[Eaton-Lambert syndrome manifested by respiratory failure associated with small cell carcinoma of the lung]

A 63-year-old man with Eaton-Lambert syndrome manifested by marked respiratory failure was reported. He began to notice blepharoptosis and diplopia in September, 1987, followed by weakness and easy fatigability in bulbar, neck and limb muscles in association with impotence by February, 1988. On admission in August, 1988, Gowers' sign, decreased tendon reflexes and muscle weakness improved by the injection of edrophonium were found. Anti-acetylcholine receptor antibody was negative. Single muscle action potential evoked in the thenar muscle was abnormally low in amplitude with the stimulation of the median nerve: repetitive nerve stimulation study revealed the waning at the low rates, but the waxing at the high rate (30 Hz), suggesting the diagnosis of Eaton-Lambert syndrome. Early gastric cancer (adenocarcinoma) was diagnosed from needle biopsy specimens in August, 1988, but no other neoplasm including thymoma or lung cancer was found. After subtotal gastric resection in September, 1988, he failed into respiratory failure, requiring artificial ventilation for seven months. Plasmapheresis and drugs such as anticholinesterase, guanidine hydrochloride, and corticosteroid were ineffective for the recovery from weakness in respiratory muscle. Lung cancer was suspected, based on a chest X-ray in March, 1989, and one month later he died of pneumonia. At autopsy, small cell carcinoma of the lung was observed, but there was neither recurrence nor metastasis of the gastric cancer. Emphasis was placed on the respiratory failure in Eaton-Lambert syndrome which has rarely been reported.

[Acute transverse myelitis associated with ECHO-25 virus infection]

A case of acute transverse myelitis associated with ECHO-25 virus infection was reported here with a brief review of the literature. The patient was a 42-year-old house wife. Without any antecedent symptoms, weakness and paresthesia of bilateral lower extremities, and sphincter disturbance developed suddenly. Neurological examination revealed paraplegia of both legs, hyperreflexia of lower extremities, bilateral positive Babinski sign and impairment of all sensory modalities below Th4 level. No abnormality was found in myelography and CT myelography. Abnormal intensity area was found in lower cervical spinal cord on MRI. Serum antibody titer to ECHO-25 virus was elevated in the convalescent stage (X4096), and 7 month later from the onset of neurological symptoms, high value was continued (X128). We diagnosed her illness as acute transverse myelitis complicating ECHO-25 virus infection. In the literature, only 3 cases of transverse myelitis following ECHO virus infection (type 2, 5, 19) were found. This case seemed to be the first case of transverse myelitis associated with ECHO-25 virus infection.

[Significance of inferior ST segment changes in acute anterior myocardial infarction--relationship between the distribution of left anterior descending artery and concomitant ischemia of the inferior wall]

The significance of inferior ST segment changes was studied in 23 patients with acute anterior myocardial infarction by the distribution of the left anterior descending artery (LAD) after percutaneous transluminal coronary recanalization. In 9 patients (Group A) LAD supplied the anterior wall of the left ventricle up to or including the apex but did not reach the inferior wall; in 8 patients (Group B) it continued beyond the apex onto the inferior wall of the left ventricle with well developed collateral circulation; in 6 patients (Group C) it continued beyond the apex onto the inferior wall of the left ventricle with less-developed or no collateral circulation. Thallium-201 scintigraphy and contrast left ventriculography showed that inferior myocardial ischemia was significantly more prominent in Group C than Group A. These results were consistent with coronary anatomy. Inferior ST segment was significantly more depressed in Group A with no concomitant inferior wall ischemia, than in Group C with concomitant inferior wall ischemia (maximal inferior ST segment change: -1.7 +/- 1.1; 0.8 +/- 1.7 mm, respectively; p less than 0.02). In Group A inferior ST segment was depressed in all 6 patients with lateral ST segment elevation, but it was depressed in only one of 3 patients with no lateral ST segment change. Lateral ST segment elevation tended to cause inferior ST segment depression. This study indicates that the inferior ST segment changes in patients with acute anterior myocardial infarction depend on concomitant ischemia of the inferior wall of the left ventricle by the distribution of LAD and the lateral ST segment changes.

[Surgical treatment of aortic arch aneurysm associated with the aberrant right subclavian artery]

A 64-year-old man, who had an aneurysm of aortic arch associated with the aberrant right subclavian artery, was treated successfully. He was pointed out to have an aneurysm of aortic arch three years ago. Three years later angiograms and computed tomography revealed that it became larger compared with the initial finding. He underwent a replacement of the aortic arch using a woven Dacron graft under open distal method. Aberrant subclavian artery was not involved in the aneurysm. But because the left subclavian artery was involved in it, a woven Dacron graft was interposed between the ascending aorta and left subclavian artery. Postoperative course was uneventful and there were no complications.

[Effects of novel immunosuppressant FK 506 in acute experimental allergic encephalomyelitis]

Experimental allergic encephalomyelitis (EAE) is a T cell-mediated autoimmune disease. It is widely used as an animal model of multiple sclerosis (MS). We studied the prophylactic effects of FK 506 electrophysiologically and immunohistochemically in acute EAE. Female Lewis rats were sensitized with guinea pig spinal cord in complete Freund's adjuvant. FK 506 suspended in distilled water was orally administered at 1.0, 3.2, 5.0 or 10.0 mg/kg per day for 12 successive days starting from the day of sensitization. A placebo was used as the control. Administration of FK 506 at doses of 3.2 mg/kg per day and over significantly delayed the onset of clinical signs. However, the FK 506 group showed a relapse or a chronic state following the onset of EAE. We made a time course recording of cortical somatosensory evoked potential (cortical SEP: P 15). P 15 latency in the placebo group was significantly delayed in accordance with the clinical signs and showed immediate improvement upon recovery. Prolongation of P 15 latency in the FK 506 group also occurred concomitantly with the clinical signs, but the delay continued after the loss of symptoms as well. After the onset of EAE, the infiltrating lymphocyte subset was examined by the avidin-biotin peroxidase complex (ABC) method in the lumbar spinal cord. In the placebo group, the number of OX3+ (Ia) cells and the W 3 25+: OX8+ (helper/inducer T: suppressor/cytotoxic T) ratio clearly reflected the development and remission of EAE. In the FK 506 group, however, increases in OX8+ lymphocytes were observed irrespective of clinical sign fluctuation, and there were corresponding decreases in the W 3/25+: OX8+ ratio.(ABSTRACT TRUNCATED AT 250 WORDS)

The long loop reflex in spinocerebellar degeneration and motor neuron disease--its changes with TRH therapy

This study aimed to define the characteristics of the long loop reflex (LLR) in patients with spinocerebellar degeneration (SCD) and motor neuron disease (MND), and observe changes in LLR caused by thyrotropin releasing hormone (TRH), a facilitator of cerebellar and motor neurons. The markers used for LLR were: V1-2 peak Latency (the latency between the V1 and V2 peaks); V2 peak-P24 Latency (the latency between the V2 peak and P24 of a somatosensory evoked potential); V2 Amplitude, and V2 Square (the area of the V2 wave). V1-2 peak Latency was significantly longer, and V2 Amplitude was significantly lower than the control in SCD. We attributed these alterations of the LLR to cerebellar ataxia, since all SCD cases had cerebellar ataxia, and extrapyramidal symptoms were only present in one SCD case; the MND cases with motor neuron disturbance showed no significant difference from the control. TRH injection resulted in an increase in V2 Square and a decrease in V2 peak-P24 Latency in SCD and other neurological disease patients. We regarded these changes as activation of the LLR by TRH. With TRH therapy, activation of the LLR coincided with improvement of cerebellar ataxia in SCD. Symptomatic improvement, however, was not observed and the LLR changes were not stable in MND. These results suggest that TRH-induced activation of LLR is caused by the activation of cerebellar function, and indirectly concerns with upper motor neurons because V2 Square increased in MND without pyramidal tract signs.

Effect of 12-O-tetradecanoylphorbol-13-acetate on intercellular communication in various clones of mouse epidermal JB6 cells

We studied gap junctional intercellular communication (IC) in various clones of mouse epidermal JB6 cells and the effect of the tumor promoter, 12-O-tetradecanoylphorbol-13-acetate (TPA) on such communication. JB6 clones used included nonpromotable, promotable, and transformed clones, representing a spectrum in susceptibility to transformation from nontransformed, to initiated (postinitiated), to transformed cells. We used the dye transfer assay and the radioisotope transfer assay, and quantified IC both in homologous pairings, where IC among cells of a single clone was examined, and heterologous pairings, where cells of initiated or transformed clones were paired with cells of a nonpromotable clone. Both pairings showed good IC in the absence of TPA and poor IC in the presence of TPA. However, suppression of IC by TPA was more effective when cells had advanced in promotability. IC was more suppressed by TPA in heterologous pairing than in homologous pairing. These results implied that in advanced stages of promotion, the capability to retain IC with each other (homologous IC) and especially with their nontransformed counterpart (heterologous IC) is progressively lost. Thus we conclude that the interaction of initiated cells and transformed cells with nontransformed cells decreases progressively in this model system for tumor promotion and progression.

Electron spin resonance spectrum of Tyr-151 free radical formed in reactions of sperm whale metmyoglobin with ethyl hydroperoxide and potassium irridate

A five-line ESR spectrum was observed at room temperature in reactions of sperm whale metmyoglobin with ethyl hydroperoxide (EtOOH) at pH 9.5 and with potassium irridate at pH's 7.0 and 9.5. A spectrum with the same g value and hyperfine splitting constant appeared in a reaction of sperm whale apomyoglobin with potassium irridate and was assigned to a tyrosyl radical on the basis of optical spectrum data obtained under the same reaction conditions. It was concluded that this radical arose from Tyr-151 for the following reasons. (i) This ESR spectrum could not be observed in the reaction of horse heart metmyoglobin, which lacks Tyr-151. (ii) Sperm whale metmyoglobin no longer gave this spectrum when treated with tetranitromethane (TNM) under conditions in which approximately one tyrosine is lost in sperm whale metmyoglobin but none is lost in horse heart metmyoglobin. (iii) A complex ESR spectrum observed in the reaction of sperm whale metmyoglobin with EtOOH at neutral pH was found to be a mixture of this five-line spectrum and one arising from an unidentified free radical formed in the reaction of horse heart metmyoglobin with EtOOH. The TNM-treated sperm whale metmyoglobin gave the same ESR spectrum as that observed in the reaction of horse heart metmyoglobin with EtOOH.

Effects of electrical stimulation of the genioglossus on upper airway resistance in anesthetized dogs

We examined the relationship between the frequency of stimulation of the genioglossus and upper airway resistance in six anesthetized dogs in the supine position. The upper airway was isolated from the lower airway by transecting the cervical trachea, and the pressure flow relationship of the upper airway was obtained by applying constant negative pressure (5, 10, and 20 cm H2O) to the proximal cut end of the trachea. Electrical stimulation of the genioglossus was performed at a constant voltage (10 to 20 V) and at various frequencies (as high as 100 Hz). Upper airway resistance (Rua) during both inspiration and expiration increased with an increase in tracheal negative pressure, and at each tracheal negative pressure Rua was significantly reduced by stimulation of the genioglossus. The effects of genioglossal muscle stimulation were nonlinearly dependent on the stimulating frequency. Below 50 Hz, Rua decreased markedly as the stimulating frequency was increased, but above 50 Hz, Rua plateaued at a minimum value. These findings suggest that at a stimulating frequency of more than 50 Hz, upper airway patency is stably maintained in anesthetized dogs.

Effects of submental electrical stimulation during sleep on upper airway patency in patients with obstructive sleep apnea

We examined the effects of percutaneous electrical stimulation of the genioglossus in six patients with obstructive sleep apnea syndrome (OSAS) during sleep and investigated the possible applicability of this procedure as a treatment of OSAS. Six patients with OSAS were polysomnographically studied in the supine position during all-night sessions with and without electrical stimulation of the genioglossus. Using an apnea demand-type stimulator that we developed, electrical pulses of 0.5 ms (repetition rate, 50 Hz) and 15 to 40 V were delivered through bipolar electrodes (10 mm in diameter) attached to the skin of the submental region when apnea lasted more than 5 s, and was stopped immediately after breathing resumed or after 10 s at the longest. With submental stimulation, the apnea index, apnea time/total sleep time, longest apnea duration, and the number of times per hour that oxygen saturation dropped below 85% decreased significantly compared with those on control nights. The lowest arterial oxygen saturation and the duration of sleep stages III and IV increased significantly. The stimulation employed did not cause arousal, and it did not affect blood pressure or heart rate significantly. These findings show that submental stimulation decreases the incidence of apnea episodes and promotes deeper sleep without accompanying serious side effects, suggesting that the apnea demand-type stimulator may be a noninvasive and effective treatment for OSAS.

Step response of lung surface-to-volume ratio by light-scattering stereology

By means of backscattered light from a pointlike source on the pleural surface, we investigated the dynamic behavior of the surface-to-volume ratio (S/V) in excised dog lobes subjected to small volume steps both in and out on both the inflation and deflation limb of standard pressure-volume maneuvers. The technique utilizes the established correlation of the pattern of backscattered light with morphometric mean linear intercept and is suitable for dynamic studies. We hypothesized that 1) there would be a difference in the timing of stress relaxation or recovery between alveolar septa and the fibromuscular tissue in the alveolar duct that would reveal itself as a temporally changing S/V after a step-volume change and 2) that geometric hysteresis (looping of S/V with volume), as seen with large volume excursion histories, would be similarly present in small tidal volume loops. Our experimental results contradicted both hypotheses. In particular, we found virtually no change in S/V after a step-volume change, even in the presence of substantial stress adaptation. In addition, when geometric hysteresis of small loops was present, it was always in the sense opposite to the geometric hysteresis of large loops. We conclude that 1) there is a functional "matching" of the stress-adaptive timing between alveolar septa and ductal mouths and 2) during small volume looping, the stress hysteresis (looping of stress with volume) in the ductal tissue may be larger than that of the septa, including surface tension.

Effect of coenzyme Q10 on hemodynamic response to ocular timolol

Coenzyme Q10 (CoQ10) is an essential component of the mitochondrial membrane and plays an important role in the maintenance of normal cardiac function. To evaluate the effects of ocular timolol on the cardiovascular system and determine the protective effect of CoQ10, 16 patients with glaucoma were studied using impedance cardiography. Following instillation of 1 mg timolol maleate in each eye, heart rate (HR) and stroke index (SI) decreased, and total peripheral resistance index (TPRI) increased significantly. Reexamination was performed after 6 weeks of 90 mg oral CoQ10. Despite decreases in HR, percent changes in HR were significantly less after CoQ10 at 120 min. Stroke index showed an initial increase which was not observed without CoQ10. These data suggest that CoQ10 delayed the appearance of inotropic blockade of timolol and hastened the disappearance of chronotropic blockade. Additional study of six normal volunteers with 6 weeks of oral CoQ10 showed a similar decrease of intraocular pressure after timolol instillation as compared to those without CoQ10. Thus, administration of oral CoQ10 in patients receiving ocular timolol may be useful in mitigating cardiovascular side effects without affecting intraocular pressure in the treatment of glaucoma.

[A case of mediastinal immature teratoma with elevated levels of CA19-9]

A 15-year-old woman was found to have a large anterior mediastinal mass on chest roentgenogram. Preoperatively, serum levels of CA19-9 were found to be elevated. From the result of pathological study on the resected lesion, it was diagnosed as immature teratoma. The fluid levels of CA19-9 extracted from the tumor were found to be elevated. Part of the tumor, the pancreas, the bronchial epithelium and the intestinal epithelium, were shown positive staining in immunoperoxidase assay using anti CA19-9 antibody. The postoperative course was satisfactory and the serum levels of CA19-9 returned to normal. In mediastinal germ cells tumors, there are no cases reported in which CA19-9 was detected in serum and in the tumors. In order to define the relation between mediastinal germ cell tumors and CA19-9, further more cases should be investigated.

[Morphological study of corneal edema after anterior segment ischemia]

This experiment was performed to investigate the correlation between morphological changes of the corneal endothelium and clinical corneal edematous opacities after a procedure causing obstruction of bilateral long posterior ciliary arteries of the albino-rabbits. Shortly after the procedure, corneal endothelium became irregular on the anterior-chamber side and there were numerous lysosomal granules in the cytoplasm of corneal endothelial cells. On the third day, endothelial cells became necrotic and collapsed and a part of the cells peeled into the anterior chamber. Fibroblast-like cells and inflammatory cells were piled up in severely damaged areas of the endothelium. On the 11th day, the corneal endothelium developed again as a single layered structure on Descemet's membrane. It's seemed that corneal edema was induced as a result of severe damage corneal endothelium exposed to biochemical mediators such as prostaglandins released into the aqueous humor because the severity of corneal edema indicated some relation to changes in the concentration of prostaglandins in aqueous humor after anterior segmental ischemia.

[Isolation perfusion chemotherapy using cisplatin in malignant tumors of the extremities]

Since 1960 isolation perfusion chemotherapy has been performed as a preoperative procedure combined with surgery in 226 patients with malignant tumor of the extremities in our department. In this report we presented the result of isolation perfusion chemotherapy using cisplatin (CDDP) for 27 patients since 1983. The histologic classification of the malignant tumor was osteosarcoma in 17 patients, malignant fibrous histiocytoma (MFH) of bone in 8, and other tumor in 2. The extremity was perfused with CDDP (100 micrograms/ml) for 60 minutes. Of 27 patients, 11 were treated with hyperthermic isolation perfusion. The two-year survival rate of the 15 patients with osteosarcoma was 80%, and that of the 7 patients with MFH of bone 71%. The tumor was microscopically analyzed, and the ratio of necrotic to viable tumor cells was calculated. The degree of tumor necrosis was classified as excellent (greater than or equal to 95%), good (80-94%), fair (50-79%), and poor (less than 50%). Of 16 patients, 7 were excellent, 5 good, 3 fair and 1 poor. We concluded that isolation perfusion chemotherapy using CDDP is an effective procedure combined with surgery for malignant tumor of the extremities.

[Morphological study of experimental corneal neovascularization after anterior uveal ischemia]

We morphologically investigated what kinds of inflammatory cells infiltrate the corneoscleral limbus by light and electron microscopy and what manner of keratocytes and vascular endothelial cells appear at the corneal limbus, when the corneal edema was aggravated severely and clinical corneal new vessels were found initially, i.e. until three days after anterior segmental ischemia in rabbit eyes. The majority of infiltrating inflammatory cells were polymorphonuclear leukocytes and the others were lymphocytes and histiocytes etc. Peripheral keratocytes around limbal vessels were stimulated and transformed to fibroblastic cells as a result of anterior segment ischemia. Proliferating endothelial cells of comparatively minor limbal vessels invaded between corneal lamellar layers toward the corneal center. Polymorphonuclear leukocytes were often found near activated keratocytes proliferating vascular endothelial cells, hear and there. Consequently, it is considered that the stimulated polymorphonuclear leukocytes play an important role when corneal neovascularization occurs after anterior segmental ischemia.

Home sleep monitor for detecting apnea episodes by nasal flow and tracheal sound recordings

We have developed a portable home sleep monitoring system using nasal airflow (NA), tracheal sound recordings (TSR), and electrocardiogram (ECG). NA was recorded by two thermisters. TSR was recorded by a microphone attached to the skin overlying the cervical trachea. Three kinds of signals were recorded with a cassette recorder. Thirty-seven outpatients who had sleep complaints were monitored during sleep at home using this recorder. Attachment of the pickups was performed by the patients themselves. Recordings were played back and analyzed by a personal computer to evaluate apnea episodes from TSR and R-R intervals beat by beat. This home monitoring system had labor-saving and cost-saving benefits and seemed to be a satisfactory technique for screening.

Effect of sleep position on obstructive sleep apnea

In order to examine the effect of sleep position on sleep apnea episodes, seven male patients diagnosed as having obstructive sleep apnea syndrome without any organic complication of the upper airway were studied while lying in a supine or lateral position during an all-night polysomnographic study. Apnea index, apnea time/total sleep time (%) and the number of episodes per hour in which oxyhemoglobin saturation dropped below 85% decreased significantly from 51.0 +/- 8.6 (mean +/- S.D.) events/hr, 40.4 +/- 5.8% and 36.2 +/- 9.8 episodes/hr during sleep in supine position to 27.6 +/- 9.1 events/hr, 19.4 +/- 6.0% and 12.9 +/- 5.3 episodes/hr during sleep in lateral position, respectively. Lowest oxyhemoglobin saturation increased significantly from 70.7 +/- 2.6% to 78.0 +/- 2.4%. Thus, sleep in the lateral position may be a simple treatment before essential treatment for patients with obstructive sleep apnea syndrome.

[Clinical trial of 5'-DFUR in patients with recurrent breast cancer]

5'-DFUR was administered orally to recurrent breast cancer patients at a daily dosage of 1,200 mg given 3 times a day for more than 8 weeks. Out of 16 evaluable cases, 1 CR, 5 PR, 5 NC and 5 PD were observed, and the overall response rate was 37.5%. There was no significant difference in the response rate between the patient with or without prior fluorinated pyrimidine therapy, or between sites of the lesion. Toxic effects consisted of gastrointestinal toxicity such as diarrhea (25%), anorexia (12.5%), abdominal pain (12.5%) and nausea and vomiting (6.3%). No other severe side effect was observed. These results suggest that 5'-DFUR can be useful for the treatment of breast cancer.

[Comparison of the binding nature of mibolerone to androgen receptor of human prostate with that of R1881]

The authors examined the binding nature of mibolerone in cytosols of hypertrophic prostates from 15 patients to androgen receptor using Dextran-charcoal assay, analyzed it by the method of Scatchard, and compared it with that of R1881. The addition of triamcinolone acetonide into the incubation medium induced specific single binding of mibolerone to androgen receptor with high affinity as well as R1881. The receptor contents obtained with mibolerone were higher than those of R1881, and both of them correlated well. The dissociation constants of both ligands showed good correlation and no significant differences. Mibolerone seems to be as suitable a ligand as R1881 for measuring the androgen receptor.

Metronidazole neuropathy: a case report

A 67-year-old man developed peripheral neuropathy characterized by glove and stocking type sensory disturbances after the ingestion of 101.25 g of metronidazole for hepatic amebiasis. The clinical pictures of metronidazole-induced neuropathy appears to be the same as that of myeloneuropathy. The morphological study of a sural nerve biopsy showed a severe loss of myelinated fibers (2,400 per mm2). The density of unmyelinated fibers was at a lower limit of the normal range (23,530 per mm2). Electronmicroscopy confirmed the axonal degeneration of both the myelinated fibers and unmyelinated fibers.

A new treatment for obstructive sleep apnea syndrome by electrical stimulation of submental region

Loss of upper airway muscle tone during sleep has been thought to be responsible for obstructive apnea episodes. To examine the effect of electrical stimulation of the submental region on sleep apnea episodes, patients with obstructive sleep apnea syndrome were polysomnographically studied during all-night session with and without stimulation.

Effect of electrical stimulation of genioglossus muscle on upper airway resistance in anesthetized dogs

The isolated upper airway pressure and flow changes during electrical stimulation of the genioglossus muscle in spontaneously breathing anesthetized dogs were measured at given pressures in the inspiratory direction. Upper airway resistance was maximal during no stimulation and decreased rapidly with stimulation at frequencies up to about 40 Hz.

Inhibition of intercellular communication by nickel(II): antagonistic effect of magnesium

The level of gap-junctional (cell-cell) communication was studied by the radioisotope transfer technique in NIH 3T3 cells exposed to NiSO4, MgSO4, or both salts combined. Monolayered NIH 3T3 donor cells were labeled with [3H]-uridine for 3 h and then co-cultured with non-labeled recipient NIH 3T3 cells for 3 h in the presence of 0.5-20 mM NiSO4, 1.0-100 mM MgSO4, or 5 mM NiSO4 plus 1.0-100 mM MgSO4. 12-O-tetradecanoylphorbol-13-acetate (TPA), 16-160 pM, served as a positive control. The exposed cells were fixed with 2.5% glutaraldehyde and processed for autoradiography. The cell-cell communication rate was based on the number of radioactive recipient cells in relation to the total number of recipient cells for 100 donor cells. NiSO4 disrupted cell-cell communication in a dose-related manner from 98% of the base value at 0.5 mM NiSO4 to 2% at 5 mM NiSO4. Cell viability was not affected by 0.5-5 mM NiSO4. The inhibitory action of 5 mM NiSO4 could be partially prevented by 5.0-100 mM MgSO4. However, MgSO4 did not prevent the inhibition by TPA. The results indicate that NiSO4 is capable of inhibiting cell-cell communication at concentrations that do not cause cytotoxic effects in NIH 3T3 cells during a 3-h period. In this respect NiSO4 resembles such classical tumor promoters like TPA. The antagonism by magnesium of the nickel-induced inhibition of cell-cell communication may indicate a contributory mechanism by which magnesium counteracts the carcinogenicity of nickel in vivo.

Optical precision profilometer using the differential method

A novel optical precision profilometer, which is nearly independent of vertical vibrations, is proposed. It can make simultaneous height measurements of both a measurement position and its surroundings and perform subsequent digital subtraction of the latter from the former. The noise level of this profilometer on the table with steady vibrations of 0.4 gal (1 gal = 10 (-2) m/sec(2)) is 0.05 nm root mean square. Data obtained from measurements of an optical flat and a Si wafer are included.

Alkaline bismuth stain as a tracer for Golgi vesicles of plant cells

An alkaline solution of bismuth subnitrate reacts well with carbohydrate-rich components of Golgi bodies in sections prepared from plant leaves fixed with glutaraldehyde and osmium tetroxide and embedded in Epon. The metal deposits formed are so fine that the stain is appropriate to ultrastructural observation at high magnification. The Golgi vesicles show polarity with respect to the localization of the reactive deposits. Golgi vesicles that had migrated farther from the Golgi cisternae showed greater reactive deposits and higher membrane contrast than those close to the Golgi cisternae. These results indicate that the alkaline bismuth stain is an excellent tracer for Golgi bodies of plant cells.

Total organic carbon as an index for specification of water for injection

Determination of organic compounds present as contaminants in purified water is of great importance. Total organic carbon (TOC) may be a useful parameter for evaluating the purity of water. This paper describes and compares the analytical results for solutions of 12 model compounds obtained by 3 methods: total organic carbon (TOC) analysis, determination of potassium permanganate consumption, and UV spectroscopy. TOC analysis gave values corresponding to the expected amounts of organic carbon for all the model compounds, whereas the other 2 methods gave highly variable results.

Effect of digitalis on the diaphragm in anesthetized dogs

We examined the effect of digitalis on diaphragmatic contractility and fatigability in 19 anesthetized mechanically ventilated dogs. The diaphragmatic force was assessed from transdiaphragmatic pressure (Pdi) developed at functional residual capacity against an occluded airway during cervical phrenic nerve stimulation. In a first group of five dogs, Pdi-stimulus frequency relationships were compared before and after administration of ouabain in doses of 0.01, 0.02, and 0.04 mg/kg. In a second group, diaphragmatic fatigue was produced by bilateral phrenic nerve stimulation at 30 Hz. Ten seconds of stimulation and 15 s of mechanical ventilation were repeated for 30 min. The rates of decrease in Pdi were compared between two groups, one of 0.05 mg/kg deslanoside-treated dogs (n = 7) and one of nontreated dogs (n = 7). After ouabain administration Pdi was significantly greater at each frequency in a dose-dependent manner. On the other hand, the rate of decrease in Pdi in the deslanoside group was significantly smaller than that in the nontreated group, whereas deslanoside did not greatly change the Pdi-frequency curves in fresh diaphragm. We conclude that ouabain improves contractility of the fresh diaphragm and that deslanoside has a protective effect against fatigability.

Idiopathic nonarteriosclerotic cerebral calcification (Fahr's disease): an electron microscopic study

A case of idiopathic nonarteriosclerotic cerebral calcification was studied post mortem by histochemical and scanning and transmission electron microscopic methods. Calcification was found bilaterally in the basal ganglia, cerebral cortex, granular layer and white matter of the cerebellum. Histochemical examination revealed that deposits were composed of a mixture of glycoproteins, mucopolysaccharides, calcium salts and iron. Transmission electron microscopy revealed minute deposits mainly in the cytoplasm of adventitial cells of blood vessels and sometimes in the cytoplasmic processes of glial cells. Scanning electron microscopy showed that some of the spherical and hemispherical bodies, which were formed in the adventitial cells of blood vessels, were connected with filamentous cytoplasmic processes of surrounding cells. Small uncalcified deposits occurring in the cytoplasm of the adventitial cells had subsequently had minerals deposited in them. Some kind of impairment of the pericytes may play an important role at the onset of this disease.

Quantitative analysis of the mitochondrial cytochrome P-450-linked monooxygenase system: NADPH-hepatoredoxin reductase, hepatoredoxin, and cytochrome P-450s27 in livers of patients with cerebrotendinous xanthomatosis

We studied the mitochondrial cytochrome P-450-linked monooxygenase system in livers of two patients with cerebrotendinous xanthomatosis (CTX). The three components of this system, which catalyzes steroid 27-hydroxylation, NADPH-hepatoredoxin reductase, hepatoredoxin, and cytochrome P-450s27, were stained on a nitrocellulose sheet with antibodies against NADPH-adrenodoxin reductase, adrenodoxin, and cytochrome P-450scc, respectively, from bovine adrenocortical mitochondria. The concentrations of hepatoredoxin in the patients were not significantly different from a control, but the level of NADPH-hepatoredoxin reductase was three times that of the control. Cytochrome P-450s27 was not detected in the patients, but it was present (22.8 pmol/mg of protein) in the control liver. This implies that a defect of mitochondrial cytochrome P-450s27 prevents steroid 27-hydroxylation of hepatic mitochondria in patients with CTX.

[Malignant paraganglioma of the peri-iliac artery]

A malignant nonfunctioning paraganglioma of the pelvic retroperitoneum (left external iliac artery) with metastases to the femoral lymph nodes was found in a 68-year-old woman at exploratory laparotomy. Light microscopy showed a typical alveolar pattern with fine vascular stroma. The tumor cells had finely granular eosinophilic cytoplasm and oval to round nuclei with pleomorphism and mitotic figures, Grimelius stain showed no argyrophilic granules, but S 100 protein was demonstrated in the cytoplasm by the PAP method of Sternberger. Formaling fixed tissues were examination by electron microscopy, and dense core granules consistent with neurosecretory granules were found in the cytoplasm of some tumor cells.

Exfoliative cytology of a primary adenocarcinoma of the renal pelvis. A case report

The cytologic features of a primary adenocarcinoma of the renal pelvis in a 64-year-old woman are reported. Cytologic examination of voided urine revealed an ordinary papillary pattern, characterized by clumping of cells with nuclear overlapping, eccentric position of nuclei and cytoplasmic vacuolization due to mucus production. Leukocytes and micro-organisms were also present. Multiple lesions of papillary adenocarcinoma were subsequently found in the right renal pelvis and ureter. The histogenesis of the primary adenocarcinoma seemed to be closely related to columnar-cell metaplasia of lining of the renal pelvis of this patient, who had previously been treated for tuberculosis of the urinary bladder.

The syndrome of self-induced water intoxication in psychiatric patients

This is a report on six psychiatric patients who indulged in excessive ingestion of water and subsequently developed tonic-clonic seizures in the course of the underlying mental disorders. On the basis of the DSM-III criteria, they were diagnosed as follows: schizophrenic disorder, 4; schizo-affective disorder, 1; borderline personality disorder, 1. The levels of serum electrolytes were estimated during five episodes of seizures in three patients. Hyponatremia was a consistent finding (serum sodium: mean = 120.6 mEq/liter). Plasma osmolality and plasma levels of arginine vasopressin (AVP) were determined during two episodes in two patients. The inappropriately high circulating levels of AVP relative to plasma hypoosmolality were documented. However, the response to the overnight fluid deprivation and acute water load during the period of no seizures in two patients revealed no evidence of the persistent SIADH, suggesting the temporal association of hyponatremic encephalopathy with inappropriate AVP secretion. It is not conclusive whether the transient SIADH is the cause or the consequence of hyponatremic encephalopathy, although a delusion or an auditory hallucination could play a critical role in drinking water excessively in three patients.