Normal sympathetic vasomotor and cardiac parasympathetic activities in patients with primary aldosteronism: assessment by spectral analysis

The role of the autonomic nervous system in hypertension due to mineralocorticoid excess remains unclear. To address this issue, we performed power spectral analysis of blood pressure (BP) and RR interval oscillations in 20 patients with primary aldosteronism (PA), 54 patients with essential hypertension (EH) and 45 normotensive (NT) subjects. Blood pressure and the degree of organ damage were similar between PA and EH groups. Age did not differ between the three groups. The Mayer wave power spectrum (MWP) of BP (approx. 0.1 Hz), an index of sympathetic vasomotor tone, was smaller in patients with PA than in patients with EH either while subjects were supine (systolic/diastolic; 3.9 +/- 3.2 (SD)/1.5 +/- 1.3 vs. 5.5 +/- 4.2/2.1 +/- 1.6 mmHg2, P < 0.05 for both) or standing (7.6 +/- 6.6/3.0 +/- 3.0 vs. 17.7 +/- 23.7/7.2 +/- 8.3 mmHg2, P < 0.05 for both). Supine respiratory-related power spectrum (RRP) of the RR interval (approx. 0.25 Hz), an index of cardiac parasympathetic tone, was greater in patients with PA than in patients with EH (545 +/- 574 vs. 302 +/- 464 ms2, P < 0.01). The MWP of BP and the RRP of the RR interval were similar between patients with PA and NT subjects. Adrenalectomy reduced the 24-h mean BP (-18 mmHg for systolic BP, P < 0.001; -12 mmHg for diastolic BP, P < 0.01) and increased the 24-h mean heart rate (+8 bpm, P < 0.001). Furthermore, the diastolic MWP increased mildly (+32%, P < 0.05) and the RRP of the RR interval decreased dramatically (-75%, P < 0.01) following adrenalectomy. These results suggest that both vascular sympathetic and cardiac parasympathetic regulatory systems have minor roles in the maintenance of hypertension in patients with PA. The autonomic nervous system contributes more to the maintenance of BP following than prior to adrenalectomy. This information may be useful for the management of hypertension still persists after removal of adrenal adenoma.

Antiviral effect of oryzacystatin, a proteinase inhibitor in rice, against herpes simplex virus type 1 in vitro and in vivo

Oryzacystatin (OC) is the first-described cystatin originating from rice seed; it consists of two molecular species, OC-I and OC-II, which have antiviral action against poliovirus in vitro (H. Kondo, S. Ijiri, K. Abe, H. Maeda, and S. Arai, FEBS Lett. 299:48-50, 1992). In the experiments reported here, we investigated the effects of OC-I and OC-II on the replication of herpes simplex virus type 1 (HSV-1) in vitro and in vivo. HSV-1 was inoculated onto monolayers of monkey kidney epithelial cells (CV-1 cells) at a multiplicity of infection of 0.1 PFU per cell. After adsorption of the virus onto cells, the cultures were incubated in the presence of either OC-I or OC-II in the concentration range of 1.0 to 300 microM, and the supernatant virus yield was quantitated at 24 h. The effective concentration for 90% inhibition of HSV-1 was 14.8 microM, while a cytotoxic effect on CV-1 cells without infection of HSV-1 was not observed below 500 microM OC-I. Therefore, the apparent in vitro chemotherapeutic index was estimated to be more than 33. In the mouse model of HSV-1-induced keratitis and encephalopathy, topical administration of OC-I to the mouse cornea produced a significant decrease in virus production in the cornea (mean virus yields: 3.11 log10 PFU in the treated group and 4.37 log10 PFU in the control group) and significant improvement in survival rates (P = 0.01). The in vivo antiherpetic effect of OC-I was comparable to that of acyclovir, indicating that topical treatment of HSV-1 infection in humans with OC-I might be possible. Our data also suggest the importance of some thiol proteinases, which may be derived from either the host's cells or HSV-1, during the replication process of HSV-1.

Two distinct species of corn cystatin in corn kernels

Besides corn cystatin I (CC-I) we found, by cloning, another molecular species of cystatin, named corn cystatin II (CC-II), which was found by screening with CC-I cDNA as a probe. The dissimilarity in amino acid sequence between CC-I and CC-II was distinct around the N-terminal region. Enzymologically, CC-II protein expressed in Escherichia coli was a stronger inhibitor of cathepsin L than CC-I.

Translocation of orally administered rat salivary cystatin into serum and kidney

This translocation was followed by means of a sensitive enzyme immunoassay. Salivary cystatin could be detected in serum, oesophagus, stomach, small intestine and kidney 15 min after oral administration. The salivary cystatin level in serum and kidney extract was maximal 15-60 and 30-60 min, respectively, after its administration and increased dose-dependently. Chromatography showed that the cystatin molecule in serum was identical to that in the submandibular saliva used for oral administration, but differed from that in kidney extract. These results suggest that salivary cystatin is absorbed intact by the gastrointestinal tract and reaches the bloodstream, from which it is taken up by the kidney and modified.

The effects of ethanol and crocin on the induction of long-term potentiation in the CA1 region of rat hippocampal slices

The effects of ethanol and crocin on the induction of long-term potentiation (LTP) were investigated in the CA1 region of rat hippocampal slices in vitro. Ethanol (50-75 mM) suppressed the LTP induced by strong tetanic stimulation (51 pulses at 100 Hz). Crocin (20 microM) did not affect the baseline synaptic responses, but significantly prevented the LTP-suppressing action of ethanol. This effect of crocin was concentration dependent (10-30 microM). Crocin (20 microM) alone did not affect the potentiation induced by weak tetanic stimulation (11 pulses at 100 Hz). These in vitro observations suggest that crocin directly prevents the LTP-suppressing action of ethanol within the hippocampus.

Vasopressin stimulates Cl- transport in ascending thin limb of Henle's loop in hamster

The effect of arginine vasopressin (AVP) on NaCl transport was investigated in the isolated microperfused hamster ascending thin limb of Henle's loop by measuring transepithelial voltage (Vt) and transmural 22Na+ and 36Cl- fluxes. In the presence of a transmural NaCl concentration gradient (100 mM higher in the lumen), Vt was 8.4 +/- 0.4 mV. Addition of 1 nM AVP to the basolateral solution increased Vt to 9.6 +/- 0.4 mV, which corresponds to an increase in the Cl- to Na+ permselectivity ratio (PCl/PNa) from 2.8 +/- 0.2 to 3.4 +/- 0.2. AVP at physiological concentrations increased Vt in a dose-dependent manner with an ED50 of 5 pM. AVP increased the Cl- efflux coefficient from 99.6 +/- 6.3 to 131.4 +/- 10.6 x 10(-7) cm2/s without affecting the Na+ efflux coefficient. 5-Nitro-2-(3-phenyl-propylamino)-benzoate (0.2 mM), a Cl- channel inhibitor, in the perfusate decreased the basal Cl- efflux coefficient and inhibited the AVP-induced increase in this parameter. The AVP-induced increase in Vt was not affected by [d(CH2)5(1),O-Me-Tyr2,Arg8] vasopressin, a V1 receptor antagonist, but was abolished by [d(CH2)5,D-Ile2,Ile4,Arg8] vasopressin, a V2 receptor antagonist. The selective V2 agonist dDAVP in 1 nM also increased Vt from 8.6 +/- 0.7 to 9.5 +/- 0.6 mV. Dibutyryl cAMP and forskolin both increased Vt, whereas H89, an inhibitor of cAMP-dependent protein kinase, abolished the AVP-induced increase in Vt. These results demonstrate that AVP stimulates Cl- transport in the ascending thin limb of Henle's loop by activating Cl- channels via a signal transduction cascade comprising V2 receptors, adenylate cyclase, and cAMP-dependent protein kinase. The ascending thin limb of Henle's loop thus participates in the formation of concentrated urine as one of the target renal tubular segments of AVP.

Alterations of p53 and k-ras genes in human colorectal-cancer with ulcerative-colitis

Using polymerase chain reaction and single strand conformation polymorphism assay, we examined genetic alterations of p53 and K-ras genes in multiple lesions of colorectal cancers that developed in three patients with ulcerative colitis. p53 gene mutations were found in two lesions and a K-ms gene mutation at codon 12 was found only in one. Neither was found in non-cancerous lesions. The results indicate that mutation of both genes may not be so frequent among Japanese patients. They were found only in very few cancerous lesions of each patient. Therefore, it is possible that the oncogenic process in each lesion is a consequence of rather independent events. Our preliminary results suggest the potential usefulness of CD44 variant forms as markers for dysplastic and cancerous tissues in ulcerative colitis.

A novel translocation involving chromosomes 2, 9, 14, and 22 in chronic myeloid leukemia

A 46-year-old man with chronic myelogenous leukemia was found to have a new complex translocation. In chronic phase, all of the bone marrow cells had a rearrangement of a t(2;9;14;22) (p21;q34;q32;q11). Southern blot analysis of leukocyte DNA revealed rearrangement of the breakpoint cluster region (bcr) within the 5.8-Kb bcr. The patient eventually died in blast crisis 28 months later. The cytogenetic findings of bone marrow cells showed a 46,XY,t(2;9;14;22)(p21;q34;q32;q11),add(1p),del(3q) karyotype in blast crisis.

Psychophysiological stress induces heat shock cognate protein (HSC) 70 mRNA in the cerebral cortex and stomach of rats

Families of 70 kDa heat shock proteins have essential roles in cellular coping to noxious stimuli. However, their roles in psychophysiological stress have not been precisely clarified. We tested our hypothesis that heat shock cognate protein (HSC)70 messenger RNA would increase in stress-vulnerable organs under psychophysiological stress. In control rats, cerebral HSC70 mRNAs were constitutively expressed while gastric HSC70 mRNAs were scarcely identified. Restraint-water immersion stress significantly increased the level of cerebral HSC70 mRNAs for 6 h and 12 h. Stress for 6 h with recovery for 6 h induced more gastric HSC70 mRNA levels than that without recovery, while stress for 12 h expressed the highest gastric HSC70 mRNA levels. Hypothermia, induced by water immersion, excluded a possible role of hyperthermia in inducing HSC70 mRNA. Our results point to a crucial cytoprotective role for families of heat shock proteins in stress-vulnerable brain-gut link in mammals under psychophysiological stress.

Polyamines promote regeneration of injured axons of cultured rat hippocampal neurons

Axons of cultured rat hippocampal neurons were injured by local irradiation of laser beam, and the effects of spermine, spermidine and putrescine on neurite regeneration following axonal injury were investigated. The axonal growth was stopped by laser irradiation, but addition of spermine remarkably promoted the axonal re-elongation from the injured site. Spermine affected neither the neurite branching at proximal part of injured axons nor the growth of uninjured dendrites. The effect of spermine was concentration dependent and seen maximally at a concentration of 10(-8) M. Spermidine and putrescine also promoted the axonal re-elongation in a concentration-dependent manner. The effects of three polyamines were very similar, and no additivity was observed when maximally effective concentrations of polyamines were added together, suggesting that they act through a common mechanism. Unlike polyamines, basic fibroblast growth factor (bFGF) did not promote the axonal re-elongation from the injured site, but rather stimulated the formation of axonal branches at proximal part of injured axons, supporting that the promotion of axonal re-elongation is a specific action of polyamines. Concomitant addition of spermine and bFGF additively or synergistically promoted both the axonal re-elongation from the injured site and the branch formation at proximal part of injured axons. These data suggest that polyamines have a capability of promoting axonal regeneration of brain neurons after lesioning.

Muscle cramps and elevated serum creatine phosphokinase levels induced by beta-adrenoceptor blockers

We have assessed the propensity of beta-adrenoceptor blockers to cause muscle cramps and to raise the serum creatine phosphokinase (CPK) level in 78 patients with essential hypertension. After a control period, a beta-adrenoceptor blocker without intrinsic sympathomimetic activity (ISA; propranolol, metoprolol or arotinolol) was administered for three months. Thereafter, the patients were randomised to receive a beta-adrenoceptor blocker with ISA (pindolol or carteolol) for three months or a beta-adrenoceptor blocker without ISA for a further three months. This pattern was continued until all beta-adrenoceptor blockers had been given. At the end of each period, CPK and CPK-MB levels were measured. Of the 78 subjects, muscle cramps occurred in 27 during treatment with pindolol and 32 during treatment with carteolol. No complaints were made by subjects treated with propranolol and arotinolol, but muscle cramps were reported in 2 treated with metoprolol. While muscle cramps were caused both by pindolol and carteolol in 16 subjects, they were caused by either of these drugs in the remainder of the subjects. Muscle cramp occurred mainly in the calves when the patients were in bed at night. Serum CPK and CPK-MB levels increased significantly during treatment with pindolol (control period vs pindolol, CPK = 96 vs 133 IU.ml-1, CPK-MB = 14 vs 18 IU.ml-1) or carteolol (CPK = 117 IU.ml-1, CPK-MB = 18 IU.ml-1) while the levels during treatment with propranolol, arotinolol and metoprolol did not change from those in the control period.(ABSTRACT TRUNCATED AT 250 WORDS)

Amiloride-sensitive Na+/H+ antiporter in basolateral membrane of hamster ascending thin limb of Henle's loop

The mechanisms of intracellular pH (pHi) regulation were investigated in the in vitro microperfused hamster ascending thin limb (ATL) of Henle's loop with the fluorescent pH indicator, 2',7'-bis(carboxyethyl)-5(6)-carboxyfluorescein. pHi of ATL cells was 7.05 +/- 0.02 (n = 30) when microperfused with a CO2/HCO(3-)-buffered solution. In HEPES-buffered solution, pHi was 7.10 +/- 0.02 (n = 16), which was significantly higher than the value in CO2/HCO(3-)-buffered solution (P < 0.05, n = 16). In HEPES-buffered solution, elimination of Na+ and addition of 1 mM amiloride to basolateral solution decreased the pHi by 0.12 +/- 0.03 (n = 6) and 0.11 +/- 0.02 (n = 5) at 1 min, respectively. The same manipulations in the luminal solution had no effect on pHi. One millimolar of N-ethylmaleimide (NEM) added to either side of ATL caused no significant change in pHi. Elimination of K+ on either side of ATL did not alter pHi. After adding 20 mM NH4Cl to basolateral solution, pHi instantaneously increased from 7.17 +/- 0.01 to 7.51 +/- 0.03 (n = 3), and then returned to steady-state level of 7.21 +/- 0.05 (n = 15) in 3 min. Removal of NH4Cl from basolateral solution then caused a rapid fall in pHi to 6.31 +/- 0.05 (n = 15), followed by spontaneous recovery at a rate of 0.43 +/- 0.06 unit/min (n = 15).(ABSTRACT TRUNCATED AT 250 WORDS)

[A 71-year-old woman with progressive gait disturbance and dementia]

We report a 71-year-old woman with progressive gait disturbance and dementia. The patient was well until 61 years of age (1980) when she noted a gradual onset of gait disturbance. A year later, she noted slurring of the speech and forgetfulness. In 1982, she noted difficulty in looking down and progression of her gait disturbance. In 1983, she became unable to walk alone unless supported. She was admitted to our service in 1984; neurological examination at that time revealed moderate dementia, limitation in the vertical gaze, slurred speech, and wide based ataxic gait. She was discharged for out patient follow up. Cranial CT scan in 1989 revealed cortical, brain stem, and cerebellar atrophies. On March 10, 1990, she fell down and hit her head. She developed headache on April 1, vomited on April 8, and was admitted to our service again. On admission, she was somnolent, she was unable to follow an object to any direction; oculocephalic response was elicited to horizontal directions, however, it was difficult to induce in the vertical direction. Rigidity was noted in the extremities except in the left lower extremity. Rapid alternating movement was difficult and dysmetria was noted in the finger-to nose test. Deep reflexes were exaggerated without clonus; the plantar response was extensor bilaterally. Cranial CT scan revealed bilateral subdural hematoma. She was treated with intravenous infusion of glycerol, and she became alert after this treatment; however, she was markedly demented. She was unable to walk alone. She was discharged to home, but she showed progressive loss of activities, and became bed ridden in December 1992. In January of 1993, she developed fever, dyspnea, and disturbance of consciousness, and was admitted again on January 26, 1993. On admission, her blood pressure was 70 mmHg by palpation and body temperature 38.5 degrees C. The lungs were clear. On neurologic examination, she was semicomatose; the optic fundi were unremarkable; only incomplete eye movements elicited by the oculocephalic reflex. She was passive supine in position; some spontaneous movements were observed in the extremities. Lead-pipe rigidity was noted in both upper extremities, but the muscle tone was decreased in the lower extremities. No abnormal involuntary movements were seen. Deep reflexes were exaggerated except for the ankle jerk which was diminished bilaterally. The plantar response was extensor on both sides.(ABSTRACT TRUNCATED AT 400 WORDS)

Characterization of Na+ transport across the cell membranes of the ascending thin limb of Henle's loop

In the ascending thin limb of Henle's loop (ATL), intracellular Na+ is extruded by Na+/K+ ATPase in the basolateral membrane. To further characterize Na+ transport across the cell membranes of the ATL, the intracellular sodium concentration ([Na+]i) was monitored using a sodium-sensitive fluorescent probe, SBFI, in the in vitro microperfused hamster ATL. Basal [Na+]i was 19.0 +/- 1.2 mM (N = 24). Removal and replacement of luminal Na+ did not change [Na+]i in the presence of Na+ in the bathing fluid. In contrast, luminal Na+ removal reduced [Na+]i from 11.6 +/- 0.9 to 6.3 +/- 0.8 mM in the absence of peritubular Na+ (P < 0.0005, N = 21). Replacement of luminal Na+ increased [Na+]i to 12.6 +/- 0.9 mM. In the absence of Na+ in the bath, the addition of 1 microM benzamil, 0.1 mM 5-(N,N-dimethyl)-amiloride (DMA), 0.1 mM furosemide, or 0.1 mM trichlormethiazide to the lumen did not change [Na+]i or the rate of change in [Na+]i/dt) after removal and replacement of luminal Na+. Decreases in luminal pH in a Hepes-buffered solution and luminal HCO3- did not affect [Na+]i. In the absence of peritubular Na+, DMA in the bathing fluid decreased [Na+]i from 11.4 +/- 1.3 to 6.4 +/- 1.2 mM (P < 0.01, N = 5) and completely inhibited the changes in [Na+]i after removal and replacement of luminal Na+. Removal of peritubular Na+ reduced [Na+]i from 18.8 +/- 1.2 to 11.3 +/- 0.7 mM (P < 0.0001, N = 23). Addition of DMA in the bathing fluid reduced [Na+]i and inhibited the changes in [Na+]i after removal and replacement of peritubular Na+.(ABSTRACT TRUNCATED AT 250 WORDS)

[Effects of combined aprotinin and prostagrandin E1 therapy on aortic arch replacement]

This study was undertaken to compare the effects of combined aprotinin and prostaglandin E1 therapy on aortic arch replacement. Twenty patients were divided into 2 groups with (group A; n = 10) or without (group B; n = 10) the treatment (200 KIU of aprotinin and 0.01-0.02 microgram/kg/min of prostaglandin E1 during cardiopulmonary bypass (CPB) and the first postoperative day. Preoperative evaluation of respiratory function and all parameters related to CPB procedure were revealed to be equal between the groups. Postoperative A-a DO2 and respiratory index (RI) as functional parameters of oxygenation capacity, dosage of dopamine were monitored at 0, 3, 6, 12, 18 and 24 hr after termination of CPB and at extubation period. Serum creatinine, platelet numbers and blood coagulation function (PT, APTT) were also assayed postoperatively. The recovery of respiratory and cardiac function were superior in group A with treatment, but renal and blood coagulation function showed no difference in the groups. We suggest the combined therapy with aprotinin and prostaglandin E1 for aortic arch replacement may emerge as a valuable treatment to save postoperative respiratory and cardiac function.

Dermonecrotic activity of a cell wall preparation from Fusobacterium necrophorum

A cell wall preparation of Fusobacterium necrophorum induced haemorrhagic necrosis in the skins of guinea pigs and rabbits. Effects in mice and rats were weak or absent. The toxic activity of the cell wall preparation was not reduced by heat treatment. A dermonecrotic toxin was isolated from the cell wall preparation with sodium dodecylsulphate and concentrated by precipitation with ethanol. A preparation of the bacterial cytoplasm from Fus. necrophorum induced mainly erythema.

[Detection of cortical infarcts in brain MR imaging: feasibility of short-TR-T2-weighted imaging using a fast spin echo sequence]

MRI of the brain using a fast SE sequence is often performed with a TR above 5000 msec, so there is a tendency for the signal of CSF to become too high. However, when cerebral atrophy is marked, small lesions of the brain parenchyma can be hard to detect. Therefore, we examined short-TR-T2-weighted images using a fast spin echo sequence. The 58 subjects included 33 men and 25 women, and cortical infarction was detected in five of them. On the short-TR-T2WI sequences, the infarct lesions were imaged as areas of higher signal intensity than cerebrospinal fluid, the signal of which was reduced. In cortical infarction cases, fluid-attenuated inversion recovery (FLAIR) images can detect the lesion more easily, but FLAIR sequences cannot be obtained with all MR equipment. Short-TR-T2WI, which readily yields images comparable to those of FLAIR, is an useful method.