[Coexistence of cyst and tumor in the same kidney: a case report]

A case of renal cyst associated with renal tumor is presented herein. A 40-year-old male patient visited our outpatient clinic for left renal cyst which had been found by ultrasonography on routine clinical examination. CT scan demonstrated an irregular area in the cyst wall measuring about 2 cm in thickness which showed enhancement of density with contrast medium. Magnetic resonance imaging (MRI) also demonstrated a round mass with abnormal signal on the cyst wall, protruding into the cyst cavity. Transabdominal radical nephrectomy was performed on 13 July 1987, and to the resected kidney was attached a cyst measuring 7 cm in diameter in the lower pole. Grossly, the cyst contained amorphous red-brown material which turned out to be old blood clots and the wall harbored a tumor (3.0 x 2.5 cm). Histologically, the tumor was renal cell carcinoma, the surface of which was covered with necrotic tissue. The coexistence of renal cyst and tumor is rare and 62 cases were collected from the Japanese literature including our case, and discussion was made in relation to the etiological factors.

Effects of sex steroid hormones on sex-associated differences in the survival time of allogeneic skin grafts in rats. Evidence that testosterone enhances and estradiol reverses the immunosuppressive activity of cyclosporine

Three-week-old DA (RT1a) male and female rats were pretreated with either orchiectomy or ovariectomy and administration of the opposite-sex steroid hormones, estradiol or testosterone. Skin from same-sex AO (RT1a) rats was then grafted when these pretreated rats reached 14 weeks of age, with a short course of immunosuppressive treatment of cyclosporine. The survival times of the grafts were reversed in that the male recipients pretreated to be like females acutely rejected the graft within 10 days as do normal adult female recipients. On the other hand, the female recipients pretreated to be like males accepted the graft as do normal adult male recipients. In addition, the synergistic effects of either testosterone or estradiol with CsA on the survival time of the graft were examined. Testosterone successfully prolonged graft survival on normal adult female and young male recipients, but negligible prolongation was observed on young females. In contrast, estradiol abrogated the immunosuppressive activity of CsA and accelerated graft rejection in both male and female recipients.

[Skeletal muscle CT scan and ultrasound imaging in two siblings with central core disease]

The computed tomography (CT) and ultrasound (US) imaging studies were performed on skeletal muscles of two siblings (5-year-old boy and 10-year-old girl) with central core disease. The appearance of low-density areas in muscles was remarkable at the levels of the 3rd lumbar vertebra (L3), the midthigh and the thickest part of legs. The muscles at the levels of L3 and thigh were more severely affected than those of legs. Especially, paravertebral muscles, m. vastus, m. sartorius, m. gracilis tended to be more severely affected. The muscles of the legs except m. soleus were well preserved. US imaging of the thigh revealed a marked increase of echogenicity of rectus muscle as well as opaque, indistinct changes of fascia and bone. In contrast, the CT finding of the rectus muscle was relatively well preserved.

[Testicular endocrine function in patients with prostatic cancer receiving medical castration by long-term administration of LH-RH agonists]

Six patients with advanced prostatic cancer who had been treated by long-term administration of LH-RH agonistic preparations (Buserelin or Leupron) were tested for their pituitary-testicular endocrine functions. Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), prolactin (PRL), estradiol (E2) and dihydrotestosterone (DHT) were measured consecutively. In all medically castrated patients, serum levels of LH, FSH, T, DHT and E2 were suppressed and particularly serum T levels were below the castration level of 1.0 ng/ml. On the other hand, serum PRL levels were unchanged after the long-term treatment with the agonists. Serum LH and FSH levels failed to respond to LH-RH stimulation after the treatment, whereas serum T responded to stimulation by human chorionic gonadotropin (hCG) to various degrees. It was remarkable that, in 4 out of 6 medically castrated patients treated up to more than 3 years, serum T response levels above 1.0 ng/ml were noted. It is suggested that testicular endocrine function to secrete T and DHT in patients under treatment with long-term LH-RH agonist administration are still preserved in response to hCG stimulation.

Clinical and statistical evaluation of the occurrence of acute myocardial infarction in the cold inland area of Hokkaido

We made a clinical and statistical evaluation of the occurrence of acute myocardial infarction with respect to the relation between its occurrence and the meterology of the cold inland area of Hokkaido (the Kamikawa Basin) over a period of 10 years (1976-1985). A total of 581 cases were studied. Monthly fluctuation of incidence was not found to be statistically significant. A cold period in the Kamikawa Basin was defined in this study as the period when ordinary mean atmospheric temperatures were below 0 degree C (from 7 Nov. to 16 Apr.). Canonical discriminant analysis was applied to 10 meterological factors between the days with occurrences and those without occurrences (245 days vs 245 days) in the cold periods of the investigated 10 years, and between the days with outdoor occurrences and those without occurrences (37 days vs 37 days). In order to compare the regional difference, this analysis was done on the same 10 factors for the cold periods over 3 years in Yamagata (46 days vs 46 days). The F values of 0.0003, 0.0155 and 0.0098 respectively in the above 3 analyses were small (much less than F 1(9) (0.25) = 1.51). A circadian rhythm of 2 cycles/day was recognized concerning the time of occurrence by power spectral analysis of the data of 562 patients for whom the time of the onset of myocardial infarction was known. Subdividing the patients into 2 groups according to physical activity just before the occurrence, the group who experienced an occurrence at rest showed a rhythm of 1 cycle/day, and the group who experienced an occurrence on effort showed a rhythm of 2 cycles/day. Therefore, the 10 meterological factors could not discriminate the probabilities between the days with occurrences and the days without occurrences of myocardial infarction in the cold periods. On the other hand, it was suggested that biological intrinsic rhythm participates in triggering the occurrence of myocardial infarction.

[Two cases of miliary tuberculosis with SIADH]

Two cases of miliary tuberculosis with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) were reported. Case 1. A 70-year-old woman suffering from general fatigue and appetite loss developed neck stiffness and stupor three days after admission. The chest X-ray film showed a miliary pattern in both lungs. The lumber puncture showed high pressure and increased leucocytes in the cerebrospinal fluid. Serum natrium concentration was 113 mEq/L. Tubercle bacilli were seen in the broncho-alveolar lavage fluid by the Ziehl-Nielsen staining. An improvement in electrolytes balance was produced by 2.5% NaCl and antituberculous treatment, then her mental function recovered. Case 2. A 71-year-old man was admitted with gastric ulcer. When he developed dry cough thirty days after admission, the chest X-ray film showed a miliary pattern in both lungs. Acute respiratory failure advanced concomitantly. Tubercle bacilli were seen in the sputum (Gaffky 5) by the Ziehl-Nielsen staining. Antituberculous treatment was started. Although the miliary shadow improved gradually, hyponatremia was rather progressing. The following values for serum constituents were determined: sodium, 118 mEq/L; antidiuretic hormone, 10.3 pg/ml. Antituberculous treatment and supplement of NaCl (10 g/day) improved serum natrium level. He had no mental disturbance in his clinical course. In both cases, thyroid, renal and adrenal function were normal. Systemic edema and dehydration did not exist at the state of hyponatremia, and it was very clear that laboratory data were compatible with SIADH criteria. Miliary tuberculosis is one of the least commonly recognized causes of SIADH.

Sex-associated differences in the survival of skin grafts in rats. Enhancement of cyclosporine immunosuppression in male compared with female recipients

Focusing on sex-difference in prolongation of allograft survival time, we have performed skin grafts between fully allogeneic rat strains, AO (RT1u) and DA (RT1a) with an immunosuppressant, cyclosporine. Isografted skins survived indefinitely, whereas allografts were severely rejected at days 7-9 without immunosuppressive treatment. When adult male DA rats received CsA (15 mg/kg/day, i.m., for 14 days postoperatively), allogeneic skin was accepted from either male or female AO rats for 38.8 +/- 20.5 days (mean survival time [MST] +/- SD) and for 44.7 +/- 43.3 days (MST +/- SD), respectively, with normal hair growth at around day 17. Additional CsA administration every 5 days after the initial short course treatment was also effective in preventing chronic rejection. Male AO rat skin grafted onto adult male DA rats survived for over 50 days as long as the treatment was carried out. In contrast, when adult female DA rats were used as recipients, only a few days' prolongation was observed in comparison with a non-treated group. The rejection always occurred, even during the initial course of treatment (MST +/- SD): 10.9 +/- 1.6 days). Younger male DA recipients, 5 and 10 weeks old, rejected AO skin within a shorter time, depending on the age. The maximal graft survival was observed when male adult rats more than 14 weeks old were used as recipients. On the other hand, the CsA serum level of female recipients at day 14 was considerably lower than that of males. However, even when the level of females was adjusted to that of males by the administration of a double dosage (30 mg/kg/day), the female recipients consistently rejected the skins (MST +/- SD: 14.5 +/- 1.9 days). Therefore, these results clearly indicate that this male-associated immunosuppressive effect depends upon the sex and age of the recipient animals.

Sex differences in the prolongation of allogeneic skin graft survival in rats treated with cyclosporin A: effects of orchiectomy and pregnancy

As reported previously, only male rats were susceptible to immunosuppression by CsA in allogeneic skin grafts. We have further investigated the sex differences observed in the prolongation of skin allograft survival time, focusing on the role of sex-related organs. Adult male DA (RT1a) rats (14 weeks old), which had been preorchiectomized at 5 weeks old or just 2 days prior to the operation, had fully allogeneic skin grafts from male AO (RT1u) rats, followed by CsA treatment. A small but significant reduction of graft survival time was observed in the recipients orchiectomized when fully mature. On the other hand, adult rats preorchiectomized while immature (five weeks old), showed a graft survival time similar to that of the comparable sham-operated group. DA female rats with syngeneic or allogeneic pregnancies always rejected AO skin, even in the course of CsA treatment, without showing any differences in graft survival time compared with nonpregnant rats.

[A case of thymoma associated with prostatic cancer]

A case of prostatic cancer treated with an LH-RH analogue depo-preparation was found to have a mediastinal thymoma which was later removed by surgery. The association of thymoma and prostatic cancer has not been documented in the world literature, and it remains to be elucidated whether the occurrence of the both tumors is a coincidence or etiologically inter-related.

Clinical and virological observations on swine experimentally infected with Getah virus

The pathogenicity of Getah virus for swine was examined. All 8 pigs (4 adults and 4 piglets) inoculated with Strains MIP-99 and MI-110 developed pyrexia ranging from 39.4 to 40.7 degrees C and anorexia. Mild depression and diarrhea were observed in 2 of the 4 piglets. These clinical signs were transient. Viremia occurred 1-2 days post-inoculation (p.i.) and the maximum titer was 10(3.0) TCID50 0.1 ml-1. The virus was recovered from a piglet autopsied on Day 3 p.i. from spleen and various lymph nodes. The maximum titer of virus (10(3.75) TCID50 0.1 g-1) was detected in the inguinal lymph node. Seroconversion was demonstrated in all the pigs on Day 6 p.i. These results suggest that Getah virus is mildly pathogenic for swine, which may play a role as an amplifying host in nature.

Deaths in early phase of acute myocardial infarction and approaches for reducing the in-hospital and out-hospital case-fatality rates of the disease

Shiritsu Asahikawa Hospital received a total of 922 patients with acute myocardial infarction (AMI) from 1961 through 1985. The numbers of AMI patients and deaths during 1981-1985 were 2.8 times and 2.3 times, respectively, those observed during 1971-1975. However, decreasing trends were noted in the overall and age-adjusted mortality due to ischemic heart disease (IHD) per population of 100,000 Asahikawa residents between 1975 and 1984, suggesting a discrepancy between our CCU data and the city's records. We investigated the prehospital condition, out-of-hospital cardiac arrest, and the mechanism of early deaths in patients hospitalized with AMI. It was found that the increase of AMI patients admitted to our hospital was due to an increase in the hospitalization rate of AMI patients and the establishment of the coronary care unit (CCU) which allowed the admittance of patients who might have been declared dead out-of-hospital in the past. On the other hand, the declining trends in IHD mortality in the entire city of Asahikawa were attributable to reductions in the in-hospital and out-of-hospital fatality rates of patients with AMI, to improved hospital fatality rates of patients with AMI, and to improved survival rates in AMI patients who developed ventricular fibrillation (Vf) or who experienced out-of-hospital cardiac arrest episode. In order to further decrease the case-fatality rate of patients with AMI, it is essential to continuously educate residents on emergency treatment to be given at the onset of AMI.

[Smoldering adult T-cell leukemia complicating severe respiratory failure--an autopsy case report]

An autopsy case of smoldering adult T-cell leukemia (ATL) is presented. 67 year-old woman was admitted to our hospital with complaints of fever, cough and increasing dyspnea on October 2, 1985. Laboratory findings revealed high LDH, azothermia and slightly leukocytosis with low percentage of flower cells. CRP was strongly positive. Gas disturbance was markedly. Anti-ATLA antibody using indirect immunofluorescence method was X40 positive. Subsets of peripheral lymphocytes showed OKT 4 dominant. (OKT 3; 67.5%, OKT4; 60.6%, OKT8; 8.8%). A chest X-ray film revealed cardiomegaly and fine granular shadows in bilateral lower pulmonary fields. Diagnosis of interstitial pneumonitis was defined in transbronchial lung biopsy (TBLB) specimen. O2 therapy, steroid therapy added antibiotics were ineffective, respiratory failure and renal failure were progressive, she died by septic shock in 39th hospital days. In autopsy, no characteristic histological changes of ATL were found in lymph node, bone marrow, spleen, liver, kidney and lung. Sepsis was the cause was of death. Finally this case diagnosed smoldering ATL and pulmonary fibrosis due to bronchial ectasia with repeated pulmonary bacterial infections. The pulmonary complications of patients with ATL were discussed.

Left ventricular volume and ejection fraction response to exercise in chronic congestive heart failure: difference between dilated cardiomyopathy and previous myocardial infarction

To determine if cause influences the left ventricular (LV) volume and ejection fraction (EF) response to exercise, 24 patients with chronic congestive heart failure (CHF) (13 dilated cardiomyopathy [DC], CHF-DC group; 11 previous myocardial infarction [MI], CHF-MI group) and 6 age-matched control subjects underwent simultaneous hemodynamic monitoring and radionuclide ventriculography during semiupright bicycle exercise. Both CHF groups had similar hemodynamic values, LV volumes and EF at rest. Exercise hemodynamics were also similar, but LV volume and EF responses to exercise were different. In the CHF-DC group LV end-diastolic volume increased by 15% during exercise, significantly less (p less than 0.01) than the 44% increase in CHF-MI group. During exercise, EF increased in CHF-DC group, but did not change in CHF-MI group because of a larger increase in end-systolic volume. The slope of mean pulmonary wedge pressure-LV end-diastolic volume relation was steeper in CHF-DC group than in CHF-MI group (p less than 0.01). The study suggests that LV volume and EF response to exercise in patients with CHF depends on the origin of the CHF.

Effect of food ingestion on nifedipine absorption and haemodynamic response

The absorption of nifedipine (10 mg) and haemodynamic response were studied in 10 patients with myocardial infarction before (Phase A) and after (Phase B) a standardized breakfast. In Phase A, the peak nifedipine concentration (Cmax) and maximum haemodynamic changes were found 1 h after drug administration. In Phase B, the Cmax was lower than that in phase A (43 +/- 6 vs 136 +/- 23 ng/ml, p less than 0.001), and both Cmax and maximum haemodynamic changes were delayed to the fourth hour after administration. Nifedipine plasma concentration correlated significantly with the percent changes in systolic and diastolic blood pressure and heart rate. This study suggests that not only dose but also the time intervals between nifedipine administration and food intake are important in determining the haemodynamic effects.

Noninvasive assessment of acute effects of nifedipine on rest and exercise hemodynamics and cardiac function in patients with aortic regurgitation

The acute effects of nifedipine (20 mg sublingually) on hemodynamics and cardiac function were studied at rest and during supine bicycle exercise in 20 patients with aortic regurgitation. At rest, heart rate increased by 13%, systemic vascular resistance decreased by 34% and regurgitant index decreased by 17%. The change in systemic vascular resistance was related to its initial rest level (r = 0.82, p less than 0.001) and to the changes in forward cardiac output (r = 0.58, p less than 0.01) and regurgitant index (r = 0.60, p less than 0.01). Left ventricular end-diastolic and end-systolic volumes, stroke volume and ejection fraction were unchanged, whereas right ventricular ejection fraction increased. During exercise, nifedipine administration further increased heart rate by 8% and decreased systemic vascular resistance by 19%. Both forward stroke volume and forward cardiac output increased, but total left ventricular stroke volume was unchanged, resulting in a significant decrease in regurgitant index. Although left ventricular end-diastolic volume was slightly decreased, end-systolic volume did not increase; thus, ejection fraction was higher than that during control exercise (p less than 0.01). Right ventricular ejection fraction increased further. In aortic regurgitation, the acute administration of nifedipine improved cardiac performance and reduced regurgitation at rest and during exercise as a result of afterload reduction and increased heart rate. Whether these beneficial effects will occur during long-term therapy requires further investigation.

Abnormal left ventricular response to isometric exercise in pure, isolated aortic regurgitation: beneficial effects of nifedipine

To examine the effects of nifedipine on the left ventricular (LV) functional response to isometric exercise in patients with aortic regurgitation (AR), 20 patients with isolated, moderate to severe AR performed 3 minutes of handgrip exercise at 33% of their maximal voluntary contraction, before and after administration of 20 mg of sublingual nifedipine. Although handgrip exercise produced similar increases in heart rate and systolic blood pressure before and after nifedipine treatment, heart rate was higher and systolic blood pressure lower with handgrip exercise during nifedipine treatment. LV end-diastolic volume index was not different during the control period and nifedipine handgrip exercise, but the increase in end-systolic volume index was smaller and the ejection fraction was higher during nifedipine handgrip exercise. Nifedipine reduces afterload and ameliorates handgrip exercise-induced LV dysfunction in patients with AR.

The importance of early treatment of myocardial infarction and approaches for shortening delays in securing medical care

The present study was conducted on 597 patients with acute myocardial infarction (AMI) who were treated at the coronary care unit (CCU) of Asahikawa Municipal Hospital from January, 1971 to December, 1982. Among 202 patients who were hospitalized within 2 hours after the onset of AMI, 27 (13.4%) developed primary ventricular fibrillation (PVf), 14 patients before hospitalization. Of these 27 patients, 25 (92.6%) were successfully resuscitated and 12 (44.4%) were discharged alive. On the other hand, of 43 patients who were seen within 15 min after the onset of AMI, 11 (25.6%) were diagnosed as having PVf. We divided a series of 365 AMI patients who were seen from 1971 to 1980 into two groups: one group consisted of 178 patients seen within 6 hours after the onset of symptoms, and the other group of 187 patients seen after 6 hours after the onset. The incidence of heart failure with Killip's class 2,3 and 4 was less in the former group than the latter (p less than 0.01). Delays in providing prompt medical treatment appear to be due to the physicians' delayed response, transportation facilities as well as the patients themselves. Public education should help considerably in reducing the time period between the occurrence of symptoms and better medical care.

The alkaline phospholipase A1 of rat liver cytosol

1. Rat liver cytosol contains a heat-sensitive phospholipase A1 active against phosphatidylethanolamine, 1-acylglycerophosphoethanolamine and, to a very much lesser extent, phosphatidylcholine and phosphatidylinositol. 2. Activity towards a pure phosphatidylethanolamine substrate is invoked by the presence of water-soluble cations that do not precipitate at the pH optimum of the enzyme (9.5). In this activation bivalent cations, e.g. Mg2+, Ca2+, Mn2+, Sr2+ and Ba2+, are effective at much lower concentrations (2.5-5 mM) than univalent cations K+, Na+ and NH4+ (100 mM). 3. In the absence of such cations the enzyme can be activated by cationic amphiphiles containing quaternary nitrogen or by basic proteins. 4. It is concluded that these agents activate the enzyme by reducing the negative zeta potential on the substrate at the high pH optimum (9.5) and allow interaction with the enzyme whose isoelectric point is at 7.15. 5. The activated enzyme is markedly inhibited by mixing the phosphatidylethanolamine substrate with many other phospholipids that exist in cell membranes, e.g. phosphatidylcholine, phosphatidylinositol. On the other hand, both phosphatidylcholine and phosphatidylinositol can be hydrolysed much more readily if they are mixed with an excess of phosphatidylethanolamine. 6. Such results on the inhibition and substrate specificity of the enzyme, coupled with birefringence measurements, allow the tentative conclusion that phospholipid substrates are only attacked when they exist in a hexagonal or non-bilayer structure and not in the bilayer (lamellar) form.

Proteolytic activation can produce a phosphatidylinositol phosphodiesterase highly sensitive to Ca2+

The phosphatidylinositol phosphodiesterase of rat brain shows little activity under conditions likely to pertain in vivo (neutral pH and micromolar Ca(2+) concentrations). A short incubation of a brain supernatant with trypsin, or a longer pre-incubation of the supernatant alone, produce new forms of the enzyme, which are active under such conditions. A possible role of receptor-linked proteinases in initiating phosphatidylinositol catabolism is discussed.

The stimulation of the brain alkaline phospholipase A1 attacking phosphatidylethanolamine by various salts and metal chelators

Rat brain contains a soluble, high molecular weight phospholipase A1 of alkaline pH optimum which shows a preference for phosphatidylethanolamine as substrate. There is evidence that the same enzyme exists in liver and kidney. At low osmotic concentrations of buffer the enzyme is markedly stimulated by CaCl2. However, MgCl2 and MnCl2 are equally as effective although at concentrations above 2 mM the activation falls away with MnCl2. The phospholipase A1 is stimulated by divalent metal ion chelators (EDTA, EGTA, CDTA) and by sodium phosphate and sodium sulphate. The activity is inhibited by hexanol, benzyl alcohol, diethylether and detergents. Although the activity can be inhibited by saturated and unsaturated fatty acids, no evidence could be obtained that the activators function by counteracting the inhibitory action of fatty acids liberated at the interface of the substrate and incubation medium. It is suggested that to achieve good enzymic hydrolysis a certain type of organised hydrated phosphatidylethanolamine structure is required in which the negative zeta potential has been reduced by metallic cations in the incubation medium.

Heterogeneity of the calcium-dependent phosphatidylinositol phosphodiesterase in rat brain

1. The Ca(2+)-dependent phosphatidylinositol phosphodiesterase (phospholipase C-type) from the cytosolic supernatant of rat brain was active against exogenous [(32)P]-phosphatidylinositol from pH5.0 to pH8.5. However, the activity in the range pH7.0-8.5 could not be recovered after precipitation with (NH(4))(2)SO(4); most of the enzyme activity was recovered in the 30-50% fraction and showed a single sharp pH optimum at 5.5. 2. The cytosolic supernatant was analysed by isoelectric focusing on acrylamide gels, and assay at pH5.5. Four peaks of phosphodiesterase activity were found at pI ranges 7.4-7.2, 6.0-5.8, 4.8-4.4 and 4.2-3.8. 3. The cytosolic supernatant was also applied to a chromatofocusing column, and again assayed at pH5.5. Four peaks were eluted: minor, but consistent, activity at the beginning of the elution with a pI of near 7.2 or above; a second peak at pH6.0-5.85; a third broad peak with a wide range pH5.3-4.2; and a fourth peak, which was eluted by washing the column with 1m-NaCl, suggesting an isoenzyme with a pI below 4.0 (supported by the result of the isoelectric focusing). 4. If all the chromatofocusing fractions were assayed at pH7.0 or 8.0 (at 1mm-Ca(2+)), only a single sharp peak was detected, with a pI of 4.6-4.8. This peak disappeared on (NH(4))(2)SO(4) fractionation (30-50%) of the cytosolic supernatant, whereas the four peaks with activity at pH5.5 were virtually unaffected. 5. The four activities (assayed at pH5.5) separated by chromatofocusing produced inositol 1:2-cyclic monophosphate, inositol 1-monophosphate and diacylglycerol as enzymic products. 6. We conclude that the Ca(2+)-dependent phosphatidylinositol phosphodiesterase exhibits considerable heterogeneity, both with respect to pH optima of activity, and its isoelectric properties.

Hydrolysis of phosphatidylinositol by pancreas and pancreatic secretion

1. The secretion from sheep pancreas and a supernatant fraction prepared from the gland contained an EDTA-insensitive acid phospholipase A1 which readily deacylated phosphatidylinositol (pH optimum, 5.3), 1-acylglycerophosphoinositol and phosphatidic acid, but had limited action of phosphatidylcholine and phosphatidylethanolamine even with deoxycholate present. The enzyme was not a triacylglycerol lipase. 2. The action of the phospholipase A1 on phosphatidylinositol was inhibited effectively by Ca2+ and Mg2+, probably by interaction of these ions with the substrate. 3. In the presence of calcium the decomposition of phosphatidylinositol and lysophosphatidylinositol by the supernatant fraction was overwhelmingly by phosphodiesterase action (EC 3.1.4.10), producing inositol monophosphate and its cyclic derivative. Its pH optimum was about 6.0 but with considerable activity extending to pH 8.5. 4. The phosphodiesterase was not secreted in the pancreatic juice.

The catabolism of phosphatidylinisitol by an EDTA-insensitive phospholipase A1 and calcium-dependent phosphatidylinositol phosphodiesterase in rat brain

1. A rat brain supernatant and microsomal fraction contained a phospholipase A1 enzyme which hydrolysed phosphatidylinositol at pH 8 in the absence of calcium. Triolein and phosphatidylcholine were not attacked under the same incubation conditions. 2. No evidence could be obtained for a phospholipase A2 in the microsomal preparation, and in the presence of Ca2+ the release of fatty acid observed was due to phosphatidylinositol phosphodiesterase followed by diacylglycerol lipase action. 3. Brain phosphatidylinositol phosphodiesterase showed extensive activity in the alkaline range (7-8.5) as well as at pH 5-5.5. The activity at higher pH values required higher calcium concentrations and disappeared on purification of the soluble enzyme by ammonium sulphate fractionation. 4. In general the ratio between inositol 1,2-(cyclic)phosphate and inositol 1-phosphate produced by phosphodiesterase action decreased with increasing pH.

The inhibitory effect of chlorhexidine digluconate on dental plaque formation. A scanning and transmission electron microscope study

The purpose of this study was to determine the effect of chlorhexidine digluconate mouthrinses on the development of dental plaque in man. The dental plaques were formed on strips of triacetylcellulose film (TAC), which were attached to the lingual surfaces of the mandibular incisors by silk suture thread on 20 human volunteers. Differences in the degree of plaque formation on TAC films after 2, 4 and 24 hours were observed in placebo vs. chlorhexidine treated samples using both scanning and transmission electron microscopy. It was found that (1) solutions containing chlorhexidine digluconate and lactic aluminum have an inhibitory effect of the development of dental plaque on the TAC film as evaluated by electron microscopy, (2) the TAC film was a convenient model for the study of early dental plaque formation by electron microscopy, (3) the three types of pellicle reported by Tryggve Lie (1977) were also observed, (4) the method enabled evaluation of the bacterial accumulation of TAC films. After 2 hours, there was no visible difference in the bacterial accumulations on placebo or chlorhexidine treated films. After 4 and 24 hours considerable differences were observed.

The hydrolysis of phosphatidylinositol monolayers at an air/water interface by the calcium-ion-dependent phosphatidylinositol phosphodiesterase of pig brain

1. The activity of Ca2+-dependent phosphatidylinositol phosphodiesterase (EC 3.1.4.10) of pig brain against [32P]phosphatidylinositol monolayers at an air/water interface has been measured. As the monolayer pressure was increased a sharp cut-off of enzymic hydrolysis occurred at 33 X 10(-3) N/m. 2. The addition of either phosphatidic acid, phosphatidylglycerol or oleyl alcohol increased the film pressure at which cut off occurred, as well as increasing the rate of hydrolysis at lower pressures. 3. The rate of hydrolysis, but not the cut-off pressure, was markedly increased by oleic acid and slightly increased by phosphatidylethanolamine. 4. Phosphatidylcholine, palmitoylcholine and octadecylamine decreased the cut-off pressure, as well as the enzymic activity below this pressure. 5. Stearic acid and stearyl alcohol had no effect on either the cut-off pressure or the activity. 6. All activators decreased the length of the lag phase before enzyme activity began, and phosphatidylcholine increased it. 7. These results are compared with the stimulatory and inhibitory effects of various amphiphiles observed previously with phosphatidylinositol dispersions [Irvine, Hemington & Dawson (1979) Eur. J. Biochem. 99, 525-530], and their possible relevance to the control of the phosphatidylinositol phosphodiesterase in vivo are discussed.

Gastric sarcoidosis in Japan

Seventeen cases of gastric sarcoidosis have been reported in Japanese literature. Age distribution was from the 3rd decade (6 cases) to the 6th decade (3 cases) and the sex ratio was 2 females to 1 male. Preoperative diagnosis included 10 cases of gastric carcinoma and 6 cases of gastric ulcer. Sites of the granulomas were limited to the mucous membrane in 4 cases, from serosa to the mucous membrane in 9 cases and from the muscle layer to the mucous membrane in 1 case. As there are granulomas in the mucous membrane in all cases, it appears that granulomas may spread from the mucous membrane to outside and they can possibly be detected by biopsy. There were no BHL in any chest X-ray. Kveim test was positive in only 2 out of 11 cases. Prognosis is very good. There has been a question whether the gastric granuloma is a local or a generalized manifestation. From our findings, we will report in detail, it may not be a local reaction, but a gastric manifestation of generalized sarcoidosis.