[Tricuspid valve motion and tricuspid valve ring size in normals and patients with atrial septal defect (author's transl)]

To investigate the normal configuration of the tricuspid valve and the normal size of the tricuspid valve ring, 17 normals, 20 patients with atrial septal defect, 4 patients with tricuspid valve prolapse, and 41 patients with various diseased conditions were studied by cross-sectional echocardiography. The tricuspid valve ring diameter in atrial septal defect was judged to be increased in comparison with that of normals. All the patients with tricuspid valve prolapse exhibited an excessive systolic ballooning of the leaflets toward the right atrium. However, a systolic ballooning of the leaflets alone was frequently observed in normals and many other conditions. Therefore, we conclude that cross-sectional echocardiography has some clinical limitations in the differential diagnosis between tricuspid valve prolapse and normals.

Effect of theophylline on insulin, glucagon and somatostatin secretion from the isolated rat pancreatico-duodenal preparation

In order to determine whether endogenous somatostatin has an inhibitory action on insulin and glucagon secretion, the isolated rat pancreas was perfused with 10mM theophylline, which strongly stimulated somatostatin release, under pretreatment or simultaneous administration of 8.3, 16.7 mM glucose and 20mM arginine with 4.4 mM glucose. 1) In the infusion of 10mM theophylline with 8.3 mM glucose, the first phase at the time corresponding with that of insulin release elicited by 8.3 mM glucose alone was suppressed by endogenous somatostatin stimulated by theophylline. 2) During the infusion of 16.7 mM glucose for 35 min, 10mM theophylline was interposed at from 15 to 25 min intervals. Its addition caused a rapid increase in somatostatin. Only at 15 min 30 sec and 16 min, insulin concentration went down and reached the levels of 70 and 74 per cent of the 15-min value, respectively. 3) During the infusion of 20 mM arginine with 4.4 mM glucose for 35 min, 10mM theophylline was added to the perfusate from 15 to 25 min. The addition of theophylline caused an increase in somatostatin and decrease in glucagon. At 15 min 30sec and 16 min, the levels of glucagon were 63 and 75 per cent of 15-min value, respectively. These results seem to support the idea that endogenous somatostatin suppressed glucose-induced insulin and arginine-induced glucagon secretion. However, the possibility of a direct effect of theophylline on the changes in insulin and glucagon secretion could not be excluded.

A Golgi and electron-microscopic study of cerebellum in methylmercury-poisoned neonatal mice

Neonatal C57BL/6J mice were injected with 5 mg/kg body weight of 203Hg-labeled methylmercuric chloride on postnatal days 3, 4, and 5, totaling 15 mg/kg body weight per animal. The experimental and control animals were sacrificed on postnatal by 15. Whole body radioactivity of 203Hg progressively increased during the 3-day injection period and reached the peak level and remained at peak levels until the time of sacrifice. This indicates a lack of clearance of 203Hg by neonatal mice during the period examined in this study. Golgi preparations of cerebella of MeHg-treated animals revealed significant reduction in dendritic arborization of Purkinje cells. Ultrastructurally, the vascular endothelium showed attenuation with increased electron density and frequent vacuolization of cytoplasm. Marked swelling of perivascular glia was noted in most of the capillaries throughout the cerebella of MeHg-treated animals.

Effect of anaesthesia and surgery on endocrine function in elderly patients

The effect of halothane-nitrous oxide anaesthesia and abdominal surgery on endocrine function was investigated in 18 elderly patients whose ages ranged from 65 to 77 (mean 69 years). Cortisol levels in plasma increased significantly during anaesthesia and surgery, and the increases were slightly higher than those in young adults. Plasma aldosterone increased and insulin levels did not change during the procedures, and these levels were lower than in younger adults. The endocrine responses in elderly patients were similar in magnitude to those in young adults. Therefore it appears that no special hormonal treatment is necessary for elderly patients undergoing routine surgical procedures.

Ascending projections of the inferior colliculus in the cat: an autoradiographic study

The ascending projections of the inferior colliculus (IC) in the cat were traced by the autoradiographic method, with special reference in the differenial projections of each subnucleus of IC. The laminated ventrolateral part of the central nucleus of IC (CNv) projects to the ventral and medial divisions of the ipsilateral medial geniculate body (MGB). The projections to the ventral division are topographically organized in the mediolateral direction, the terminals being arranged in the form of lamina, while those to the medial division are diffuse. The unlaminated dorsomedial part of the central nucleus of IC (CNd) sends fibers to every division of the ipsilateral MGB, particularly to the dorsal division and the ventromedial portion of the ventral division. It is noteworthy that the external nucleus of IC (EN) projects to the superior colliculus, part of the pretectum, and the anterior extremity of MGB ipsilaterally, in addition to the ventral and medial divisions of MGB. The posterior cap of IC, regarded as the pericentral nucleus of IC (PC), projects ipsilaterally to the ventral part of the caudal tip of MGB and the posterior part of the suprapeduncular nucleus. In addition of these projections, the parabrachial region and interstitial nucleus of the brachium of IC (BIC) are identified as common targets of projections of each nucleus of IC on the ipsilateral side. Contralaterally, every subnucleus of IC except for PC projects via the commissure of IC to areas corresponding to the targets of the ipsilateral projections, such as the ventral and medial divisions of MGB and the parabrachial region and the interstitial nucleus of BIC, although these contraleral projections are in general much sparser than those ipsilateral. Intrinsic and commissural connections within IC are also revealed in this study, providing characteristic configurations of each subnucleus of IC. It is concluded that the ascending projections of IC in the cat are highly differentially organized according to its subnucleus.

[Iatrogenic intraspinal epidermoid cyst (author's transl)]

A case of an intraspinal cyst following a lumbar puncture is described. A 57 year-old man had a myelography at the level of L-2 revealing a disc herniation of L-4. About two years later he had another myelography for recurrent back pain, which disclosed an intradural extramedullary tumor at the level of L-2. Pathological diagnosis of the tumor was epidermoid cyst. From the topographical standpoint of the tumor, the previous lumbar puncture was thought to be the most likely cause of the epidermoid cyst. This is the third case report, to the best of our knowledge, which had a normal myelogram prior to the development of epidermoid cyst in the spinal canal.

Dose-dependency and reproducibility of the prolactin response to metoclopramide

Six normal volunteers were tested to ascertain the dose-dependency and reproducibility of the prolactin response to metoclopramide. Furthermore, pretreatments with 1-dopa or cyproheptadine were performed. The same subjects also received intravenously 500 microgram TRH. The oral administration of 5 mg metoclopramide produced a significant rise in prolactin at 60 min and a maximal elevation at 90 min. The intravenous administration of 5 mg metoclopramide produced a significant increment at 15 min and a maximal prolactin level at 30 min. Peak prolactin levels following i.v. administration of the drug were greater than those after oral administration. Intravenous administration of 1 mg of metoclopramide produced a potential increment in plasma prolactin. Maximal prolactin response to 1 mg i.v. metoclopramide was similar to that found with 500 microgram i.v. TRH. Reproducibilities of prolactin response were good in all doses and modes of administration of metoclopramide. Pretreatment with 1-dopa inhibited the metoclopramide-induced prolactin response, but pretreatment with cyproheptadine did not influence the prolactin response to metoclopramide. Metoclopramide is a good and reproducible stimulator of prolactin secretion.

Effect of adenosine deaminase replacement therapy on a child of adenosine deaminase deficiency with severe combined immunodeficiency disease

Enzyme replacement therapy was performed for a 1-year and 5-month old boy with adenosine deaminase deficiency disease, the first case in Japan. Irradiated fresh red blood cells were administered without any clinical improvement, but there was an increase in the peripheral lymphocytes from 300/mm3 to 1849/mm3, of which 88% had T cell marker. B lymphocytes did not bear any classes of surface immunoglobulins. The proliferative responses of these lymphocytes to phytohemagglutinin, concanavalin A, pokeweed mitogen and allogeneic cells were examined. More than two-fold increase in response to these mitogens was observed in lymphocytes after treatment as compared with responsiveness before treatment, but these responses still remained to a much lesser degree than that of lymphocytes from controls.