Coexistence of vasoactive intestinal polypeptide and neuropeptide Y immunoreactivity within axon terminals in the canine and human lower esophageal sphincter: electron microscopy by a double immunogold labeling procedure

Subcellular localization of vasoactive intestinal polypeptide (VIP) and neuropeptide Y (NPY) immunoreactivity within nerves was investigated in the lower esophageal sphincter of dogs and humans by double immunogold staining of sections prepared for electron microscopy. Coexistence of VIP and NPY immunoreactivity was clearly demonstrated in the large granular vesicles (LGVs) in axon terminals that were closely associated with the smooth muscle cells, as well as in the LGVs within the perikarya of neurons located in the myenteric plexus. Some LGVs appeared immunopositive only for VIP or NPY. This phenomenon might have been partly due to the fact that the double-labeling procedure with immunogold particles of different sizes was performed on both faces of each section. The results obtained in this study suggest that VIP and NPY are synthesized in the same neuron, stored in the same axon terminal, and released together to act on sphincter muscle cells.

The mechanism of arachidonic acid release in collagen-activated human platelets

The mechanism of arachidonic acid (AA) release in collagen-activated human platelets was studied. An arachidonic acid metabolite, thromboxane B2 (TXB2), was formed in parallel with the formation of phosphatidic acid (PA) without formation of lysophosphatidic acid (lysoPA) or lysophosphatidylinositol (lysoPI) in the absence of extracellular Ca2+, suggesting that AA was released from PI via a PI-specific phospholipase C (PI-PLC)/diacylglycerol (DG) lipase/monoacylglycerol (MG) lipase pathway under the cytosolic low Ca2+ concentrations. Moreover, solubilized DG lipase and MG lipase could hydrolyze the substrates at basal cytosolic free Ca2+ concentrations. Subsequently, the relationship of cytosolic free Ca2+ concentrations and formation of AA metabolites was analyzed using Ca2+ ionophore, A23187. Collagen was able to induce a release of small amounts of AA under basal cytosolic Ca2+ conditions. However, a release of large amounts of AA was induced by phospholipase A2 activated by both collagen-receptor occupancy and elevated Ca2+ levels. A TXA2 mimetic agonist, STA2 induced all the responses except for AA release. From these results, the mechanism of AA release and signal transduction in collagen-activated human platelets is discussed.

[Clinical application of transrectal ultrasonic therapy to nonbacterial prostatitis and prostatodynia cases which were resistant to conventional drug therapy]

A total of 25 patients with nonbacterial prostatitis and prostatodynia which were resistant to conventional drug therapy underwent 5 minutes course of transrectal ultrasonic therapy in association with application of 1% hydrocortisone acetate cream to the anterior rectal wall for consecutive 8 days. The efficacy of the treatment was evaluated only by comparison of symptom scores for subjective symptoms obtained before and after treatment. Excellent results, which were defined as more than 70% reduction of symptom scores after treatment, were obtained in 5 (27.8%) among 18 evaluable cases in which symptom scores before treatment were more than 4, good (40-69% reduction of scores) in 4 (22.2%), fair (10-39% reduction of scores) in 4 (22.2%) and poor (less than 10% reduction of scores) in 5 (27.8%). Because of good clinical efficacy and the absence of complication, transrectal ultrasonic therapy combined with hydrocortisone acetate cream application was thought to be useful for the treatment of nonbacterial prostatitis and prostatodynia cases which responded poorly to the conventional therapy.

[Clinical analysis of surgical treatment of benign prostatic hypertrophy patients over 80 years old]

We compared several clinical parameters between two different prostatectomy procedures, transurethral prostatectomy (TUR-P, 26 cases) among aged cases of benign prostatic hypertrophy. All patients were over 80 years old and were treated at Nippon Medical School Hospital from January 1983 to December 1988. TUR-P was superior to open prostatectomy in the following aspects, (1) operation time, (2) total amount of transfused blood and (3) hospital stay.

Heterogenous distribution of peptide-containing nerve fibres within the circular muscle layer of the human pylorus

The distribution of nerve fibres immunoreactive for vasoactive intestinal polypeptide (VIP), substance P (SP), methionine-enkephalin (ENK), calcitonin gene-related peptide (CGRP) and neuropeptide Y (NPY) within the circular muscle layer was examined histochemically in the human pylorus, adjacent antrum and duodenum. Longitudinal cryostat sections of the pyloric and surrounding regions were stained by an indirect immunofluorescence method, and the total length of each type of peptide-containing fibre per unit sectional area (micron/mm2) was measured using an image-analysing system. The narrow region of the circular muscle layer bordering the submucosa in the pylorus contained a rich supply of VIP, SP, ENK and CGRP immunoreactive fibres; VIP fibres were most prominent with less SP and ENK fibres and moderate amounts of CGRP. These peptide-containing nerve fibres were more dense than in the pyloric circular muscle, the longitudinal muscle layer and also the adjacent muscle layer. NPY-immunoreactive fibres were sparsely distributed throughout the pyloric region. These results suggest that the inner edge of the circular muscle, lying adjacent to the submucosa and densely innervated with peptide-containing fibres, may be a characteristic feature of the human pyloric sphincter.

Distribution and origin of extrinsic nerve fibers containing calcitonin gene-related peptide, substance P and galanin in the rat upper rectum

The distributions of nerve fibers containing calcitonin gene-related peptide (CGRP), substance P (SP) and galanin (GAL) were examined in the rat rectum of mutants rats, aganglionic rats (AGRs), which completely lack the intramural nerve cells in the large intestine, and of their normal littermates. The origin of extrinsic peptide-containing nerve fibers was examined using retrograde tracing combined with immunohistochemistry in normal rats. In the rectum of normal rats, CGRP-, SP- and GAL-immunoreactive varicose fibers were observed throughout all layers of the rectal wall, and immunoreactive nerve cells were present in the enteric ganglia of colchicine-treated rats. In the aganglionic rectum of AGR, a rich supply of CGRP-immunoreactive fibers was observed in the mucosa, around the blood vessels, and in the submucous and intermuscular spaces. SP- and GAL-immunoreactive fibers in the aganglionic rectum showed a similar distribution to CGRP-immunoreactive fibers but were less dense. These results suggest that most of CGRP-positive fibers in the rectum are extrinsic whereas a large part of SP- or GAL-positive fibers are intrinsic. Fluoro-gold injected into the upper rectum of normal rat labelled nerve cells (less than 10% of total ganglion cells) in the lumbar (L1 and L2) and lumbosacral (L6 and S1) dorsal root ganglia. More than half of nerve cells in the dorsal root ganglia (L6 and S1) projecting to the rectum were immunoreactive for CGRP, and less than 10% were immunoreactive for SP or GAL. Comparison of serial sections of the dorsal root ganglion revealed that about half of the CGRP-immunoreactive cells were also positive for SP or GAL. These results indicate that SP- or GAL-positive neurons projecting to the rectum are scarce in the dorsal root ganglia. The present investigation suggests that CGRP-containing nerves are visceral afferents forming a major component of the sensory innervation of the rat rectum, and SP- and GAL-containing nerves which share their extrinsic origins appear to form a lesser proportion of the sensory innervation.

Distribution of cholinergic and catecholaminergic nerves in the colon of the rat with aganglionosis

We compared localization and distribution of putative cholinergic fibers by acetylcholinesterase and of adrenergic fibers visualized by the glyoxylic acid technique in the aganglionic segment using whole mount preparations of aganglionosis rat (AGR) and compared them with those of normal littermates. We also attempted simultaneous staining of acetylcholinesterase (AChE) and catecholamine fluorescence (C-F) on the same whole mount preparations to compare the differences in distribution pattern. All AGR used in this study had narrowed segments of the bowel extending from the distal ileum to the anus, and had no ganglion cells in these narrowed segments. In the intermuscular space, normally occupied with myenteric ganglion, of the narrowed distal colon and rectum, various sizes of nerve bundles and fibers reactive for AChE and C-F appeared to make coarse and irregular networks. These thick nerve bundles appeared to ascend to the proximal colon and disappeared in the cecum. In the distal ileum, almost totally absence of AChE positive nerve fibers, but a few fine C-F fibers, probably associated with blood vessels, were observed. By the method of simultaneous staining of AChE and C-F method in the whole mount preparations, the thick nerve bundles in the narrowed segments showed both of AChE positive and C-F positive. However, there were differences in peripheral fine nerve fibers in the segment; especially numerous perivascular C-F positive nerve fibers, but a few AChE positive ones were found. In the upper aganglionic narrowed segments, greatly diminished numbers of AChE positive and C-F positive nerve fibers were found in the circular muscle layer and in the submucosal layer. In the lower aganglionic narrowed segments, there were thick nerve bundles, forming irregular interlaced network. The role of these extrinsic nerve fibers in aganglionic segments is unclear.

[Clinical application of extracorporeal shock wave lithotripter (SD-3) to upper urinary tract stones]

The extracorporeal shock wave lithotripter (SD-3) was used on 30 patients with upper urinary tract calculi from December, 1988 to March, 1989. At one month after the treatment, 11 patients (36.7%) were free from stones and 9 (30.0%) had stone fragments than 5 mm in diameter, making an effective rate of treatment of 66.7%. Gross hematuria, skin ecchymosis, pain and fever were observed as side effects, but none of them were serious. We concluded that extracorporeal shock wave lithotripsy using SD-3 for upper urinary tract stones is an effective treatment without any serious side effects.

[Treatment of superficial bladder tumor]

In period of April, 1982 to March, 1987 for 5 years, fifty-four patients with superficial bladder tumors were treated at the Department of Urology, Nippon Medical School. There were 42 males and 12 females with age ranged from 28 to 85 years old. All patient underwent TUR-Bt (trans urethral resection-bladder tumor) as an initial treatment. The rather long term follow-up study after initial treatment was 47 months in average. Recurrence rate at 2 years after TUR-Bt was 30%. The risk factors of recurrence were analysed in connection with sex, age, tumor number, histological grade and stage, and infiltration pattern. In conclusion, significantly higher recurrence rate were observed in G2 than G1 and G3, and in pT1b rather than pTa and pT1a. Other factors were not distinctly correlated with incidence of recurrence.

[A case of signet ring cell carcinoma of the urachus]

A 71-year-old female was seen initially with the complaint of gross hematuria. Cystoscopic examination revealed non-papillary tumor at the dome of the bladder and a transurethral biopsy showed signet ring cell carcinoma. En bloc segmental resection was performed, and the patient has been well without any evidence of progression. We report a case, which we believe to be the 6th in Japan, of signet ring cell carcinoma of the urachus.

Purification of polymeric phospholipase Cs from human platelets

Two types of cytosolic phospholipase C specific for phosphoinositides were purified from human platelets. The molecular masses of the purified enzymes were 440 and 290 kDa. These enzymes were concluded to be respectively a trimer and a dimer of homologous 146 kDa polypeptides. The 146 kDa polypeptide may be an immunologically novel isozyme among the 140-150 kDa PLC isozymes. Both enzymes hydrolyzed phosphatidylinositol and phosphatidylinositol 4,5-bisphosphate in a Ca2(+)-dependent manner.

Pharmacological activities of synthetic human cholecystokinin-33 of which tyrosine was sulfated by arylsulfotransferase

The pharmacological activities of synthetic human CCK-33, in which a tyrosine molecule was sulfated by arylsulfotransferase, were investigated in the rat and the guinea-pig. The activities were compared with those of non-sulfated CCK-33 (CCK-33NS), CCK-8 and CCK-4. CCK-33 was about 100 fold more potent than non-sulfated CCK-33(CCK-33NS) but was about 20 fold less potent than CCK-8 in the contraction of the isolated gallbladder of the guinea-pig. In rat pancreatic secretion, intravenous CCK-33 and CCK-8 showed almost the same activity. The potency of each was about 1000 fold more than the individual potency of CCK-33NS, non-sulfated CCK-8 (CCK-8NS) and CCK4. There were no significant differences in gastric acid stimulatory activities among CCK-33, CCK-8, CCK-4, but the activities of CCK-33NS and CCK-8NS were less than those of CCK-33 and CCK-8, respectively. CCK-33 and CCK-8 produced a reduction in the intake of powder chow in doses of 10(-8) and 3 x 10(-8) mol/kg i.p., but CCK-33NS, CCK-8NS and CCK-4 did not. In conclusion, the activities of synthetic human CCK-33 are almost the same as those of CCK-8 on exocrine pancreatic secretion, gastric acid secretion and food intake, but less than CCK-8 on isolated gallbladder contraction.

An in vitro study of the projections of enteric vasoactive intestinal polypeptide-immunoreactive neurons in the human colon

The anatomical basis of the peptidergic neural control of the human colon is largely unknown. In this study, in vitro retrograde tracing methods have been used on fresh human colon to determine the projection pathways of the enteric nerves and, in particular, those containing vasoactive intestinal polypeptide, one of the most abundant and potent of the gut neuropeptides. Two components of the submucous plexus were identified, the inner one projecting to the lamina propria, and the outer to the circular muscle. The lengths of projections within the submucous plexus were up to 5-14 mm in all directions. Myenteric ganglion cells projected to both longitudinal and circular muscles, for distances of up to only 5 mm. The subpopulation of nerves containing vasoactive intestinal polypeptide arose mainly from the submucous plexus and projected up to 6.5 mm anally, 5 mm orally, and 14 mm within the submucous layer to the mucosa or circular muscle. These findings provide entirely new data on the neuroanatomy of the human colon and may help in the understanding of the neural control of colonic secretion and motility.

Pharmacological activity of angiotensin-II modified by tyrosine sulfation

An angiotensin-II analogue with a sulfated tyrosine residue was prepared by arylsulfotransferase treatment of synthetic human angiotensin-II. Its biological activities were studied in isolated smooth muscles, and its effect on blood pressure was determined. The sulfated angiotensin-II (AII-S) was about 15-30 fold less potent than angiotensin-II (AII) for ileum contraction and gallbladder contraction. The hypertensive potency of AII-S was about 30-fold less than that of AII.

Distribution and function of enteric GAL-IR nerves in dogs: comparison with VIP

The distribution of nerves containing galanin-immunoreactive (GAL-IR) material was compared to the distribution of neurons containing vasoactive intestinal polypeptide (VIP) immunoreactivity in the canine gastrointestinal tract. The actions of intra-arterially administered galanin and VIP on motility in the gastric antrum and corpus and the intestines were also studied. All sphincter muscles contained galanin- and VIP-immunoreactive nerve profiles. VIP-immunoreactive nerve profiles were present in all layers of the stomach, small intestine, and colon. GAL-IR nerve somata were common in the submucous plexus of ileum and colon and in the myenteric plexus of the terminal antrum, as were nerve processes in various layers. In the small intestine, galanin inhibited contractile responses to field stimulation of intrinsic nerves and also reduced the contractions after nerve blockade with tetrodotoxin (TTX). VIP often enhanced field-stimulated contractions at low doses but inhibited these and the contractions after TTX at higher doses. In the stomach and colon, both peptides inhibited responses to field stimulation; whether these effects were due to actions on smooth muscle was not tested. The distribution and actions of galanin in gut are consistent with the hypothesis that it acts at smooth muscle sites and possibly at prejunctional sites.

[243 cases of percutaneous nephrolithotomy--result of 5 years]

Between May, 1982 and April, 1987, upper urolithiasis of 247 kidneys of 243 patients, 174 male and 69 female, were treated by percutaneous nephrolithotomy (PNL). The main stone was successfully removed from 236 kidneys (about 95.5%). Seven cases of ureteral stone could not be removed by PNL, and were treated by traditional ureterolithotomy. In 3 cases of pelvic stone, the stone descended to the ureter during the PNL procedure, and was also removed by ureterolithotomy. In one case of pelvic stone, complete obstruction of uretero-pelvic junction after PNL occurred, and pyeloplasty was needed. One pelvic stone patient who had basical hypertension and arrhythmia died soon after PNL, because of acute myocardial infarction. Blood transfusion was needed in 31 cases (12.8%). The residual stones over 5 mm were noticed in 48 cases (20.3%). The most important point to succeed in PNL is to make a nephrostomy through the most suitable calyx to the stone. The easiest way to identify the location and connection of the aimed calyx with the stone in three dimensional position, is to take X-ray films in intravenous pyelograms not only from postero-anterior but also oblique positions. Additional transureteral lithotripsy (TUL) for the fragment descending to the ureter after PNL produces a much better result.

Frequency dependence of the suppressive effects of vibration on atherosclerosis in the rabbit

Whole-body vibration suppresses the development of atherosclerosis in the rabbit (Oki and Matoba, 1987). The present study was designed to clarify whether the effect of vibration on atherosclerosis depends on the frequency of vibration. Longitudinal vibrations at a frequency of 30 or 60 Hz was applied to 12 New Zealand white rabbits for 12 weeks. The gradual decrease in body weight and blood hematocrit in the vibration groups with time were parallel to the changes in the controls. The rate of increase in serum lipid concentrations induced by a cholesterol-rich diet was significantly suppressed in the vibration groups, as compared to the controls. This may be due to the vibration and not the diet. The aortic wall was thinner at 60 Hz than at 30 Hz, whereas the ratios of trace metals (Ca/Mg and Zn/Cu) in the aortic tissues were smaller at 30 Hz. The area of plaque formation in the intima was smaller at 60 Hz than at 30 Hz (p less than 0.05). Thus, the suppressive effect of vibration on the development of atherosclerosis in the aorta may be greater at a frequency of 60 Hz than at 30 Hz. Vibration may play an important role in lipid metabolism.

[The influence of percutaneous nephrolithotomy on renal function evaluated by 99m-Tc-DTPA renoscintigram]

The influence of percutaneous nephrolithotomy (PNL) on renal function was evaluated by 99m-Tc-DTPA renoscintigraphy. The renoscintigram was recorded and regions of interest of both kidneys (R) and background (BKG) were settled. Renal uptake ratio was calculated by the following formula. Renal uptake ratio = (formula; see text). The renal uptake ratio of 50 patients were compared before and up to 6 months after PNL. Most cases showed an increase or no change in post-PNL renal uptake ratio in operated kidney. Five cases (10%) showed decreased renal uptake ratio of post-PNL. No risk factors for the renal damage caused by PNL such as age, sex, stone size, number of nephrostomy and course of PNL were detected when compared with increased or no change groups. In cases of complete staghorn calculi in the decreased renal uptake ratio group, compensatory hypertrophy of contralateral kidney PNL course might occur, and the function of the operated kidney might not have recovered. More during cases and longer follow-up is necessary for the recovery of renal function.

Studies on the stability of muroctasin and degradation products built under extreme conditions

Decomposition of N2-[(N-acetylmuramoyl)-L-alanyl-D-isoglutaminyl]-N6-stearoyl-L-lysine (MDP-Lys(L18), muroctasin) under extreme conditions was investigated. MDP-Lys(L18) in an aqueous solution was heated under reflux for 4 h to give the decomposition products D-1, D-2, D-3 and D-4. Reaction of MDP-Lys(L18) with 0.1N NaOH at room temperature for 5 h gave D-1, and that with 1 N HCl under reflux for 1 h afforded D-4. MDP-Lys(L18) was found to be stable to light and heat. MDP-Lys(L18) in a powder form was stored at room temperature or at 25 degrees C and 75% relative humidity for 3 days to 18 months. Quantitative analysis, thin-layer chromatography, and tests for appearance and color change, etc., were performed in the stored samples. MDP-Lys(L18) was found to be stable, but hygroscopic.

Neural control of canine colon motor function: studies in vitro

The responses of strips of the canine colon to stimulation of intrinsic nerves and to the probable mediators of these nerves were studied in vitro. Studies were carried out using longitudinal and circular muscle strips from proximal and distal colon with field stimulation and addition of agents to the bath. Overall, these and other studies in vivo suggested that acetylcholine was an ubiquitous mediator of neural excitation. Norepinephrine had mixed inhibitory and excitatory effects, the latter only in circular muscle. Inhibitory effects of norepinephrine seemed to be both pre- and post-synaptic but no evidence that it was released by field stimulation was obtained. Substance P had excitatory effects chiefly by release of acetylcholine. It, in addition to norepinephrine, at least in circular muscle, deserves evaluation as the mediator of noncholinergic excitation to high frequency field stimulation. Although vasoactive intestinal peptide sometimes had inhibitory effects, these were incomplete and inconsistent. However, further evaluation of its possible role as a nonadrenergic, noncholinergic inhibitory mediator is required to determine if it is involved as one component in the response. Few qualitative differences existed between responses of various regions of the colon to potential neuromediators, although there were some consistent differences between responses of longitudinal and circular muscle. Some differences existed in responses obtained earlier in vivo and in vitro. In particular, inhibitory effects following excitation by substance P on field stimulation were found only in vivo. Nonadrenergic, noncholinergic inhibitory responses to field stimulation were consistently present only in vitro. These differences have not been explained.

Neural control of canine colon motor function: studies in vivo

The responses of the circular muscle of canine colon to stimulation of intrinsic nerves and to the probable mediators of these nerves were studied in vivo. In vivo studies were carried out using close intra-arterial injections and local field stimulation of proximal, mid-, and distal colon while recording circumferential contractions. Our results suggest that acetylcholine is the major excitatory mediator, but another excitatory mediator could be released by high frequency field stimulation after atropine. Norepinephrine had mixed inhibitory and excitatory effects, but no evidence was obtained that it was released by field stimulation. Substance P had mainly excitatory effects partly by a mechanism involving nerves and partly by a direct effect on muscle; it in addition to norepinephrine deserves further evaluation as the mediator of noncholinergic excitation to high frequency field stimulation. There is no explanation of the inhibition it produced after initial excitation during field stimulation. Vasoactive intestinal peptide had inhibitory effects but these were incomplete and inconsistent. This may be related to our inability to demonstrate relaxation or inhibition to field stimulation after atropine. Further evaluation of the possible role of vasoactive intestinal peptide and other agents as nonadrenergic, noncholinergic inhibitory mediators is required.

[A case of retroperitoneal fibrosis]

We report a case of retroperitoneal fibrosis. A 75-year-old man complained of edema of bilateral lower limbs and lumbago. Blood urea nitrogen and serum creatinine were increased. Renal function was improved after he had bilateral percutaneous nephrostomies. Antegrade pyelography showed bilateral hydronephrosis, left ureteral obstruction and medial deviation with narrowing of the right ureter. CT revealed a soft tissue density surrounding the aorta, inferior vena cava and bilateral ureters in the retroperitoneal space. Inferior venocavagraphy displayed stenosis. Bilateral ureterolysis combined with omental sleeve plasty was performed. Post-operatively, the clinical course has continued to be good.

Distribution of nerves containing vasoactive intestinal polypeptide-like immunoreactivity in rats with congenital aganglionosis of the colon

The distribution of nerves containing vasoactive intestinal polypeptide-like immunoreactivity was examined immunohistochemically in whole-mount specimens of the colons of mutant rats, which completely lacked intramural nerve cells in the colon, and of their normal littermates. In the aganglionic colon, greatly diminished numbers of vasoactive intestinal polypeptide-like immunoreactive nerve fibers were found in the circular muscle layer, lamina propria of the mucosa, and in the submucosa. In the intermuscular space of the aganglionic colon, unlike the pattern of the normal Auerbach's plexus, vasoactive intestinal polypeptide-like immunoreactive nerve fibers were arranged in an irregular, coarse network. These findings suggest the existence of extrinsic nerves containing vasoactive intestinal polypeptide in the aganglionic colon of the hereditary aganglionic rat.

[A case of signet ring cell carcinoma of the urinary bladder]

A 60-year-old female complained of gross hematuria and urinary frequency on November 27th, 1982. Cystoscopic examination revealed papillary invasive tumor around the bladder neck and a transurethral biopsy showed signet ring cell carcinoma. Since there was no adenocarcinoma in any other organs, we diagnosed it as primary signet ring cell carcinoma of the urinary bladder. Total cystectomy with ileal conduit and post-operative irradiation were performed, but she died on May 13th, 1983. We summarize 16 cases of primary signet ring cell carcinoma of the urinary bladder including this case and discuss this rare condition.

[A case of Fournier's gangrene requiring extensive debridement including bilateral orchiectomy and amputation of the penis]

With the evolution of antibiotic agents, necrotizing fasciitis of the male genitalia first described by Fournier has become rare. However, its mortality rate is still high. We present a severe case of this disease. An 80-year-old man who had poor controlled diabetes mellitus was admitted to our hospital with painful swelling of penoscrotal region. Chemotherapy using broad-spectrum antibiotics and drainage of penis, scrotum and lower abdominal wall was performed combined with insulin therapy. Despite the drainage and aggressive chemotherapy with insulin therapy, the gangrene enlarged rapidly and the patient's general condition was getting very poor. Then, we performed extensive debridement including bilateral orchiectomy and amputation of the penis. After the operation, the patient became afebrile and his general condition was improved.

Surveys of workers occupationally exposed to PCBs and of yusho patients

Surveys of workers occupationally exposed to polychlorinated biphenyls (PCBs) in the production of thread or of paint, and of yusho patients were carried out from 1973 to 1982. PCB concentrations in the plasma of the workers ranged from 2 to 521 ppb, and some showed higher PCB levels in the plasma than typical Japanese yusho patients. Gas chromatographic patterns of plasma PCBs of the workers with high PCB levels were shown to match the patterns of the PCBs to which they had been exposed in the workplace. Japanese yusho children showed remarkable decrease with time, but no such decrease was observed in the yusho adults and the workers. Polychlorinated quaterphenyls (PCQs) were detected in the blood of typical Japanese and Taiwanese yusho patients, but PCQ levels in the plasma of the workers were below the detection limit of 0.02 ppb. Clinical findings and subjective complaints of the workers were usually slight compared with typical yusho patients, though some of them had mild dermal manifestations and their PCB levels were suspected to be related to serum triglyceride values. On the basis of these results, we discussed the relationship between the health status of the subjects and their contamination with PCBs or related compounds.

[Chemotherapy of disseminated germ cell testicular tumors with cis-diamminedichloroplatinum and other drugs]

The effect of single CDDP therapy and PVB therapy was examined in 7 cases of stage III germ cell testicular tumors with measurable metastases. The mean age of the patients was 30.6 years old, and their histological types of primary sites were seminoma in 3 cases, embryonal carcinoma in 2, immature teratoma in 1 case and embryonal carcinoma + teratoma in 1 case. In 1 case of seminoma, 375 mg of CDDP was administered. In 1 case of embryonal carcinoma + teratoma, 100 mg of CDDP and then 2 courses of PVB therapy were performed, and 3 courses of PVB therapy were given in all other cases. Three cases showed complete response, 2 cases partial response and 2 cases no change. Pulmonary metastatic nodules were extirpated after the PVB therapy in 1 of the cases showing no change, and the histological examination of these nodules was found to be mature teratoma. As a result, the effectiveness of the chemotherapy alone was 71.4%, and that of chemotherapy + surgical operation was 85.7%. Significance of intensive chemotherapy and necessity of extirpation of residual metastatic nodules after intensive chemotherapy in the management of advanced germ cell testicular tumors are stressed.

Coexistence of substance P- and methionine5-enkephalin-like immunoreactivity in nerve cells of the myenteric ganglia in the cat ileum

Intramural ganglia of colchicine-injected cat ileum were examined immunohistochemically using antisera to substance P (SP), vasoactive intestinal polypeptide (VIP) and methionine5-enkephalin (ENK). SP- and ENK-like immunoreactive nerve cells were preferentially located in the myenteric ganglia, whereas VIP-like immunoreactive nerve cells were distributed in both myenteric and submucous ganglia. A small number of nerve cells in the myenteric ganglia showed immunoreactivities to both ENK and SP antisera, but not to VIP antiserum. These findings provide supportive evidence for the coexistence of SP and ENK in a small population of neurones in the cat myenteric plexus.

[A case of testicular tumor with uncommon clinical course: testicular lesion that was initially not palpable led to a wrong diagnosis of huge retroperitoneal hematoma due to trauma]

A case of testicular tumor with uncommon clinical course is presented. Although the patient underwent abdominal trauma and was diagnosed as having retroperitoneal hematoma, a retroperitoneal bulky tumor was revealed at surgery. After that left orchiectomy was performed because the testicular swelling gradually developed. The retroperitoneal tumor was confirmed to be a secondary lesion metastasized from left testicular carcinoma.

The effects of substance P and met5-enkephalin in dog ileum

Substance P initiated tonic contraction of dog ileum when administered in doses from 1 pg to 20 micrograms intraarterially (ED50 = 67 ng). Low doses acted to excite cholinergic postganglionic neurones since atropine or tetrodotoxin (TTX) increased the ED50 of substance P about 25-fold, while hexamethonium and local field stimulation had only a small effect to increase the ED50. Also atropine and tetrodotoxin effects were not additive. Higher doses apparently acted to stimulate smooth muscle directly, but no evidence was obtained that local field stimulation could release substance P to act on smooth muscle. Substance P tachyphylaxis prevented substance P actions on cholinergic nerves, but it did not affect responses to intraaterial acetylcholine or block distal inhibition from proximal distention or field stimulation. Met-enkephalin given intraarterially, was also excitatory in doses from 1 ng to 20 micrograms; the amplitude of tonic and phasic contractions produced was significantly decreased by TTX and atropine but was not diminished by hexamethonium or substance P tachyphylaxis. Partial tachyphylaxis to met-enkephalin was produced but was not diminished by hexamethonium or substance P tachyphylaxis. Partial tachyphylaxis to met-enkephalin was produced without affecting the ED50 for substance P. We conclude that substance P acts in small amounts on receptors in myenteric nerves to release acetylcholine by a mechanism, presumably involving postganglionic cholinergic nerves, while met-enkephalin also apparently may act at least in part through a similar TTX- and atropine-sensitive mechanism. These peptides also caused activation of other receptors, probably on smooth muscle by noncholinergic. TTX-insensitive mechanisms. Also the receptors for each peptide which are located on nerves were distinct and independent since tachyphylaxis could be produced to each without affecting the response to the other.

Nonsteroidal antiinflammatory agents. 2. Derivatives/analogues of dibenz[b,e]oxepin-3-acetic acid

6,11-Dhydro-11-oxodibenz[b,e]oxepins and some related compounds have been synthesized and evaluated for antiinflammatory effect according to the carrageenan paw edema method in rats. The structure-activity relationships have been discussed among acetic acid, carboxylic acid, alcohol, and tetrazole derivatives of dibenzoxepins and acetic acid derivatives of thienobenzoxepins and of the corresponding thiepins. The 3-isopropyl alcohol 9 and 11-deoxo-3-propionic acid (49) were more active than indomethacin but not as active as the title compound (i.e., 43). Carboxylic acids, tetrazoles, esters, amides, and ketones were less active than the corresponding acetic acids. Three compounds (31, 33, and 34) were evaluated for ulcerogenicity and lethality but none surpassed 6,11-dihydro-11-oxodibenz[b,e]oxepin-3-acetic acid (41) in therapeutic ratio.

Is the nexus necessary for cell-to-cell coupling of smooth muscle?

Electronmicroscopic study of electrically coupled smooth muscles was undertaken to determine the distribution of nexuses in various types of smooth muscle. The study revealed that while nexal structures were commonplace in some types of smooth muscle, they were very rare or absent in others, even though in some cases these cells were only a few nanometers distant from one another. The persistence in thin section of these structures in the main circular muscle of dog intestine after poor fixation, fixation under strain, cell shrinkage, and metabolic damage of various sorts seems to rule out the thesis that they are labile. The absence of nexuses in longitudinal muscle of dog intestine examined both by thin section and by freeze fracture suggests that in this tissue they are absent or very rare in vivo and cannot account for electrical coupling. Nexuses were discernible in thin sections of main circular muscle after a variety of experimental conditions of fixation. Metabolic inhibition or in vitro permanganate fixation partially destroyed nexal contacts. These procedures induced tissue, membrane apposition and an accompanying increase in the number of structures which resemble nexuses at low magnification (nexus-like structures). "Nexus-like" structures occurred in all smooth muscle fixed by in vitro permanganate associated with apposition of membranes and poor preservation of basement membrane. A technique of in vitro permanganate fixation was developed which prevented tissue swelling; consequently "nexus-like" structures were absent in tissues so treated. The suggestion is made that some structures described in the literature as nexuses, following permanganate fixation, may represent "nexus-like" structures. The balance of evidence suggests that nexuses need not be present for electrical coupling of some smooth muscle cells, in which other types of cell-to-cell contacts must be invoked.