Functional localization of pain perception in the human brain studied by PET

To elucidate the functional localization and somatotopic organization of pain perception in the human cerebral cortex, we studied the regional cerebral blood flow using positron emission tomography during selective painful stimulation in six normal subjects. Response to a painful stimulus was elicited using a special CO2 laser, which selectively activates nociceptive receptors, to the hand and foot. Multiple brain areas, including bilateral secondary somatosensory cortices (SII) and insula, and the frontal lobe and thalamus contralateral to the stimulus side, were found to be involved in the response to painful stimulation. While our data indicate that the bilateral SII play an important role in pain perception, they also indicate that there is no pain-related somatotopic organization in the human SII or insula.

Studies of polymorphic DNA fingerprinting and lipid pattern of Mycobacterium tuberculosis patient isolates in Japan

Strain differentiation by DNA restriction fragment length polymorphism (RFLP) has been used mainly for the epidemiological purpose of Mycobacterium tuberculosis infection. In this study, we tried to connect the molecular and phenotypic characteristics of M. tuberculosis patient isolates by comparing the DNA fingerprints obtained by RFLP using IS6110 and lipid patterns using two-dimensional thin-layer chromatography (2-D TLC) with silica gel, since M. tuberculosis has a lipid-rich cell envelope which contributes to the virulence and immunomodulatory properties. We found that 66 isolates of M. tuberculosis from tuberculosis patients showed that the occurrence of IS6110 varied from 1 to 24 copies. The IS6110 patterns were highly variable among isolates. Fifty different RFLP patterns were observed, and 12 RFLP patterns were shared by two or more strains. By computerized analysis of the RFLP patterns of M. tuberculosis patient isolates, we found that 95% of the isolates fell into seven clusters, from A to G, with at least two isolates in each (> 30% similarity). Among the cellular lipids, the phospholipid composition did not differ by strain, whereas the glycolipid pattern differed markedly. Especially, the relative concentration of cord factor and sulfolipid, both of which were known as virulent factors, varied by strain. The fingerprints of some strains showed an association between the DNA and glycolipid patterns, even though some of the same DNA fingerprint strains showed differences in lipid patterns. Among the patient isolates, M. tuberculosis strain 249 possessed a specific glycolipid with 2-O-methyl-L-rhamnose and L-rhamnose, which is rarely found in other strains. This glycolipid showed serological activity against the sera of tuberculosis patients, even if the reactivity was not as strong as trehalose dimycolate. It also showed the inhibition of phagosome-lysosome fusion in macrophages, suggesting involvement with virulence. These results suggest that RFLP analysis using IS6110 is useful for clustering the human isolates of M. tuberculosis, however, for further strain differentiation on virulence, a lipid analysis provides more information.

Ten-year follow-up of intraocular pressure after phacoemulsification and aspiration with intraocular lens implantation performed by the same surgeon

We evaluated the pre- and postoperative intraocular pressure (IOP) levels of 498 patients, to determine whether IOPs are affected over a 10-year period. All surgeries were performed by the same surgeon using phacoemulsification and aspiration (PEA) with posterior chamber intraocular lens (PCIOL) implantation. The mean preoperative IOP was 12.2 +/- 4.0 mm Hg, and the mean postoperative IOPs were not affected for 10 years. However, when the preoperative IOP was over 20 mm Hg, a significant decrease was achieved without glaucoma surgery. When the preoperative IOP was under 10 mm Hg, the IOP significantly increased. PEA with implantation of a PCIOL provides an excellent chance for improved intraocular tension control, providing that the surgery is properly performed.

Rounded atelectasis formation following decrease of pleural effusion: a case report

We present a case of rounded atelectasis (RA) observed continuously following decrease of pleural effusion. The collapsed right lower lobe adjacent to pleural effusion changed its shape from wedge-shaped consolidation with air-bronchogram to oval and flat formation at last. The vessels and bronchi curving into RA were detected by CT and we called it horizontal comettail sign. When a mass is detected following decrease of pleural effusion and vessels and bronchi are curving into the mass, the mass may be diagnosed as RA and no further examination may be necessary.

Quinazoline derivatives suppress nitric oxide production by macrophages through inhibition of NOS II gene expression

We have found three novel quinazolidine derivatives which inhibit the formation of nitrite dose-dependently in a murine macrophage cell line, RAW264.7. The decreased nitrite formation was due not to the inhibition of nitric oxide synthase activity but to suppression of NOS II mRNA and protein expression. In rat vascular smooth muscle cells (VSMC), however, these compounds rather enhanced NOS II mRNA. These compounds also prevented LPS-stimulated heme oxygenase-1 (HO-1) and cyclooxygenase-2 (COX-2) gene expression in RAW264.7 cells, but again not in VSMC. The three quinazolidine derivatives specifically inhibit gene expression of NOS II, HO-1 and COX-2 only in macrophage cells, indicating that they are selective inhibitors of inducible gene expression in macrophages.

Regionally different elevation of intracellular free calcium in hippocampus of septic rat brain

The effect of sepsis on cellular calcium homeostasis in the central nervous system (CNS) was investigated using hippocampal slices of rats in which sepsis was induced by cecal ligation and puncture (CLP). Hippocampal slices were prepared from septic or sham-operated rats at 24 h after abdominal surgery. The basal intracellular calcium ([Ca2+]i) and its response to oxygen-glucose deprivation in hippocampal slices were measured for assessing cellular calcium homeostasis using fura-2 fluorescent imaging technique. The levels of [Ca2+]i were estimated by the fluorescence ratio (R340/380). Twenty-four hours after CLP, spontaneous movement was reduced and plasma lactate was increased in the septic rats in comparison with the sham-operated rats in which laparotomy was performed without CLP. Basal level of R340/380 in the CA4 ara (.72 +/- .07) was significantly higher (p < .001) in the septic group than that in the sham-operated group (.55 +/- (.06). The fluorescence ratio of septic vs. sham-operated in other hippocampal regions were .55 +/- .09 vs. .48 +/- .06 in CA1 (not significant) and .65 +/- .10 vs. .59 +/- .08 (not significant) in CA3, respectively. Increase in [Ca2+]i due to oxygen-glucose deprivation was significant in CA1 and CA3 of the septic group and in all hippocampal regions of sham-operated group. However, it was not significantly increased in CA4 of the septic group. These results suggest that regional deregulation of cellular calcium occurs in the CNS following CLP. Cellular calcium deregulation may be one of the pathogeneses occurred in clinically observed septic encephalopathy.

Relationship between induction of macrophage chemotactic factors and formation of granulomas caused by mycoloyl glycolipids from Rhodococcus ruber (Nocardia rubra)

Mycoloyl glycolipids cause granulomas in the lungs, liver, and spleen of mice, but the mechanism is not fully understood. To understand the role of macrophage chemotactic factors (MCFs) in granuloma formation, we prepared various mycoloyl glycolipids with different carbohydrate moieties: trehalose dimycolate (TDM), glucose mycolate (GM), mannose mycolate (MM), and fructose mycolate (FM) from Rhodococcus ruber, and examined the relationship between their MCF induction in peritoneal macrophages and the extent of granuloma formation. The molecular mass of each glycolipid was confirmed by fast-atom-bombardment mass-spectrometry. TDM or GM caused granulomas in the lungs, spleen, and liver of ICR mice, but MM and FM did not. The culture supernatant of peritoneal macrophages stimulated with TDM or GM increased macrophage migration, whereas MM and FM had no chemotactic activity. The activity of interleukin-1 (IL-1) in the supernatant was increased equally by each glycolipid and was therefore not related to chemotaxis. Tumor necrosis factor-alpha (TNF-alpha) and granulocyte-macrophage colony-stimulating factor (GM-CSF) were not detected in the four supernatants. The TDM-induced MCF was heat-stable, trypsin-labile, and undialyzable. Furthermore, we separated two MCF active fractions from the supernatant of TDM-stimulated macrophages by gel filtration. These factors acted on macrophages but not on neutrophils. Our results suggested that macrophages recognize the sugar moieties of mycoloyl glycolipids and may, in response, generate a MCF that may play an important role in the macrophage or monocyte recruitment which is essential prior to granuloma formation.

The effects of halothane on arginine-vasopressin-induced Ca2+ mobilization from the intracellular stores and the receptor-mediated Ca2+ entry from the extracellular space in single cultured smooth muscle cells of rat aorta

Halothane has a direct action on vascular smooth muscle cells and causes relaxation of these cells, yet neither the mechanism nor the site of its action is completely understood. Using digital imaging microscopy with the Ca2+ indicator fura-2, the effects of halothane on the intracellular [Ca2+] dynamics induced by arginine vasopressin (AVP) in the perinuclear region and cytosol in single cultured smooth muscle cells of rat aorta were studied. Changes in intracellular [Ca2+] were expressed as percent increases in the ratios of fluorescence intensity at 500 nm excited by 340 nm and 380 nm. AVP (10(-7) M) elicited an initial transient increase in [Ca2+] in the perinuclear region higher than that in the cytosol in Ca(2+)-containing solution (346% +/- 21% and 213% +/- 22%, respectively). Halothane, 0.5%, attenuated the [Ca2+] increase induced by AVP in the perinuclear region and cytosol, and halothane, 1.0% and 2.0%, abolished the differential increase. Under the continuous application of AVP (10(-7) M), Ca2+ restoration in the medium after perfusion with Ca(2+)-free solution increased the perinuclear [Ca2+] more than the cytosolic [Ca2+]. Both were significantly attenuated by 2.0% halothane, but not by nicardipine (10(-5) M) or ryanodine (10(-6) M). Our results suggest that halothane may attenuate the Ca2+ release from the intracellular Ca2+ stores more than the receptor-mediated Ca2+ entry from the extracellular space in the AVP-induced response in these cells.

Thy-1-mediated phosphatidylinositol turnover in cultured rat glomerular mesangial cell

Thy-1 glycoprotein is expressed in rat glomerular mesangial cells, and anti-Thy-1 nephritis induced by anti-Thy-1 antibodies is a model of human renal diseases. In this study, we examined Thy-1-mediated biological reactions in cultured rat glomerular mesangial cells utilizing two anti-Thy-1 monoclonal antibodies (mAbs), 1-22-3 and OX-7. Incubation of the cells with these mAbs resulted in increased inositol trisphosphate (IP3) levels. The rise in IP3 produced by mAb 1-22-3 was greater than that produced by mAb OX-7 at the same dose. Incubation of mesangial cells with these mAbs resulted in an increase in the intracellular free calcium concentration ([Ca2+]i). mAb 1-22-3 induced a sustained increase in [Ca2+]i, while that induced by mAb OX-7 lasted 1-2 min, then decreased to the basal level. An transient increase in [Ca2+]i was also observed in Ca(2+)-free medium, indicating that these [Ca2+]i increases are due to release of Ca2+ from internal stores by IP3 without calcium flux across cell membrane. When cells were pretreated with protein tyrosine kinase (PTK) inhibitors (herbimycin A or genistein), Thy-1-mediated increases in [Ca2+]i were inhibited. These data suggest that Thy-1 induces the production of IP3 (including inositol 1,4,5-triphosphate, an intracellular Ca(2+)-releasing factor) and that PTKs may contribute to the Thy-1-mediated elevation of [Ca2+]i which presumably results from phospholipase C activation following Thy-1-mediated signaling in rat mesangial cells.

Radiologic manifestation of spinal accessory neurinoma: a case report

Spinal accessory nerve neurinoma is very rare; only 12 cases have been reported in the literature. We describe a 54-year-old woman who had a cisterna magna tumor expanding extracranially to the C1 cervical body. The tumor originated from the spinal root of the right accessory nerve. The radiological features including CT, MRI, and angiography are discussed. There have been reports on cranial MRI studies of spinal accessory neurinoma. MRI suggested an extra-axial tumor. The histological diagnosis was mixed Antoni A and B neurinoma. The neuroradiological findings of 12 cases of neurinoma of the accessory nerve reported in the literature are reviewed.

Tachyphylaxis to furosemide in isolated airways of guinea pigs

This in vitro study was conducted to determine whether tachyphylaxis of guinea pig airway to furosemide occurs under conditions that produce tachyphylaxis to the beta 2-adrenoceptor agonist, salbutamol. Isometric tension was measured in tracheal rings bathed in HEPES buffer from 4-6 d newborn guinea pigs of either sex, and 6 wk old males. Paired rings were first incubated with furosemide, 30 or 300 microM, or control for 60 min, washed, then constricted with 3 microM acetylcholine. At stable contraction, relaxation to furosemide (30 microM-1 mM) was measured. For comparison, similar experiments were performed with 10 microM salbutamol incubation for 30 min. 86Rb uptake, a marker for K+ transport and Na-K-Cl cotransport activity, was also measured in these airway segments. Pre-exposure to these airway relaxants did not affect contractile force generation by acetylcholine. Tracheal desensitization to both salbutamol and furosemide was observed. Partial recovery of furosemide induced relaxation was seen one hour after desensitization. Pre-exposure to 300 microM furosemide did not inhibit the decrease in 86Rb uptake normally observed with furosemide. In summary, we found that: 1) tachyphylaxis of guinea pig airway relaxation occurred with both salbutamol and furosemide under similar experimental conditions; however 2) inhibition of 86Rb uptake by furosemide was not affected by prior exposure. Taken together, these results suggest that furosemide induced airway relaxation could be affected by repeated or prolonged exposure, but this response may not be associated with changes in furosemide-sensitive Na-K-Cl cotransporter activity.

Pain-related somatosensory evoked potentials can quantitatively evaluate hypalgesia in Wallenberg's syndrome

In 6 patients with Wallenberg's syndrome who showed a dissociated loss of pain sense, we recorded pain-related somatosensory evoked potentials following CO2 laser stimulation of the hand dorsum (pain SEPs). Two components, N2 and P2, were recorded by stimulation of the unaffected hand, whereas on the affected side they were absent or decreased in proportion to the severity of hypalgesia which was evaluated by both needle test and CO2 laser stimulation. Latency of either component, if appeared, was longer in the affected hand stimulation than that in the unaffected one. In contrast, N20 of the conventional electrically-stimulated SEPs (electric SEPs) showed no difference between the two sides. It is concluded that, unlike other electrophysiological methods, pain SEPs following CO2 laser stimulation can quantitatively evaluate functional impairment of the spinothalamic tract in Wallenberg's syndrome.

Septal structure of incomplete interlobar fissures of the lung

RATIONALE AND OBJECTIVES

Some septal structures have been observed in the areas of incomplete interlobar fissures (IIFs) in resected lungs. We describe the anatomy of IIFs with or without the presence of septal structures.

METHODS

Twenty fused areas from 16 autopsy cases were examined histologically. Other septal structures outside the areas of IIFs also were examined.

RESULTS

In 10 of the 20 fused areas, there was a mixture of septal structures with and without defects. In the remaining 10, there were no septal structures. The septal structures consisted of two inner layers from both lobes. Other septal structures examined were the same as ones observed in the IIFs.

CONCLUSION

Linear shadows seen at interlobar fissures and on computed tomography scans do not necessarily depict the presence of complete interlobar fissures. The absence of linear shadows does not necessarily imply the absence of septal structures.

Transvenous embolization of high flow carotid cavernous fistula: a case report

We treated a patient with a high flow traumatic carotid-cavernous fistula (CCF) by embolization using detachable balloons and metallic coils, by transarterial and transvenous approaches. The patient was a 20-year-old woman who had fractures in the skull base from a traffic accident. She was admitted to our hospital one month after the accident due to exophthalmos, chemosis, and periorbital bruit. Cerebral angiograms demonstrated left traumatic CCF and steal phenomenon of blood flow. Balloon embolization by transarterial approach performed three times was unsuccessful, probably because of balloon puncture due to bone fragments. Embolization using metalic coils via the superior ophthalmic vein route was then attempted. As a result of this approach, complete obliteration of CCF was obtained, and clinical symptoms subsided within a few days. Treatment of CCF by transvenous approach is one alternative when transarterial occlusion is difficult.

Pain-related and cognitive components of somatosensory evoked potentials following CO2 laser stimulation in man

We recorded cortical potentials evoked by painful CO2 laser stimulation (pain SEP) employing an oddball paradigm in an effort to demonstrate event-related potentials (ERP) associated with pain. In 12 healthy subjects, frequent (standard) pain stimuli (probability 0.8) were delivered to one side of the dorsum of the left hand while rare (target) pain stimuli (probability 0.2) were delivered to the other side of the same hand. Subjects were instructed to perform either a mental count or button press in response to the target stimuli. Two early components (N2 and P2) of the pain SEP demonstrated a Cz maximal distribution, and showed no difference in latency, amplitude or scalp topography between the oddball conditions or between response tasks. In addition, another positive component (P3) following the P2 was recorded maximally at Pz only in response to the target stimuli with a peak latency of 593 msec for the count task and 560 msec for the button press task. Its scalp topography was the same as that for electric and auditory P3. The longer latency of pain P3 can be explained not only by its slower impulse conduction but also by the effects of task difficulty in the oddball paradigm employing the pain stimulus compared with electric and auditory stimulus paradigms. It is concluded that the P3 for the pain modality is mainly related to a cognitive process and corresponds to the P3 of electric and auditory evoked responses, whereas both N2 and P2 are mainly pain-related components.

Effect of a nitric oxide synthase inhibitor, S-ethylisothiourea, on cultured cells and cardiovascular functions of normal and lipopolysaccharide-treated rabbits

Nitric oxide (NO) is synthesized from L-arginine by three isoforms of NO synthase (NOS). It is essential to suppress the function of the inducible isoform (macNOS) for amelioration of some inflammatory diseases in which the cytotoxic effect of NO is involved. S-Ethylsiothiourea (S-EIU) was reported to be a potent and specific inhibitor of macNOS. We also confirmed that it rather specifically inhibited the activity of the purified macNOS and the formation of nitrite by RAW264.7 cells compared to NG-monomethyl-L-arginine (L-NMA) and NG-nitro-L-arginine (L-NNA), the other isoforms being less effective. S-EIU suppressed the release of nitrite and lactate dehydrogenase from rat vascular smooth muscle cells treated with interleukin-1 beta and forskolin more potently than L-NMA or L-NNA. S-EIU also slightly suppressed internucleosomal DNA cleavage in pancreatic beta-cells induced by NO produced by macNOS. Intravenous administration of either S-EIU at 0.1 mg/kg/min or L-NMA at 1 mg/kg/min increased the blood pressure but decreased the heart rate in normal rabbits, while aminoguanidine at 1 mg/kg/min affected neither cardiovascular function. These inhibitors at these doses caused recovery of the blood pressure in lipopolysaccharide-treated rabbits that exhibited lowered blood pressure similar to that in the case of septic shock. Although S-EIU seemed not to be an adequate inhibitor for therapeutic use in vivo due to its side effects on cardiovascular functions, it is one of the most potent inhibitors of macNOS among reported inhibitors in vitro.

Cerebral vasospastic vessels: histologic changes after percutaneous transluminal angioplasty

PURPOSE

To investigate histologic changes before and after percutaneous transluminal angioplasty (PTA) in experimental cerebral vasospasm in comparison with normal vessels.

MATERIALS AND METHODS

In seven monkeys, vasospasm was induced in the subarachnoid space. After 7 days, PTA was performed. Microscopic studies were performed in vasospastic vessels. In two animals, vasospasm was induced but angioplasty was not performed. The controls were two animals without vasospasm who underwent only contralateral angioplasty.

RESULTS

Angiography after vasospasm revealed marked narrowing but dilatation after PTA, without changes in distal spastic vessels. Specimens after PTA showed platelets that covered denuded endothelium, stretching, and focal dehiscence of internal elastic lamina and altered myocytes in media. Myocytes were deformed and arranged irregularly. These changes were not uniform.

CONCLUSION

The prolonged effect of PTA may be caused by mechanical damage of myocytes and the nonuniformity of histologic changes in vascular walls.

Relationship between tissue ischemia and venous endothelin-1 during abdominal aortic aneurysm surgery

OBJECTIVES

Several substances may be released from ischemic tissues with the declamping shock that occurs during abdominal aortic aneurysm surgery. To clarify the relationship between tissue ischemia and venous endothelin-1 (ET-1) level in humans, plasma ET-1 and oxygen content in the iliac vein were measured before anesthesia, after the induction of anesthesia, after the release of the proximal and first distal clamps, after the release of the second distal clamp, and 1 hour after the second clamping.

DESIGN

Prospective study.

SETTING

A University hospital.

PARTICIPANTS

Seven patients who underwent abdominal aneurysmectomy and replacement with bifurcated graft.

INTERVENTIONS

A 20G catheter was inserted into the radial artery for the direct measurement of blood pressure and for collecting arterial blood. An 18G, 20-cm catheter was inserted into the femoral vein for collecting venous blood from the lower extremities.

MEASUREMENTS AND MAIN RESULTS

The arterial and venous ET-1 levels did not change after the induction of anesthesia. Immediately after the initial release of the proximal and distal clamps, venous oxygen content dramatically decreased from 11.3 to 3.6 mL/dL (vol%) with significant increases in venous ET-1 concentration from 2.3 to 4.9 pg/mL. Concomitant with the decrease in venous oxygen content, venous plasma pH and base excess decreased with increase in PCO2, suggesting that ischemic changes in tissues distal to the cross-clamp may occur during aortic clamping. Venous ET-1 levels were significantly correlated with venous oxygen content, pH, PO2, oxygen saturation, base excess, blood sodium concentration, and potassium concentration. One hour after the second declamping, the venous ET-1 level remained high in comparison with the preanesthetic level, whereas the venous oxygen content returned to the preanesthetic level. There was no correlation between venous plasma ET-1 and venous plasma norepinephrine or epinephrine concentration.

CONCLUSIONS

Tissue ischemia may increase venous ET-1 levels in humans. Factor(s) other than tissue ischemia may provoke the increase in venous ET-1 that occurs after the release of the second distal clamp.

[Two patients who recovered fully from profound circulatory and respiratory failure after cardiac arrest]

Two patients who were both 62-year-old males, also with various complications fully recovered from profound circulatory and respiratory failure. Both patients had experienced cardiac arrest one week or three months previously. Ischemic insult of brain produced from the prior cardiac arrest may be related to these excellent outcomes, because induction of tolerance to brain ischemia was demonstrated in animals which had undergone prior sublethal brain ischemia.

[Relationship between vibratory sense threshold and blood lead concentration in ceramic color workers and transfer printing manufacturers]

We measured vibratory sense thresholds (VSTs) at 63Hz and 125Hz on the third fingertip of the right hand and on the third toe of the right foot of 74 male workers. The subjects were workers engaged in manufacturing ceramic color and transfer printing paper, whose blood lead (Pb-B) levels were 2-58 micrograms/dl. They were divided into three groups according to the Pb-B levels, namely, below 9, 10-19, and 20 micrograms/dl or more. For statistical analysis, simple and partial correlations, and Scheffé's multiple comparison between the least squares means were used. The VSTs on the fingertip as well as on the toe showed a significant correlation with age. The VSTs at 125Hz on the fingertip were also significantly correlated with alcohol consumption and cigarette smoking. Controlling for age, systolic blood pressure, alcohol consumption and smoking habit, a significant dose-effect relationship was observed between the VSTs at not only 63Hz but at 125Hz on the fingertip, and each of the corresponding Pb-B levels. A similar tendency was also observed at the two frequencies on the toe. The measurement of VSTs was considered to be an effective screening test for sensory nerve disorders caused by lead poisoning.

Geographical distribution of genes for resistance to formae speciales of Erysiphe graminis in common wheat

The geographical distribution of Pm10, Pm11, Pm14, and Pm15 wheat genes for resistance to inappropriate formae speciales of Erysiphe graminis was investigated using gene-for-gene relationships. Pm10 and Pm15 were very common among many indigenous accessions of common wheat collected from various areas in the world. The diversity of genotypes, which consisted of allelic combination at those loci, was high near the center of origin of common wheat and decreased with increasing distance from the center. In Europe, an apparent contrast of predominant genotypes occurred between the south and the north, suggesting that these genes are useful markers for revealing the routes by which common wheat spread in Europe. On a whole, the genes for resistance to inappropriate formae speciales were observed to be widely distributed throughout the world. We suggest that the difference between these genes and the genes for resistance to races of an appropriate forma specialis may only be in their distribution and that of their corresponding avirulence genes.

Properties of intracellular calcium stores and their role in receptor-mediated catecholamine secretion in rat adrenal chromaffin cells

Simulation of rat adrenal chromaffin cells either with receptor agonists such as muscarine, bradykinin and histamine or with caffeine in Ca(2+)-free Krebs solution induced a brief increase in the intracellular free Ca2+ concentration, [Ca2+]i, which terminated within 90 s. Both the agonist- and caffeine-induced [Ca2+]i responses were abolished in cells which had been treated with either 500 nM thapsigargin (TG) or 20 microM ryanodine, suggesting that inositol trisphosphate and caffeine cause Ca2+ release either from the same Ca2+ store or from distinct stores which exchange Ca2+ rapidly. In normal Krebs solution, these agonists evoked catecholamine (CA) secretion which showed an initial transient followed by a sustained component. Neither component of the secretion was significantly affected by TG or ryanodine. In the medium containing 16 microM Ca2+ or no Ca2+, CA secretion evoked by 30-second stimulation with 100 microM muscarine was 59 or 7%, respectively, of that evoked in the normal medium containing 2 mM Ca2+. In TG-treated cells, the CA secretion at 16 microM Ca2+ was reduced to 23% and that in the Ca(2+)-free medium was completely abolished. These results suggest that the receptor-mediated Ca2+ entry solely determines the rate of CA secretion in rat chromaffin cells when stimulated by receptor agonists in the normal medium, whereas intracellular Ca2+ release and Ca2+ entry may cooperatively support the secretion when cells are stimulated in media containing low concentrations of Ca2+.

Pain-related somatosensory evoked potentials following CO2 laser stimulation of foot in man

Since our previous study of pain somatosensory evoked potentials (SEPs) following CO2 laser stimulation of the hand dorsum could not clarify whether the early cortical component N1 was generated from the primary somatosensory cortex (SI) or the secondary somatosensory cortex (SII) or both, the scalp topography of SEPs following CO2 laser stimulation of the foot dorsum was studied in 10 normal subjects and was compared with that of the hand pain SEPs and the conventional SEPs following electrical stimulation of the posterior tibial nerve recorded in 8 and 6 of the 10 subjects, respectively. Three components (N1, N2 and P2) were recorded for both foot and hand pain SEPs. N1 of the foot pain SEPs was maximal at the midline electrodes (Cz or CPz) in all data where that potential was recognized, but the potential field distribution was variable among subjects and even between two sides within the same subject. N1 of the hand pain SEPs was maximal at the contralateral central or midtemporal electrode. The scalp distribution of N2 and P2, however, was not different between the foot and hand pain SEPs. The mean peak latency of N1 following stimulation of foot and hand was found to be 191 msec and 150 msec, respectively, but there was no significant difference in the interpeak latency of N1-N2 between foot and hand stimulation. It is therefore concluded that N1 of the foot pain SEPs is generated mainly from the foot area of SI. The variable scalp distribution of the N1 component of the foot pain SEPs is likely due to an anatomical variability among subjects and even between sides.

Prior mechanical injury inhibits rise in intracellular Ca2+ concentration by oxygen-glucose deprivation in mouse hippocampal slices

Prior mechanical brain microinjury has been found to have a preventive effect on brain ischemia. To investigate the mechanism responsible for this, the effect of mechanical brain injury on changes in intracellular free Ca2+ concentration ([Ca2+]i) in response to ischemic insult was studied in mouse hippocampal slices. The mechanical injury was made by inserting a 25G hypodermic needle into the CA1 region of the hippocampus in mice anesthetized with pentobarbital. Sagittal slices of the hippocampus were prepared two hours, and 1, 3, 7, and 14 days after the brain injury. Changes in [Ca2+]i in the slices by oxygen-glucose deprivation were analyzed from fluorescence images, using fura-2. Increases in [Ca2+]i induced by oxygen-glucose deprivation were inhibited in the vicinity of the injury 1 and 3 days after injury. [Ca2+]i levels were lower in the posterior side from the injury than in the anterior side 1 and 3 days after injury. No significant regional differences in [Ca2+]i responses were found 2 h or 7 and 14 days after the injury. Membrane potential and membrane resistance of CA1 neurons in the vicinity of the injury measured 1 day after the injury were not significantly altered in comparison with non-injured slices. These results indicate that mechanical brain injury inhibits ischemic [Ca2+]i increase. This inhibition may be induced not only by damage of the presynaptic fibers projecting to the CA1 neurons but also by the other certain factor(s) that prevent [Ca2+]i increase, and it appears to be related to the protective effect of prior mechanical injury against ischemic neuronal damage.

Stabilization and rational design of serine protease AprM under highly alkaline and high-temperature conditions

Rational shift of the optimum pH toward alkalinity and enhancement of thermostability were investigated by using a thermostable extremely alkaline protease (optimum pH, 12 to 13) from the alkaliphilic and thermophilic Bacillus sp. strain B18'. The protease gene (aprM) was cloned, and the sequence analysis revealed an open reading frame of 361 amino acids that was composed of a putative signal sequence (24 amino acids), a prosequence (69 amino acids), and a mature enzyme (268 amino acids) (molecular weight, 27,664). The amino acid sequence of this protease was compared with those of other serine proteases. A direct correlation of higher optimum pH with an increase in the number of arginine residues was observed. An even more thermostable mutant enzyme was created by introducing a point mutation. When the position of the beta-turn, Thr-203, was replaced by Pro, the residual activity of this mutant enzyme at 80 degrees C for 30 min was higher than that of the wild-type enzyme (50% versus 10%). The specific activity of this mutant enzyme at 70 degrees C was 105% of that of the wild-type enzyme under nondenaturation condition. These data suggest that the higher content of Arg residues favors the alkalinity of the serine protease and that introduction of a Pro residue into the beta-turn structure stabilizes the enzyme.

Differential regional effects of ketamine on spontaneous and glutamate-induced activities of single CNS neurones in rats

Ketamine and L-glutamate were applied microiontophoretically to neurones of several central nervous system (CNS) structures in urethane anaesthetized Wistar rats. The spontaneous single-unit activities of all the hippocampal CA1 and CA3 neurones were suppressed by ketamine in an iontophoretic current-dependent manner. The spontaneous single-unit activities of eight of nine neurones in the thalamus were not affected by ketamine and suppressed in one. Spontaneous neurone activities in the midbrain reticular formation were not significantly affected by ketamine. Spontaneous activities of the cerebellar Purkinje cell were suppressed by ketamine in four of eight neurones. L-Glutamate excited all 13 hippocampal and nine thalamic neurones in a current-dependent manner. L-Glutamate-induced excitation of all CA1, CA3 and thalamic neurones was inhibited by ketamine. The inhibitory effects of ketamine on L-glutamate-induced excitation were dependent on the injection current intensity, although the sensitivity of thalamic neurones to the injection current was approximately three times that of hippocampal neurones. We conclude that the effects of ketamine on spontaneous activities of neurones vary according to the brain region, probably because of the distribution of NMDA receptors. Moreover, the actions of the drug on NMDA receptors appear to differ between the hippocampus and thalamus. These regionally differential actions of ketamine may reflect characteristics of anaesthesia induced by this drug.

Erb's point stimulation produces slow positive potentials in the human lumbar spinal cord

Evoked spinal cord potentials (SCPs) were recorded from the posterior epidural space (PES) at the cervical and lumbrosacral enlargements in response to electrical stimulation of the brachial plexus at Erb's point in 17 chronic pain patients. Erb's point stimulation produced slow positive potentials (heterosegmental slow positive potentials, HSPs) in the PES at the lumbrosacral enlargement in all 13 subjects without spinal cord lesions but not in 4 subjects with spinal cord lesions. The HSP1 with a central peak latency of 21 +/- 2 ms (mean +/- SE) was recorded at the stimulus intensity up to two to three times the threshold strength (T) of the initially positive spike (P1) of the segmental SCP, which was simultaneously recorded from the PES at the cervical enlargement. At the stimulus intensity of more than 3T, another slow positive potential (HSP2) with central peak latency of 71 +/- 6 ms was recorded. These slow positive potentials (HSP1 and HSP2) might be produced by a feedback loop via supraspinal structures, presumably primary afferent depolarizations, in comparison to the HSPs of our previous studies in the rat. Slow negative potentials were sometimes noted before (5 of 13) and/or after (2 of 13) the HSP1. These slow negative potentials probably reflect the activities of dorsal horn neurons producing the HSP1 and HSP2, respectively, also elicited by a feedback loop via supraspinal structures.

Characterization of low pH-induced catecholamine secretion in the rat adrenal medulla

Catecholamine (CA) secretion was evoked when the isolated rat adrenal gland was perfused with HEPES-buffered Krebs solution acidified by the addition of HCl or by gassing with 95% O2/5% CO2. The secretion was detectable at pH 7.0 and increased with decreasing pH until at approximately 6.4. The low pH-induced CA secretion consisted of two phases, an initial transient response followed by a sustained phase. An intracellular Ca2+ antagonist, 3,4,5-trimethoxybenzoic acid 8-(N,N-diethylamino)octyl ester, selectively inhibited the initial phase of secretion. Both of the responses were resistant to nifedipine, a blocker of voltage-gated Ca2+ channel, but were completely inhibited in Ca(2+)-free (1 mM EGTA containing) solution. Adrenaline was an exclusive component in CAs released by low pH. The time course and extent of intracellular acidification caused either by low pH in the external medium or by the offset of a transitory NH4Cl application had no correlation with those of the secretory responses in the corresponding period. These results suggest that extracellular acidification preferentially activates adrenaline secretive cells to evoke CA secretion and that this low pH-induced CA secretion may be mediated by dihydropyridine-insensitive Ca2+ influx. Furthermore, the initial transient phase of the low pH-induced CA secretion might be caused by a Ca2+ release from intracellular stores, which is also induced by the Ca2+ influx.

Hypoxia modifies the vasodilatory effects of nitroglycerin, prostaglandin E1, and hydralazine on isolated porcine coronary arteries

To evaluate the potency of vasodilatory drugs in hypoxia, we studied the effects of nitroglycerin (NTG), prostaglandin E1 (PGE1), and hydralazine on porcine coronary artery constricted with endothelin-1 (ET-1) in both oxygenated and hypoxic conditions. Removal of endothelium potentiated NTG-induced relaxation in oxygenated conditions. Hypoxia potentiated relaxation of endothelium-intact arteries induced by NTG, but not relaxation of endothelium-denuded arteries. These findings suggest that hypoxia may modify endothelial function in NTG-induced relaxation. The relaxation of endothelium-intact and -denuded arteries induced by PGE1 in hypoxia was significantly greater than that in the oxygenated condition. PGE1 significantly increased the content of cyclic AMP in the hypoxic condition; it was much greater than that in the oxygenated condition, suggesting that hypoxia may enhance PGE1-induced relaxation by increasing cyclic AMP levels. Hypoxia attenuated hydralazine-induced relaxation in both endothelium-intact and denuded arteries. Indomethacin and aspirin attenuated hydralazine-induced relaxation in the oxygenated condition, suggesting that cyclooxygenase-related eicosanoid(s) may be involved in hydralazine-induced relaxation. However, indomethacin did not alter relaxation of hypoxic arteries induced by hydralazine. These findings suggest that hypoxia may inactivate cyclooxygenase in hydralazine-induced relaxation. Hypoxia may greatly modify the action of vasodilators on porcine coronary smooth muscle.

[The effect of PTA on cerebral vessels in experimental vasospasm: a histopathological study]

Although the percutaneous transluminal angioplasty (PTA) is an useful procedure for the treatment of symptomatic vasospasm after subarachnoid hemorrhage, the morphological changes in spastic intracranial vessels after PTA are not yet clear. The purpose of this study was to evaluate the effects of PTA angiographically and histologically. Chronic cerebral vasospasm was induced by producing a blood clot in the subarachnoid space around the top of internal carotid siphon in Japanese monkey. After angiographic recognition of vasospasm, PTA was carried out with silicone microballoon at 1 atmosphere, 3 times for 10 seconds. Angiography after PTA disclosed significant dilatation at the site of PTA, without any significant dilatation of distal spastic vessels. Papaverine hydrochloride was then infused intra-arterially, which resulted in significant dilatation of distal spastic vessels. Upon histological examination, deformation and some denudation of endothelial cells were noted in the intimal layer. At the site of denudation, attachment of platelets was observed despite generalized heparinization. Internal elastic lamina and the media were also stretched and myocytes were deformed and arranged irregularly. These changes were not uniform all over the vascular walls. We conclude that the prolonged effect of PTA may be caused by mechanical damage of endothelial cells and myocytes, and the nonuniformity of histological changes in vascular wall may be a leading cause of its rupture during PTA.

Mild acidosis inhibits the rise in intracellular Ca2+ concentration in response to oxygen-glucose deprivation in rat hippocampal slices

Changes in the intracellular Ca2+ concentration ([Ca2+]i) induced by ischemia in vitro (oxygen-glucose deprivation) were continuously recorded using fura-2-loaded hippocampal slices under normal (pH 7.4), acidotic (pH 6.8) and alkalotic (pH 7.8) conditions. Oxygen-glucose deprivation induced an initial slow and a subsequent characteristic rapid increase in [Ca2+]i in most of the normal and alkalotic preparations regardless of whether or not Ca2+ was present in the bathing solutions. This characteristic rapid increase in [Ca2+]i was observed in a minority of the acidotic preparations and its latency was significantly longer in acidotic preparations than in normal and alkalotic preparations. The rise in [Ca2+]i at 10 min of oxygen-glucose deprivation was significantly smaller in the acidotic preparations than in the normal and alkalotic preparations, regardless of whether or not Ca2+ was present. At 15 min, the differences in the increase in [Ca2+]i between normal and acidotic preparations in Ca(2+)-containing solutions (2.5 mM) were insignificant. However, significant differences were still observed between the acidotic preparations and either the normal or alkalotic preparations under Ca(2+)-free conditions. These results suggest that acidosis inhibits the ischemia-induced rise in [Ca2+]i by attenuating both Ca2+ influx from the extracellular space and Ca2+ release from intracellular sites.

Against-the-rule astigmatism judged at one week after phacoemulsification and aspiration procedures

To determine the characteristics of astigmatism 1 week postoperatively or whether the final astigmatism is predictable from that present 1 week postoperatively, we analyzed 544 postcataract against-the-rule (AR) cases of astigmatism among 1,649 standard phacoemulsification cataract operations, all utilizing 10-0 Mersilene in double-running fashion. Postoperative AR astigmatism < or = 1.0 dpt increased markedly 1 week postoperatively (2.72 +/- 0.09 dpt) but decreased 6 months postoperatively. However, in postoperative AR astigmatism > 2.0 dpt, the increase 1 week postoperatively was not as great (2.16 +/- 0.13 dpt) but tended to continue to increase even 6 months postoperatively, with a flatter corneal curvature being the responsible factor. Eyes with less astigmatism 1 week postoperatively showed exacerbation of final astigmatism 6 months postoperatively. This course was different from that of small incision cataract surgery.

Morphological changes during survival, cellular transformation, and calcification of the embryonic mouse: Meckel's cartilage transplanted into heterotopic sites

Meckel's cartilages obtained from 18-day-old embryonic mice were transplanted into heterotopic sites to examine their site-specific effects on cellular modification, calcification, and long-term survival. The explants were isografted into the liver, subcutaneous tissue, anterior chamber of the eye, kidney, peritoneal cavity, and intrafemoral muscle of mouse for up to 2 weeks. In addition, Meckel's cartilages were wrapped in a Nucleopore filter and transplanted into the spleen. Grafted Meckel's cartilages were observed by light and electron microscopy, including application of von Kossa's reaction and osmium-potassium ferrocyanide fixation. It was demonstrated by von Kossa's reaction that when Meckel's cartilage was grafted in liver parenchyma, initial calcification appeared on the territorial matrix as spotted deposits. The chondrocytes gradually transformed into small ovoidal cells and showed a morphology closely resembling that of osteocytes. Transplants in the kidney subcapsular site contained active surviving chondrocytes, and subcutaneously grafted Meckel's cartilage revealed three types of chondrocytes: nonhypertrophic and calcification-inducing hypertrophic chondrocytes, as well as cells showing osteocytelike phenotypes. Intraocular and Nucleopore filter-wrapped explants showed degenerative changes, and peritoneal-cavity transplants showed cellular hypertrophy, but calcified precipites were not observed. The present investigation demonstrated that in blood-rich tissues Meckel's cartilage showed long-term survival and could modulate calcified precipitation. Thus, this adaptation of Meckel's cartilage to the environment of various heterotopic sites suggests that it has the ability to induce calcification.

Reduction of intraocular pressure after phacoemulsification and aspiration with intraocular lens implantation

We prospectively evaluated the pre- and postoperative intraocular pressures (IOP) of 1,118 cataract patients. All surgical procedures were performed by the same skilled surgeon using the same method of phacoemulsification and aspiration with intraocular lens implantation. The mean +/- SE preoperative IOP was 13.29 +/- 0.12 mm Hg, while the mean IOP values were 10.87 +/- 0.12, 9.94 +/- 0.09, and 10.43 +/- 0.14 mm Hg 1, 3, and 6 months, respectively, after surgery. When the preoperative IOP was in the low 20 s, a decrease of approximately 40% was achieved. The present study shows that the IOP decreased postoperatively to a greater extent than previously considered, and the rate of decrease was dependent on the initial measurement.

Stafne's bone cavity. Classification based on outline and content determined by computed tomography

Fifteen cases (16 concavities) of the so-called "Stafne's bone cavity" were investigated with the use of computed tomography. The sizes, bony outlines, and contents were analyzed on axial images. In all cases, computed tomography clearly demonstrated the concavities on the lingual surface of the mandible. There were no empty concavities. The bony outlines and contents were divided into three types. The concavities with a portion of submandibular gland as a content were larger than those with other contents. Four of six concavities not extending to the buccal cortical plate were filled solely with fat tissue, whereas all concavities with expansion of the buccal cortical plate contained submandibular gland.

Purification and properties of the highly thermostable alkaline protease from an alkaliphilic and thermophilic Bacillus sp

Thermostable alkaline protease from an alkaliphilic thermophile Bacillus sp. B18' was purified by using DEAE- and CM-Toyopearl 650M column chromatographies. Molecular weights of the enzyme determined by SDS-PAGE and gel filtration were 30,000 and 28,000, respectively. The optimum pH and temperature toward the hydrolysis of casein were pH 12-13 and 85 degrees C, both of which are higher than those of a mesophilic alkaline protease from an alkaliphile, Bacillus sp. B21-2. The enzyme was stable at pH 5.0-12.0 and about 60% of the initial enzymatic activity was retained after a 60 min incubation period at pH 10.0 and 70 degrees C. Thermostability of the enzyme was enhanced by Ca2+. The enzyme activity was inhibited by DFP, suggesting that the enzyme is a serine protease. The NH2-terminal amino acid is Gln, which is that of many subtilisin-type proteases. The 20 residues of the NH2-terminal amino acid sequence have a comparative high homology with those of other alkaline proteases from alkaliphiles (40-50%), especially thermostable alkaline protease from Bacillus sp. No. AH-101 (95%) and Thermoactinomyces sp. HS682 (95%).

Arginine vasopressin increases perinuclear [Ca2+] in single cultured vascular smooth muscle cells of rat aorta

The effects of arginine vasopressin (AVP, 10(-7) M) on the spatial dynamics of intracellular [Ca2+] in single cultured smooth muscle cells of the rat aorta were studied by digital imaging microscopy using the fluorescent Ca2+ indicator fura-2. The nuclear and cytosolic regions were distinguished by the fluorescent image excited at 380 nm. Changes in intracellular [Ca2+] were expressed as percent increases in the ratios of fluorescence intensity at 500 nm excited by 340 and 380 nm. AVP increased the nuclear and cytosolic [Ca2+] in Ca(2+)-containing (control) (285 +/- 27 and 172 +/- 22%, respectively) or Ca(2+)-free (203 +/- 26 and 121 +/- 15%, respectively) solutions. However, caffeine (20 mM) and ryanodine (20 microM) greatly attenuated the [Ca2+] increase induced by AVP in both regions (61 +/- 21 and 42 +/- 15%, respectively). On the ratio image, the nuclear region was discriminated from other regions at the peak response to AVP in preparations treated with caffeine and ryanodine, whereas the outline of the nuclear region was indistinct in untreated preparations. The finding implies that caffeine- and ryanodine-responsive Ca2+ storage sites may exist in the region surrounding the nucleus. The results suggest that the region surrounding the nucleus may be one of the important Ca2+ storage sites with regard to the responses of rat aortic smooth muscle cells to AVP.

Management of intractable pain with percutaneous epidural spinal cord stimulation: differences in pain-relieving effects among diseases and sites of pain

This study is a survey of the overall clinical results achieved with our pain treatment method, percutaneous epidural low-frequency (1.6-8.0 Hz) spinal cord stimulation. It examines the relationship between the effectiveness of epidural spinal cord stimulation (ESCS) and diseases or sites of pain. Continuous indwelling of the catheter electrodes in the posterior epidural space ranged from 3 to 67 days, and the duration of percutaneous ESCS varied from less than 1 wk to more than 1 yr. Complete pain relief (100%) was achieved during stimulation in 11.5% of the patients (52 of 454). Complete (100%) to partial (more than 30%) pain relief occurred in 71.1% of the patients. In six (1.3%) patients pain was aggravated by stimulation. Analgesics and/or sedatives were discontinued completely after treatment in 52 patients (11.5%) and reduced in 263 patients (57.9%). The number of patients who rated pain relief better than 50% was significantly more in carcinoma/sarcoma and causalgia (P < 0.001), and significantly less in postherpetic neuralgia and thromboangitis obliterans/arterial sclerosis obliterans (P < 0.001) than the average in all diseases. There was a significantly high responsiveness to ESCS in female patients in comparison to male patients (P < 0.05). Pain in the head/face, neck/upper extremities, and trunk responded more to ESCS than pain in the lower extremities. Alleviation of pain by ESCS was lower when the verbal pain score was high. There were no major complications in percutaneous ESCS. Thus, we have demonstrated that pain-alleviating effects of ESCS varies significantly by disease and site of pain, and that this simple percutaneous method can be used for a relatively long period.

Characterization of two novel pyruvylated glycosphingolipids containing 2'-aminoethylphosphoryl(-->6)-galactose from the nervous system of Aplysia kurodai

Two novel acidic glycosphingolipids containing pyruvylated galactose were purified from the nervous tissue of Aplysia kurodai by successive Iatrobeads column chromatographies. By component analysis, sugar analysis, permethylation studies, fast atom bombardment-mass spectrometry, and proton magnetic resonance spectrometry, the structures of these acidic glycosphingolipids, named F-9 and FGL-I, were determined to be: [3,4-O-(S-1-carboxyethylidene)]Gal beta 1-->3 GalNAc alpha 1-->3[6'-O-(2-aminoethylphosphonyl)Gal alpha 1-->2] (2-aminoethylphosphoryl 1-->6)Gal beta 1-->4Glc beta 1-->1ceramide and [3,4-O-(S-1-carboxyethylidene)] Gal beta 1-->3GalNAc alpha 1-->3(Fuc alpha 1-->2)(2-aminoethylphosphonyl-->6 Gal beta 1-->4Glc beta 1-->1ceramide, octadeca-4-sphingenine and anteisononadeca-4-sphingenine. Thus, pyruvylated glycosphingolipids containing phosphoethanolamine in addition to or in place of 2-aminoethylphosphonate are present in the nervous system of Aplysia.

Effects of pentobarbital on heterosegmentally activated dorsal root depolarization in the rat. Investigation by sucrose-gap technique in vivo

Slow positive cord dorsum (P-) potentials activated by segmental stimulation are believed to reflect primary afferent depolarizations and have been shown to be augmented by barbiturates. However, there have been no data to confirm whether heterosegmentally activated P-potentials also represent primary afferent depolarizations and are similarly affected by barbiturates. We therefore tested whether heterosegmental P-potentials reflect primary afferent depolarizations and how these heterosegmental potentials are affected by barbiturates. Heterosegmentally activated dorsal root (DR) depolarizations (depolarizations evoked in DRs of lumbar segments in response to afferent volleys to cervical segments produced by electrical stimulation of the forepaw) and P-potentials were simultaneously recorded, adapting the sucrose-gap technique for recording DR depolarization in vivo in the rat. Forepaw (heterosegmental) stimulations produced a large depolarization in the DRs of L5-S1 as well as a slow P-potential in the lumbosacral enlargement. Transection of the spinal cord at the level of C1-C2 abolished both the P-potential and DR depolarization activated by heterosegmental stimulation as well as the second component of segmentally (hind-paw) activated P-potential. Bicuculline (100 micrograms/kg, intravenous) augmented the P-potential and DR depolarization produced by heterosegmental stimulation, but larger doses, 400-600 micrograms/kg, eventually suppressed these. However, the drug, in a dose-dependent manner, suppressed both the P-potential and DR depolarization produced by the segmental stimulation. Pentobarbital (10-40 mg/kg, intravenous) suppressed in a dose-dependent manner both the heterosegmental P-potential and heterosegmental DR depolarization and prolonged their peak latencies. By contrast, pentobarbital augmented and prolonged the segmental P-potential and segmental DR depolarization.(ABSTRACT TRUNCATED AT 250 WORDS)