The efficiency of new leukocyte removal filters. CF-1 and CF-2

Two new leukocyte removal filters, Nipro CF-1 and CF-2 (Nipo Medical Industries, Osaka, Japan), were evaluated. These non-woven polyester filters, which are gravity flow devices that require no priming and no rinsing after use, were developed for preparing 400 ml of whole blood or red cell concentrates from 400 ml of whole blood. A flow cytometric technique was developed to measure extremely low white blood cell (WBC) counts. To evaluate the efficiency of these filters, leukocyte counts were measured by three techniques: 1) electronic, 2) visual, and 3) flow cytometry. Flow cytometric counting was done using a Coulter EPICS-C cytometer (Coulter Corp., Hialeah, FL). Nipro CF-1 removed 99.97 +/- 0.01% (mean +/- SD, n = 14) of leukocytes measured by flow cytometry, and CF-1 recovered 90.7 +/- 4.47% (n = 21) of red blood cells. After filtration through CF-2, more than a 6 log10 (> 99.9999%) depletion of WBCs was detected in six samples, a 6 log10 (99.9999%) depletion of WBCs was detected in two samples, a 5 log10 (99.999%) depletion was detected in five samples, and a 4 log10 (99.99%) depletion was detected in one sample. CF-1, in which size and priming volume was smaller than other commercial leukocyte removal filters, accomplished a 3 log10 reduction in WBC count, compared with other commercial filters. CF-2 achieved a 4-6 log10 depletion of WBCs assayed by flow cytometry.

Cerebral arteriovenous malformations associated with a straight sinus anomaly

Nine cerebral arteriovenous malformations (AVM) associated with straight sinus anomaly were demonstrated on angiograms. All 10 AVM (1 patient had two AVM) occupied deep cerebral structures: Seven were totally or partially located in the basal ganglia or the corpus callosum, and 3 were in the medial occipital or temporal lobe. In 6 patients, almost no filling of the straight sinus was observed, although the AVM were located deeply and the main drainage was via the vein of Galen. All 6 patients showed retrograde flow in the deep cerebral veins or venous drainage through a persistent facial sinus. The other 3 patients had duplication or septal formation of the straight sinus. Straight sinus anomaly is extremely rare in the normal population but seems not uncommon in patients with deep-seated AVM.

Examination by scanning electron microscopy of oviductal epithelium of the prolific Chinese Meishan pig at follicular and luteal phases

The luminal surfaces of epithelial cells in the fimbriae, ampulla, isthmus, and utero-tubal junction of the oviducts of the prolific Chinese Meishan pig at follicular and luteal phases of the estrous cycle were examined by scanning electron microscopy. Marked cyclic changes were observed on the surfaces of cells in the fimbriae and ampulla, but little change was found in the isthmus and at the utero-tubal junction. The cells of the fimbrial epithelium in the follicular phase were densely ciliated, and the cilia partially concealed the bulbous processes of the secretory cells. In the luteal phase, the secretory cells predominated in the epithelium, and most of the ciliated cells were hidden by the processes of the secretory cells. The ampullar epithelium showed similar changes, but to a lesser extent. In the isthmus and at the utero-tubal junction, the secretory cells had many microvilli on their bulbous processes at the follicular phase, but they were flat and the microvilli were fewer in number and shorter in length during the luteal phase. Conspicuous solitary cilia protruded from the surfaces of secretory cells in the fimbriae and ampulla during the luteal phase. These results demonstrate that there are regional variations in the cyclic changes associated with the oviductal epithelial cells of the Chinese Meishan pig.

[Intraoperative monitoring of facial electromyographic responses during neurovascular decompressive surgery for hemifacial spasm]

In this paper, we reported our experience of intraoperative facial electromyographic recordings obtained during microvascular decompression for hemifacial spasm.

MATERIALS AND METHODS

Intraoperative electromyographic recordings from the mentalis muscle during stimulation of the temporal branch of the facial nerve has been attempted in 31 patients. No muscle relaxants were used except for those before intubation. Of 31 patients, 22 were female and 9 were male. The age on admission ranged from 31 to 60 years with a mean of 54 years.

RESULTS

1. Abnormal response appeared with a latency of about 10 msec after stimulation. This response disappeared in 30 out of 31 patients at the end of operation. In 4 patients, the abnormal response disappeared prior to decompression of the nerve. 2. 30 patients in whom the abnormal response disappeared were free of spasm immediately after surgery. Hemifacial spasm has been relieved in 28 patients with a follow up period of 6 months to 2 years and 7 months. The remaining two patients had mild spasm. The one patient in whom the abnormal response did not disappear had persistent hemifacial spasm.

CONCLUSION

The authors think that intraoperative facial electromyographic recording is useful to identify the blood vessel that is causing the spasm and to ensure that decompression of the nerve has been accomplished.

Anticipatory activity and entrainment of circadian rhythms in Syrian hamsters exposed to restricted palatable diets

Activity rhythms were recorded from hamsters in three conditions: during timed feedings of an attractive diet with free access to regular food, during restriction to 70% of normal food consumption, and during moderate food deprivation with limited temporal access to an attractive diet. An attractive diet given to intact animals did not induce anticipatory activity or entrainment, but damage to the suprachiasmatic nuclei (SCN) led to the development of anticipatory activity. Food restriction to 70% of normal intake led to anticipatory components in some intact animals, without entraining the dominant circadian pacemaker. The combination of a palatable diet and food restriction led to anticipatory activity before the daily feeding times and entrainment of a previously free-running circadian rhythm in some animals. Ablation of the SCN did not eliminate anticipatory activity in experimental animals, but did eliminate the free-running component of the rhythms. These results indicate that hamsters have a mechanism separate from the SCN that can anticipate daily feeding times, as rats do, and that they may show entrainment of the SCN-based pacemaker to such feeding schedules.

Analysis of novel imidazoles from isolated perfused rabbit heart by two high-performance liquid chromatographic methods

The paper reports two analytical high-performance liquid chromatographic methods to detect and quantify cardiac-derived histidyl derivatives. Method A relies on relative hydrophobicities as a basis of separation. Method B is an ion-pairing method in which the compounds are eluted in an entirely different order. Fractions collected from method A have been co-eluted in admixture in method B with authentic reference compounds. Thus the existence of the following imidazole ring-containing compounds derived from heart have been confirmed: N-acetylhistidine, N-acetyl-1-methylhistidine, N-acetylcarnosine, N-acetylhomocarnosine, homocarnosine, anserine, carnosine, balenine. Compounds were found in both tissue samples and perfusates.

On-line cell manipulation for cancer treatment

We hypothesized that the host immune system is directly stimulated by contact between blood and the materials used in blood purification systems. This concept has never been applied in therapeutic plasmapheresis. Two new materials have been invented since 1983. One of those is lipopolysaccharide (LPS)-immobilized beads, which are chemically bonded bacterial LPS (LPS-B). Another is immobilized pokeweed mitogen (PWM-B). We studied these two materials for their anti-tumor cell activity in vitro and in vivo. Their efficacy on tumor cells was demonstrated to be much stronger than that of lymphocyte activated killer (LAK) cells. Our new concept was proven to be correct.

"True" posterior communicating artery aneurysm--report of two cases

Two cases of true posterior communicating artery (PcomA) aneurysm are described. A 27-year-old female with subarachnoid hemorrhage demonstrated a saccular aneurysm at the branch of the anterior choroidal artery from the PcomA. The aneurysm was successfully clipped. A 23-year-old male involved in an automobile accident suffered from traumatic subarachnoid hemorrhage. Computed tomography 10 weeks after head injury demonstrated a high-density mass in the right parasellar region, diagnosed as a traumatic aneurysm arising from the PcomA. The aneurysm was successfully clipped. Histological examination demonstrated findings consistent with true aneurysm.

Localization of mRNA for protein phosphatase 2C in the brain of adult rats

Type 2C protein phosphatase (PP2C) is one of four major serine-threonine specific phosphoprotein phosphatases which modulate various intracellular activities. By in situ hybridization analysis of the adult rat, expression signals of mRNA for PP2C were observed most highly in the granule cells and Purkinje cells of the cerebellum, the pyramidal cells of the hippocampus and granule cells of the dentate gyrus, and plexus choroideus of the lateral ventricle, whereas moderate levels of its expression were observed in the medial habenula, piriform cortex and the pineal body. Several discrete nuclei of the brainstem including pars compacta of the substantia nigra, the pontine nuclei, and the locus ceruleus expressed the mRNA moderately. Weak expression of PP2C mRNA was observed in mitral and internal granule cells of the olfactory bulb, spinal cord gray matter, the cerebral neocortex, thalamic and hypothalamic nuclei. Only faint expression was detected in the caudate putamen. These patterns of expression are different from that of calcineurin/PP2B reported by other immunohistochemical studies and it is suggested that various neuronal proteins are differentially dephosphorylated by the different types of PP.

Behavior of cardiac output during progressive exercise tests: a preliminary report

The behavior of cardiac output (Q) during progressive incremental exercise tests was studied in young healthy men. Q approached a plateau and leveled off at almost the same work rate at which oxygen uptake (VO2) attained its maxima, while heart rate (HR) still continued to rise. This suggests that the limiting factor for maximal aerobic capacity in healthy subjects is Q. The rate of increase in Q and HR accelerated from a work rate which is close to the ventilatory anaerobic threshold (AT). The prime cause of the progressive augmentation in cardiac activity is probably an accelerated release of plasma catecholamine and/or potassium. There is a possibility that these substances might also affect the AT.

NMDA and non-NMDA receptor antagonists inhibit photic induction of Fos protein in the hamster suprachiasmatic nucleus

We previously reported that systemic treatment with a noncompetitive antagonist affecting the NMDA subtype of excitatory amino acid (EAA) receptor, MK-801, inhibits photic induction of Fos-like immunoreactivity (Fos-lir) in the hamster suprachiasmatic nucleus (SCN). Because MK-801 blocks the Ca2+ channel associated with the NMDA receptor, it may also influence the activity of other transmitters acting through Ca2+ channels. To assess the specificity of these effects, we compared the effects on photic induction of Fos-lir of several treatments: central injection of a competitive NMDA antagonist, CPP; central injection of a non-NMDA antagonist, DNQX; and systemic injection of the non-competitive NMDA antagonist, ketamine. Fos-lir was induced in SCN cells of vehicle-injected hamsters exposed to a light pulse 4-5 h after dark onset. Pretreatment with CPP (greater than 2 nmoles) or ketamine (greater than 100 mg/kg) caused a dose-related inhibition of photic induction of Fos-lir in portions of the SCN. These treatments reduced Fos-lir mainly in the rostral SCN and ventrolateral, but not dorsolateral, portions of the caudal SCN. Pretreatment with DNQX (greater than 20 nmoles) also inhibited photic induction of Fos-lir in the same regions of the SCN. These results indicate that photic induction of Fos protein in a portion of the hamster SCN is regulated by both NMDA and non-NMDA types of EAA receptor.

Novel eosinophilic inclusion in astrocytes

Intracytoplasmic and brightly eosinophilic inclusions within neuroglias are reported in a patient with Aicardi's syndrome. Most inclusion-bearing neuroglias were protoplasmic astrocytes in the cerebral cortex. Compared with similar eosinophilic and intracytoplasmic inclusions in other studies using both light and electron microscopy, the inclusions in this report are regarded as being novel and not previously described. Ultrastructurally, the inclusions were composed of electron-dense granules and amorphous substances, and were not surrounded by a limiting membrane. They were numerous in the cerebral cortex, especially in part of the microgyrus, but absent in the deep cerebral white matter, subcortical nuclei, brain stem and the cerebellum. Therefore, they may be closely associated with brain malformation and congenital astrocytic dysfunction. They also suggested a functional difference in protoplasmic astrocytes themselves, according to the differentiation of related gray matter.

Takayasu's arteritis with collateral circulation from the right coronary artery to intracranial vessels--a case report

A forty-four-year-old woman with Takayasu's arteritis and involvement of the aortic arch and its main branches complained of precordial pain on effort. Exercise electrocardiograms revealed significant ST segment depression in leads II, III, aVF, and V. Coronary arteriograms demonstrated no stenosis. However, the right coronary arteriogram revealed collateral circulation arising from the sinus node artery to the bilateral vertebral arteries and the left internal carotid artery. The collateral circulation was considered to be an important route of blood flow supply to the brain and, at the same time, a cause of coronary steal syndrome and, consequently, of angina pectoris.

Major buffering constituents in animal muscle

1. Among the muscles of six fish species, three mammals, and a bird, white muscle of skipjack tuna showed the highest buffering capacity (BC) in the pH range 6.5-7.5, followed by the muscle of little-piked whale, chicken pectoralis minor, and mackerel white muscle. 2. Contribution of low-molecular weight components to the muscle BC was as high as 48-96%, while the contribution of muscle proteins was below 50%. 3. Histidine-related dipeptides and inorganic phosphate were found to be major buffering constituents in muscle. 4. The dipeptides accounted for the BC differences found between the species and muscle types.

Immunological characterization of oviductal glycoproteins associated with the zona pellucida of the golden hamster egg

Three monoclonal antibodies (MAbs) were produced against materials obtained from the golden hamster oviduct. The MAbs (C11E8, C8B11, and A3D5) selectively reacted with the zona pellucida (ZP) of oviductal eggs. An immunohistochemical study demonstrated that all MAbs bound strongly to the epithelial cells of the oviduct and, to a lesser extent, of the uterus, the cervix, and the vagina. Weak reactions were also observed with some other tissues. All immunohistochemical reactions were completely eliminated by treatment of tissues with periodic acid, suggesting that the antigenic determinants that react with the MAbs are carbohydrate in nature. Antigens that reacted with the MAbs were characterized by immunoblotting analyses of 1- or 2-dimensional polyacrylamide gels after electrophoresis to fractionate tissue extracts under reducing conditions. With the oviductal extract, C11E8 and A3D5 specifically bound to broad bands that corresponded to macromolecules of more than 200 and 160 kD, respectively, whereas C8B11 reacted with a broad range of macromolecules, with the strongest reactivity being detected at molecular weights (MWs) higher than 160 kD. The macromolecules that reacted with the MAbs had carbamilation trains, suggestive of extensive microheterogeneity with respect to charge and size. Similar substances of high MW were not detected in extracts of tissues from the other reproductive organs. In addition, one MAb-positive oviductal antigen bound to the ZP of ovarian eggs, but the others did not bind to the ZP of ovarian eggs. This result indicates that the binding activity is specific for the oviductal glycoproteins. We have thus established clones that produce 3 different MAbs with strong affinity for oviduct-specific glycoproteins, one of which is associated with the ZP of the golden hamster.

Localization of gene expression of calbindin in the brain of adult rats

Localization of gene expression of calbindin, a cytosolic calcium-binding protein, was examined throughout the adult rat brain by in situ hybridization with cDNA probes. The gene was expressed most intensely in the Purkinje cells in the cerebellum, intensely in the granule cells of the dentate gyrus, and moderately in the inferior olivary nucleus, in the nuclei of the trapezoid body, in the medial part of the lateral habenular nuclei, entorhinal cortex and in the mammillary nuclei. In addition, weak expression of the gene was widespread in the forebrain and brainstem gray matter, and also in small cells in the spinal posterior horn as well as the ependymal cells. The widespread and heterogeneous expression of the gene in the brain suggests that calbindin is differentially involved in calcium-regulated phenomena in different neurons.

[Anterior approach for cervical dumb-bell typed neurinomas]

We experienced three cases of the dumb-bell typed cervical neurinoma. All of them compressed the spinal cord in the spinal canal, and had developed through the intervertebral foramen and compressed and displaced the vertebral artery. The decompression of the vertebral artery and reconstruction of the spine as well as the removal of the tumor were thought to be important. We used the anterior approach and were able to operate safely and completely. The anterior approach was thought to be effective for the surgical treatment of dumb-bell typed cervical neurinoma.

[Cerebral blood flow reactivity to hyperventilation in children with spontaneous occlusion of the circle of willis (moyamoya disease)]

To elucidate the relationship between cerebral blood flow (CBF) after hyperventilation (HV) and the rebuild-up phenomenon on the encephaloelectrogram (EEG) in children with moyamoya disease, comparative study of CBF immediately after HV and CBF after administration of acetazolamide (Diamox) was examined. CBF was measured by means of single photon emission CT (SPECT) using the 133Xe inhalation method. The subjects were 11 children (21 hemispheres) with moyamoya disease who were divided into two groups as follows, 1) Bypass group; who underwent STA-MCA anastomosis with other synangiosis. 2) Non-Bypass group; who underwent only some synangiosis such as EDAS, EMAS, EMS. The summary of the results is shown below. Regional CBF (rCBF) after HV of the frontal lobes in the Non-Bypass group had an evident tendency to show low perfusion compared with CBF in other regions. The correlation between low perfusion area after HV, and areas where the increase of rCBF is less after administration of acetazolamide became clear. The strongest relation was observed between low perfusion after HV and re-build-up phenomenon on EEG. On the other hand, rCBF after HV of the frontal lobes in the Bypass group had, compared with other regions, no tendency to show low perfusion. From this study and our previous reports, it is assumed that there is some hemodynamic insufficiency in the frontal lobes of the Non-Bypass group. The reason why the reduction of rCBF was less after HV especially in the frontal lobes of the Bypass group is still unknown.(ABSTRACT TRUNCATED AT 250 WORDS)

Sodium and noradrenaline in cerebrospinal fluid and blood in salt-sensitive and non-salt-sensitive essential hypertension

1. The effects of dietary sodium on blood pressure and levels of sodium, other electrolytes and noradrenaline (NA) in the cerebrospinal fluid (CSF) and blood of 15 patients with essential hypertension were studied. The CSF and blood sampling was carried out after 7 days of a high salt intake (16-18 g/day) and after 7 days of a low salt intake (1-3 g/day). 2. Blood pressure and sodium concentrations in CSF and serum were significantly higher in the high salt period than the low salt period (CSF Na+ concentration: 147.7 +/- 0.4 mmol/L vs 145.3 +/- 0.5 mmol/L; P less than 0.001). Levels of CSF pressure and potassium or calcium concentrations were not different between the two periods. Plasma NA and plasma renin activity (PRA) were lower and CSF NA levels tended to be lower in the high salt period. 3. The levels and the changes in sodium and NA in CSF were not significantly different between the salt-sensitive (n = 8) and the non-salt-sensitive (n = 7) subjects, but the changes in plasma NA and PRA were smaller in the salt-sensitive subjects. 4. These results indicate that the sympathetic nervous system is less suppressed in salt-sensitive subjects during high salt intake. This may be due to altered neural responsiveness to sodium loading rather than being greater increases in sodium concentration in the central nervous system.

Efficacy of nafamostat mesilate as a regional anticoagulant in experimental direct hemoperfusion and in plasma exchange on humans

As an anticoagulant, we compared Nafamostat mesilate (FUT) to heparin in experimental direct hemoperfusion (DHP) and studied the efficacy of FUT in clinical plasma exchange (PE). In in vitro study, FUT (5 micrograms/ml) inhibited the activation of C4 more strongly than heparin (100 U/h), and larger dose of FUT (50 micrograms/ml) inhibited the activation of C3. Experimental DHP with FUT on jaundiced dogs was safely performed, but not with heparin. Clinical PE with FUT was safely performed and the hemostatic condition was not aggravated either during or after PE in patients with bleeding.

[Infection of C type hepatitis virus in patients with alcoholism. Studied by serum HCV antibody of C100-3 and 2nd generation]

To investigate the infectious situation and causes of hepatitis C virus (HCV) in patients with alcoholism, C100-3 antibody (C100-3) and HCV antibody of the 2nd generation (HCV-2nd) were examined on admission, and the factors that affected the infection of HCV were studied in 226 alcoholics. The positive rate of anti-HCV was as high as 16.4% by C100-3 and much higher by HCV-2nd as 33.2%. The incidence of cases with the history for blood transfusion, drug addict and/or tattoos in alcoholics was as high as 39.4% (89/226). To clarify the influence of the background such as blood transfusion, drug addict and/or tattoos on HCV infection, the positive rate of anti-HCV was compared between those with the background and without the background. In alcoholics without the backgrounds, the positive rate of C100-3 and HCV-2nd were significantly (p less than 0.001) higher than patients without the backgrounds, namely 27.0% vs 9.5%, 56.2% vs 18.2%, respectively. In alcoholics without the backgrounds, the positive rate of anti-HCV became higher in proportion as the age of the patients grows older from 20 to 60 years. These results suggest that a high incidence of HCV infection in alcoholics may resulted from increased the backgrounds that can provide chances of HCV infection and that in those without the backgrounds, alcohol and aging may lead the tolerance to HCV infection.

Double atrial response to a single ventricular extrastimulus in a patient with Wolff-Parkinson-White syndrome

Electrophysiological examination in a 39-year-old male disclosed an accessory pathway between the right atrium and the right ventricle and AV nodal dual pathways. Atrial and ventricular extrastimuli induced paroxysmal supraventricular tachycardia (PSVT), which was shown to be AV reciprocating tachycardia. Double atrial response was noted during ventricular extrastimuli at V1V2 of 280 msec and V1V2 of 250 msec. The first atrial response is considered to have been transmitted in a retrograde fashion in the accessory pathway, and the second atrial response similarly in the slow pathway of the AV node.

Zahn infarct of the liver resulting from occlusive phlebitis in portal vein radicles

A 56-yr-old man had a solitary nodular mass in the right hepatic lobe. The nodule was clinically diagnosed as hepatocellular carcinoma, and a right hepatic lobectomy was performed. The nodule had a previously undescribed histological appearance, and was finally diagnosed as a Zahn infarct with the additional feature of fibrosis. We think that the mass was produced by occlusive phlebitis in a medium-size portal vein radicle and its smaller radicles. This is the case of a very unique Zahn infarct in two respects: 1) the histological appearance (fibrosis), and 2) the fact that it was due to occlusive phlebitis in portal vein radicles. The data obtained here indicate that a special type of Zahn infarct, as represented by this case, may present with clinical information (nodular mass and neovascularity) suggestive of hepatocellular carcinoma.