Morphine analgesia and the bulbospinal noradrenergic system: increase in the concentration of normetanephrine in the spinal cord of the rat caused by analgesics

1 Administration of an analgesic dose (10 mg/kg, s.c.) of morphine increased the concentration of a noradrenaline metabolite, normetanephrine (NM) in the spinal cord of normal rats. The time course of the change in the NM concentration corresponded approximately to that of the morphine analgesia. The concentration of noradrenaline was not affected.2 A similar effect on the NM concentration was also observed after the administration of pentazocine (30 mg/kg, s.c.) and nalorphine (20 mg/kg, s.c.).3 The NM increasing effect of morphine, pentazocine and nalorphine was found in the dorsal half of the spinal cord but not in the ventral half.4 The increase in the concentration of NM induced by morphine, pentazocine or nalorphine was completely suppressed by naloxone (1 mg/kg, s.c.) given 5 min before the administration of these drugs.5 When the spinal cord was transected at C1, the NM increasing effect of morphine disappeared, yet when the brain stem was transected at the inter-collicular level, the effect remained.6 In morphine-tolerant rats, the concentration of NM in the spinal cord was almost the same as that observed in normal rats, but the increase in the concentration of NM in the spinal cord after the acute administration of morphine did not take place.7 The NM concentration in the spinal cord of normal rats was not modified by aminopyrine (75 mg/kg, s.c.), chlorpromazine (10 mg/kg, s.c.), mephenesin (100 mg/kg, i.p.) or naloxone (25 mg/kg, s.c.).8 The possible relation between morphine analgesia and the descending noradrenergic neurones in the spinal cord of rats is discussed.

Morphologic alterations in sheep after implantation of the Akutsu total artificial heart

The present report describes morphologic alterations produced in sheep after implantation of a four-chambered total artificial heart. Two groups of sheep were studied. The first group was given no special antishock therapy and had an average survival time of 25.8 hours. Major morphologic changes produced in the first group were focal infarction and massive hemorrhage of the large and small bowel, ascites, severely altered lungs and multiple infarcts in the kidneys. The second group of sheep was given antishock therapy and showed an average survival time of 35.4 hours. Severe morphologic alterations in this group were generally absent in all organs except the lungs, which showed varying degrees of congestion, hemorrhage, edema, pneumonitis and atelectasis. Death in both of the above groups was due to development of irreversible hypotension and respiratory failure.

Effect of morphine on the cerebral contents of metabolites of dopamine in normal and tolerant mice: its possible relation to analgesic action

1. The administration of an analgesic dose (10 mg/kg, s.c.) of morphine increased the concentrations of the dopamine metabolites, 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) in the brains of normal mice, and the time course of the change in the DOPAC concentration corresponded approximately to that of morphine analgesia. The increase in the concentration of the DOPAC induced by morphine (20 mg/kg, s.c.) was completely suppressed by nalorphine (2 mg/kg, s.c.) given 5 min after the morphine administration.2. In morphine-tolerant mice the concentrations of DOPAC and HVA in the brain did not differ from those observed in normal mice, and the increase in the concentrations of DOPAC and HVA in brain after the acute administration of morphine no longer occurred.3. Nalorphine (2 mg/kg) given alone did not cause any change in brain DOPAC and HVA concentrations in normal mice.4. The morphine-induced increase in DOPAC and HVA concentrations in the brain are discussed in the light of the hypothesis that dopamine might participate not only in the extrapyramidal motor system but also in the sensory mechanisms of the brain.

Renal homotransplantation in pediatric patients

Fifty-seven patients were treated with renal homotransplantation from 1½ to 7⅔ years ago; 23 patients were 12 years or younger and the other 34 patients were 13 to 18. Family members (usually parents) were the primary donors in 45 cases. Unrelated volunteers or cadavers donated the other 12 homografts. Immunosuppression was with azathioprine and prednisone, and in some cases also with ALG. Forty-two of the 57 recipients survived for at least 1 year. Additional deaths occurred at 17½ and 19 months leaving 40 recipients (70.2%) alive. Six survivors had successful retransplantation following late failure of their original homografts. Control of rejection was not particularly different than in adult cases. “Homograft glomerulonephritis” was found in chronically tolerated transplants, but no more frequently than in older patients. Many postoperative problems in the pediatric age group were the consequence of retardation of growth caused either by pre-existing uremia or by the need for high dose postoperative steroid therapy, orthopedic accidents such as femoral and vertebral fractures, and psychiatric complications which led to two suicides. In spite of these difficulties, the meaningful rehabilitation that was obtained in the chronic survivors makes us regard pediatric patients as favorable candidates for therapy with renal transplantation.