Effect of piperidine and related alicyclic amines on nicotinic and muscarinic agonist binding sites in the mammalian brain

The effect of piperidine and related alicyclic amines on central nicotinic and muscarinic cholinoceptors was investigated by measuring specific binding of [3H]nicotine and [3H]cismethyldioxolane (CD) in rat cerebral cortical membranes. Piperidine, pyrrolidine, 4-hydroxypiperidine and piperazine at concentrations of 1 microM-30 mM completed dose-dependently with [3H]nicotine and [3H]CD for the binding sites. Among these compounds, piperidine was the most potent competitor of brain [3H]nicotine binding sites. Piperidine and pyrrolidine showed a greater affinity for [3H]nicotine binding sites in the rat cerebral cortex than of [3H]CD binding sites. In contrast, 4-hydroxypiperidine and piperazine displayed approximately 10 times greater affinity for [3H]CD binding sites. Pipecolic acid had little effect on these cholinoceptor agonist binding sites. The inhibitory effect of brain [3H]nicotine binding by piperidine did not differ between brain regions or during development. In addition, there was little difference in the piperidine-induced inhibition of brain [3H]nicotine binding between species such as rat, mouse, guinea-pig and rabbit. Thus, the present study demonstrates a high affinity of piperidine for nicotinic cholinoceptors in the mammalian brain.

Suspected rotavirus encephalitis

A 9 month old boy with suspected rotavirus encephalitis developed infantile spasms and delayed psychomotor development. Anti-rotavirus antibodies in cerebrospinal fluid, blood, and faeces were studied.

[A mild form of brain stem encephalitis due to herpes simplex virus]

A 10-year-old boy had gait and speech disturbances 17 days after the initial symptoms of a fever, headache and cough. Four days later he was admitted to a hospital with mild disturbances of gait, speech, writing, visual acuity, left facial nerve, nystagmus and consciousness. Impairments of cranial nerves (II, III and VII), pyramidal sign and cerebellar sign were noticed. EEG showed generalized slow waves. Auditory brain stem response showed prolongation of the interval between I and V waves and poor differentiation between them. Brain CT could not find any abnormalities. Brain stem encephalitis was diagnosed. Clinical signs and symptoms continued for two weeks when steroid therapy was started and it was effective to improve the disease. He was discharged from the hospital without sequelae. Herpes simplex virus (HSV) type 1 was detected from cells in CSF on admission by fluorescence antibody method. HSV antibody titers in sera changed from 1/8 to 1/64 during three months by complement fixation test. Specific IgG and IgA by enzyme linked immunosorbent assay (ELISA) was high in CSF. Specific antibody in CSF/total antibody in CSF: specific antibody in serum/total antibody in serum for IgG and IgA classes were more than 1. Reports of mild type of HSV brain stem encephalitis seemed to be rare. Our case which was followed for several months carefully would be important to discuss.

Effect of calcium supplementation on the vascular sensitivity to angiotensin II in pregnant women

Pregnant women destined to develop pregnancy-induced hypertension lose refractoriness to the pressor effects of infused angiotensin II. The effect of calcium supplementation on the vascular sensitivity to angiotensin II was investigated in pregnant women. We administered orally 600 mg of calcium L-aspartate daily to 22 pregnant women from 20 weeks of gestation to delivery. The values for the effective pressor dose of angiotensin II in the calcium-supplemented women were compared with those in 72 nonsupplemented pregnant women. The vascular sensitivity was significantly decreased after calcium supplementation. The values for the effective pressor dose of angiotensin II in the calcium-supplemented patients were 18.1 +/- 1.2 ng/kg/min at 20 weeks of gestation, 32.2 +/- 2.6 ng/kg/min at the twenty-sixth week, 41.1 +/- 3.4 ng/kg/min at the thirtieth week, and 25.9 +/- 2.9 ng/kg/min at the thirty-sixth week (mean +/- SEM), while those in the nonsupplemented patients were 17.3 +/- 1.2, 17.7 +/- 1.6, 17.6 +/- 1.2, and 15.0 +/- 1.6 ng/kg/min, respectively. Assessment of the changes in the effective pressor dose of angiotensin II in the individual patients indicated that the percentile changes from 20 weeks of gestation in the calcium-supplemented patients were also significantly greater than those in 22 nonsupplemented patients. These findings suggest that calcium supplementation tends to reduce the vascular sensitivity in pregnancy. The present dosage of calcium did not affect the blood chemical parameters and did not reduce the blood pressure. The incidence of pregnancy-induced hypertension in the calcium-supplemented patients was 4.5%, which was smaller than that (21.2%) in the nonsupplemented patients. Although there is no clear explanation of the mechanisms involved in such an effect of calcium, the present results do provide evidence to support the idea that oral calcium intake can prevent the onset of pregnancy-induced hypertension.

Histopathologic classification of uterine choriocarcinoma

Histopathologic features of uterine choriocarcinoma were studied to establish new criteria for grading malignancy of the disease. Thirteen items of histopathologic findings concerning the degree of differentiation and the forms of masses of trophoblasts (Trs), the manner of Tr invasion, and host response of surrounding tissues were studied with relationship to prognosis in 70 patients with uterine lesions (alive, 49; dead, 21). Chi-square test results were examined for each item in relation to prognosis of the patients. Four items were thought to have significance and were selected as criteria: (1) island formation; (2) massive proliferation of intermediate-type Trs; (3) rectangular infiltration of Trs to surrounding muscle fibers; and (4) atypia of Trs at the end-point of tumor invasion. A discriminant analysis was carried out (under the standardization of tumor extension and the historical staging of treatment). From the results obtained in discriminant analysis, scores were given to the four items that existed in the specimen. New criteria for grading malignancy are proposed based on scoring these four items. The algebraic sum of the scores had a possible range of +4 to -16. Patients with scores of -9 and above had a low-grade malignancy with a mortality rate of 7%. Patients with scores of -10 and lower had a mortality of 69% and were classified as having tumors of high-grade malignancy.

Detection of Clostridium difficile enterotoxin in neonates by latex agglutination

Clostridium difficile enterotoxin (D-1) was detected in 13 symptomatic and nine asymptomatic neonates in the neonatal intensive care unit by latex agglutination test but was not found in 18 healthy neonates in two other newborn nurseries. Environmental contamination in the intensive care unit may have been the cause. An association between the presence of enterotoxin and clinical symptoms is discussed.

[Assessment of cases with ovarian cancer stage I]

In the therapy of primary ovarian cancer in which the tumor is located in one ovary, radical operation including the uterus and contralateral ovary is performed in principle even in the case of young patients. However, there have been only a few results reported on the primary cases in our country, and the radical operation is adopted at present in line with western policy. In the present study, the authors examined mainly the prognosis of 49 patients with primary ovarian cancer (stage Ia, 25 cases; stage Ib, 2 cases; stage Ic, 22 cases), and the following results were obtained. Among 25 cases at stage Ia, the radical operation was performed on 14 cases, and only the conservative operation was performed on the remaining 11 cases. All of the latter are still well. Only one died among patients at stage Ia. Therefore, in these cases, complete treatments were done, including radical operation, postoperative irradiation and chemotherapy, and second look operation. The prognosis of the patients at Ic was worse than that at IIa + b. Therefore, it was felt to be necessary to treat them as progressive cancer. There was no difference between the prognoses of the conservative and radical operations even at stage Ic. Thus, problems such as functional maintenance were thought to be taken into consideration. Risk factors considered were tissue type, amount of ascites, capsular rhexis, and advanced age, etc. Since the prognosis after the second look operation was good, it was considered to be a treatment which should be introduced actively, even at stage I.

Acute and delayed neurologic reaction to inoculation with attenuated live measles virus

A Japanese boy developed a high fever and a prolonged convulsion 11 days after inoculation with live measles vaccine. He had 4 more seizures during the next 6 mos. His EEG became transiently abnormal 14 mos later. Antimeasles complement fixation, hemagglutination, and neutralization titers were elevated.

Isolation of murine rotavirus in cell cultures. Brief report

Murine rotavirus was isolated in primary monkey kidney cells. Electrophoretic pattern of genome RNA of murine rotavirus was different from that of human rotaviruses. Oral administration of cultured murine rotavirus caused mild diarrhea in newborn BALB/C mice.