Hepatic lesions indicative of systemic infection were also found in four of the children. The viral etiology was confirmed in three cases by in-situ hybridization, electron-microscopy and immunofluorescence performed in paraffin-embedded tissues, and in one case by cell culture isolation of adenovirus type 2 from nasopharyngeal exudate. Routine testing by methods additional to conventional light microscopy would probably have revealed a larger number of adenovirus infections among the 1,103 autopsy records analyzed in this study.

Mechanism of blockade by flunarizine of bovine adrenal catecholamine release

How flunarizine, a class IV Ca2+ antagonist, affects the secretion of catecholamines in response to nicotinic receptor activation (10-s pulses with 100 microM dimethylphenylpiperazinium, DMPP) or direct depolarization of chromaffin cells (10-s pulses with 100 mM K+ and 2.5 mM Ca2+, 100 K+/2.5 Ca2+) was studied in bovine adrenal glands perfused with an oxygenated Krebs-Tris solution at 37 degrees C at a rate of 20 ml/min. Experimental protocols aimed to test voltage and time dependence of the flunarizine blocking effects on secretion are described. The DMPP pulses released an average of 217 micrograms catecholamines and the K+ pulses, an average of 117 micrograms. These responses were blocked by flunarizine concentration dependently; IC50s were 3.7 microM for DMPP and 1.1 microM for K+. Under polarizing conditions (60-s perfusion with a solution containing 5.9 mM K+ and nominally zero Ca2+), a 10-s pulse with 100 K+/2.5 Ca2+ released 117 +/- 26 micrograms of catecholamines (n = 12). Under depolarizing conditions (60-s perfusion with 118 K+/0 Ca2+ prior to the Ca2+ pulse), the pulse with 118 K+/2.5 Ca2+ released 307 +/- 36 micrograms of catecholamines (n = 14). Flunarizine blocked these secretory responses equally and concentration dependently with an IC50 of 3.4 microM under polarizing conditions and of 3.8 microM under depolarizing conditions. Thus, blockade by flunarizine of secretion was apparently not voltage-dependent. The blockade was, however, clearly dependent on the time of exposure of the adrenal medullary tissue to flunarizine.(ABSTRACT TRUNCATED AT 250 WORDS)

Permeation and inactivation by calcium and manganese of bovine adrenal chromaffin cell calcium channels

Stimulation of fura-2-loaded bovine chromaffin cells with the nicotinic agonist 1,1-dimethyl-4-phenylpiperazinium iodide (DMPP; 10 microM) or depolarization with high [K+] (50 mM) accelerated the entry of both Ca2+ and Mn2+, used here as a Ca2+ surrogate for Ca2+ channels. Removal of extracellular Na+ prevented the effects of DMPP but did not modify the effects of K+, indicating that Na+ is necessary for coupling of Ca2+ entry to the nicotinic receptor activation and that the ionophore associated with it is functionally impermeable to divalent cations. DMPP- as well as K(+)-evoked Ca2+ and Mn2+ influx were blocked completely by Ni2+ but only partially by dihydropyridines, suggesting that, in addition to L-type Ca2+ channels, other Ca2+ entry pathways may be present. Inactivation of Ca2+ channels, followed by comparing the rates of Mn2+ uptake at different time periods after the addition of DMPP or high K+, did not happen in the absence of extracellular Ca2+. When 1 mM Ca2+ was present, a delayed inhibition (half time, 10-20 s) was observed, suggesting that it is not due to the entry of Ca2+ itself but to the increase of the cytoplasmic Ca2+ concentration ([Ca2+]i) that takes a few seconds to develop. The influx of Ca2+, estimated from the increase of [Ca2+]i, was also impaired in a time-dependent fashion by previous entry of Mn2+. Inactivation of Ca2+ entry was achieved at estimated mean intracellular Mn2+ concentrations as low as 10(-9) M.

In vitro denervation of the rat vas deferens through hypothermic storage

1. The rat vas deferens was excised, stored at 4-6 degrees C and tested after 24, 48, 72 or 96 h for its contractile activity and for the presence of innervation. 2. The maximal contractile capacity of the vas, tested through cumulative concentrations of barium chloride (3 x 10(-2) M) was progressively reduced from about 110 mm to about 63 mm after 72 h, without further decay after 96 h. Spontaneous rhythmic contractions were practically absent. 3. A loss of endogenous pools of catecholamines was indicated by four parameters: (a) a decline of about 80% after 24 h and of more than 95% after 48 h of the contractile effect of the indirect sympathomimetic agonist tyramine; (b) a fall of about 20%, 50% and 85% on the concentration of noradrenaline, respectively after 24, 48 and 72 h; (c) a fall of about 25% and 90% after respectively 24 and 48 h, of the activity of dopamine-beta-hydroxylase (DBH); (d) a decline of noradrenaline-induced histofluorescence on cross sections of the vas. 4. A loss of neuronal uptake capacity was indicated by: (a) a progressive variation of the apparent affinity for adrenaline, expressed as pD2 values, that increased by about 1.5 log units (corresponding to a 30 fold potentiation) after 72 h, and (b) a reduction of the ability of cocaine to potentiate the contractile effects of adrenaline. 5. The pD2 values for barium chloride, 5-hydroxytryptamine (5-HT) and histamine were not significantly changed, while the corresponding value for acetylcholine was slightly but significantly reduced by about 0.8 log units. 6. The maximal heights of concentration-response curves for noradrenaline, acetylcholine, histamine and 5-HT were reduced by 42-66% in relation to controls. However, when this reduction was measured in relation to the corresponding barium effect, by means of the relative responsiveness ratio (p), a small though significant increase was observed for noradrenaline, and a fall for the other drugs.7. It is concluded that: (1) the values for the various biochemical and pharmacological parameters decline at different rates, though revealing altogether that denervation is completed by at least 85% after 72 h of hypothermic storage; (2) two of the results, i.e., the lack of spontaneous rhythmic contractions and the lack of increased contractile effects for acetylcholine, 5-HT and histamine, indicate that in these conditions the vas is devoid of the so-called nonspecific signs of denervation.

Membrane-mediated effects of the steroid 17-alpha-estradiol on adrenal catecholamine release

The effects of 17-alpha-estradiol on the secretion of catecholamines from the perfused bovine and cat adrenal gland and bovine chromaffin cells in culture elicited by dimethylphenylpiperazinium (DMPP), methacholine and high potassium were studied. In perfused cat adrenal glands, secretion of catecholamines evoked by pulses of DMPP (1 microM for 30 sec) was decreased by 17-alpha-estradiol at concentrations of 1 and 10 microM by 50 and 80%, respectively. However, secretion evoked by pulses of methacholine (3 microM for 30 sec) was not affected by 1 microM of 17-alpha-estradiol and was affected to a variable extent by 10 microM 17-alpha-estradiol. Catecholamine secretion evoked by higher concentrations of methacholine (100 microM for 60 sec) was reduced by 50% by 10 microM 17-alpha-estradiol. 17-alpha-Estradiol decreased secretion evoked by pulses of 120 mM K+ for 10 sec to a similar extent in the perfused bovine and cat adrenal gland. The 45Ca++ uptake into bovine chromaffin cells in culture stimulated by DMPP (100 microM for 10 sec) or high K+ (59 mM for 10 sec) was almost inhibited completely by 100 microM 17-alpha-estradiol. The rapid action precludes a classical genomic mechanism and suggests effects at the cell membrane.

Enterovirus associated placental morphology: a light, virological, electron microscopic and immunohistologic study

The purpose of this study was to identify the possible effect of enteroviruses on placental tissue. Seventy-eight pregnant women were studied throughout their pregnancy: enteroviral infection was detected by faecal viral isolation and seric neutralization of previously identified virus in cell culture. In 19 cases of confirmed maternal infection, placentae were examined grossly, by optical microscopy, immunohistochemical and electron microscopic methods. Ten term placentae from women included in the study, with no clinical, serological or virological evidence of enteroviral infection, were used as control, and examined by gross and optical microscopy. In 17 specimens (echovirus-coxsackievirus) an haematogenous placentitis was suspected on the basis of gross observation. Microscopic lesions were similar to those found in other viral infections, with specific features. The nature of the inflammatory reaction pointed to the presence of an acute type of haematogenous placentitis, not present in placentae of the control group. The authors (AA) comment on the results and present the hypotheses about the available data: (1) maternal enteroviremia and faecal virus shedding without placental invasion, placentary damage being an unspecific consequence of infection; (2) direct virus-induced injury is not the only possible cause for the lesions: (3) placental enteroviral infection occurred with placental pathology but the virus did not cross the organ as the newborn had no signs of infection.

Characterization of two chromaffin cell populations isolated from bovine adrenal medulla

Cultures of chromaffin cells isolated from the bovine adrenal medulla have been extremely useful for investigating secretory mechanisms, but such cultures used up to the present time represent mixed populations of adrenergic and noradrenergic cells. This report describes how, with slight modifications to standard procedures, two separate chromaffin cell populations may be separated from bovine adrenal medullae. These two cell fractions have been characterized by biochemical, immunocytochemical, and morphological techniques as enriched populations of adrenergic or noradrenergic cells, respectively. The adrenergic cell-enriched fraction consists of greater than 90% adrenergic cells, whereas the noradrenergic cell-enriched fraction contains greater than 60% noradrenergic cells. We also demonstrate that these cells may be cultured with their secretory machinery intact: analysis of secreted catecholamines from nicotine- or high K+ concentration-stimulated cells cultured from each fraction confirms that adrenaline is the major catecholamine secreted by one fraction, whereas noradrenaline is mainly secreted by the other.

Reinnervation of the transplanted vas deferens: differential recovery of various biochemical and pharmacological parameters

Biochemical and pharmacological parameters were used to follow the innervation characteristics of the rat was deferens transplanted (T) to the caecum. After about 5 months, a regeneration of autonomic nerves was clearly shown: first, by a complete recovery of neuronal uptake, indicated by: a) potentiation by cocaine of epinephrine (EPI) dose-response curves (T = 1.47 +/- 0.25, controls (C) = 1.50 +/- 0.14 log units); b) reversion to normal levels of pD2 values for norepinephrine (NE) and EPI (T = 6.6 +/- 0.1; 7.0 +/- 0.1, and C = 6.4 +/- 0.1; 6.9 +/- 0.1, respectively); second, a partial restoration of nerve terminals, and corresponding pools of NE, which was seen through histofluorescence and was indicated by a percent increase of: a) NE content, 47% (T = 3.8 +/- 0.8, C = 8.5 +/- 0.7 micrograms/g); b) dopamine-beta-hydroxylase (DBH) activity, 37% (T = 136 +/- 80, C = 364 +/- 15 nmol(hr.g); c) release of NE by 57 mM-potassium, 23% (T = 33.0 +/- 12.0, C = 147 +/- 14 ng/g. 5 min). Yet, two peculiarities of denervated organs remained practically unchanged even after 5-month transplantation: NE supersensitivity, measured by the relative responsiveness (rho) ratio (T = 0.96 +/- 0.02, C = 0.69 +/- 0.03), and tyramine-induced contraction, that was recovered by only 14% (T = 10.0 +/- 2.4, C = 72.0 +/- 3.5 mm). This differential recovery of the aforementioned parameters is discussed in the light of receptor mechanisms and functional changes following reinnervation.

Separate [3H]-nitrendipine binding sites in mitochondria and plasma membranes of bovine adrenal medulla

1. Two binding sites for the 1,4-dihydropyridine (DHP) derivative [3H]-nitrendipine have been found in the bovine adrenal medulla. The high-affinity site (Kd = 0.48 nM and Bmax = 128 fmol mg-1 protein) was specifically located in purified plasma membranes. The low-affinity site (Kd = 252 nM and Bmax = 169 pmol mg-1 protein) was located only in mitochondria. Chromaffin granule membranes lacked specific binding sites for [3H]-nitrendipine. 2. Kinetic analysis of the rates of association and dissociation of [3H]-nitrendipine, saturation isotherms and displacement experiments with unlabelled nitrendipine and PN200-110 revealed single, homogeneous populations of high- and low-affinity sites in plasma and mitochondrial membranes, respectively. 3. The high affinity site was sensitive to Ca2+ deprivation and heating; it was practically unaffected by changes in ionic strength of the medium and its optimal pH was slightly alkaline. This site exhibited a strong DHP stereoselectivity; diltiazem increased and verapamil decreased the affinity of [3H]-nitrendipine. 4. In contrast, binding of [3H]-nitrendipine to the low affinity site was more heat resistant and less affected by Ca2+ removal. Its optimal pH was slightly acid and the increase in ionic strength enhanced the number of available sites. The site had no DHP stereoselectivity. Verapamil decreased the dissociation constant of [3H]-nitrendipine acting in a non-competitive manner; diltiazem did not affect equilibrium binding parameters of [3H]-nitrendipine. 5. These results suggest that both biding sites reflect different receptor entities. The high-affinity binding site corresponds to the dihydropyridine receptor associated with the L-type calcium channel. The function of the mitochondrial, low-affinity binding site is, at present, unknown.

Congenital echo virus infection--morphological and virological study of fetal and placental tissue

A prospective study of 78 pregnant women was undertaken to detect maternal enterovirus infection. Maternal faecal specimens and blood samples, placental and fetal tissue were taken for viral study, electron microscopy, histochemistry, and morphological examination. We present the post-mortem findings in three fetuses whose maternal infection was detected before delivery by isolation of ECHO virus type 33 and type 27 from faecal specimens and/or placental and fetal tissues. The morphological aspects were similar in all cases and included an acute infection of the placenta and hypoxic/hypotensive injury to fetal organs. In one case, viral particles were detected by electron microscopy of the fetal liver. This series of cases of intrauterine ECHO virus infection confirms the potential gravity of such infection during pregnancy and the need to prevent enteroviral disease.

Enterovirus isolation from foetal and placental tissues

Four spontaneous abortions and two stillbirth occurred during a prospective survey following the teratogenicity of echoviruses in 80 pregnant women selected at random from the Antenatal Care Service. Echovirus types 19, 27, and 33. Coxsackie B2 and B6 were isolated from placental and foetal tissues (brain, liver, kidney, heart, and spleen). The mothers also excreted the virus by faeces at least twenty days before abortion and responded serologically, indicating active virus infection. Almost all aborted children were anomalous with signs of viral infection.

Phosphorylation of myosin light chain from adrenomedullary chromaffin cells in culture

The myosin-light-chain (MLC) phosphorylation accompanying catecholamine release in chromaffin cells was investigated with the objective of assessing the possible role of this contractile protein in catecholamine secretion. The electrophoretic characteristics of adrenomedullary MLC were determined by immunochemical techniques using two different specific antibodies. The identified 22 kDa phosphoprotein was mainly present in the cytosol, as demonstrated by ultracentrifugation and immunocytochemical analysis. A part of this protein was located on, or close to, the plasma membrane. Cell stimulation by secretagogues resulted in a Ca2(+)-dependent 32P incorporation into MLC, the time course of this process being related to catecholamine release. These findings were supported by a two-dimensional gel-electrophoretic analysis by which means this protein was resolved into two acidic forms. A role for Ca2(+)-calmodulin and Ca2(+)-phospholipid kinases in adrenomedullary MLC phosphorylation is reported. The results obtained suggest a regulatory role for such a protein in the underlying exocytotic event.

Separate binding and functional sites for omega-conotoxin and nitrendipine suggest two types of calcium channels in bovine chromaffin cells

Purified adrenomedullary plasma membranes contain two high-affinity binding sites for 125I-omega-conotoxin, with KD values of 7.4 and 364 pM and Bmax values of 237 and 1,222 fmol/mg of protein, respectively. Dissociation kinetics showed a biphasic component and a high stability of the toxin-receptor complex, with a t1/2 of 81.6 h for the slow dissociation component. Unlabeled omega-conotoxin inhibited the binding of the radioiodinated toxin, adjusting to a two-site model with Ki1 of 6.8 and Ki2 of 653 pM. Specific binding was not affected by Ca2+ channel blockers or activators, cholinoceptor antagonists, adrenoceptor blockers, Na+ channel activators, dopaminoceptor blockers, or Na+/H+ antiport blockers, but divalent cations (Ca2+, Sr2+, and Ba2+) inhibited the toxin binding in a concentration-dependent manner. The binding of the dihydropyridine [3H]nitrendipine defined a single specific binding site with a KD of 490 pM and a Bmax of 129 fmol/mg of protein. At 0.25 microM, omega-conotoxin was not able to block depolarization-evoked Ca2+ uptake into cultured bovine adrenal chromaffin cells depolarized with 59 mM K+ for 30 s, whereas under the same conditions, 1 microM nitrendipine inhibited uptake by approximately 60%. When cells were hyperpolarized with 1.2 mM K+ for 5 min and then Ca2+ uptake was subsequently measured during additions of 59 mM K+. Omega-conotoxin partially inhibited Ca2+ uptake in a concentration-dependent manner. These results suggest that two different types of Ca2+ channels might be present in chromaffin cells. However, the molecular identity of omega-conotoxin binding sites remains to be determined.

Sodium-dependent and sodium-independent nicotine-evoked catecholamine release from cat adrenals

Cat adrenal glands were stimulated with nicotine under Na-free conditions; subsequently, Na was gradually introduced as a continuously increasing gradient from 0 to 134 mM. With this experimental approach two catecholamine secretory peak responses were obtained: one was Na-independent and the second was dependent of this cation. This second response was greater in magnitude than the first and selectively blocked by (+)PN200-110, a potent dihydropiridine Ca channel blocker. The results suggest that Na, although not essential to evoke some degree of secretion, plays, however, a prominent role in amplifying the nicotine-secretory response by causing cell depolarization and opening of voltage-dependent Ca channels.

Placental morphology in cytomegalovirus infection

Three groups of placentae from 27 cases of cytomegalovirus infection were examined morphologically and by specific immunofluorescence. Placentae in Group 1 (four cases) had a mean gestational age of 24.5 +/- 2.5 weeks; those in Group 2 (11 cases) had a mean gestational age of 36.4 +/- 2.7 weeks; those in Group 3 (12 cases) had a mean gestational age of 40 +/- 1.8 weeks. A tendency towards increased placental weight was observed. In 23 cases, a haematogenous placentitis was suspected on gross examination. Some specific features were detected on light microscopy. In Group 1 the lesions were represented by pronounced dysmaturity of villous structures, diffuse reparative villitis and intervillitis allied to an abundance of cytomegalic cells and areas of necrosis and calcification. In Group 2 a chronic active process was indicated by the presence of vascular involvement, proliferative-necrotic and reparative villitis and fresh villous necrosis; cytomegalic cells were scarce. In Group 3 placentae there was a predominance of villous plate lesions similar to those found in the septicaemic phase of maternal infections; necrotizing, proliferative and, rarely, reparative villitis was present; cytomegalic cells were rare. We may conclude that placental morphology needs to be substantiated by special laboratory techniques for the detection of cytomegalovirus infection.

Contractile responses of the guinea-pig vas deferens to the combination of vanadium ions with ouabain

1. Vanadate and vanadyl ions (10(-5)-10(-2) M) induced dose-dependent rhythmic contractions of the vas deferens of reserpine-treated guinea-pigs. The Na, K-ATPase blocker ouabain (10(-5)-10(-3) M) induced similar, though smaller, effects. Experiments were performed to verify if these effects are due to an interaction with the same receptor population. 2. Ouabain caused a striking potentiation of vanadium effects, which was also observed in denervated organs, indicating that a release of neuronal substances is not involved in potentiation. Similar potentiations were observed by combining vanadium with K-free solutions instead of ouabain, corroborating the involvement of the latter drug with Na, K, ATPase. 3. From the analysis of time-response and concentration-response curves, there are at least three indications that vanadium and ouabain interact with different sites: (a) the combined effect of both agonists was several times higher than the corresponding isolated effects; (b) the combined effect, expected to be independent of the order of addition of the agonist, was higher if vanadium was added before, than after ouabain; (c) the combined effect on the time elapsed between the addition of the two agonists, being higher if an interval of at least 10 min was allowed between vanadium and ouabain additions. 4. In conclusion, our results do not support the hypothesis that vanadium compounds and ouabain have a similar mechanism of action for the contraction induced in guinea-pig vas deferens.

Effects of Bay K 8644 on cat adrenal catecholamine secretory responses to A23187 or ouabain

Calcium ionophore A23187 increases the rate of spontaneous catecholamine release from cat adrenal glands perfused at 37 degrees C with oxygenated Krebs bicarbonate solution, in a time- and Ca-concentration-dependent manner. The secretory profile obtained with the ionophore was not modified in the presence of the Ca channel activator Bay K 8644. Ouabain also enhanced the rate of spontaneous catecholamine outputs in a time- and concentration-dependent manner. The threshold ouabain concentration capable of producing a clear, yet delayed secretory response was 10(-6) M. Increasing ouabain concentrations up to 10(-4) M enhanced catecholamine release and shortened the time to peak release. The dihydropyridine Ca channel activator Bay K 8644 (10(-6) M) markedly potentiated the secretory effects of all ouabain concentrations used (10(-7)-10(-4) M). However, the most impressive potentiations were seen at 10(-5)M ouabain; while at this concentration ouabain alone released 2.6 +/- 0.07 micrograms catecholamines per 30 min, in the presence of Bay K 8644 the release was 73.4 +/- 5.7 micrograms per 30 min. Conversely, at a fixed ouabain concentration (10(-5) M), the potentiation was also dependent on the Bay K 8644 concentration (10(-8)-10(-5) M). Although K deprivation inhibits Na pumping as does ouabain, Bay K 8644 did not modify the rate of catecholamine release evoked by K removal from the perfusion medium. Potassium deletion, nimodipine or high Mg all reversed the fully developed secretory response evoked by ouabain plus Bay K 8644. In glands depolarized by continuous perfusion with high K solutions, once the secretory response was inactivated, the introduction of ouabain caused an enhancement of the catecholamine secretory rate. This increase was dependent on the extracellular Na concentration and was not affected by Bay K 8644. In the presence of 6 mm Na the secretory effects of Bay K 8644 plus ouabain were abolished. 7 These results are compatible with the following conclusions: (i) Bay K 8644 potentiates only those catecholamine secretory responses that are known to be mediated through the activation of voltagesensitive Ca channels; the drug does not seem to affect secretory responses by acting on the membrane Na/Ca exchange system or at some intracellular Ca-dependent component of the secretory machinery of Ca buffering systems. (ii) It is likely that ouabain enhances the rates of adrenal catecholamine release by a dual mechanism: chromaffin cell depolarization and activation of a membrane Na/Ca exchange system.

Congenital toxoplasmic myocarditis: case report of an unusual presentation

Extensive calcification of the heart, involving predominantly the right ventricle and interventricular septum, was observed in a 3-h-old baby. The aetiology of the condition was attributed to infection by Toxoplasma gondii, based on the presence of several visceral lesions allied to the identification of the microorganism. The case is reported in view of the rarity of the type of the heart lesion. It is considered that calcification of the myocardium is secondary to vascular, inflammatory or toxic condition. The factors implicated in the pathogenesis of this unusual myocardial lesion are discussed.

Placental pathology in congenital rubella

Two groups of placentae from 18 cases of maternal rubella were examined morphologically and virologically. Placentae in Group I (four cases) had a mean gestational age of 21 +/- 1.9 weeks, whilst those in Group 2 (14 cases) had a mean gestational age of 38 +/- 2.8 weeks. A tendency to hypoplasia was observed. The microscopic lesions were similar to those found in other viral infections but in each group some specific features were noted. Only placentae of Group I showed nodules of villi agglutinated by fibrin. This lesion suggested recent maternal infection. Attention is drawn to the presence of abnormal areas of lobular rarefaction due to dysmaturity of villous stem and terminal villi. This aspect was more diffuse and accentuated in Group 2 placentae. Villitis of reactive, necrotic, proliferative and reparative types was seen only in placentae of Group 2. Devastating villitis was not observed. Inclusions in placental cells suggested rubella infection. The lesions were non-specific and hence stress the need for virological examination of the placenta, immunofluorescence studies and electron microscopy to confirm the diagnosis.