Positive chronotropic and inotropic effects of higenamine and its enhancing action on the aconitine-induced tachyarrhythmia in isolated murine atria

Aconitine and higenamine are the components of aconite root. We investigated the cardiac effects of these compounds on murine right and left atria and the interaction of higenamine with aconitine on the rate of spontaneously beating right atria. Higenamine increased the rate (EC50 = 38 nM) and the force of contraction (EC50 = 97 nM), the maximal responses being comparable with those of isoproterenol. The positive chronotropic effect of higenamine was antagonized by propranolol (30-300 nM) and practolol (10 nM-3 microM), but not by butoxamine (1 microM), indicating that it was a beta 1-adrenoceptor-mediated action. The positive chronotropic effect of higenamine was not changed by pretreatment with reserpine (4 mg/kg, i.p., 4 hr). Aconitine (0.16-0.25 microM) induced tachyarrhythmia in right atria was attenuated by quinidine (1 microM), atropine (8.6 microM) and AF-DX 116 (8.6 microM), suggesting that aconitine activates sodium channels and muscarinic receptors. Higenamine (2.5 nM) and dobutamine (1 nM) did not cause chronotropic effects by themselves, but enhanced the aconitine-induced tachyarrhythmia. These results indicate that higenamine is a beta 1-adrenoceptor full agonist in murine atria and that the aconitine-induced tachyarrhythmia is augmented by the beta 1-adrenergic action of higenamine.

Structural components of beta-eudesmol essential for its potentiating effect on succinylcholine-induced neuromuscular blockade in mice

beta-Eudesmol, a sesquiterpenoid alcohol isolated from Atractylodes lancea rhizoma, potentiates the neuromuscular blocking effect of succinylcholine (SuCh). The potentiating effect is greater in diabetic muscles than in normal ones. To identify the structural components of beta-eudesmol contributing to this action, we examined the potentiating effect of newly synthesized tertiary alcohols related to beta-eudesmol in phrenic nerve-diaphragm muscle preparations of normal and alloxan-diabetic mice. Potentiating effects were exhibited by cyclohexylidene derivatives but not by cyclohexanone or cyclohexanol derivatives. The compound 2-(3-hydroxy-3-methylbutyl)cyclohexylidene exhibited a potentiating effect, but 3-(3-hydroxy-3-methylbutyl)cyclohexylidene did not. These results indicate that both the presence of an exo-methylene attached to a cyclohexane ring and the distance between the exo-methylene and the hydroxy group in beta-eudesmol are involved in the potentiating effect on SuCh-induced neuromuscular blockade.

Effects of intraventricular administration of neuropeptide Y on feeding behavior in fasted female rats with ventromedial hypothalamic lesions

The role of ventromedial hypothalamic nucleus (VMN) in feeding behavior induced by central administration of porcine neuropeptide Y (NPY) in fasted female rats was investigated focusing on the effect of the intracerebroventricular (i.c.v.) injection of NPY on food intake in rats with VMN lesions after 24 h of food deprivation. Cumulative food intake was measured 1, 3 and 6 h after injection. In Exp. 1, the i.c.v. injection of NPY into intact rats stimulated food intake compared with the injection of saline 1 and 3 h after the injections in a dose dependent manner (1 h; NPY 1 microgram, 3.29 +/- 0.43, 2 micrograms, 4.64 +/- 0.88, 5 micrograms, 5.15 +/- 0.61 vs. saline 2.48 +/- 0.42 g, P < 0.05 in 2 and 5 micrograms). 5 micrograms of NPY significantly stimulated food intake 6 h later. In Exp. 2, i.c.v. injection of NPY (2 micrograms) in VMN-lesioned rats showed no significant effect on food intake compared with the injection of saline 3 weeks after VMN lesioning (1 h; NPY 2 micrograms, 2.46 +/- 0.58 vs. saline 2.39 +/- 0.12 g). These results suggest that central administration of NPY enhances food intake in fasted female rats and that the VMN is one of the crucial sites of NPY induced feeding.

Transformation of Pseudomonas putida by electroporation

The optimum electrotransformation conditions were determined for Pseudomonas putida PpY101 with plasmid pSUP104 (9.5 kb) and pSR134 (18.6 kb). Field strength was a very important parameter for electrotransformation efficiency. Optimum efficiencies (1.1 x 10(5) transformants/micrograms DNA) with pSUP104 and pSR134 were obtained at a field strength of 12.5 kV/cm, a time constant of about 4.5 ms (resistance setting of 200 ohms), a supercoiled DNA concentration of 100 ng/ml, and a cell concentration of 10(9)/ml. Because the efficiency obtained is high enough, electrotransformation is useful for the direct cloning of P. putida PpY101. No significant relationship between plasmid size and electrotransformation efficiency was observed. These efficiencies were about 4.5 times higher than those using the MgCl2 method. Under these conditions, electrotransformation efficiencies of relaxed plasmid DNA treated with topoisomerase I and that linearized by EcoRI digestion were high.

[Cerebellar infarcts that require differentiation from tumors: diagnosis with MRI]

It is often difficult to differentiate cerebellar infarct with cerebellar swelling from neoplastic disorders, because former can be shown as cerebellar mass with marked contrast enhancement on CT scan. We analyzed radiologically three cases with cerebellar infarction by using MRI, conventional CT scan and angiography. Two cases in the acute stage could be diagnosed as cerebellar infarction by MRI alone based on the following findings: 1) the lesion was distributed in the territory of cerebellar arteries; 2) the normal pattern of cerebellar folia and fissures was preserved in Gd enhancement MRI image; 3) characteristics of MRI intensity were compatible with hemorrhagic infarction. The other case in the chronic stage showed peculiar enhancement, which was unusual for infarction. It was diagnosed as cellular infarction with reference to the angiographic findings. MRI is generally useful to obtain early diagnosis of tumor-like cerebellar infarcts, and proper treatment should be started as early as possible.

[Clinical analysis of the fatal cases of adult malignant gliomas after aggressive treatment]

Six patients operated on for supratentorial malignant astrocytomas and seven patients operated on for glioblastoma multiforme were analyzed to evaluate the effect of aggressive surgical resection on the length of survival and causes of death. Early postoperative contrast enhanced CT scan was used to assess the extent of surgical resection. A gross total resection was considered to have been accomplished when there was no evidence of any residual enhanced mass. When 10% or less of the preoperative enhanced mass remained, the resection was classified as a subtotal resection. Subsequent follow-up CT scan showed that a gross total resection was accomplished in nine patients, and a subtotal resection was attained in four patients. The patients' ages ranged from 40 to 78 years (mean, 59 years). The median survival after the first aggressive surgical resection was 18.0 months in patients with malignant astrocytoma and 13.6 months in those with glioblastoma multiforme. The median duration between first operation and recurrence of tumor was 8.8 months in patients with malignant astrocytoma and 11.5 months in those with glioblastoma multiforme. A second aggressive surgical resection for recurrent malignant astrocytoma or glioblastoma multiforme was carried out in four patients (40%) of the evaluated ten patients. The median survival of these patients after reoperation was 8.25 months. Accordingly, aggressive surgical resection of malignant astrocytoma and glioblastoma multiforme is correlated with longer survival and is advocated in the treatment of recurrent tumors. Leptomeningeal dissemination was diagnosed in nine patients (90%) of evaluated ten patients.(ABSTRACT TRUNCATED AT 250 WORDS)

[Percutaneous transluminal angioplasty for progressing stroke caused by severe basilar artery stenosis: case report]

We encountered one case of progressing stroke caused by severe basilar artery stenosis. The patient was treated with emergent percutaneous transluminal angioplasty (PTA) with satisfactory results. A 54 year-old woman was admitted 15 minutes after the sudden onset of rt. hemiparesis, rt. hemidysesthesia, dysarthria and consciousness disturbance. CT scan on admission showed no abnormal findings. The consciousness level of the patient deteriorated rapidly from JCS 1 to JCS 20 within 30 minutes from the ictus. An emergent angiogram revealed severe basilar artery stenosis at its middle portion and poorly developed collateral circulation. One hour after the stroke occurred, PTA was performed. Using a 3mm diameter balloon catheter, we introduced the balloon into the stenotic lesion and inflated it 6 times from 4 atm to 8 atm pressure. The patient recovered immediately on the operating table improving from JCS 20 to JCS 1. Rt. hemiparesis also improved. Follow-up MRI showed a small area of ischemic change in the brain stem, but no large infarction appeared. The patient was discharged with no neurosurgical deficits after 30 days of PTA. PTA for basilar artery stenosis is still a controversial subject. One reason is the risk of basilar artery perforating branches occlusion by balloon catheter and the other is the difficulty of introducing a flexible balloon catheter into the basilar artery beyond the acute angulation of the vertebral artery. If those two problems were solved, PTA would be the first-choice therapy for basilar artery stenosis in both acute and chronic stages.

Gastric damage and body weight loss in LHA-lesioned rats: effects of cytoprotective geranylgeranylacetone

We investigated the development of gastric damage and body weight (BW) loss in lateral hypothalamic area (LHA)-lesioned rats, measured 2 h and 1 and 3 days after the lesioning (experiment 1), as well as the effects of geranylgeranylacetone (GGA), a cytoprotective antiulcer agent, on these disorders (experiment 2). In experiment 1, BW of LHA-lesioned rats decreased throughout the 3-day experiment. In LHA-lesioned rats, gastric mucosal lesions appeared 1 day after lesioning in the glandular portion and persisted, whereas those in the rumenal portion appeared only after 3 days. Gastric transepithelial potential differences (PDs) of glandular portion began to decrease after 2 h and had decreased in both portions. Gastric acid output was increased transiently at 2 h but it was not high after 1 day and after 3 days was lower than that in sham-LHA-lesioned rats. In experiment 2, PDs of the rumenal decreased more in LHA-lesioned rats than in sham-LHA-lesioned rats pair fed to LHA-lesioned rats after 3 days. Three days of treatment with GGA (200 mg/kg ip) improved PDs of rumenal and glandular portions in LHA-lesioned rats and reduced lesions of the rumenal portion. Loss of BW in LHA-lesioned rats was significantly but not completely inhibited by GGA. These results indicate that disturbance to the gastric defensive mechanism plays an important role in the development of gastric lesions after LHA lesions and that the impairment of gastric functions may be a partial cause of the loss of BW in LHA-lesioned rats.

Impaired immunity in obesity: suppressed but reversible lymphocyte responsiveness

Although obese people have been reported to have a higher incidence of infections and some types of cancer, the immunocompetence of obese subjects remains poorly understood. To investigate whether obesity affects immunity, we studied obese subjects (BMI > 30 kg/m2) whose health was uncomplicated by any other disorder, including hyperglycemia. We compared mitogen-induced blastogenic response of peripheral blood lymphocytes in 34 obese subjects (mean +/- s.e. BMI: 38.4 +/- 2.0 kg/m2) and 35 non-obese controls (BMI: 21.3 +/- 0.4 kg/m2) who were matched for age and sex. The effects of weight reduction were also evaluated in 19 obese persons (BMI: 36.4 +/- 1.8 kg/m2) on a very low calorie diet. Mean (+/- s.e.) intracellular incorporation of [3H]-thymidine, on stimulation of T lymphocytes with either phytohaemagglutinin (PHA) or concanavalin A (Con A), and B lymphocytes with pokeweed mitogen, was significantly diminished in obese subjects compared to non-obese controls (47552 +/- 6917 vs. 83720 +/- 6252 cpm, P < 0.001; 30301 +/- 6018 vs. 45942 +/- 3723 cpm, P < 0.05; 13669 +/- 2971 vs. 23735 +/- 2048 cpm, P < 0.01, respectively). After weight reduction (BMI: 27.8 +/- 1.2 kg/m2), the mean T lymphocyte responses to PHA and Con A were increased significantly vs. baseline (98404 +/- 2444 vs. 50337 +/- 9516 cpm, P < 0.05 and 69523 +/- 15480 vs. 36695 +/- 8006 cpm, P < 0.05, respectively). Depressed blastogenesis of B lymphocytes was also augmented but was not statistically significant. The results suggest that obese subjects have underlying immune impairment in responsiveness of lymphocytes and that these impairments are reversible with adequate weight reduction.

Determinants of fasting hypertriglyceridemia in ventromedial hypothalamic obesity in rats

The present study investigated the mechanism of fasting hypertriglyceridemia in ventromedial hypothalamic (VMH) obesity by measurement of post-heparin plasma lipoprotein lipase (LPL) activity, triglyceride secretion rate (TGSR), and plasma insulin. One week after VMH lesions, when the lesioned rats were gaining weight rapidly (the dynamic phase), they showed normal plasma triglyceride levels with increased plasma LPL activity and TGSR. There was a positive correlation between hyperinsulinemia and elevated plasma LPL activity or TGSR in VMH-lesioned rats, while no correlation was observed in control rats. Ten weeks after VMH lesions, when the rats had become obese and reached a steady-state weight gain (the static phase), they showed hypertriglyceridemia with increased plasma LPL activity and TGSR. There was, again, a positive correlation between hyperinsulinemia and elevated plasma LPL activity or TGSR in VMH-lesioned rats. These results suggest a possible mechanism of fasting hypertriglyceridemia in these rats; in the dynamic phase adipose tissue adequately takes up circulating triglyceride because the tissue has sufficient take-up capacity and hence hypertriglyceridemia does not develop. In the static phase the tissue cannot adequately take up circulating triglyceride because of a limitation of its capacity, resulting in hypertriglycemia despite enhanced triglyceride secretion and increased LPL activity in both phases.

Effects of GABA and L-glutamate on the gastric acid secretion and gastric defensive mechanisms in rat lateral hypothalamus

The effects of administration of an inhibitory GABAergic or excitatory glutaminergic neurotransmitter into the lateral hypothalamic area (LHA) on gastric acids, an aggressive mechanism, and transepithelial potential difference (PD) and mucosal blood flow (MBF), defensive mechanisms, were examined in anesthetized rats, since lesions of LHA in these animals cause gastric mucosal damage and electrical stimulation stimulates gastric acids and antral contractions. Microinfusion of the inhibitory neurotransmitter, muscimol (GABA agonist) resulted in an increase in gastric acid secretion and in PD and MBF. The GABA antagonists picrotoxin and bicuculline methiodide, in contrast, decreased these three factors. The excitatory neurotransmitter L-glutamate induced only an increase of MBF. Thus, the GABAergic system in LHA stimulates the gastric functions, both defensive and aggressive mechanisms, while the glutaminergic system increases only a portion of the defensive system. The results suggest that there is a significant interaction between LHA and stomach functions.

Increased hepatic arterial blood flow in acute viral hepatitis: assessment by color Doppler sonography

To evaluate the effect of acute viral hepatitis on hepatic arterial blood flow, we performed color Doppler sonography with point-spectral analysis in 15 patients with acute viral hepatitis and compared the results with those in 15 normal volunteers. During the acute phase of hepatitis, the peak-systolic and end-diastolic velocity of the hepatic artery were significantly larger than those in normal arteries (p < 0.01). During the recovery phase, these indexes of the hepatic artery decreased significantly to the control levels (p < 0.01). The resistive indexes related to vascular resistance in the hepatic artery during the acute phase were significantly less than those in normal arteries (p < 0.01), and they increased significantly to the control levels during the recovery phase (p < 0.01). No significant correlation was found between these indexes of the hepatic artery and conventional liver function parameters. However, the interval between the acute phase and the recovery phase did correlate negatively with the peak-systolic velocity of the hepatic artery in the acute phase (r = -0.630, p < 0.05) and with the end-diastolic velocity (r = -0.514, p < 0.05). We conclude that color Doppler sonography is useful for imaging increased hepatic arterial blood flow in patients with acute viral hepatitis. We believe that increased hepatic arterial blood flow during the acute phase may provide a marker for earlier recovery from hepatitis-induced damage.

Impaired growth hormone secretion in VMH lesioned rats

To investigate impaired growth hormone (GH) secretion in ventromedial nuclei (VMH) lesioned rats, we examined spontaneous plasma GH secretion, and plasma GH responses to arginine, clonidine and growth hormone releasing factor (GRF) under unanaesthetized and unrestrained conditions. Spontaneous GH secretion was blunted with 75% decrease of peak value in VMH lesioned rats, while it clearly existed in control rats. When rats were pre-treated with chlorpromazine (1-2 mg/kg, i.v.) which eliminates pulsatile GH secretion, no difference was observed in the plasma GH response to arginine (1 g/kg, i.v.) or to clonidine (100 micrograms/kg, i.v.) between VMH lesioned and control rats, but response to GRF (10 micrograms/kg, i.v.) was enhanced in the former animals. Administration of antiserum against somatostatin (1 ml) plus chlorpromazine significantly elevated the basal plasma GH level and GH response to arginine in control rats, but did not elevate them in VMH lesioned rats. These results suggest that reduction of both hypothalamic GRF and somatostatin release contribute to the impaired GH secretion in VMH lesioned rats. Reduction of somatostatin caused enhanced GH response to GRF and no increase in basal GH level with pre-treatment of antiserum against somatostatin. Reduction of GRF resulted in a failure to restore GH response to arginine with pre-treatment of antiserum against somatostatin. Reduction of both GRF and somatostatin caused blunted spontaneous GH secretion and normal GH response to arginine and clonidine.

Thiolactomycin resistance in Escherichia coli is associated with the multidrug resistance efflux pump encoded by emrAB

Thiolactomycin (TLM) and cerulenin are antibiotics that block Escherichia coli growth by inhibiting fatty acid biosynthesis at the beta-ketoacyl-acyl carrier protein synthase I step. Both TLM and cerulenin trigger the accumulation of intracellular malonyl-coenzyme A coincident with growth inhibition, and the overexpression of synthase I protein confers resistance to both antibiotics. Strain CDM5 was derived as a TLM-resistant mutant but remained sensitive to cerulenin. TLM neither induced malonyl-coenzyme A accumulation nor blocked fatty acid production in vivo; however, the fatty acid synthase activity in extracts from strain CDM5 was sensitive to TLM inhibition. The TLM resistance gene in strain CDM5 was mapped to 57.5 min of the chromosome and was an allele of the emrB gene. Disruption of the emrB gene converted strain CDM5 to a TLM-sensitive strain, and the overexpression of the emrAB operon conferred TLM resistance to sensitive strains. Thus, activation of the emr efflux pump is the mechanism for TLM resistance in strain CDM5.

Diagnosis of portal vein thrombosis in patients with hepatocellular carcinoma: efficacy of color Doppler sonography compared with angiography

OBJECTIVE

The aim of this study was to determine the efficacy of color Doppler sonography in the diagnosis of portal vein thrombosis in patients with primary hepatocellular carcinoma. The findings on angiography were used as the gold standard for diagnosis.

SUBJECTS AND METHODS

We compared the findings on color Doppler sonograms and hepatic angiograms in 18 patients with hepatocellular carcinoma and portal vein thrombosis and in 22 patients with hepatocellular carcinoma without portal vein thrombosis. In most patients, tumor-related thrombus of the portal vein was confirmed by autopsy or surgery. The sonographic criteria for diagnosing portal vein thrombosis included nonvisualization of portal vein flow, pulsatile flow in the thrombus, arterioportal shunts, and cavernous transformation of the portal vein.

RESULTS

Nonvisualization of portal vein flow was the predominant color Doppler finding in all patients with portal vein thrombosis. Other flow abnormalities overlapped the finding of nonvisualization of portal vein flow in 10 of 18 patients with portal vein thrombosis. The sensitivity of color Doppler sonography was 100% for nonvisualization of portal vein flow, 89% for detection of pulsatile flow in the thrombus, 60% for detection of arterioportal shunts, and 100% for detection of cavernous transformation. Among these findings, pulsatile flow in the thrombus was diagnostic for pathologically proved neoplastic thrombi in the main portal vein; sensitivity and specificity were 89% and 100%, respectively, and accuracy was 96%. No portal vein that appeared normal on color Doppler sonograms was thrombosed on arteriograms.

CONCLUSION

We conclude that color Doppler sonography is a useful means of imaging the vascular extension of a tumor-based thrombus and an accurate means of screening for portal vein thrombosis.

Age-related changes of DRG neuronal attachment to extracellular matrix proteins in vitro

Attachment of dorsal root ganglion (DRG) neurones from 3-month-old (young adult) and 24-month-old (aged) mice to the following substrates was evaluated after 6 h in culture: (1) poly-L-lysine (PL), (2) PL + type I collagen (CL-I), (3) PL + type IV collagen (CL-IV), (4) PL + laminin (LM) and (5) PL + fibronectin (FN). In the young adult mice, each substrate coated onto PL, significantly increased the ratio of attachment, compared with PL alone. In the aged mice, CL-I and LM, but not CL-N or FN improved the attachment. There was no difference in cell survival or neurite extension after 48 h in culture between the two groups of mice. These results suggest that ageing causes selective changes of the neuronal cell-surface receptors respective to extracellular matrix proteins such as CL-IV and FN.

Glucoregulatory hormones in the immobilization stress-induced increase of plasma glucose in fasted and fed rats

We investigated 1) the effect of immobilization stress on glucose metabolism in rats after sham operation (SHAM), adrenomedullectomy (ADMX), and adrenalectomy (ADX); and 2) the effect of glucoregulatory hormone infusion on plasma glucose using untreated normal fasted and fed rats under unanesthetized conditions. In immobilization stress, the plasma glucose concentration increased only in the SHAM group during fasting, while under fed conditions, all three groups showed significant increases (SHAM > ADMX > ADX). Plasma glucagon and norepinephrine significantly increased in all groups; plasma epinephrine increased only in the SHAM group, and plasma corticosterone increased in SHAM and ADMX groups under both conditions. The hepatic glycogen content in all fed groups significantly decreased after immobilization stress, while a very low content before stress and an undetectable level after stress were observed in all fasted groups. Only epinephrine infusion increased plasma glucose during fasting, while epinephrine and glucagon infusion increased it under fed conditions. Corticosterone infusion did not change it under either condition. These results suggest that in the fasted condition, only epinephrine plays an essential role, while under fed conditions, glucagon and corticosterone as well as epinephrine also act as synergistic factors in stress-induced hyperglycemia.

Hepatic vagal amino acid sensors modulate amino acid induced insulin and glucagon secretion in the rat

To clarify the physiological role of vagal amino acid sensors in the liver, the effect of hepatic vagotomy and/or celiac vagotomy (sectioning of the hepatic branch and/or the celiac branches of the vagus nerve) on the secretion of insulin and glucagon after intraperitoneal injection of neutral (L-alanine, L-leucine, and L-phenylalanine), acidic (L-glutamate), or nonmetabolized (cycloleucine) acids, was examined in rats. Hepatic vagotomy enhanced both plasma glucose and glucagon concentrations after intraperitoneal injection of alanine more than those in sham-vagotomized (control) rats, while after intraperitoneal injection of leucine, hepatic vagotomy decreased plasma glucose concentrations and enhanced plasma insulin concentrations more than in control animals. These effects, following both alanine and leucine administration, were blocked by celiac vagotomy. Glutamate, phenylalanine, and cycloleucine stimulation in hepatic-vagotomized rats caused no significant differences in plasma glucose, insulin, or glucagon levels as compared to those in sham-vagotomized rats. Celiac vagotomy alone did not affect plasma glucose, insulin, or glucagon concentrations after stimulation by these five amino acids. The physiological role of alanine and leucine sensors may be to prevent amino acid-induced exaggerated pancreatic hormone secretion and to maintain blood glucose homeostasis, while glutamate, phenylalanine, and cycloleucine have no effect on this pancreatic neuroendocrine system.

Elevated serum thymidine kinase activity in patients with acute viral hepatitis

To evaluate the clinical applications of serum thymidine kinase (TK) activity, we compared the results obtained with this parameter with those of other liver function tests in 27 patients with acute viral hepatitis and 16 normal controls. In those in the acute stage, the serum TK activity increased significantly to 55.5 +/- 66.5 U/L. There was no significant correlation between serum TK activity and findings for serum albumin, bilirubin, alkaline phosphatase or r-glutamyl transpeptidase. However, it did correlate significantly well with the serum activity of aspartate aminotransferase (AST) (r = 0.621, P < 0.01), alanine aminotransferase (ALT) (r = 0.551, P < 0.01), and lactate dehydrogenase (LDH) (r = 0.620, P < 0.01). Serum TK activity reached higher than 70 U/L in 8 of 11 patients with hepatitis A; however, no patients with the other types of hepatitis reached such a high level. During the recovery stage, the serum TK activity decreased significantly to 5.9 +/- 1.7 U/L (P < 0.01), and did not correlate with AST, ALT, LDH or other conventional liver function parameters. The data suggest that an elevation of serum TK in patients with acute viral hepatitis results from hepatocellular damage. A marked elevation of serum TK activity may thus provide a marker for acute hepatitis A infection.

Glycine sensor in the hepato-portal system and their reflex effects on pancreatic efferents in the rat

We earlier reported the existence of vagal arginine, alanine, and leucine sensors in the liver which modulate amino acid-induced pancreatic hormone secretion. To determine the possible existence of glycine sensors in the liver and their reflex effects, afferent discharges from the hepatic branch and efferent discharges from the pancreatic branch of the vagus nerve were recorded. Intraportal administration of 0.1, 1, and 10 mM of L-glycine solution (0.1 ml) depressed the afferent discharge rate of the hepatic branch of the nerve in a dose-dependent manner, and increased the efferent discharge rate of the pancreatic vagal branch. The results suggest the existence of glycine sensors in the hepato-portal system that exert reflex regulation on the pancreatic vagus nerve activity.

Acute and chronic effects of VMH lesions on circadian rhythms in food intake and metabolites

In the dynamic phase, 3 weeks after surgery, food intake increased especially during the latter part of the light cycle in VMH-lesioned rats, and the difference between light and dark cycles disappeared. The rhythms of serum insulin, glucose, and triglyceride disappeared. Concentrations of glucose during the light cycle were lower than those of sham-operated rats, although concentrations of triglyceride and insulin were higher than those of sham-operated rats at all times. In the static phase, 12 weeks after surgery, the difference of food intake between light and dark cycle appeared in VMH-lesioned rats, but the loss of rhythmicity for serum glucose, insulin, and triglyceride remained. Concentrations of glucose except early light phase and concentrations of triglyceride and insulin at all times were higher than those of sham-operated rats. VMH lesions thus abolished circadian rhythmicity in serum insulin, glucose, and triglyceride for a long period; however, the disturbed rhythmicity of food intake was reversible.

Hepatic glucose-sensitive unit regulation of glucose-induced insulin secretion in rats

Vagal glucose receptors, or glucose-sensitive units which modulate insulin secretion, exist in the liver. This study sought to determine the pathway of portal glucose-sensitive unit-regulated insulin secretion by measuring plasma insulin after intraperitoneal (IP) injection of glucose under unanesthetized and unrestrained conditions (Experiment 1), and by recording electrical discharge after intraportal injection of glucose (Experiment 2) in rats with hepatic and/or celiac vagotomy. In Experiment 1, plasma insulin was significantly reduced and plasma glucose elevated after IP glucose injection (1 g/kg) in the three groups of hepatic-, celiac-, and hepatic- and celiac-vagotomized rats in comparison with a sham-vagotomized group. There were no significant differences among the four groups in plasma insulin or glucose after IV glucose injection (0.5 g/kg). In Experiment 2, intraportal injection of 400 mg/dl of glucose solution, a similar concentration to that produced by 1 g/kg of IP glucose injection, caused a reduction in the discharge rate of hepatic vagal afferents and an increase in that of pancreatic vagal efferents. This increase was blocked by prior sectioning of the hepatic branch of the vagus nerve. These results suggested that hepatic glucose-sensitive units enhanced glucose-induced insulin secretion via the hepatic vagal afferents and the pancreatic vagal efferents mediated by the brain stem center in vivo. The physiological role of these hepatic glucose-sensitive units is assumed to maintain blood glucose homeostasis by enhancing glucose-induced insulin secretion.

Hepatocellular carcinoma: treatment with percutaneous ethanol injection and transcatheter arterial embolization

The therapeutic effectiveness of a new combination therapy--pretreatment with transcatheter arterial embolization (TAE) and subsequent percutaneous ethanol injection (PEI)--for solitary large (> 3.0 cm in diameter) primary hepatocellular carcinoma lesions was compared with that of TAE alone. With TAE alone, a partial response of the tumor was seen in only 10% of the patients, and the 1-, 2-, and 3-year survival rates were calculated to be 68%, 37%, and 0%, respectively. Histologic examination of specimens obtained at hepatectomy showed that TAE alone caused complete necrosis in only 20% of the tumors. In contrast, PEI combined with TAE significantly (P < .05) increased the partial response rate (45%) and significantly (P < .01) prolonged the 1-, 2-, and 3-year survival rates (100%, 85%, and 85%, respectively). Combination therapy caused complete histologic necrosis in 83% of the tumors. It also was significantly (P < .05) better than TAE alone in terms of rate of primary tumor recurrence during follow-up.

Very-low-calorie-diet therapy in severe obesity

This study investigated the effects of very-low-calorie-diet (VLCD) therapy on body weight, plasma glucose, and lipid metabolism in severely obese patients. Ninety-one patients were subjected to VLCD therapy for 4-24 wk. Reduction of body weight was remarkable during the first 4 wk, then leveled off despite continuous treatment. Fasting plasma glucose, triglyceride, and 75-g oral glucose-tolerance test showed a significant improvement. Total cholesterol fell in the early stages but then increased more than the pretreatment level during VLCD. VLCD therapy is useful for the treatment of severe obesity.