Coronary flow characteristics of left coronary artery in aortic regurgitation before and after aortic valve replacement

In 6 patients with pure aortic regurgitation, the velocity waveform in the left anterior descending coronary artery (LAD) was measured using an 80-channel 20-MHz-pulse Doppler velocimeter before and immediately after aortic valve replacement. All patients showed normal coronary angiograms. Flow velocity was analyzed by both zero-cross and fast Fourier transform methods in real time. The LAD flow in severe aortic regurgitation was characterized by an increase in the systolic flow component, a small and rapidly decreased diastolic flow, an irregular velocity profile across the vessel, and a wider velocity spectrum. After aortic valve replacement, systolic flow decreased by 36.3 +/- 21.7% (p less than 0.01), whereas diastolic flow increased by 81.4 +/- 51.8% (p less than 0.05). The ratio of diastolic flow to total LAD flow increased from 63 +/- 13% to 82 +/- 7% (p less than 0.05). The velocity profile became more parabolic and had a narrow spectrum. These results suggest that operation for aortic regurgitation induces beneficial effects on the myocardial inflow immediately after valve replacement.

Endogenous Gibberellins from Sporophytes of Two Tree Ferns, Cibotium glaucum and Dicksonia antarctica

Gibberellin A(1) (GA(1)), 3-epi-GA(1), GA(4), GA(9), 11alpha-hydroxyGA(12), 12alpha-hydroxyGA(12), GA(15), GA(17), GA(19), GA(20), GA(25), GA(37), GA(40), GA(58), GA(69), GA(70), and GA(71) have been identified from Kovats retention indices and full scan mass spectra by capillary GC-MS analyses of purified extracts from sporophytes of the tree fern, Cibotium glaucum. Abscisic acid, dihydrophaseic acid, an epimer of 4'-dihydrophaseic acid, and the epimeric ent-6alpha, 7alpha, 16alpha, 17-(OH)(4) and ent-6alpha, 7alpha, 16beta, 17-(OH)(4) derivatives of ent16, 17-dihydrokaurenoic acid, in addition to the epimeric 16alpha, 17- and 16beta, 17-dihydroxy-16, 17-dihydro derivatives of GA(12), were also identified in extracts of C. glaucum. An oxodihydrophaseic acid and a hydroxydihydrophaseic acid were also detected. In extracts of sporophytes of Dicksonia antarctica, GA(4), GA(9), 12alpha- and 12beta-hydroxyGA(12), GA(15), GA(25), and GA(37) were identified by the same criteria, as well as abscisic acid, phaseic acid, 8'-hydroxymethylabscisic acid and dihydrophaseic acid. This is the first time that GA(40) has been identified in a higher plant; it is also the first report of the natural occurrence of the two gibberellins, 11alpha- and 12beta-hydroxyGA(12). The total gibberellin (GA) content in C. glaucum (tall) was at least one order of magnitude greater than that of D. antarctica (dwarf) based on total ion current response in GC-MS and bioassay data. Abscisic acid was a major component of D. antarctica and the oxodihydrophaseic acid was a major component of C. glaucum.

Furosemide-induced alteration of drug pathway to cochlea

The ototoxicity of aminoglycosides is known to be enhanced by post-treatment with loop diuretics. The present experimental study was undertaken to elucidate the mechanism of this enhancement immunohistologically. Intravenously administered kanamycin (KM) reached the organ of Corti rapidly (within 10 min) via the capillaries of the basilar membrane and spiral limbus. Besides this direct pathway, KM penetrated through the perilymphatic space pathway. This penetration, however, took a much longer time (90 min). In contrast, in the case when KM was followed by intravenous furosemide (FM), KM reached the perilymphatic region within a short time (1-5 min). The KM content of the organ of Corti ascertained 1-5 min after FM injection seemed almost equivalent to that determined 90 min after injection of KM alone. This FM-induced change in the time-course penetration pattern of KM might have a bearing on the enhancement of its otoxicity.

Subsets of tonsillar lymphocytes and activated cells in each subset analysed by three-color flow cytometry

Among the four subsets of tonsillar T cells, active cells were most abundant in the helper T subset, followed by the cytotoxic T, inducer T, and suppressor T subsets in order of decreasing cell count. The number of active cells was very small in the suppressor T subset. Plasma cells (PCA-1-positive cells) accounted for only about 3% of tonsillar cells. However, nearly half of the tonsillar B cells were activated (positive for Ba, being either Ba+/IgD+ or Ba+/IgD-). Ba-positive cells were hardly found in the population of peripheral-blood B cells. Ba+/IgD+ cells, which are ready to be transformed to cyclic cells or dormant cells depending upon the degree of stimulation, outnumbered cyclic cells. Many Ba+/IgD+ cells were present even in the small tonsils of adults, although these cells were very scarce in the peripheral blood. These findings show that the tonsil is prepared to perform immunologic functions in prompt response to external stimuli.

Subsets of tonsillar lymphocytes and activated cells in each subset analysed by two-color flow cytometry

We analysed subsets of tonsillar lymphocytes and activated cells in each subset by two-color flow cytometry. There were many helper T cells (CD 4+ leu 8-) and few inducer T cells (CD 4+ leu 8+) in the tonsil. The situation was the reverse in the peripheral blood. The tonsil had few suppressor T cells (CD 8+ CD 11+). The proportion of activated cells (HLA-DR+) was low in the peripheral blood and high in the tonsil. In the tonsil, the ratio of cells with transferrin receptors to total lymphocytes was higher in the B than in the T subset, and higher in the subset of CD 4+ than in that of CD 8+ cells. Activated and proliferating lymphocytes were more abundant in the tonsils of children than in those of adults and more abundant in patients with hyperplastic tonsillitis than in those with recurrent tonsillitis.

Morphological changes of intercellular junctions in the rat submandibular gland treated by long-term repeated administration of isoproterenol

Long-term repeated administration of isoproterenol (IPR) 2 mg/100 g bw, once daily for ten days, resulted in morphological changes in the intercellular junctions of rat submandibular glands, which were investigated by means of the freeze-fracture technique. A significantly increased number of tight-junctional strands was present. These junctional strands extended much deeper toward the basal membrane than those in normal acinar cells. The basal frontier strands that branched from the networks of tight junctions were elongated and had either free-endings or terminal loops, which were more frequently observed in the IPR-treated acinar cells than in untreated acinar cells. Some of the strands of tight junctions were connected to small gap junctions. The diameters of gap junctions were not significantly different from those of control acinar cells. However, smooth areas devoid of particles were found intermingling with the usual packed particles in irregularly shaped small gap junctions. There was no significant difference between the desmosomes of IPR-treated and untreated acinar cells, in terms of either morphology or distribution. These changes in junctional morphology in the IPR-treated acinar cells resemble those seen in salivary glands during development, and in some experimental conditions including tumorous changes.

Drug permeability of the endolymphatic sac

Intravenously injected kanamycin sulfate (KM) was located in the endolymphatic sac (ES) of guinea pigs by an immunohistologic method. Kanamycin sulfate had passed through the capillaries in the subepithelial layer and reached the epithelial layer as early as 1 minute after injection. The amount of KM in the epithelial layer gradually increased with time (until 30 minutes after injection). The KM also accumulated in floating cells in the ES. These results tend to indicate that the ES is rather easily permeable to systemically administered drugs, which readily get into the regional endolymph. In conclusion, much more attention should be paid to the ES and drug ototoxicity associated with drug therapy in the management of patients with inner ear disturbances.

Base liberation from nucleotides by superoxide and intramolecular enhancement effect of phosphate group

The reaction of nucleotides with superoxide gave the corresponding nucleobases in good yield. The base-release reaction of nucleotides due to superoxide was examined and compared to that of nucleosides. Hence, the phosphate moiety greatly enhances the yields, in particular those of adenine from adenosine monophosphates. Superoxide in combination with the phosphate moiety has been revealed to be more active than superoxide alone. The phosphate peroxy radical, generated in situ from superoxide and phosphate, seems to be the species responsible for the formation of the free bases.

The occurrence of IgG in the endolymphatic sac of the guinea pig

We investigated the occurrence of immunoglobulin G (IgG) in the endolymphatic sac (ES) of the guinea pig in order to show that the ES is an organ involved in the immunoreactivity of the inner ear. By using an immunohistological technique, we were able to show that IgG is located mainly in the subepithelial layer of the ES. We also found that IgG is present in some epithelial cells of the ES as well as in free floating cells in the ES lumen. Although plasma cells have been described previously in the subepithelial layer, none could be recognized in this layer of the ES in our specimens. Our results suggest that the ES is an immunoreactive organ of the inner ear in some pathological states, while IgG in the normal ES is primarily of systemic origin.

Enhanced production of gamma-interferon by therapy with parenteral OK-432 and alpha-interferon in patients with head and neck cancer

Although the drug OK-432 can induce the release of gamma-interferon (IFN-gamma), the serum concentrations of IFN-gamma produced are very low. We studied the effects of combining OK-432 with alpha-interferon (IFN-alpha) on the endogenous production of IFN and the postoperative courses of patients with oral cavity cancers. Forty patients operated on for head and neck cancers were studied. Each patient was given an injection of OK-432 1 week after surgery. Between 10 and 14 days later, a combination of OK-432 and IFN-alpha was given to assess the effects of the concomitant use of IFN-alpha on IFN production. In 18 of the 30 patients given a large dose of IFN-alpha (3 or 5 X 10(6) IU/mg protein), IFN production induced by OK-432 was enhanced. A small dose of IFN-alpha (7 X 10(3) IU) did not enhance the action of OK-432. OK-432 also induced the release of both endogenous IFN-gamma and IFN-alpha, and the production of both types of IFN was enhanced by the concomitant administration of parenteral IFN-alpha. Next, 50 patients operated on for oral cavity cancers were given OK-432 or a combination of OK-432 and IFN-alpha for 4 months, and their postoperative courses were followed for 2-5 years. The clinical courses were better in the combined therapy group than in the group given OK-432 alone.

Metabolic pathway of 2-deoxy-2-fluoro-D-glucose studied by F-19 NMR

The behavior of 2-deoxy-2-fluoro-D-glucose (FDG) in mouse has been studied by F-19 NMR method for long period. The F-19 NMR signals of FDG or its metabolites were observed in tissues without serious broadening. FDG was found to be accumulated in organs in the form of FDG or FDG-6-phosphate and 2-deoxy-2-fluoro-D-mannose (FDM) or FDM-6-phosphate, and the latter dominated the former in the heart sampled at 24 hr or later. The fluorine compounds were excreted in urine in both forms. The clearance was rapid from brain, liver, and blood, but was slow from heart.

[Imaging diagnosis of hepatobiliary system and pancreas--computed tomography, ultrasound and angiography]

CT, US and angiography have become the most important examinations in the diagnosis of hepatobiliary and pancreatic diseases. Therefore updated and precise knowledge of these modalities are mandatory not only for the diagnosis but also for the interventional radiology in this field. General review on the advantages and limitations of these medical images are described.

Nodular fascitis of the mandible in a child

Nodular fascitis is an unusual, tumor-like, proliferative, fibroblastic lesion with infiltrative properties. We describe a case of nodular fascitis appearing in the mandible of a 2-year-old boy. A brief review of the literature on this lesion arising from intra or perioral regions, and the importance of differential diagnosis for this lesions are discussed.

Studies on 3-methoxy-4-hydroxyphenylglycol (MHPG) and 3,4-dihydroxyphenylglycol (DHPG) levels in human urine, plasma and cerebrospinal fluids, and their significance in studies of depression

Both concentrations of total 3-methoxy-4-hydroxyphenylglycol (MHPG) and 3,4-dihydroxyphenylglycol (DHPG) in the human urine, plasma and CSF were determined with a high-pressure liquid chromatography with electrochemical detection in order to clarify the dynamic change in these noradrenaline metabolites. Three different biological fluids were collected simultaneously from 16 orthopedic patients who were regarded clinically as substitutes for normal subjects. In the urine, the MHPG concentrations were 1.67 +/- 0.65 micrograms/mg creatinine (mean +/- S.D.) and DHPG 0.39 microgram/mg creatinine +/- 0.21. The plasma levels were 21.16 ng/ml +/- 9.58 for MHPG, and 19.58 ng/ml +/- 8.13 for DHPG. The CSF levels of MHPG and DHPG were 24.08 ng/ml +/- 8.10 and 34.76 ng/ml +/- 11.46, respectively. The CSF levels of these metabolites were correlated significantly with those in the plasma (r = 0.852, p less than 0.001 for MHPG; r = 0.799, p less than 0.001 for DHPG), while no significant correlations were found between the urinary levels and either the plasma or CSF levels of these metabolites. In the urine, the MHPG levels were proportional to the DHPG levels, while the former were inversely proportional to the latter in the plasma or CSF. Neither the MHPG nor DHPG levels in the urine from depressed patients revealed to have any significant correlation with their clinical assessments using the Hamilton Rating Scale Score (HRS). The patients were treated with an antidepressant active selectively on the noradrenergic system, and no significant changes in urinary excretion of these metabolites were observed before and after the drug treatment. These findings suggest that in the case of psychiatric disorders such as depression, these compound levels in the plasma or CSF would provide more important information than those in the urine.

Identification of Ten Gibberellins from Sporophytes of the Tree fern, Cyathea australis

Ten gibberellins (GAs) have been identified by Kovats retention indices and full mass spectra from GC-MS analysis of purified extracts of sporophytes of the tree-fern, Cyathea australis. These include the known GA(1), GA(4), GA(9), GA(15), GA(24), GA(35), and GA(58) and three new GAs, 12beta-hydroxyGA(9) (GA(69)), 12alpha-hydroxyGA(9) (GA(70)) and 12beta-hydroxyGA(4) (GA(71)). The structure of GA(71) was established by the preparation and characterization of its methyl ester (as a metabolite of GA(4) methyl ester in a culture of prothallia of Lygodium japonicum).

Location of intravenously injected kanamycin sulfate in the middle ear mucosa

Twelve guinea pigs were treated with intravenous kanamycin sulfate (KM) and sacrificed 2, 5, 10, and 30 min later to investigate its location in the middle ear mucosa, especially in the Eustachian tube (ET). Immunological examinations evidenced KM in the epithelial and subepithelial layers of the ET on each occasion of observation. But, it was never recognized in the tubal gland. These observations might indicate that clinically used drugs easily get to the ET except for the tubal gland which might have some barrier mechanism against foreign bodies.

[Several factors influencing the male sexual function in patients with atherosclerotic disease]

Patients with arteriosclerosis obliterans (ASO, n = 58), abdominal aortic aneurysm (AAA, n = 27) and the combined disease (n = 4) were the subjects of this study. All patients were evaluated by retrograde aortography and questioned personally as to their present male sexual function. The penile and ankle systolic pressure index (PSPI and ASPI) of patients with ASO were measured using a Doppler device, but in the patients with AAA, only the PSPI was taken. Several factors relating to male sexual function, such as, age, PSPI, ASPI, sites of the arterial occlusion or dilatation, classification of the ischemic symptoms according to Fontaine's category, numbers of pulsations of the femoral artery, were statistically analysed. All of the patients with both diseases, 66 percent of those with ASO and 52 percent of those with AAA were impotent. In the patients with AAA, the PSPI of the potent group was not significantly higher than that of the impotent group; however, in patients with ASO, the PSPI of the former group was significantly higher than that of the latter group. In the patients with ASO, a significant correlation between the PSPI and the ASPI (r = 0.49, p less than 0.01) was found. When a PSPI value (PSPI = 0,70) was chosen as a demarcation between the impotent group and the potent group, 84 percent of the patients with ASO were correctly classified. However, when the ASPI (ASPI = 0.45) was used, only 69 percent were properly classified.(ABSTRACT TRUNCATED AT 250 WORDS)

Auditory brain-stem response and temperature: relationship in the guinea pig

The neurological applications of the auditory brain-stem response depend largely on the stability of the interval between the peaks of waves I and V. Using guinea pigs, it was demonstrated that hyperthermia and small temperature changes, as well as hypothermia, may affect interpeak latency (IPL) sufficiently to affect its clinical interpretation. The relationship between temperature and IPL is specified by a power function such that there is a 5.3% increase in IPL for a 1 degree C drop. Although the constant for humans may differ from that of guinea pigs, the results of this animal study demonstrate that the relationship between temperature and IPL is invariant from 27 degrees C to 40 degrees C.

Free-floating cells in the endolymphatic sac after surgical utricular nerve section

Free-floating cells (FFC) in endolymphatic sac (ES) were microscopically examined, counted, and statistically studied in 8 squirrel monkeys after the unilateral section of the utricular nerve (UNS). After the operation these monkeys were kept for 17-38 days until the acquisition of functional (locomotor balance) compensation was completed. The result showed twice more FFC in the ES on the operated side, than those on the nonoperated side. The result showed a significant increase (p less than 0.05) of FFC in the ES under the pathological condition with autogenous debris in the endolymphatic space, and proved the existence of some reactive role of the ES to the labyrinthine insult.

Alteration of strial capillary transport in kanamycin-treated guinea pigs

Ferritin transport through the strial capillary during kanamycin intoxication was examined under a transmission electron microscope. Twelve guinea pigs were treated intramuscularly with kanamycin (400 mg/kg/day) for 2-3 weeks. When full hearing loss was recognized by estimating the Preyer reflex or auditory brain-stem response (ABR), ferritin was given intravenously and animals were sacrificed 1/3, 1, and 2 h later. At 1/3 h, ferritin was present diffusely not only in the endothelial cell but also in the basal lamina and within vesicles in the strial cell. Alternatively, it was discharged into the endolymphatic space. At 2 h, ferritin was seen on the luminal surface and in the cytoplasm of the endolymphatic cells of Reissner's membrane. These results suggest that the basal lamina of the strial capillary was altered qualitatively by kanamycin administration.

Frequency-selective auditory brain-stem response in newborns and infants

The efficacy of the frequency-selective auditory brain-stem response (ABR) in new borns and infants was assessed using an auditory stimulus of a 1-kHz tone pip and compared with the results of click-evoked ABR. In subjects whose responses to conventional behavioral audiometry were obtained at intensities of 40 to 70 dB, the ABR thresholds evoked by 1-kHz tone pips and clicks lay between 5 and 20 dB hearing threshold level (HTL). In subjects who did not respond to conventional behavioral audiometry at the intensity of 70 dB, ABR thresholds in each auditory stimulus were elevated by 35 to 70 dB HTL, and no responses were noted at 80 to 90 dB HTL. These results indicate that frequency-selective ABR can be applied clinically as an objective method of audiometry for newborns and infants.

Otoconia degradation

During certain stages of mammalian inner ear development, small crystallized bodies which resemble otoconia may be found in the endolymphatic sac. In order to examine whether the endolymphatic sac plays any part in the process of degradation and dissolution of otoconia, we made an electron-microscopic examination on the endolymphatic sac of fetuses and adult guinea pigs injected with streptomycin sulfate (SM). In 30-day-old fetal guinea pigs we found miniature otoconium-like bodies (OLBs) in the endolymphatic sac and a giant OLB in the endolymphatic duct. In adult animals we found no otoconia in the endolymphatic sac following SM intoxication. However, the results suggested that both the dark cells of the utricle, as well as the non-sensory epithelium of the saccule, may be engaged in the absorption and dissolution of otoconia.

Application of loop diuretics for treatment of sensorineural hearing impairment. Experimental and clinical study

In a series of animal experiments on guinea pigs and rats, conducted in an attempt to find a better solution for the treatment of sensorineural hearing impairment and tinnitus-known as diseases almost impossible to heal-it was revealed electrophysiologically, biochemically and electronmicroscopically that loop diuretics, referred to as ototoxic drugs, cause an increased amount of the therapeutic preparation to transfer to the inner ear fluid. It is concluded, on the basis of the encouraging results of these experiments, that combined medication with metabolic activator, steroid hormone and loop diuretics is significantly more effective in improving the symptoms of patients with inner ear deafness and tinnitus.