Nicotine improves cognitive disturbance in rodents fed with a choline-deficient diet

The effect of nicotine on learning disturbances was tested in rats. Rats were fed either a choline-enriched or a choline-deficient diet. Concentration of acetylcholine in the whole brain was significantly lower in rats fed with choline-deficient diet than rats fed with choline-enriched diet. Passive avoidance learning shows that rats on a choline-deficient diet showed significantly impaired learning compared to rats on a choline-enriched diet. Nicotine (0.04 mg/kg) administered intraperitoneally significantly potentiated learning in rats on a choline-deficient diet, as well as in rats on a choline-enriched diet. We, therefore, suggest that nicotine may potentiate learning in an acetylcholine-deprived brain.

[A case of heterozygous protein C deficiency associated with nephrotic syndrome and deep femoral artery thrombosis]

A 54-year-old male patient with heterozygous Protein C deficiency associated with the nephrotic syndrome and deep femoral artery thrombosis is described. He was admitted to the hospital because of nephrotic syndrome. A few days later, severe pain appeared in his left leg and a diagnosis of deep femoral artery thrombosis was made. Thrombectomy was performed immediately. His proteinuria disappeared in response to corticosteroid. He was found to have Protein C deficiency, antigen: 44%, activity 31%, which was also present in his father and son. Digital subtraction angiography (DSA) revealed the obstruction of left internal iliac and deep femoral arteries at their origins. Renal and hepatic biopsy revealed minor glomerular abnormalities, and chronic active hepatitis. The presence of heterozygous Protein C deficiency, nephrotic syndrome and chronic active hepatitis seem to cause marked decrease in serum Protein C level and deep femoral artery thrombosis. He is now under successful control with warfarin (1.7 mg/day) and bucolome (300 mg/day). It was reported that Protein C might have a suppressive effect on hypercoagulability in nephrotic syndrome. Therefore, Protein C deficiency may not counteract the hypercoagulable state and promote thrombus formation in the case. The present report is the first of a case of Protein C deficiency associated with nephrotic syndrome and arterial thrombosis.

[A case of 67-year-old female with multiple giant pulmonary arteriovenous fistula combined with mitral regurgitation]

The patient was a 67-year-old female, complaining of cyanosis, clubbed finger and anoxic spell-like symptom. She was diagnosed as pulmonary arteriovenous fistula combined with mitral regurgitation. The fistula was giant and multiple, and was located in the right middle-lower lobe. Right to left shunt ratio was 27%, SO2 was 58.2%, %VC was 60%, mean pulmonary arterial pressure was 19 mmHg. Mitral regurgitation was mild (II). Ligation of the middle-lower branch of right pulmonary artery and the right lower pulmonary vein was performed through a median sternotomy. All of her symptom improved.

[Development of a liquid chromatography/multiple electrochemical detector (LCMC) and its application in neuroscience]

A liquid chromatographic system with multiple electrochemical detectors (LCMC) was newly developed for quantitating 20 to 30 neurochemicals simultaneously within 20 to 25 min from one sample derived from biological specimens. The device can be used for estimating neurofunctional changes in the central nervous system under the influence of CNS drugs, behavioral changes of experimental animals and psychic effects in clinical stages, etc. The system consists of four parallel liquid chromatographs with multiple electrochemical detectors. The first three systems determine catecholamines, indoleamines and related compounds. The fourth system is for measuring acetylcholine and choline with an internal standard. A new type of electrochemical detector was developed that consists of 4 electrodes set at a different potentials: each of the eluting components was identified by the variation of 4 current peaks on each electrode. Twenty-eight standard compounds, including four internal standards, could be clearly separated; and the detection limits of these compounds were at least 0.1 to 0.4 pmol per injection. In this report, the usefulness and applicability of this system were confirmed by measuring neurochemicals in the striatum of rats sacrificed either by decapitation or microwave irradiation and in the human ventricular cerebrospinal fluid of patients with Parkinson's disease and essential tremor.

Ascending scapular flap and its use for the treatment of axillary burn scar contracture

A new ascending scapular island flap, based on the superficial circumflex scapular vessels, and its use for the repair of axillary burn scar contracture are presented. Seven flaps in six cases are discussed and evaluated in comparison with alternative procedures.

Different responses of left ventricular systolic function to changes in right ventricular volume and shortening--comparison between aorto-femoral vein and aorto-left atrium shunts in dog hearts

It has been reported that left ventricular end-systolic volume decreases during arteriovenous shunt and increases during subclavian artery-left atrium shunt at a constant end-systolic pressure. The mechanism of the opposing changes in end-systolic volume during the two types of shunt is not clear. One possible cause is that left ventricular pump function with enhanced right ventricular ejection differs from that without enhancement. To investigate this hypothesis, we studied the two types of shunt (Aorto-femoral vein shunt, AoFV; aorto-left atrium shunt, AoLA) with matched reduction of systemic vascular resistance in open-chest dogs with beta-blockade. Both right and left ventricular volumes and shortenings were assessed from short-axis views by two-dimensional (2D)-echocardiogram. Left ventricular end-systolic short-axis area decreased from 76 +/- 3 to 62 +/- 3% in AoFV shunt (p less than 0.05), but tended to increase in AoLA shunt (76 +/- 4 in control state vs 81 +/- 5% in AoLA, NS) in spite of a similar reduction in left ventricular end-systolic pressure. There was no difference in left ventricular shortening, but significant differences were observed in right ventricular shortening (50 +/- 8 in AoFV vs 24 +/- 7% in AoLA, p less than 0.05) and right ventricular short-axis area at end-diastole (142 +/- 6 in AoFV vs 96 +/- 3% in AoLA, p less than 0.01), and at end-systole (92 +/- 8 in AoFV vs 73 +/- 7% in AoLA, p less than 0.05) between the two types of shunt. We conclude that the different changes in left ventricular end-systolic short-axis area found in the two shunts are not caused by the different left ventricular shortenings, but by the different right ventricular mechanical actions. These findings suggest that left ventricular pumping action in the high output state changes, depending on whether it is accompanied by augmented ejection of the right ventricle or not.

[A case of squamous cell carcinoma of the urinary bladder associated with bladder calculi]

A case of squamous cell carcinoma of the urinary bladder associated with a bladder stone in a 43-year-old man is reported. Because a 1 cm x 1 cm sized mass was found in the right lateral side of the dome at the time of vesicolithotomy, partial cystectomy was performed. The weight of the stone was 285 g and the tumor was histologically diagnosed as squamous cell carcinoma, grade 2, pT2. Radical cystectomy with ileal conduit was sandwiched by a total of 6 cycles of chemotherapy with PVB. Twelve cases of squamous cell carcinoma of the urinary bladder associated with a bladder stone(s) from the Japanese literature are reviewed, and the relationship between bladder stone, leukoplakia and squamous cell carcinoma discussed.

[Ultrasonic observation on distribution of subcutaneous fat in Japanese young adults with reference to sexual difference]

Utilizing an ultrasonic device (B-mode, 7.5MHz), the thickness of subcutaneous fat was measured at 54 different points in the bodies of 59 males (aged 20-25) and 66 females (aged 20-23). The results were as follows: 1. The females had significantly thicker subcutaneous fat than those of the males at every point measured. 2. The thick subcutaneous fats were observed at the abdomen, buttocks, and the anterior and medial parts of the thigh in the males, and at the breast, buttocks, abdomen, the posterior, medial, and anterior parts of the thigh, and the anterior, medial, and posterior parts of the upperarm in the females, respectively. 3. The subcutaneous fat of both sexes was more likely to be thicker in body parts closer to the trunk than the extremities. 4. The correlation coefficient between the percent body fat and the mean thickness of subcutaneous fat obtained from data was 0.91 for the males and 0.83 for the females.

[A study on the frequency of von Willebrand factor deficiency state]

In order to elucidate the prevalence of von Willebrand factor (vWF) deficiency state, we investigated plasma vWF levels among 343 patients with bleeding tendency, 465 patients without bleeding tendency and 704 random unrelated normals living in Kagoshima prefecture. The prevalence of symptomatic vWF deficiency state was at least 2.3 per 100,000 of the population, and that of asymptomatic one in healthy individuals was 1.3%. These results indicate that the overall incidence of vWF deficient state in general population would be considerably higher than that previously reported.

Application of FRIT fast atom bombardment liquid chromatography/mass spectrometry for the determination of acetylcholine levels in rat brain regions

This report describes the use of FRIT fast atom bombardment (FAB) liquid chromatography/mass spectrometry for the analysis of acetylcholine in rat brain regions. Direct assessment of acetylcholine levels is possible without the need for either derivatization or extensive sample preparation. Quantification is accomplished by monitoring intact molecular cations of acetylcholine and a deuterated internal standard. The results are compared with those obtained by conventional pyrolysis gas chromatography/mass spectrometry and by liquid chromatography with electrochemical detection.

Early mesangiolysis and monocyte influx observed in diabetic glomerulosclerosis: relation to nodule formation

Lytic changes to the mesangium and subendothelial area in diabetic glomerulosclerosis were studied by electron microscopy with an emphasis on the mechanism of nodule formation. Renal biopsy specimens were obtained from 30 diabetics (11 males, 19 females; 27 NIDDM, 3 IDDM; mean age, 52.2 years) with renal involvement. Evaluations were made of the glomerular lesions, particularly the ultra-structural findings contributing to nodule formation, mainly by electron microscopy. Varying degrees of lytic change, such as a loose and edematous mesangial matrix, widening of the subendothelial space, followed by endothelial detachment, and destruction of anchor points, were observed in close association with progression of the diffuse lesions. Plasma proteins were found to infiltrate into the widened subendothelial space. Mesangial cells also protruded into the same space and encroached around the whole capillary wall. The interposed mesangial cells were occasionally separated from the basement membrane. Monocytes identified from their ultrastructure were frequently present noticed in the lytic areas, suggesting a reaction to lytic changes. These processes may occur repeatedly with direct expansion of the mesangial matrix, subsequently revealing a nodular appearance.

Subclavicular approach in head and neck reconstruction with the latissimus dorsi musculocutaneous flap

As an alternative procedure in transferring the pedicled latissimus dorsi musculocutaneous flap to the head and neck, we have devised a subclavicular approach and applied it successfully in our clinic. This approach reduces the distance of the transfer and leaves no bulkiness over the clavicle. The subclavian vessels, the brachial plexus and the cervical pleura are retracted safely beyond the periosteum during the procedure, and the pedicle of the flap is protected under the clavicle postoperatively.

Inappropriate elevation of the aldosterone/plasma renin activity ratio in hypertensive patients with increases of 11-deoxycorticosterone and 18-hydroxy-11-deoxycorticosterone: a subtype of essential hypertension?

Among 436 patients with hypertension unrelated to any renal lesion, renovascular damage, pheochromocytoma, Cushing's syndrome or hyperthyroidism, 15 patients had low plasma renin activity (PRA) and elevated plasma aldosterone concentrations in the upright position and resultant high aldosterone/PRA ratios: 8 with aldosterone-producing adenoma (APA; group 1) and 7 with idiopathic hyperaldosteronism (IHA; group 2). Thirty-nine patients had suppressed PRA in the presence of normal plasma aldosterone levels and moderately elevated aldosterone/PRA ratios (group 3). Thirty of them had elevated plasma 11-deoxycorticosterone (DOC) and 18-hydroxy-11-deoxycorticosterone (18-OH-DOC) concentrations (group 3a) and 9 of them had normal levels of those mineralocorticoids (group 3b). The rest of them (382 patients) had low aldosterone/PRA ratios (group 4). Adrenal scintigraphy with dexamethasone pretreatment revealed [13I]-cholesterol accumulation not only in patients with APA (unilateral) or IHA (bilateral), but also in patients of group 3a (bilateral). In patients in groups 3a and 3b adrenal size (especially thickness), as measured by computed tomography (CT scan), was enlarged, as in patients with IHA (group 2), and was significantly greater than in patients of group 4 (p less than 0.001). Spironolactone reduced blood pressure in all tested patients of group 3a, and the removal of adrenal tumor or hyperplastic tissue normalized blood pressure in patients of groups 1, 2 and 3a. Excised adrenal glands exhibited cortical hyperplasia with or without nodular hyperplasia in patients of group 3a. Good agreement was found between the actual size of the excised tissue and the measurement obtained by CT scan. Since beta-endorphin and beta-lipotropin were depressed in patients of group 3a, it is suggested that an unknown pituitary substance stimulates the adrenal cortex to release too large amounts of DOC and 18-OH-DOC and inappropriate secretion of aldosterone.

Interleukin-1 beta (IL-1 beta) induces thrombocytosis in mice: possible implication of IL-6

We administered recombinant human interleukin-1 beta (IL-1 beta), the common mediator of inflammation process, to C57B1/6 male mice (0.5 microgram, every 12 hours over five times) intraperitoneally and consequently induced a remarkable thrombocytosis. Day 1 was designated as the following day of the last injection in the morning. A significant thrombocytosis was observed on days 1 through 5 with a peak on day 2 (162 +/- 9 x 10(4)/mm3) compared with the control mice injected with heated IL-1 beta (101 +/- 11 x 10(4)/mm3). A striking increase in mean size of marrow megakaryocytes was noted on days 1 and 2. The incorporation of 75Se-selenomethionine into circulating platelets as a measure of platelet production was about 2.3 times higher in IL-1 beta-treated mice than in control mice. To determine which factor(s) is responsible for elicited thrombocytosis, the in vitro studies and bioassays for several hematopoietic factors were performed. IL-1 beta by itself did not stimulate megakaryocytopoiesis in vitro, suggesting that the thrombocytosis is attributed to other factor(s) via IL-1 beta stimulation. Serum colony-stimulating factor (CSF) activity after a single IL-1 beta (0.5 microgram) injection, monitored by colony assay with 10% tested serum, peaked at 3 hours. Formed colonies were mostly granulocyte (G) and granulocyte-macrophage (GM)-types, and studies using rabbit anti-mouse GM-CSF serum or using human marrow as target cells showed that the CSF activity of the tested serum consisted of, at least, GM-CSF and G-CSF. Addition of IL-3 concomitantly with the tested serum gave rise to a greater number of megakaryocytic colonies. Serum IL-3, monitored by IL-3-dependent cell line 32D clone 5, and erythropoietin activities were not detected at serum level in IL-1 beta-treated mice. Serum IL-6 assay by IL-6-dependent mouse hybridoma cell line MH-60.BSF2 showed high levels of the tested serum with a peak at 2.5 hours with no detection at 10 hours after the injection. Heated IL-1 beta caused an increase of neither IL-6 nor CSF activities. Our data suggest that the thrombocytosis induced by IL-1 beta is mediated by IL-6 or a combination of IL-6 and other cytokine(s), and that IL-6 may play a regulatory role in platelet production in vivo.

Effects of N4-behenoyl-1-beta-D-arabinofuranosylcytosine on blast progenitors of acute myeloblastic leukemia

To determine the antileukemic effect of N4-behenoyl-1-beta-D-arabinofuranosylcytosine (BH-AC), a synthetic masked compound of 1-beta-D-arabinofuranosylcytosine, the pharmacokinetics and suppressive effect on leukemic blast progenitors of BH-AC were studied. When BH-AC was added to the suspension culture of leukemic cells, BH-AC gradually decreased in concentration in the culture media and was rapidly taken into the cellular fraction. The conversion from BH-AC to 1-beta-D-arabinofuranosylcytosine was noted in both the culture media and the cellular fraction. The concentration of 1-beta-D-arabinofuranosylcytosine converted from BH-AC in the culture medium gradually increased during 7 days of culture, although the rate of conversion was variable among the samples. BH-AC suppressed primary and secondary blast colony formation in a dose responsive manner. BH-AC also suppressed the recovery of clonogenic cells in suspension culture. The suppression by BH-AC was more prominent in secondary blast colony formation and the recovery of clonogenic cells in suspension culture than in primary blast colony formation. Secondary blast colony formation and the recovery of clonogenic cells in suspension are considered to reflect the self-renewal of blast progenitors, while primary blast colony formation is considered to reflect the terminal divisions of blast progenitors. The results obtained in the present study suggest that BH-AC is more effective to suppress the self-renewal of blast progenitors than the terminal divisions. The findings offer a theoretical basis in the utility of BH-AC in the therapy of acute myeloblastic leukemia.

A case of right atrial thrombosis associated with isolated right ventricular hypoplasia

A rare case of right atrial thrombosis was observed in a 49-year-old woman. She had cyanotic ostium secundum atrial septal defect without pulmonary hypertension. By postoperative cardiac catheterization, she was diagnosed as having isolated right ventricular hypoplasia.

Evaluation of time-dose and fractionation for 252Cf neutrons in preoperative bulky/barrel-cervix carcinoma radiotherapy

Time-dose fractionation factors (TDF) were calculated for 252Cf (Cf) neutron therapy versus 137Cs for intracavitary use in the preoperative treatment of bulky/barrel-shaped Stage IB cervix cancers. The endpoint assessed was gross and microscopic tumor eradication from the hysterectomy specimen. We reviewed the data obtained in clinical trials between 1976-1987 at the University of Kentucky Medical Center. Preoperative photon therapy was approximately 45 Gy of whole pelvis irradiation in 5 weeks for both 137Cs and Cf treated patients. 137Cs implant was done after pelvic irradiation x1 to a mean dose of 2104 +/- 36 cGy at point A at a dose rate of 50.5 cGy/h. There were 37.5% positive specimens. Using Cf intracavitary implants, dose varied from 109 to 459 neutron cGy in 1-2 sessions. Specimens were more frequently cleared of tumor (up to 100% at appropriate dose) and showed a dose-response relationship, both by nominal dose and by TDF adjusted analysis of dose, dose-rate, number of sessions, and overall time. Limited understanding of relative biological effectiveness, schedule, effect of implants, and dose rate all made it difficult to use TDF to study neutron effects. Relative biological effectiveness (RBE) was estimated and showed that for Cf, RBE was a complex function of treatment variables. In the pilot clinical studies, a value of 6.0 had been assumed. The present findings of RBE for tumor destruction are larger than those assumed. Cf was effective for cervix tumor therapy and produced control without significant side effects due to the brachytherapy method used. The TDF model was of limited value in the present analysis and more information is still needed for RBE, dose-rate, and fractionation effects for Cf neutrons to develop a more sophisticated and relevant model.

Determination of succinylcholine hydrolytic enzyme activity in human plasma

Succinylcholine is frequently employed in surgical procedures as a pre-anaesthetic. However, the lack of existing metabolic activity for this compound in some individuals entails a substantial risk. Normally, the risk is assessed indirectly through the measurement of pseudocholinesterase activity using other substrates, such as acetylcholine, rather than the agent itself. Thus, a method was devised to assess directly the hydrolysis of succinylcholine in human plasma samples. This method was applied to plasma samples derived from healthy men, healthy women, pregnant women and patients with silent pseudocholinesterasaemia.

[Estimation of I-123 metaiodobenzylguanidine (MIBG) myocardial washout]

A crosstalk from I-123 to Tl-201 (Tl) window was 35 +/- 30% (mean +/- SD) and 30 +/- 10% in a myocardial phantom and the images of 6 patients respectively. However, the crosstalk from Tl to I-123 was approximately 1% in each. I-123 MIBG (MIBG) and Tl myocardial SPECT images were recorded in 3 normal volunteers (N), 10 patients with myocardial infarction (MI), and 4 with dilated cardiomyopathy (DCM). The MIBG and Tl imagings were performed on the other day to avoid the crosstalk. Myocardial washout rates (WR) of Tl and MIBG were derived from 15 min and 4 hour images. WR of Tl was approximately 36% in each group. On the other hand, WR of MIBG in DCM (52 +/- 7%) and MI (41 +/- 14%) groups were statistically higher than in N (24 +/- 7%) group. Thus WR of MIBG would be useful to detect abnormalities in adrenergic nervous system.

Inhibitory effects of arachidonic acid on muscarinic current response in single pancreatic acinar cells of rats

1. In single, enzymatically dissociated rat pancreatic acinar cells both acetylcholine (ACh) stimulation and IP3 (inositol 1,4,5-trisphosphate) injection evoke Ca2(+)-dependent transient responses. Exogenously applied arachidonic acid (AA) inhibits both responses in a dose-dependent manner. 2. Arachidonic acid oxidation inhibitors, indomethacin and nordihydroguaiaretic acid, cause no significant changes in ACh- and IP3-induced responses. The inhibitory effects of AA (50 microM) on IP3-induced responses are not influenced by the presence of these oxidation inhibitors. 3. An inhibitor of phospholipase A2 (PLA2), 4-bromophenacyl bromide (4-BPB; 10 microM), augments the ACh-induced response, and it potentiates the IP3-induced response by a factor of 10 to 20. The IP3-induced response, after its complete decay, is recovered by an administration of 4-BPB. 4. The results suggest that an increase in [Ca2+]i, induced by IP3 injection, activates PLA2, and that this resultant release of AA in turn inhibits IP3-dependent Ca2+ mobilization.

[Successful repair of an acute type A dissection during pregnancy]

We report a successful repair of an acute type-A aortic dissection during pregnancy. A 29-year-old pregnant woman in the 32 weeks of gestation with Marfan Syndrome was admitted to our hospital for the treatment of anterior chest and back pains. An urgent aortogram through pulmonary artery revealed an aortic dissection beginning from the ascending aorta to the aortic bifurcation. On the following day, an emergent Cesarean section was performed and a baby weighing 1944 g was delivered. Thereafter, cardiopulmonary bypass was instituted and the ascending aorta was opened. An intimal tear was found 2 cm above the aortic valve. The dissected space was closed with reinforcement of Teflon felt strip. A Dacron gusset was sutured to restore aortic continuity. During the weaning from the CPB, a retrograde aortic dissection developed and the heart became arrested. Therefore we immediately converted the aortic perfusion cannula from the right external iliac artery to graft of the ascending aorta, and the operation was completed successfully with a good recovery of the heart. The mother and her child have been alive and well for 3 years and 5 months after the operation.

[Assessment of myocardial viability by resting 201Tl SPECT image]

The aim of this study was to assess whether resting 201Tl scintigraphy is superior in detecting viable myocardium than previous conventional methods. We performed not only stress 201Tl SPECT but also resting 201Tl SPECT within one month in 65 patients with coronary artery disease. Resting 201Tl images were quantitatively compared with 4 hour late images of stress study using a polar map. In stress study, redistribution was recognized on 83% (25/30) of non-MI SEGs with perfusion defect in the stress 201Tl image, and on 39% (18/46) of infarcted SEGs. The agreement of resting 201Tl study with 4 hour late images of stress study was shown on 93% (28/30) of non-MI SEGs and on 52% (24/46) of MI SEGs. The increased uptake of 201Tl in resting study, however, was found on 13 (46%) of 28 MI SEGs showing fixed defects in stress study. In stress delayed image with fixed defect, the %Tl uptake of improved SEGs was higher than that of unchanged SEGs (59 +/- 10% vs 48 +/- 11%; p greater than 0.05). There was no viable myocardium which had %Tl uptake less than 40% at stress delayed image. In conclusion, the resting 201Tl imaging will give an important information as for the myocardial viability showing fixed defects, if more than 40% Tl uptake is observed.

Purification and characterization of yeast protein disulfide isomerase

Protein disulfide-isomerase (PDI), which reactivates inactive scrambled RNase, was purified from Saccharomyces cerevisiae. The enzyme was purified 1,850-fold to apparent homogeneity by five purification steps: 30-70% ammonium sulfate fractionation, DEAE Toyopearl-650S and Butyl Toyopearl-650S chromatographies, and differential Phenyl-5PW HPLC with or without cysteine. The native enzyme had an apparent Mr of 140,000 on gel filtration chromatography, and its NH2-terminal was blocked. The Mr of its subunits were estimated to be 70,000 by sodium dodecyl sulfate polyacrylamide gel electrophoresis, indicating that the enzyme is probably composed of two identical subunits. The Mr of the subunits changed to 60,000 on endoglucosaminidase H treatment, indicating that the enzyme is transported into the endoplasmic reticulum. The enzyme has a pH optimum of 8.5, and pI of 4.02. Its enzymic properties were compared with those of purified bovine liver PDI. The Km values of yeast and bovine PDIs for scrambled RNase were 1 x 10(-5) and 2 x 10(-5) M, and their Vmax values were 6 and 7 units/mg protein, respectively. The two enzymes showed no significant differences in Km or Vmax values with respect to thiol compounds. Bacitracin inhibited both PDIs in the same fashion. These results indicate that this yeast PDI corresponds to mammalian PDI.