The protective effect of propranolol on ischemic myocardium: an electron microscopic study

The protective effect of propranolol on ischemic myocardium was studied experimentally and clinically by electron microscope. In an animal experiment, ischemic changes were produced in the posterior papillary muscle of the rabbit following 3, 15, 30 minutes of occlusion of the circumflex coronary artery. Propranolol (0.25 mg/kg) was injected into the left atrial cavity before occlusion of the artery. The posterior papillary muscle was excised and examined by electron microscope. In clinical experience, propranolol (20 microng/kg) was given intravenously to 6 patients who underwent open heart surgery. Transmural left ventricular myocardial biopsy was performed after the anoxic cardic arrest and the material, particularly the subendocardium, was examined by electron microscope. It was shown that propranolol was effective, both in the experiment and in the clinical experience, in preserving ischemic myocardium. The possible mechanisms through which propranolol might act were considered to be (1) indirect effect of altered oxygen supply vs. demand, effect by reducing heart rate and reducing cardiac output due to the drug's function as a beta blocker, (2) direct cellular effect, i.e., reducing myocardial substrate metabolism along with stabilization of cellular structure, and (3) increase collateral circulation to the subendocardium.

Assessment of endoscopic aspiration cytology and endoscopic retrograde cholangi-pancreatography (ERCP) in patients with cancer of the pancreas. Part I

This report is concerned with studies on duodenofiberscopic examinations with aspiration cytology endoscopic retrograde cholangio-pancreatography (ERCP) in 44 patients with cancer of the pancreas. Aspiration cytology alone was diagnostic in 91% of cancer of the head of the pancreas, 55% of cancer the body and tail of the pancreas and 100% of cancer of the whole pancreas. ERCP alone was diagnostic in 59% of cancer of the head of the pancreas, 75% of cancer of the body and tail of the pancreas and 100% of cancer of the whole pancreas. By combining these two approach a diagnostic result was obtained in 95% of cancer of the head of the pancreas and 90% of cancer of body and tail of the pancreas. It is concluded that the combined diagnostic approach has enhanced diagnostic accuracy of malignant lesions of the pancreas and that it has not yet led to an improvement resectability and mortality.

A study of hypertension: participation of central adrenaergic mechanism on the angiotensin II-induced hypertension

I. Interactions of angiotensin II and norepinephrine in the rat hypothalamus and other brainstem were studied by intraventricular perfusion or/and intravenous administration. (1) Intravenous administration of angiotensin reduced the hypothalamus norepinephrine content. (2) Intraventricularly perfused angiotensin reduced the hypothalamus norepinephrine but did not alter that in other parts of brainstem. Hypothalamus norepinephrine was reduced more by intravenous administration of angiotensin than by intraventricularly perfused angiotensin. II. The involvements of adrenergic mechanism in the central pressor effect of angiotensin II were studied through observation of blood pressure changes following injection of angiotensin II, phentolamine and propranolol into the rabbit lateral ventricle of rabbit brain.(1) Intraventricular administration of phentolamine suppressed the central mediated pressor respons of angiotensin. (2) Simultaneous intraventricular administration of propranolol enhanced the angiotensin pressor effect in anesthetized rabbits.

Assessment of endoscopic aspiration cytology and endoscopic retrograde cholangio-pancreatography in patients with cancer of the hepato-biliary tract. Part II

Aspiration cytology and ERCP were evaluated in 66 patients with cancer of the hepato-biliary tract. Cytology was diagnostic in 100% of ampullary cancer, 83% of cancer of extrahepatic bile duct, 0% of cancer of intrahepatic bile duct, 25% of cancer of gall bladder and 0% of cancer of liver. ERCP was diagnostic in 65% of ampullary cancer, 90% of cancer of extrahepatic bile duct, 100% of cancer of intrahepatic bile duct, 25% of cancer of gall bladder and 25% of cancer of liver. Endoscopic findings was diagnostic in 77% of cancer of ampullary region. By combining these approaches, a diagnostic result was obtained in 100% of ampullary cancer, 96.5% of cancer of extrahepatic bile duct, 100% of cancer of intrahepatic bile duct, 50% of cancer of gall bladder and 25% of cancer of liver. It is concluded that the combined diagnostic approach has enhanced the diagnostic accuracy of malignant lesions of the hepato-biliary tract and that it has not yet led to an improvement in resectability and mortality.

Effect of angiotensin II on noradrenaline content in the rat hypothalamus

1. Intravenous administration of angiotensin II reduced the adrenaline content, increased the catechol-O-methyltransferase activity, and decreased the monoamine oxidase activity of rat hypothalamus. 2. Intraventricularly administrated angiotensin II reduced the noradreanline content to a smaller extent. 3. The change produced by intravenous administration of angiotensin might be indirectly caused by a response to angiotensin.

Surgical treatment of pulmonary atresia with intact ventricular septum

Fifty-nine children with pulmonary atresia and intact ventricular septum underwent various forms of surgical treatment at the Hospital for Sick Children, Toronto, during 1950 to mid 1975. Twenty-three patients had pulmonary valvotomy, 15 direct, 2 indirect, and 6 both direct valvotomy and infundibulectomy. All died, 19 early and 4 late. Of 13 patients who received a systemic-pulmonary artery shunt, 4 combined with surgical atrial septectomy, there are only 2 long-term survivors both of whom were children who had had a Waterston anastomosis. Recently we have been treating infants with small right ventricles with balloon atrial septostomy at cardiac catherterization followed by a Potts anastomosis and pulmonary valvotomy. If the Potts anastomosis appears satisfactory the persistent ductus arteriosus is ligated. This scheme was used in 23 infants, with 4 early deaths and 2 late deaths. Of 17 survivors, further shunts were required in 4 children. One child has had a formal repair, with insertion of valves in both tricuspid and pulmonary areas. We believe that this operative combination of Potts anastomosis and pulmonary valvotomy offers the infant with pulmonary atresia and a small right ventricle a relatively low initial mortality and the possibility of right ventricular enlargement and subsequent repair.

Transformation of tonsil lymphocytes by Epstein-Barr virus

Tonsil lymphocytes obtained from children and adults at tonsillectomy were examined for susceptibility to infection with Epstein-Barr virus (EBV) in vitro. Of 37 specimens, 24 (65%) were transformed by EBV. Rate of transformation was higher in the cells from younger children than in those from older children and adults, but the susceptibility was not directly correlated to the titer of antibody against EBV in donor serum. All 22 transformed tonsil cell lines tested were carrying EBV-associated nuclear antigen, and 8 of them produced cytoplasmic IgA in 15-45% of cells. The results suggest that tonsil lymphocytes are targets of EBV.

Ultrastructural change in myocardium subsequent to ischemic cardioplegia "no-reflow phenomenon"

Mongrel dogs were subjected to cardiopulmonary bypass with hemodilution and to normothermic anoxic arrest for 30 minutes, to study the subepicardial and the subendocardial myocardial ultructure and the DPTI/TTI ratio. "No-reflow phenomenon" was demonstrated in the myocardium after cardiopulmonary bypass, associated with normothermic anoxic arrest. No-reflow phenomenon was a contributing factor to subendocardial ischemia in the normotrophied ventricle after open-heart surgery. Severe hemodilution with hemoglobin less than 5.0 g% resulted in irreversible damage in both myocardial layers.

A new approach to repair of pulmonary branch stenosis following ascending aorta-right pulmonary artery anastomosis

Ascending aorta-right pulmonary artery anastomosis may result in branch stenosis or occlusion of the right pulmonary artery from growth or from failure to place the anastomosis on the posterior surface of the aorta at the time of construction. Closure of the anastomosis is usually easily accomplished by simple suture through the ascending aorta. When branch stenosis is present at the site of anastomosis, reconstruction of the pulmonary artery is necessary. A new approach that facilitates repair of pulmonary branch stenosis by transecting the ascending aorta over the obstructed area has been utilized in 2 patients who required reoperation for branch stenosis following repair for tetralogy of Fallot. The method is an alternative approach to gain exposure for reconstruction of the pulmonary artery.

Clonal transformation of human leukocytes by Epstein-Barr virus in soft agar

The B95-8 strain of Epstein-Barr virus (EBV) induced colony formation of human umbilical cord-blood leukocytes in soft agar medium. One-hit response relationship between the number of colonies and the virus dose was observed with high dilutions of the virus preparation. However, there was a presumed cell-killing effect with low dilutions of virus. The colonies were similarly induced, but with a lower efficiency, in adult peripheral blood leukocyte cultures infected with the virus. The colony-forming activity of EBV was neutralized by anti-EBV-positive but not by negative human sera. The cells in colonies were capable of growing continuously and carried EBV-associated nuclear antigen. Thus, it was evident that the colony formation was caused by clonal transformation by EBV.

Red-Far Red Reversible Effect on Polysome Formation in the Embryos of Pinus thunbergii Seeds

Polysome formation in the embryos of Pinus thunbergii seeds was studied. Free ribosomes were dissociated to smaller subunits in a high salt buffer, but the complex ribosomes were not. The free ribosomes could be distinguished from monomer ribosomes derived from polysomes after RNase treatment. The monomer ribosomes present in the embryos of the dark-imbibed seeds were predominantly free ribosomes; very small quantities of polysomes could be detected in the embryos from dark-imbibed seeds. Such polysomes remained at a very low level during dark imbibition at least for a month. The level of polysomes increased 4 hours after a brief exposure to red light. The effect of red light on polysome formation was partially reversed when followed by far red light irradiation.

Comparative studies of the growth promoting effects of ascitic or pleural effusion from patients with malignant tumors, human serum and fetal calf serum on human cells cultured in vitro

Twelve specimens of ascitic and pleural effusion (APE) from patients with malignant diseases were examined quantitatively for growth promoting effect on three human cell lines and one human cell strain, by four different assay procedures. Simultaneously, healthy human serum (HS) and fetal calf serum (FCS) were also examined for comparison. When the activity per mg protein of the test specimen was evaluated, the value of APE on an average was somewhat greater than that of HS in three out of four different assays, although FCS gave a higher average value than either APE or HS did in two of the three assays. However, a portion of APE specimens were found to have a unique promoting activity responsible for increase in number of cell colonies.

Diagnosis of carcinoma of the papilla of Vater by duodenofiberscopy: simultaneous attempt on endoscopic observation, aspiration cytology, retrograde pancreatocholangiography and biopsy

Clinical features and validity of a duodenofiberscopic examination for the diagnosis of carcinoma of the papilla of Vater were evaluated on 13 cases preoperatively diagnosed endoscopically. Followings are the conclusions derived. 1) Average age was 59.8 years. Incidence was equal among men and women. 2) As initial symptoms, general fatigue and easy fatigability or symptoms of cholangitis should be emphasized. 3) Other important symptoms include jaundice, fever with chills and weight loss. Abdominal pain, when present, was noted as one of symptoms of cholangitis in most cases. 4) Important laboratory findings include elevated serum bilirubin and alkaline phosphatase, elevated erythrocyte sedimentation rate, positive occult blood in stool. 5) Carcinomas of the papilla of Vater were divided into 3 types (type I, II and III) according to endoscopical and pathological findings. Clinical features and laboratory findings were discussed in relation to the type of lesions. Characteristic endoscopic findings of each type of the lesions were described. Validity of aspiration cytology, pancreatocholangiography and biopsy under duodeno-fiberscopic observation was also discussed. As a result, duodenofiberscopy was considered to be the most useful method for the diagnosis of carcinoma of the papilla of Vater because it provides us with an opportunity to perform simultaneously an endoscopic observation, aspiration cytology, pancreatocholangiography and biopsy.

Formation of hybrids between coliphage lambda and Salmonella phage P22 with a Salmonella typhimurium hybrid sensitive to these phages

An unusual Salmonella typhimurium hybrid with sensitivity to coliphage lambda and salmonella phage P22 has been recovered from matings between an Escherichia coli K-12 Hfr donor and an S. typhimurium recipient. The hybrid is an excellent host for achieving genetic recombination between lambda and P22. Two broad classes of hybrid phages were isolated. The lambda-P22 hybrid class, which has the protein coat of lambda, contains at least the c region of P22. The P22-lambda hybrid class has the protein coat of P22 and has inherited at least the c marker of lambda.

Genetic evolution of bacteriophage. II. Physical length of the homologous region in a hybrid between serologically and morphologically unrelated phages

P22 and P221 DNA were labeled with (3)H-thymidine and hybridized with P22 DNA, P221 DNA, or Fels 1 DNA immobilized on Millipore membrane filters. With this technique, 31% of the P22 genome was computed to be homologous to the P221 genome. Since the molecular weight of P22 DNA is 2.65 x 10(7) daltons, the homologous region between P22 and P221 should be equivalent to about 8.2 x 10(6) daltons and contain 13,300 nucleotide pairs or about 4400 triplets. Moreover, 46% of the P221 genome was computed to be homologous to the P22 genome. Therefore, the molecular weight of P221 DNA was calculated to be about 1.80 x 10(7) daltons. Sucrose gradient centrifugation showed that the molecular weight of P221 DNA was 2.01 x 10(7) daltons. Thus, the P221 genome is about 25 to 30% smaller than the P22 genome. Further-more, 54% of the P221 genome was found to be homologous to the Fels 1 genome. However, the labeled P22 DNA hybridized with Fels 1 DNA was about 2% of the labeled P22 DNA hybridized with P22 DNA.