The effect of hydrocortisone on the production and differentiation of granulocyte/macrophage progenitor cells in long-term bone marrow cultures

In long-term murine (BDF1) marrow cultures with a 'sufficient' lot of horse serum, hydrocortisone (HC) treatment (10(-6) M) had no apparent effect on the production of granulocyte/macrophage precursor cells (CFUc) in suspension. There was, however, a remarkable increase in granulopoiesis with a corresponding decrease in monocyte-macrophage production; the mean ratio of total granulocyte to monocyte-macrophage was approximately 6.0 during HC treatment, while it was approximately 1.0 in control cultures. Although there was no biodetectable colony-stimulating activity in the cultures, colony-enhancing activity was demonstrated without differences in the activity and specificity on colony formation between cultures with and without HC supplement. Moreover cells harvested from the cultures with HC gave rise to a significantly higher incidence of granulocyte colonies and so did the freshly isolated bone marrow cells in the presence of HC in agar culture system. This effect of HC on CFUc differentiation was not affected by indomethacin treatment.

[Clinical studies of patients with bladder tumors]

One hundred and seventy eight patients treated in our clinic were analyzed. The five-year survival rates for the patients (69 cases) given transurethral resection (TUR), total cystectomy (65 cases) and palliative treatment (40 cases) were 92.7%, 61.1% and 3.9%, respectively. The four patients who could not be treated lived no longer than one month. The five-year survival rate for the patients treated with TUR of the tumor was the highest. The recurrence rate for the TUR group was 19.5% at one year, 39.5% at three years and 47.1% at five years after surgery; and, it was higher in the patients with histologically high grade tumors. Generally, we obtained good results with TUR, but total cystectomy had to be performed later on three patients due to progression of the tumor. We felt the need for an indicator to express the biological activity of the tumor, and maintain that regular follow-up by endoscopy and cytology is mandatory. The clinical results of the total cystectomy and urinary diversion were considered to be satisfactory compared to other reports; and, patients with high stage tumor had poor prognosis. Five patients died of progression of the disease after total cystectomy. Operative mortality was 10.7%, which should be decreased by avoiding operative morbidity. In our experience, two-stage operations or preoperative irradiation can increase the indication for total cystectomy; and, improved clinical results are expected.

[Estimation of infarct size with 201Tl by multiprojection analysis]

Since mortality resulting from cardiac arrhythmia has been decreased by an introduction of CCU, power failure has become the major cause of death in patients with acute myocardial infarction. The power failure is assumed to be related to an infarct size. Therefore, noninvasive quantification of the infarct size is required for proper assessment of prognosis and treatment. Recently, a scintigraphic technique using radionuclide thallium-201 has developed, which is accumulated not in myocardial necrosis but in the intact myocardium. In this study, we tested two different parameters expressing the infarct size based on 5-projection myocardial scintigrams. One parameter is the ratio of the defect area to the total myocardium (% area), and the other is the ratio of a count decrease by the defect to total counts (% loss counts) in the planar image. Each parameter was obtained from uni- and multi-projection analysis. Six items were selected in the study including % area of 1-projection analysis, % area of 3-projection analysis, % area of 5-projection analysis, % loss counts of 1-projection analysis, % loss counts of 3-projection analysis, and % loss counts of 5-projection analysis. In 56 patients with the first attack of acute myocardial infarction, these parameters showed a clinically acceptable correlation with ejection fractions obtained by contrast ventriculography performed about 4 weeks later, with pulmonary end-diastolic pressure shortly after the onset, and with peak-CPK and sigma CPK obtained by 4 or 6 hourly measurements. Correlation coefficients between two parameters among 6 items showed no difference from each other. Scintigraphy was performed more than twice in 11 patients and the infarct size of these patients was decreased with the clinical course. Validity for estimates of the infarct size obtained with two parameters (% loss counts and % area) in different projection analysis was examined by a phantom model experiment and the clinical implications were discussed. In conclusion, an infarct size estimated by 201Tl scintigraphy provides useful informations about the size of necrosis and cardiac function in patients with acute myocardial infarction.

Neuro-pharmacologic studies on neurogenic bladder after radical hysterectomy

Miction function of patients who had had radical hysterectomy was investigated neuro-pharmacologically. The patients were divided into two groups according to the operation, with or without preservation of the plexus pelvicus, and bladder and urethral functions were compared by the bethanechol test and phentolamine test. The group with transected plexus pelvicus showed neurogenic bladder with impairment of functions of parasympathetic and sympathetic nerves and the preserved group showed much less impairment in functions of both nerves.

Differentiation of human bone marrow-derived fibroblastoid colony forming cells (CFU-F) and their roles in haemopoiesis in vitro

Human bone marrow-derived fibroblastoid colonies have been quantitatively developed in a liquid culture. A linear relationship between cell number plated and colony number formed supports their clonal origin and hydroxyurea killing indicates that the fibroblastoid colony forming cell (CFU-F) is not in cell cycle in normal bone marrow. Adipose cells were induced in the fibroblastoid colonies by the addition of hydrocortisone (optimal concentration: 10(-6) M). Furthermore, adherent layers with adipocytes provided a more favourable condition for maintaining haemopoiesis in Dexter-system cultures. These results indicate that CFU-F belongs to stromal precursor cells intimately involved in the formation of the haemopoietic microenvironment. Colony incidence of CFU-F was almost normal in most patients with aplastic anaemia, haemopoietic dysplasia and chronic myelogenous leukaemia. However, in acute myelogenous leukaemia, it varied with the stage of the disease. It is concluded that the colony assay is useful for investigating stroma/haemopoietic cell interactions.

A reaction cell with short optical path and oxygen electrode compartment for convenient quantitative determination of oxygen binding by hemoglobin

1. A simple and compact apparatus, with which the oxygen equilibrium of hemoglobin can be determined easily, was constructed and its performance was examined. 2. The oxygen partial pressure and the degree of oxygen saturation in a hemoglobin solution were determined by combined used of a Clark oxygen electrode and a spectrophotometer. 3. This apparatus can be used in a usual 1 cm square cell holder of a commercial spectrophotometer without any modifications, and has the advantage that the light path length of the optical cell is variable and can be shortened to about 2 mm.

Urethral pressure profiles following radical hysterectomy

Urethral function following radical hysterectomy was studied by chronologic analysis of the urethral pressure profile. Thirty patients who had radical hysterectomy were divided into 2 groups according to the degree of preservation of the plexus pelvicus at operation. The method of complete preservation is described. Urethral pressure profiles showed a significant postoperative decrease of mean maximum urethral closure pressure in the group of 20 patients with bilateral nerve transection; this was not found in the group of 10 patients with complete preservation of the plexus pelvicus. The decrease was ascribed to possible damage of sympathetic nerves originating from the hypogastric nerve. The results indicated that postoperative abnormalities in urination are caused by damage not only to the parasympathetic nerves (the pelvis nerve) but to the sympathetic nerves (the hypogastric nerve) as well.

[The influence on the urinary tract function after modified radical hysterectomy (author's transl)]

Total urodynamics tests, subjective complaints and intravenous pyelographic findings were investigated in order to clarify the condition of urinary tract after modified radical hysterectomy, comparing with radical hysterectomy with complete preservation of the plexus pelvics. The following results were obtained. 1) No subjective complaints of urination were obtained at three months after the operation. 2) The cystometrograms and the urethral profile pressure patterns after the operation were same as the preoperative patterns. 3) The urinary flow curves revealed normal patterns except one case. 4) In I.V.P. findings, considerable transient disturbances were noted on the upper urinary tract in 15.8%. 5) The patients with radical hysterectomy of complete preservation of the plexus pelvics remained direct operative disturbance at three months and from any view points we investigated the radical hysterectomy, even with complete preservation of the plexus pelvics remained worse influence in patients than modified radical hysterectomy.

[Middle fossa neurinoma with proptosis and oculomotor palsy (author's transl)]

Proptosis and oculomotor palsy which occur with intracranial neurinoma are very rare.

CASE

A 29-year-old right-handed female was admitted to the Department of Neurosurgery, Hokkaido University School of Medicine on Sept. 6, 1975. Eight months before admission, the patient complained of double vision and one month later, noticed decreasing of right visual acuity. Four months before admission, right-sided ptosis occurred and she noticed right temporal visual field's defect. Two weeks before admission she became aware of proptosis of right side. On admission, the general examination and vital signs were normal. The neurological examination revealed right optic nerve atrophy, right oculomotor palsy and slight decreasing of right corneal reflex. Radiological examination revealed extracerebral mass lesion in the middle fossa. On Sept. 19, 1975, a right frontotemporal craniotomy was performed and a large dura-covered tumor was found. It was found to extend from the middle fossa to the superior orbital fissure and attached to the anterior wall of the middle fossa. The tumor expanded into the interdual space and tightly attached to the dura mater. Histological examination of the tumor revealed typical neurinoma. Reports on cases with middle fossa neurinoma were reviewed and the origin of the tumor was discussed. It was presumed that the origin of the tumor in this case was the dural branch of the trigeminal nerve in the middle fossa.

Effects of kinins and dipeptidyl carboxypeptidase on the motility of highly washed human sperm

The influences of bradykinin, kallidin and dipeptidyl carboxypeptidase (kininase II) on the motility of human sperm thoroughly washed with Ficoll were investigated by an objective method with multiple exposure photography technique which recorded stroboscopically the tract of sperm migration. Addition of 0.1--10 ng/ml of bradykinin or kallidin to sperm suspension caused a stimulation of motility. The effect appeared by increase of the velocity of forward motile sperm, whereas the percent of motile sperm was not altered. On the contrary, higher dose of kinins suppressed the motility by decreasing the percent of motile sperm. There was a minor contamination of dipeptidyl carboxypeptidase even in the highly washed sperm suspension. This enzyme was identical with angiotensin I converting enzyme or kininase II and the major enzyme of kinin degrading activity in seminal plasma. Stimulation of sperm motility by kinin was further enhanced in the presence of SQ 14225, a specific inhibitor of dipeptidyl carboxypeptidase, by protection of added kinins from the residual dipeptidyl carboxypeptidase in the sperm suspension. Dipeptidyl carboxypeptidase level in ejaculated human semen was found to correlate to the semen quality, such as sperm density and motility, but it gave no direct influence on sperm motility.

[Temporal lobe damage as pitfalls at subtemporal transtentorial approach (author's transl)]

It is essential to make a proper approach to the lesion site and retract brain, thereby securing an adequate field of vision, upon performing operations on patients for lesions of deep temporal lobe and tentorium. Although subtemporal transtentorial approaches to tumors in the tentorium, pyramis and cerebellopontine angle have been described by a number of workers, further studies have to be made on temporal lobe damage as a pitfall since only a few reports have been published to date. We have therefore examined the possible factors which are responsible for temporal lobe damage and brain swelling in six cases in which subtemporal transtentorial approaches were made. We have encountered two cases of meningioma of the pyramis and tentorium growing in the middle and posterior fossa, one case each of acoustic neurinoma and trigeminal neurinoma located in the middle and posterior fossa, one case of aneurysm at a marginal branch of the superior cerebellar artery and one case of arteriovenous malformation of the deep temporal lobe. Temporal lobe damage was observed in two of these cases during operation and in post-operative CT scans. Although no particular symptoms were noted, CT scan revealed temporal lobe damage in one case. One of the main factors responsible for temporal lobe damage is cutting major veins, namely inferior cerebral vein, transverse sinus, etc. However, no damage was resulted from cutting superior petrosal sinus. Intermittent release of the brain retractor and repeated use of hyperosmotic solution including ventricular drainage are recommended for preventing temporal lobe damage.