Dorsal dislocation of the four ulnar metacarpals

A patient presented to the emergency department (ED) with hand pain after striking a wall with a partially clenched fist. X-rays showed small dorsal carpal avulsion fractures and a dorsal dislocation of the ulnar four metacarpals. Closed reduction maneuvers reduced all but the second metacarpal. The patient underwent open reduction, internal fixation of this joint, and was healed within 6 weeks. Although typically associated with significant amounts of kinetic energy, the particular position of the hand and wrist during this injury may have allowed this dislocation pattern to occur with relatively minor trauma. A discussion of this injury, the carpometacarpal joint, and important radiographic features is presented.

Endoscopic sinus surgery for the treatment of frontoethmoidal mucocele complicated with orbital abscess: a case report

Mucoceles may develop after several decades following sinus surgery. They can progressively expand over many years and destroy the surrounding bones, which may result in severe complications such as orbital infection or intracranial lesions. A 68-year-old woman was hospitalized with the chief complaints of exacerbated right orbital swelling and progressive visual loss for one week in May 1995. Under the impression of the right frontoethmoidal mucocele complicated with orbital abscess, she underwent endoscopic sinus surgery for marsupialization and wide drainage of the mucocele. The symptoms subsided one week post-operatively without ophthalmological sequelae. There has been no recurrence one-year post-operatively. Endoscopic sinus surgery is an effective treatment for frontoethmoidal mucocele.

Nitric oxide-dependent and -independent norepinephrine release in rat mesenteric arteries

The role of nitric oxide (NO) in endogenous norepinephrine (NE) release in the perfused isolated rat mesenteric vasculature was examined. NE overflow elicited by electrical field stimulation (EFS) at various frequencies was significantly smaller at 24 than at 37 degrees C. The pressor response upon EFS at 8 and 10 Hz, however, was higher at 24 than at 37 degrees C. When production of NO was blocked by N omega-nitro-L-arginine (L-NNA), NE overflow upon EFS at each frequency of stimulation was diminished by 50% at 37 degrees C but remained unchanged at 24 degrees C, whereas the pressor response elicited by EFS became greater at 37 than at 24 degrees C. These effects of L-NNA were reversed by L-arginine, but not by its D-enantiomer. Sodium nitroprusside, an NO donor, increased EFS-elicited NE overflow at 24 degrees C but had no effect at 37 degrees C. These results demonstrate that NE release is NO dependent and NO independent. The NO-dependent mechanism is more sensitive to cooling than the NO-independent mechanism. The increase in EFS-elicited perfusion pressure at 24 degrees C may be due to reduction in synthesis of NO (a potent vasodilator), thus unmasking the effect of NE and other noncatecholamine vasoconstrictors.

Congenital quadrigeminal lipoma with osteocartilagenous element. A case report

A case of congenital tectal lipoma found incidentally at an autopsy is reported. This female fetus was a product of pregnancy termination at 24 weeks of gestational age after sonographic detection of hydrocephalus. Autopsy revealed a small mass in the periaqueductal portion. The mass was composed of adipose tissue, cartilage, and mature bony tissue with hematopoiesis. The resultant diagnosis was tectal lipoma with osteocartilagenous element. It is uncertain whether the lesion represents a teratoma or hamartoma or mesenchymal metaplasia. The osteocartilagenous component suggests the latter.

Norepinephrine attenuates serotonin inhibition of pial venous tone

Serotonin (5-hydroxytryptamine, 5-HT) has been shown to inhibit the rhythmic constrictions, accompanied by an increase in cAMP synthesis, in porcine pial veins. Since porcine pial veins contain predominant postsynaptic alpha 2-adrenoceptors which are coupled to Gi-protein, the possibility that the inhibitory effect of 5-HT is antagonized by norepinephrine was examined pharmacologically, using tissue bath techniques. The results indicated that norepinephrine (0.1-1 microM) attenuated 5-HT-induced inhibition of rhythmic constriction. This effect of norepinephrine was mimicked by clonidine (an alpha 2-adrenoceptor agonist), but not by methoxamine (an alpha 1-adrenoceptor agonist). Furthermore, the effect of norepinephrine was prevented by yohimbine (an alpha 2-adrenoceptor antagonist) and pertussis toxin, but was not prevented by prazosin (an alpha 1-adrenoceptor antagonist). In parallel studies, the basal concentration of cAMP and that induced by 5-HT in the pial veins were inhibited by norepinephrine (0.3 microM). These results are consistent with the previous findings that 5-HT-induced inhibition of rhythmic constriction in the porcine pial veins is associated with an increase in vascular cAMP synthesis and suggest that norepinephrine attenuates 5-HT-induced inhibition of rhythmic constriction in part by negatively coupling to adenylate cyclase via alpha 2-adrenoceptors.

Inhibition of cerebral neurogenic vasodilation by L-glutamine and nitric oxide synthase inhibitors and its reversal by L-citrulline

The possibility that L-citrulline is able to reverse inhibition of neurogenic vasodilation in isolated porcine cerebral arteries produced by nitric oxide synthase (NOS) inhibitors and Gln was examined by using in vitro tissue bath techniques. The results indicated that transmural nerve stimulation elicited a frequency-dependent and tetrodotoxin-sensitive vasodilation in isolated ring segments of arteries with or without endothelial cells. The dilation was abolished by L-N-omega-nitro-L-Arg and L-N-omega-L-Arg methyl ester and was completely reversed by L-citrulline, but not by D-citrulline. In parallel studies, the transmural nerve stimulation-induced relaxation was blocked in part by Gln. The blockade was completely reversed by L-citrulline and L-Arg, but not by their D-enantiomers. The time courses of relaxation after L-citrulline reversal of inhibition of vasodilation produced by Gln and NOS inhibitors were identical to that of relaxation in the control. The residual relaxation after L-citrulline reversal was abolished by L-NNA and L-N-omega-nitro-L-Arg. At 1 mM, L-glutamate, tau-aminobutyric acid or NH4Cl did not block transmural nerve stimulation-induced relaxation, nor did Gln inhibit sodium nitroprusside-induced relaxation or neuronal NOS activity. These results provide pharmacological evidence that cerebral perivascular nerves can recycle L-citrulline to L-Arg for synthesizing nitric oxide to induce neurogenic vasodilation. Although the exact mechanism of action of Gln in inhibiting nitric oxidergic neurovascular transmission remains undetermined, Gln does not seem to act by releasing ammonium ions, inhibiting NOS or modifying the nitric oxide-cyclic GMP pathway. Cerebral metabolism of Gln may play an important role in regulating nitric oxidergic neurogenic vasodilation.

Inhibition of alpha1-adrenoceptor-mediated contractions in isolated tail arteries and aorta of the rat by alpha2-adrenoceptor agonists

The effects of alpha2-adrenoceptor agonists, clonidine, tizanidine and UK-14304 on alpha1-adrenoceptor-mediated contractile responses were studied in isolated tail arteries and thoracic aorta of the rat. When applied during sustained contractile responses to almost maximum concentration (10 microM) of phenylephrine, clonidine (0.3 microM to 100 microM) produced concentration-dependent relaxations in both tissues. The maximum relaxation was smaller in tail arteries than in thoracic aorta. Clonidine up to 100 microM failed to relax both tissues precontracted with KCl (60 microM) or U-46619 (1 microM), a thromboxane mimetic. The clonidine-induced relaxation in tail arteries, was reversed by alpha2-adrenoceptor antagonists, yohimbine and idazoxane. Effects of the alpha2-adrenoceptor antagonists were concentration-dependent (0.1 microM to 1 microM), but not in a competitive manner. On the other hand, the relaxation in thoracic aorta was not significantly antagonized by these alpha2-adrenoceptor antagonists. Tizanidine and UK-14304 also relaxed both tail arteries and thoracic aorta precontracted with phenylephrine. The characteristics of the relaxation and their antagonism by yohimbine in both arteries were similar to those induce by clonidine. In tail arteries, NG-nitro-L-arginine, a nitric oxide synthase inhibitor, at a concentration that completely inhibited acetylcholine-induced relaxations did not significantly affect the relaxation induced by clonidine. In contrast, the relaxation of thoracic aorta in response to clonidine was partly reduced in the presence of NG-nitro-L-arginine. These results indicate that the alpha2-adrenoceptor agonists selectively inhibit the contractions induced by phenylephrine in both tissues. Regional differences in the modes of the inhibition by the alpha2-adrenoceptor agonists exist.

Microform cleft lip associated with a complete cleft palate

Clefting of the lip with or without an associated cleft palate may be present in varying degrees of severity. The so-called microform cleft lip or forme fruste has been characteristically described as having the appearance of a repaired cleft lip. The following case describes a patient with microform cleft lip and a complete cleft of the hard and soft palates. To the best of our knowledge, this is the first report of such an association.

Effect of insulin-like growth factor type 1 on critical-size defects in diabetic rats

A number of investigators have reported on the clinically significant relationship between diabetes mellitus and impaired wound healing. Diabetic patients have an increased frequency of infection, delayed scar formation, and poor bony union. Investigations completed in our laboratory have demonstrated that insulin-like growth factor type 1 (IGF-1), a somatomedin C, has shown promise for accelerating bony repair. The purpose of this study was to examine the effects of recombinant IGF-1 on standardized, critical-size calvarial defects in 25 adult, male streptozocin-induced diabetic rats. From our study, it appears that IGF-1 exerts a potentiating effect on the repair of bony defects in diabetes-induced rats.

Ginsenosides-induced nitric oxide-mediated relaxation of the rabbit corpus cavernosum

1. Ginsenosides, the active ingredients extracted from Panax ginseng, have been shown to promote nitric oxide (NO) release in bovine aortic endothelial cells. Since the endothelial cells and the perivascular nerves in penile corpus cavernosum contain NO synthase and an NO-like substance has been shown to be released from these cells which relaxes corpus cavernosum, the possibility that ginsenosides may relax corpus cavernosum by releasing endogenous NO was examined. 2. With an in vitro tissue superfusion technique, ginsenosides (250, 500 and 750 micrograms ml-1) relaxed corpus cavernosum, concentration-dependently. 3. Using an in vitro tissue bath technique, acetylcholine (ACh)-induced relaxations were increased in the presence of ginsenosides (250 micrograms ml-1). 4. Ginsenosides at 100 micrograms ml-1 significantly enhanced the tetrodotoxin (TTX)-sensitive relaxation of corpus cavernosum elicited by transmural nerve stimulation. 5. The ginsenosides-induced, ACh-induced and ginsenosides-enhanced transmural nerve stimulation-elicited relaxations were significantly attenuated by NG-nitro-L-arginine (100 microM) and oxyhaemoglobin (oxyHb; 5-10 microM), and were enhanced by superoxide dismutase (SOD; 50 u ml-1). 6. The relaxations and their attenuation by NG-nitro-L-arginine and TTX were associated with increase and decrease in tissue cyclic GMP levels, respectively. 7. It is concluded that ginsenosides may release NO from endothelial cells, and enhance NO release from endothelial cells elicited by other vasoactive substances and from perivascular nitrergic nerves in the corpus cavernosum. These endothelial and neurogenic effects of ginsenosides in inducing relaxation of the corpus cavernosum may account for the aphrodisiac effect of Panax ginseng.

Arginine synthesis from citrulline in perivascular nerves of cerebral artery

Cerebral neurogenic vasodilation is mediated predominantly by nitric oxide (NO). Thus, NO was suggested to be a vasodilator transmitter. In the present study, the possibility that cerebral perivascular nerves can convert citrulline to arginine was examined to ascertain that NO is derived directly from these perivascular nerves. To investigate the uptake of citrulline and its conversion to arginine, both fresh and cold storage-denervated porcine cerebral arteries with or without endothelial cells were incubated at 37 degrees C for 2 hr in Krebs-Ringer bicarbonate buffer containing 0.5 mM purified [14C]ureido-citrulline. The formation of [14C]arginine was measured as 14CO2 by a coupled enzymatic assay involving arginase and urease. The abolishment of nitric oxidergic nerves was verified by NADPH-diaphorase (constitutive NO synthases) histochemical staining method. The results indicated that there was an active conversion of [14C]arginine from [14C]citrulline in nerve-intact arteries denuded of endothelial cells. The conversion was significantly decreased in denervated arteries, accompanied by a significantly reduced citrulline uptake into these denervated arteries. L-Glutamine, but not L-glutamate, gamma-aminobutyric acid, or nitro-L-arginine significantly inhibited the uptake of [14C]citrulline into cerebral perivascular nerves. These data suggest that porcine cerebral vasodilator nerves are nitric oxidergic in nature and citrulline, co-produced with NO by NO synthases from arginine, can be recycled to form arginine in these nerves. The existence of a functional arginine-citrulline cycle may contribute to a constant supply of L-arginine and suggests a neuronal source of NO for inducing cerebral vasodilation.

A novel 5-HT1-like receptor subtype mediates cAMP synthesis in porcine pial vein

The 5-hydroxytryptamine (5-HT) receptor subtype mediating 5-HT inhibition of spontaneous rhythmic contractions (SRC) in the porcine pial vein was characterized. Results from pharmacological studies using in vitro tissue bath techniques indicated that the inhibitory effects of 5-HT on SRC were qualitatively and quantitatively mimicked by 5-HT1-like agonists 5-methoxytryptamine (5-MT) and 5-carboxamidotryptamine (5-CT). 5-HT-, 5-MT-, and 5-CT-induced inhibitions of SRC were attenuated in a concentration-dependent manner by methysergide, which yielded similar pA2 values against these three agonists, suggesting that 5-HT, 5-MT, and 5-CT act on the same 5-HT1-like receptors. 5-MT inhibition of SRC was not affected by blocking 5-HT2 (with ketanserin and spiperone), 5-HT3 (with MDL-72222 and ICS-205-930), or 5-HT4 (with ICS-205-930) receptors. Neither was 5-MT inhibition of SRC affected by blocking 5-HT1A (with propranolol and spiperone), 5-HT1B (with propranolol), or 5-HT1C (with ketanserin) receptors. Furthermore, 5-HT and 5-MT inhibitions of SRC were enhanced by cilostazol [a selective adenosine 3',5'-cyclic monophosphate (cAMP) phosphodiesterase inhibitor] and were diminished by KT-5720 (a cAMP-dependent protein kinase inhibitor) but were not affected by M&B-22948 [a selective guanosine 3',5'-cyclic monophosphate (cGMP) phosphodiesterase inhibitor] or KT-5823 (a cGMP-dependent protein kinase inhibitor). Biochemical studies further demonstrated that 5-HT inhibition of SRC in porcine pial veins was accompanied by an increase in cAMP, but not cGMP, synthesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Protein farnesyltransferase inhibitors block the growth of ras-dependent tumors in nude mice

The posttranslational addition of a farnesyl moiety to the Ras oncoprotein is essential for its transforming activity. Cell-active inhibitors of the enzyme that catalyzes this reaction, protein farnesyltransferase, have been shown to selectively block ras-dependent transformation of cells in culture. Here we describe the protein farnesyltransferase inhibitor 2(S)-[2(S)-[2(R)-amino-3-mercapto]propylamino-3(S)-methyl] pentyloxy-3-phenylpropionylmethioninesulfone methyl ester (L-739,749), which suppressed the anchorage-independent growth of Rat1 cells transformed with viral H-ras and the human pancreatic adenocarcinoma cell line PSN-1, which harbors altered K-ras, myc, and p53 genes. This compound also suppressed the growth of tumors arising from ras-transformed Rat1 cells in nude mice by 66%. Under the same conditions, doxorubicin inhibited tumor growth by 33%. Control tumors formed by v-raf- or v-mos-transformed Rat1 cells were unaffected by L-739,749. Furthermore, mice treated with L-739,749 exhibited no evidence of systemic toxicity. This is a demonstration of antitumor activity in vivo using a synthetic small molecule inhibitor of protein farnesyltransferase.

Differentiation of Mycobacterium tuberculosis strains by arbitrarily primed polymerase chain reaction-based DNA fingerprinting

Arbitrarily primed polymerase chain reaction (AP-PCR) method was applied to the differentiation of clinical isolates of M. tuberculosis strains. The primer which is specific to human papilloma virus (HPV) type 18 was found to be appropriate for the AP-PCR-based differentiation of M. tuberculosis isolates, since AP-PCR produced multiple polymorphic DNA bands when M. tuberculosis DNA was used as template. AP-PCR was performed using either one of the HPV type 18 primer and IS6110-specific primer (half-specific PCR, HS-PCR) or HPV type 18 primer pair only (nonspecific PCR, NS-PCR). The usefulness of these two methods in differentiating M. tuberculosis isolates, was measured by calculating dissimilarity values of 16 isolates using Cluster Analysis software. The highest dissimilarity values by HS-PCR and NS-PCR methods were 0.38 and 0.59, respectively. This suggested that NS-PCR method is better than HS-PCR method in strain differentiation. Although the dissimilarity value calculated by Cluster analysis of the standard restriction fragment length polymorphism method, in which IS6110 was used as a probe, was much more higher than the NS-PCR method, NS-PCR method using HPV 18 primers was quite useful for the differentiation of M. tuberculosis strains due to its rapidity and simplicity.

Cerebral pial arterial innervation with special reference to GABAergic innervation

Glutamic acid decarboxylase (GAD)-immunoreactive (I) nerve fibers were observed to run parallel to other autonomic nerve fibers, especially vasoactive intestinal polypeptide (VIP)- and calcitonin gene-related peptide (CGRP)-I nerve fibers at the light microscopic level. At the ultrastructural level, GAD-immunoreactivities co-localized with CGRP immunoreactivities in nerve terminals, but not with choline acetyltransferase, VIP, tyrosine hydroxylase and neuropeptide Y immunoreactivities. GAD immunoreactivities were observed in the trigeminal ganglion, some of which were co-localized with CGRP-immunoreactivities. In the proximal portion of the internal carotid artery, GAD-I adventitial ganglion cells were observed and some were also immunoreactive for CGRP. These results strongly suggest that the origin of GABAergic innervation of the major cerebral pial arteries of the cat is mainly in the trigeminal ganglion, and partly in the adventitial ganglia of the internal carotid artery.

Serotonin relaxes porcine pial veins

The effect of serotonin [5-hydroxytryptamine (5-HT)] on pial venous tone of the pig was examined using in vitro tissue bath techniques. Isolated pial venous rings exhibited spontaneous rhythmic contractions (SRC) on mechanical stretching and/or applications of several vasoactive substances, including norepinephrine. On the other hand, KCl induced sustained active muscle tone (SAT) without SRC. The SRC induced by mechanical stretching were not affected by tetrodotoxin, nitro-L-arginine, alpha- and beta-adrenergic, histaminergic, and muscarinic receptor antagonists, indicating that the SRC in porcine pial veins are of myogenic origin. The SRC induced by stretching or applications of vasoactive substances and SAT induced by KCl were inhibited by 5-HT in a concentration-dependent manner. The inhibition was prevented by methysergide and methiothepin but not by ketanserin, propranolol, 3 alpha-tropanyl-1H-indole-3-carboxylic acid ester, hemoglobin, or nitro-L-arginine. The SRC and SAT were inhibited by 5-carboxamidotryptamine (5-CT), 8-hydroxy-2-di-N-propylaminotetralin HBr (8-OHDPAT), 1-[3-(trifluoromethyl)phenyl]piperazine (TFMPP), and 5-methoxytryptamine (5-MT), but not by sumatriptan, alpha-methylserotonin, or 2-methylserotonin. On the other hand, 5-CT, 8-OHDPAT, TFMPP, 5-MT, and sumatriptan constricted the porcine pial arteries exclusively. In 15% of pial venous preparations examined, 5-HT at low concentrations induced ketanserin-sensitive constrictions. These results indicate that the porcine pial venous smooth muscle contains multiple subtypes of 5-HT receptors. The 5-HT inhibition of SRC and SAT is predominant and is mediated by 5-HT1-like receptors, which, however, do not seem to correspond to 5-HT1A, 5-HT1B, 5-HT1C, 5-HT1D, 5-HT1E, or 5-HT1F receptor subtypes.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of N omega-nitro-L-arginine and capsaicin on neurogenic vasomotor responses in isolated mesenteric arteries of the monkey

Monkey isolated mesenteric arterial rings denuded of endothelium constricted upon transmural nerve stimulation (TNS) in the absence of active muscle tone. The constriction was potentiated by N omega-nitro-L-arginine (3 x 10(-5) M), but not by the D-enantiomer (3 x 10(-5) M). The potentiation was reversed by L-arginine (3 x 10(-4) M). The neurogenic vasoconstriction of mesenteric arteries was also augmented by capsaicin, but to a lesser extent than that induced by N omega-nitro-L-arginine. Indomethacin (10(-5) M) did not affect TNS-induced vasoconstriction. These findings suggest that nerve-derived nitric oxide or a related substance may play a greater role than do capsaicin-sensitive vasodilator transmitters in neurogenic regulation of mesenteric arterial tone in the monkey. The transmitter mechanisms for vasodilation in mesenteric circulation vary among species.

[The mode of medical inference in the history of medicine]

In the primitive ages the system of thought about health and disease was a closed system of thought which had the premise of witchcraft. In the ancient and middle ages the problems of health and disease had been dealt with within logical thinking but the phenomena of human life had been explained metaphysically and the medical problems had been inferred from deductive logic. The abnormalities of health problems which were inferred from deductive logic had not been substantiated because anatomy, physiology and technology had not been advanced far enough. In the Renaissance and modern ages the knowledge of anatomy, physiology and pathology of living body have begun to increase. The human body could be explained in the terms of structure and function of the body as a machine. Approaching this way the disease has been understood as the abnormality of structure or function of the body and the problems of health and disease are inferred from inductive logic. ...

Endotoxin decreases the contractile responses of the porcine basilar artery to vasoactive substances

The effects of endotoxin (lipopolysaccharide; LPS) on the reactivity of isolated porcine basilar artery were examined using in vitro tissue bath techniques. The active muscle tone of the basilar arterial rings with or without endothelial cells induced by U46619 (1 microM) reached a plateau in 15 min, which was stable for the first hour and gradually decreased during the next 5 h. This time-dependent decrease in tone was significantly potentiated in the presence of LPS (20 micrograms/ml). The potentiation by LPS was blocked by Nw-nitro-L-arginine (L-NNA; 60 microM), methylene blue (10 microM), and dexamethasone (1 microM) but not by hemoglobin (1 microM). The effect of L-NNA was readily reversed by L-arginine but not by D-arginine. Furthermore, the contractile responses of porcine basilar arterial rings with or without intact endothelium to U46619 and KCl were decreased following incubation with LPS (20 micrograms/ml) for 4 h. Similar hyporeactivity was observed in cold storage-denervated cerebral arteries incubated with LPS for 4 h. This decrease in contractile responses in LPS-treated rings was reversed by 60 microM L-NNA and 1 microM dexamethasone. These results indicate that LPS treatment renders the porcine basilar arteries hyporesponsive to vasoconstrictors. Since effects of LPS were not modified by the presence of endothelial cells and perivascular neurons, the alteration in cerebral arterial reactivity may be due in part to an enhanced formation of nitric oxide from L-arginine in the vascular smooth muscle cells.

Role of nitric oxide in neurogenic vasodilation of porcine cerebral artery

A superfusion bioassay cascade, with porcine pial arteries as donor tissues and rabbit aortic rings as detector tissues, was used to examine the role of nitric oxide (NO) in cerebral nonadrenergic, noncholinergic neurogenic vasodilation. All arteries were mechanically denuded of endothelium. In the presence of atropine (1 microM) and guanethedine (0.3 microM), transmural nerve stimulation (TNS) of cerebral arteries (CA) resulted in a frequency-dependent relaxation of phenylephrine-precontracted aortic rings. Relaxation was abolished by tetrodotoxin (2 microM) superfused onto and by cold-storage denervation of CA, suggesting that a vasodilating factor (VF) of neuronal origin in CA was released upon TNS. The VF-induced relaxation was inhibited by NW-nitro-L-arginine (0.3 mM) superfused onto CA. This inhibition was reversed by L-arginine (0.3 mM) but not D-arginine (0.3 mM). Exogenously applied NO onto CA also induced dilations of aortic rings in a concentration-dependent manner. The VF- and NO-induced dilations, which were abolished by hemoglobin (0.3 microM), and enhanced by superoxide dismutase (30 U/ml), declined to the same extent with similar time courses from the first to the second aortic ring. These findings indicate that VF and NO possess a similar labile nature and half-life, suggesting that VF is NO or a related substance. Identical frequency-response curves of TNS (2-16 Hz) and concentration-response curves of NO (10-1000 nM) further suggest that < 1000 nM of NO was released from CA upon TNS at the maximal frequency used.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of hemoglobin on sympathetic neurovascular transmission in the porcine cerebral circulation

Subarachnoid hemorrhage (SAH) exposes the adventitia of the cerebral blood vessels to erythrocytes which lyse to release hemoglobin (Hb). Both SAH and Hb have been demonstrated to deplete adrenergic innervation and alter neurogenic responses in these vessels. We examined the effect of Hb on sympathetic adrenergic transmission in isolated pig cerebral arteries. The results indicate that Hb blocks neuronal [3H]norepinephrine ([3H]NE) uptake into anterior cerebral, internal carotid, and middle cerebral arteries in a dose-dependent manner. Gel-filtration experiments suggest that the mechanism underlying the [3H]NE uptake blockade involves binding of NE to Hb, rather than a specific blockade of the uptake pump. Although Hb blocked [3H]NE uptake, it did not influence electrically stimulated, tetrodotoxin (TTX)-sensitive [3H]NE release from cerebral arteries. These findings indicate that the presence of Hb in the subarachnoid space may alter cerebrovascular sympathetic transmission by preventing NE uptake. The altered neurogenic responses observed in the presence of Hb may be influenced by the affinity of NE for this protein but also may involve release of a substance other than NE from the sympathetic terminals.

[A medico-historical review on biomedicine and its limitations and problems]

Biomedicine is a conceptualized technical term for current medicine in a historical perspective. Physics, chemistry and biology are considered to be the sciences basic to biomedicine. This medical model depends essentially on a mechanistic approach based on understanding of the structure and function or the body. The biomedical model assumes that illness can be explained in terms of morphological, physiological and biochemical derangements or dysfunctions (a reductionist concept of disease). As medicine of primitive ages and ancient times can be conceptualized in terms of witch-philosophical medicine, medicine of the Middle Ages can be conceptualized in terms of religious medicine. The early steps by which modern medical sciences have been gradually built up appeared in the 10th and 17th century. In those ages direction and methodology forward scientific medicine were established. Medicine of Renaissance ages can be conceptualized in terms of mechanical medicine. Remarkable progress has been made in biomedicine in the last three centuries. ...