Afferent and efferent connections of the oculomotor region of the fastigial nucleus in the macaque monkey

Afferent and efferent connections of the fastigial oculomotor region (FOR) were studied in macaque monkeys by using axonal transport of wheat germ agglutinin conjugated horseradish peroxidase (WGA-HRP). When injected HRP is confined to the FOR, retrogradely labeled cells appear in lobules VIc and VII of the ipsilateral vermis and in group b of the contralateral medial accessory olive (MAO). In reference to the maps of topographical organization, the extent of the effective site in the fastigial nucleus (FN) could be assessed from the distributions of labeled Purkinje cells (P cells) in the vermis and labeled olivary neurons in the MAO. In contrast to the unilateral nature of the P-cell and climbing-fiber projections, those from the other brainstem regions to the FOR were bilateral. Following the injection of HRP into the FOR, the largest number of retrogradely labeled cells appeared in the pontine nuclei. Although the number of labeled cells was greater on the contralateral side in both the peduncular and dorsomedial pontine nuclei (DMPN), the number of each side was virtually identical in the dorsolateral pontine nucleus (DLPN). In the nucleus reticularis tegmenti pontis (NRTP), labeled cells were located only in its medial and dorsolateral portions bilaterally. In the vestibular complex, labeled cells appeared in the superior (SVN), medial (MVN), and inferior vestibular nuclei (IVN) bilaterally. The lateral vestibular nucleus (LVN), including y group and the ventrolateral vestibular nucleus, were free of labeled cells. Labeled cells appeared also in the perihypoglossal nucleus (PHN) bilaterally. In the pontine raphe (PR) and paramedian pontine reticular formation (PPRF), labeled cells appeared bilaterally in the caudal third of the area between the oculomotor and abducens nuclei. Labeled cells appeared also in the mesencephalic and medullary reticular formation. Tracing of anterogradely labeled axons demonstrated that most fibers from the FOR decussated within the cerebellum and entered the brainstem via the contralateral uncinate fasciculus. Some crossed fibers ascended with the contralateral brachium conjunctivum and terminated in the midbrain tegmentum. A small contingent of fibers advanced further to the thalamus. In the mesodiencephalic junction, labeled terminals were found contralaterally in the rostral interstitial nucleus of medial longitudinal fasciculus (riMLF) and a medial portion of FOrel's H Field. They appeared also in the central mesencephalic reticular formation (cMRF), the periaqueductal gray (PAG), the posterior commissure nucleus, and the superior colliculus. The oculomotor and trochlear nuclei, the red nucleus, and the interstitial nucleus of Cajal were free of labeled terminals.(ABSTRACT TRUNCATED AT 400 WORDS)

[Retinal projections into the diencephalon in the fowl (Gallus gallus domesticus)]

The localization of the primary visual centers in the hen diencephalon was determined by anterograde transport horseradish peroxidase (HRP) techniques. Twelve fowls (Gallus gallus domesticus) were used for HRP study and four were used for cytoarchitectural study (Nissl and Klüver-Barrera stained preparation). One-hundred microliter of 30% HRP solution in physiological saline was injected into the vitreous body of one eye of each hen under anesthesia of sodium pentobarbital (30 mg/kg body wt). After a postoperative period of 48 hours, the animals were deeply anesthetized and perfused with an injection of 1,000 ml of Ringer solution which was followed by 2,000 ml of 1% paraformaldehyde and 1.25% glutaraldehyde in a 0.1 M phosphate buffer (pH 7.4) which was then followed by 1,000 ml of 10% sucrose in the same buffer. The brain was cut into serial transverse sections of 60 microns on freezing microtome. Every section was treated with tetramethylbenzidine (TMB). Retinal projections were found in the hypothalamic area, lateral geniculate nucleus (GL), lateral part of dorsolateral thalamus (DLL), medial part of dorsolateral thalamus (DLM), ventrolateral thalamus (VLT), rostrolateral part of dorsolateral anterior thalamus (DLAlr), magnocellular part of dorsolateral anterior thalamus (DLAmc), lateral anterior thalamus (LA), ectomammillary nucleus (EM), external nucleus (NE), and nucleus superficial synencephalica (SS), contralaterally. No labeled terminals were found in the ipsilateral brain stem. In the hypothalamic region, terminals were found to be just lateral to the rostral part of the third ventriculus and the bottom of the lateral margins of the hypothalamus, which we termed medial (MRH) and lateral (LRH) retinorecipient hypothalamic nucleus. LRH had high density terminals compared with MRH and caudal MRH continued into rostral LRH so that there was no boundary between MRH and LRH in HRP preparation. MRH is contained large cells (25-35 microns in diameter) and occupied rostral 1/4 of retinorecipient of hypothalamus (RH), whereas LRH contained small type cells (about 15 microns in diameter) and occupied caudal 3/4 of RH. In the retinorecipient nuclei of the thalamus, high density terminals were found in GL, LA, DLAlr, NE, SS and EM. In DLAlr and EM, granulae of HRP product were bigger than in other terminal nuclei and also the density of those terminals was high. GL and LA have large nuclei which receive retinal afferents. Labeled terminals of those nuclei were distributed homogeneously throughout the whole nucleus except for the inner layer of GL. Cytoarchitectonically, GL was divided into two layers.

Spinal cord location of the motoneurons innervating the tail muscles of the cat

The localisation of the motoneuronal pool of the individual tail muscles of the cat was studied by using intramuscular injections of horseradish peroxidase (HRP) to retrogradely label motoneurons innervating tail muscles. The motoneurons innervating muscles located on the medial side, extensor caudae medialis (ECM) and flexor caudae brevis (FCB), were placed in the mediodorsal area of the ventral horn, while those of extensor caudae lateralis (ECL) and flexor caudae longus (FCL) muscles were located in the ventral part of the ventral horn in S2 and 3 segments. The distribution of these motoneurons was shifted to the lateral side in coccygeal segments, but the motoneurons of lateral muscles (ECL, FCL) were located lateral to those of medial muscles (ECM, FCB). The motoneurons of abductor caudae externus (ACE), abductor caudae internus (ACI) and iliocaudalis and levator ani (IC) were distributed in the intermediate area of the ventral horn. The minimum and maximum diameters of motoneurons innervating the tail muscles were measured and shown in histograms. The histograms were unimodal and the motoneurons of ECM, ECL, FCL and FCB were bigger than those of ACE and ACI.

[Fenestrated basilar artery with ruptured cerebral aneurysms: case report]

Two cases of aneurysms with basilar artery fenestration are presented. A 45 year-old lady had a saccular aneurysm associated with a fenestrated basilar artery. The fenestration was located in the proximal third of the basilar artery. The aneurysm arose from the proximal end of the fenestration, projecting antero-inferiorly. Via a left retromastoid craniectomy, the aneurysm was successfully obliterated through the space between the eighth cranial nerve and the lower cranial nerve complexes. Postoperative deficit in the lower cranial nerves was minimal and transient. The other patient, a 63 year-old lady, had multiple aneurysms arising from the anterior circulation associated with a basilar artery fenestration. These aneurysms were clipped uneventfully. Surgical approach to an aneurysm arising from the basilar artery fenestration is discussed with other related literature. Full study of posterior circulation with multiple projection is mandatory to detect basilar artery fenestration, and the possible presence of saccular aneurysm at the site of the anomaly.

[Analysis of electrically evoked response (EER) in relation to the central visual pathway of the cat (1). Wave shape of the cat EER]

To analyze the Electrically evoked response (EER) in relation to the central visual pathway, the authors studied the properties of wave patterns and peak latencies of EER in 35 anesthetized adult cats. The cat EER showed two early positive waves on outward current (cornea cathode) stimulus and three or four early positive waves on inward current (cornea anode) stimulus. These waves were recorded within 50 ms after stimulus onset, and were the most consistent components in cat EER. The stimulus threshold for EER showed a less individual variation than amplitude. The difference of stimulus threshold between outward and inward current stimulus was also essentially negligible. The stimulus threshold was higher in early components than in late components. The peak latency of EER became shorter and the amplitude became higher, as the stimulus intensity was increased. However, this tendency was reversed and some wavelets started to appear when the stimulus was extremely strong. The recording using short stimulus duration and bipolar electrodes enabled us to reduce the electrical artifact of EER. These results obtained from cats were compared with those of humans and rabbits.

Cerebellar corticonuclear and nucleocortical projections in the vermis of posterior lobe of the rat as studied with anterograde and retrograde transport of WGA-HRP

Corticonuclear (CN) and nucleocortical (NC) projections of the cerebellum were studied in rats by using antero- and retrograde transport of wheatgerm agglutinin-conjugated horseradish peroxidase (WGA-HRP). Following minute injections of WGA-HRP in different folia for vermal lobules VI-VIII, a rostrocaudal topography was observed in the CN projection; lobules VIa and VIb, c projected to distinctly separate areas in the ipsilateral fastigial nucleus (FN): VIa projected to the ventral part of the medial subdivision of the FN (FNm), whereas VIb, c projected to the dorsocaudal part of the caudomedial subdivision of the FN (FNcm) and to the caudal FNm. The terminals from lobules VIb, c and VII occupied partially overlapping areas in the caudal part of the ipsilateral FNcm and FNm. A few terminal fibers were also seen in the dorsolateral protuberance of the FN (dlp). The fibers from vermal lobule VIII terminated in the ipsilateral rostral FNcm and in the FNm. The latter terminal area was divided into two parts: a smaller dorsal and a larger ventral part that in turn overlapped almost completely with the terminal area of fibers from lobule VIa. Retrogradely labeled fastigial neurons were found in the areas of the FN where Purkinje-cell (P-cell) axons from the respective injection sites terminated. In addition, retrogradely labeled fastigial neurons were scattered in areas outside the P-cell terminal fields on the injection side and in the contralateral FN.

Evolutionary pattern of the hemagglutinin gene of influenza B viruses isolated in Japan: cocirculating lineages in the same epidemic season

The unexpectedly low efficacy of influenza vaccine during school outbreaks of influenza B virus in the spring of 1987 in Japan was probably attributable to a poor antibody response of vaccinees to the epidemic viruses. An antigenic analysis of the causative B viruses isolated in 1987 and 1988 showed much variation in hemagglutination inhibition patterns. The nucleotide sequences that code for the HA1 domain of B/Fukuoka/c-27/81, B/Ibaraki/2/85, B/Nagasaki/1/87, and B/Yamagata/16/88 viruses were determined and compared with those of the previously reported hemagglutinin genes. The nucleotide sequences of the hemagglutinin gene of a new variant, B/Yamagata/16/88, had only 93.4% homology with those of two other viruses from the same epidemic. An analysis of nucleotide and amino acid substitutions of the hemagglutinin genes of influenza B viruses revealed that new and some old variants could cocirculate in the same epidemic. A phylogenetic tree constructed by the neighbor-joining method allowed estimation of an evolutionary rate of 2.3 x 10(-3) synonymous (silent) substitutions per nucleotide site per year in the hemagglutinin gene.

Calcium-dependent potentials with different sensitivities to calcium agonists and antagonists in guinea-pig hippocampal neurons

Effects of organic Ca channel blockers, Ca channel activators and omega-conotoxin on guinea-pig hippocampal CA1 neurons in vitro preparations were studied with intracellular recording methods. Most of the Ca channel blockers, such as prenylamine, D 600, flunarizine, nifedipine, cinnarizine and nicardipine (0.2-4 microM), raised the threshold for Na-dependent spike generation and decreased the amplitude of the spike afterhyperpolarization. Verapamil (5 microM) and diltiazem (5 microM) did not significantly alter the threshold and amplitude of the Na spike. Action potentials elicited in the presence of either tetrodotoxin (0.5 microM) and tetraethylammonium (20 mM) or tetrodotoxin (0.5 microM) and Ba (1.25 mM) consisted of an initial spike component followed by a long depolarization. Both responses were abolished by addition of Co (2 mM) or Cd (0.25-0.5 mM), or by superfusion with a low Ca (0.25 mM)-high Mg(15 mM) medium, indicating that the potentials resulted from Ca entry. The Ca-dependent slow depolarization was preferentially blocked by most of the organic Ca channel blockers at approximately one-third the concentrations (0.1-2 microM) which were required to shorten the Ca spike. When the cell in a solution containing tetrodotoxin (0.5 microM), Co (2 mM) and 4-aminopyridine (2 mM) was hyperpolarized and then depolarized by passing current pulses across the membrane, a transient depolarizing hump occurred on the decay phase of the electrotonic potential. This transient depolarization was abolished by Co (2 mM), Ni (2 mM) or most of the organic Ca channel blockers (0.2-5 microM). Diltiazem (5 microM) did not significantly change these Ca-dependent potentials. The evoked excitatory postsynaptic potential was very resistant to the Ca channel blockers. Approximately 2-10 times higher concentrations (0.5-3 microM) were necessary to decrease the excitatory postsynaptic potential amplitude than to shorten the Ca spike. On the other hand, the minimal concentrations and order of potencies of the Ca channel blockers for depressing the evoked inhibitory postsynaptic potential and for elevating the threshold for Na spike generation were almost the same. Dihydropyridine Ca channel activators, such as Bay K 8644, CGP 28 392 and YC 170 at low concentrations (0.1-1 microM), decreased the Ca spike, the Ca-dependent slow depolarization and the evoked synaptic potentials, while the substances augmented the Ca-dependent transient depolarization. On the other hand, omega-conotoxin (5 microM) reversibly depressed the Ca spike and slow depolarization to the same degree, without affecting the transient depolarization and the evoked excitatory or inhibitory postsynaptic potentials.(ABSTRACT TRUNCATED AT 400 WORDS)

Effects of lithium on alterations of pharmacokinetics of imipramine and on the related changes of monoamines in rat brain

Rats were given chronically i.p. imipramine (20 mg/kg), LiCl (1 mg/kg) or both drugs to examine the effects of lithium (Li) on the alterations of imipramine pharmacokinetics in the whole brain and on the imipramine-related changes of norepinephrine (NE) and serotonin (5-HT) levels in the brain. When rats were given Li for 3 days, followed by a single injection of imipramine, the concentrations of desipramine in the brain and serum were higher than those in the vehicle-treated rat, although the imipramine concentrations in both tissues did not differ in Li- and in vehicle-treated rats. In rats receiving both drugs for 10 days, the steady state levels of imipramine and desipramine in the brain were the same as those in the vehicle-treated rats but the steady state level of desipramine was reached earlier with Li treatments presumably because of the enhanced demethylation of imipramine. Consequently, the desipramine-dependent alterations of NE and 3-methoxy-4-hydroxyphenylglycol levels in the brain appeared to be induced earlier and more markedly when Li was given simultaneously. As the 5-hydroxyindole acetic acid (5-HIAA) levels were elevated in the brains of Li-treated rats and reduced in brains of imipramine-treated rats as compared with the level in vehicle-treated rats, the 5-HIAA level in rats receiving both drugs was equivalent to that in vehicle-treated rats.

Projections from the superior colliculus to the ventral lateral geniculate nucleus in the hereditarily microphthalmic rat

Projections from the superior colliculus (SC) to the ventral lateral geniculate nucleus (LGNv) were studied in hereditarily microphthalmic and normal rats by means of wheatgerm agglutinin conjugated with horseradish peroxidase (WGA-HRP). Unilateral injection of a tracer into the LGNv in normal rats revealed WGA-HRP positive neurons on both sides of the SC. In the ipsilateral SC, most of the labeled neurons were distributed in the upper part of the stratum opticum (SO) and the lower part of the stratum griseum superficiale (SGS). A few labeled neurons were also found in the same layers of the contralateral SC. After unilateral injections of the tracer into the LGNv of microphthalmic rats, labeled neurons appeared in similar layers of the SC on both sides. However, the number of labeled neurons in the ipsilateral SC decreased to 30% of normal, whereas on the contralateral side these neurons were apparently more numerous than those in normal rats. The soma size of the labeled SC neurons in microphthalmia was not significantly different from normal. These results indicate fundamentally that tecto-LGNv projecting neurons exist in microphthalmic rats despite the fact that they lack optic nerve afferents. Furthermore, the present results, taken together with our previous results, indicate that the diminution in the number of tecto-LGNd neurons was severest (3%), the tecto-LGNv neurons less severe (30%) and the tecto-LP neurons least severe (50% of that of normal).

[A study on the goals and achievements of postgraduate medical education]

In order to evaluate postgraduate medical education (PGME) in Japan, residents and supervisors of all the postgraduate teaching hospitals (128 university hospitals and 216 non-university hospitals designated by the Ministry of Health and Welfare) were surveyed. The purposes of this study were, 1) to compare the goals of PGME set by residents and the achievements of PGME by residents in university hospitals and non-university hospitals, 2) to compare the goals of PGME between residents and supervisors, 3) to identify how clinical skills and knowledge related to the behavioral sciences and social medicine are stressed on PGME. Residents and supervisors received a newly developed questionnaire consisting of 41 items concerning clinical skills and knowledge. The items were divided into four categories: 17 basic areas, 9 allied areas, 12 areas related to the behavioral sciences and social medicine, and 3 areas related to clinical research. The response rate was 52.3% for university hospitals and 75.5% for non-university hospitals. The results are 1) residents in non-university hospitals scored at higher levels than residents in university hospitals for 14 items concerning goals and 11 items of achievements, mainly basic clinical skills and knowledge, 2) there was an incongruence between residents and supervisors for 23 items concerning goals, 3) clinical skills and knowledge related to the behavioral sciences and social medicine were not as highly stressed as other areas of clinical skills and knowledge. This study suggests that more effort is needed to create or improve the system of PGME, especially in university hospitals.

Topographical organization of the olivocerebellar projection upon the posterior vermis in the rat

Projections from the medial accessory olive (MAO) to lobules VI, VII and VIII of the cerebellar vermis were investigated in the rat using the retrograde transport of wheatgerm agglutinin-conjugated horseradish peroxidase (WGA/HRP). When WGA/HRP was injected into the anterior half of lobule VI (VIa), retrogradely labeled neurons were found in a relatively narrow zone which traversed approximately the middle of the MAO and a portion of the nucleus beta. In contrast, injection into the posterior half of lobule VI (VIb, c) resulted in labeling of neurons in the medial and lateral portions of the MAO and in the nucleus beta. When HRP was confined to lobule VII, labeled neurons were found in the medial portion of the caudal MAO. No labeled neurons were found in the nucleus beta. When the injection was restricted to lobule VIII, labeled neurons appeared along the caudal end of the MAO. There were many labeled neurons in the nucleus beta. The central portion of the caudal MAO was free of labeled neurons unless the enzyme encroached upon a part of the anterior lobe. Thus, the projection areas to lobules VI-VIII formed a circle surrounding the free area and each of the lobules received fibers from a well-circumscribed portion: lobules VI-VIII received projections from the rostral, medial and caudal portion of the imaginary circle, respectively. The lateral portion was shared by the areas projecting to lobules VI and VIII. In addition, these lobules received projections also from an overlapping area in the nucleus beta.

Correlative changes of serotonin and catecholamines with pharmacokinetic alterations of imipramine in rat brain

Rats were given i.p. imipramine (20 mg/kg), acutely or chronically, and the levels of serotonin (5-HT), norepinephrine (NE), dopamine (DA) and their metabolites in the brain at different times were compared with the concentrations of imipramine and desipramine. The levels of 5-HT, DA, dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) in the brain did not appear to be affected by quantitative alterations in the concentrations of imipramine and desipramine. The level of 5-hydroxyindole acetic acid (5-HIAA) was reduced and the level of 3-methoxy-4-hydroxyphenylglycol (MHPG) tended to decrease 3 h after imipramine administration in acutely treated rats. The reduced level of 5-HIAA was maintained during the chronic treatment with imipramine, whereas the MHPG level increased and the NE level decreased. The decrease in 5-HIAA depended on the concentration of imipramine in the brain, whereas the changes in the levels of NE and MHPG appeared to be caused by desipramine. The present studies show that pharmacokinetic variations of imipramine in the brain might correlate with the altered levels of 5-HIAA, NE and MHPG.

Olivocerebellar and cerebelloolivary connections of the oculomotor region of the fastigial nucleus in the macaque monkey

Anatomical connections of the caudal portion of the fastigial nucleus (FN) with the inferior olive (IO) were studied in macaque monkeys with wheat-germ-agglutinin-conjugated horseradish peroxidase (WGA/HRP) and HRP. When injected HRP was confined to a caudal portion of the FN, retrogradely labeled Purkinje cells (P cells) appeared in the oculomotor vermis. We defined the area that receives the projection from vermal lobule VII as the fastigial oculomotor region. The same HRP injection resulted in retrograde labeling of IO neurons in an area of group b (of Bowman and Sladek: J. Comp. Neurol. 152:299-316, '73) of the contralateral medial accessory olive (MAO). This area was designated as the Z-portion because in the coronal section it appears like the letter "Z." Retrogradely labeled IO neurons were also found in the Z-portion when HRP was injected into the oculomotor vermis, indicating that neurons in this portion project to both the fastigial and vermal oculomotor regions. Anterogradely labeled axons from the contralateral fastigial oculomotor region also terminated in the Z-portion. When the effective site included a region anterior to the fastigial oculomotor region, labeled P cells appeared in lobule V and labeled IO neurons appeared in group a. Labeled terminals of fastigial fibers were also found in group a. When the effective site included a region ventral to the oculomotor region, labeled P cells appeared in vermal lobules VIII and IX and labeled IO neurons appeared in caudal parts of a and b, in addition to group c. HRP injection into the posterior interposed nucleus (PIN) resulted in labeling of P cells in the paravermal zone and of IO neurons in the rostral two-thirds of the MAO and the dorsal accessory olive (DAO). The location of the labeled terminals coincided with the region where the densest labeling of IO neurons was found. Thus, the olivary projections to both the cerebellar cortex and deep cerebellar nuclei and the nucleoolivary projection exhibited a closely related topographical organization.

Changes in spontaneous firing patterns of rat hippocampal neurones induced by volatile anaesthetics

1. The effects of the volatile anaesthetics, halothane, isoflurane and enflurane, on rat hippocampal CA1 and CA3 neurones in in vitro preparations were studied by intracellular recording methods. 2. The three anaesthetics, at concentrations similar to those used clinically (0.2-1.2 mM), initially increased and then subsequently decreased the spontaneous firing of CA1 neurones without affecting the resting membrane properties or the EPSPs evoked by focal stimuli. 3. The anaesthetics at these concentrations depressed both the fast after-hyperpolarization of the soma spike and the post-tetanic hyperpolarization induced by repetitive stimulation. They also decreased the IPSPs evoked by focal stimuli. 4. The threshold for spike generation was gradually elevated by as much as 4-6 mV during application of the anaesthetics at these concentrations. The subthreshold potential oscillations (which are likely to be associated with periodic alterations in non-inactivating Ca2+ and Na+ currents) were enhanced in the low concentrations (0.2-0.5 mM), but were depressed in the high concentrations (0.8-1.2 mM). 5. The results suggest that the transient increase in the firing frequency was caused by a depression of both the spike after-hyperpolarization and the post-tetanic hyperpolarization, and that the reduction of spontaneous firing was mainly due to an elevated threshold for spike generation. 6. The three anaesthetics altered the pattern of spontaneous spike-firing in CA3 neurones from solitary spiking to burst firing without affecting the resting membrane properties. 7. The effects of the anaesthetics on the active membrane properties and the postsynaptic potentials in CA3 neurones were similar to the effects in CA1 neurones. 8. In the majority of CA3 neurones, soma spikes elicited by depolarizing current pulses were followed by a Ca2+-dependent after-depolarization, which was in turn followed by a prolonged after-hyperpolarization (post-burst hyperpolarization). The anaesthetics facilitated the after-depolarizing potential, while they depressed the post-burst hyperpolarization. Combination of the two effects would give rise to the highly stereotyped burst (about 1 Hz in frequency) in the presence of the volatile anaesthetics.

Experimental portal fibrosis produced by intraportal injection of killed nonpathogenic Escherichia coli in rabbits

An attempt was made to develop an animal model for the study of the etiology of noncirrhotic portal fibrosis or idiopathic portal hypertension based on the assumption that it is related to chronic abdominal infection. Rabbits were given killed nonpathogenic Escherichia coli intraportally or intravenously. The animals to which a mixture of killed E. coli and rabbit antiserum (aggregated E. coli) was given intraportally developed remarkable histologic changes in the liver. The early inflammatory reactions in the portal area and parenchyma were followed by rapid disappearance of inflammation and development of portal fibrosis with bile duct proliferation. Three intraportal challenges with aggregated E. coli were sufficient to produce pronounced portal fibrosis, although there was considerable variation in response among individual animals. This procedure also produced splenomegaly, and in some animals marked portal hypertension. Injection of nonaggregated killed E. coli into the portal vein or aggregated E. coli into the ear vein also caused similar hepatic changes, but they were milder in degree. These histologic changes resemble portal fibrosis seen in idiopathic portal hypertension and, less closely, pericholangitis associated with inflammatory bowel disease in humans.

Histological changes in the liver and portal hypertension subsequent to repeated intraportal injections of killed E. coli in the dog

The etiology of idiopathic portal hypertension (IPH) is not known. To obtain clues to the pathogenesis, an attempt was made to produce a hepatic lesion similar to that in IPH by repeated injections of aggregated killed non-pathogenic E. coli directly into the portal vein. In the treated dogs, histology of the liver showed dense fibrosis in the portal tract and an aberrant vasculature around the portal area after 1 month. Portal pressure was elevated and middle-to-small-sized portal branches were decreased in number as studied by portography. These changes closely mimic those seen in human IPH. The possibility is discussed that chronic entrance of an antigen such as bacteria from the intestine to the portal venous system plays an etiologic role in IPH.

Prognosis of hepatocellular carcinoma smaller than 5 cm in relation to treatment: study of 100 patients

A total of 100 patients with small hepatocellular carcinoma, less than or equal to 5 cm in diameter, seen during the last 8 years were analyzed retrospectively for survival time in relation to treatment and Child's grading. When analyzed with respect to major treatment modalities without considering stage, the median survival was 35.0 months for 34 patients treated by surgery, 28.8 months for 20 patients treated by transcatheter arterial embolization, 10.6 months for 25 patients treated by intraarterial chemotherapy and 9.7 months for 17 patients who received no specific treatment. When patients were divided into three stages without considering treatment, the median survival was 37.1 months for 37 Child's A patients, 16.2 months for 36 Child's B patients and 1.6 months for 27 Child's C patients. These results suggest that the prognosis depended on treatment given and the Child's grade. The effects of major therapeutic modalities on survival were analyzed with regard to Child's grading. Among Child's A patients, the actuarial survival rate for surgery was better than that for transcatheter arterial embolization and for arterial chemotherapy. Among Child's B patients, the survival rate for transcatheter arterial embolization was better than for other treatments. Among Child's C patients, there was no significant difference in survival rate regardless of treatment and its modality. These results suggest that surgery may be indicated as a first choice in Child's A patients, transcatheter arterial embolization in Child's B patients, and there is no effective treatment in Child's C patients. The major cause of death was hepatic failure irrespective of treatment.

Arterial chemoembolization with mitomycin C microcapsules followed by transcatheter hepatic artery embolization for hepatocellular carcinoma

Of 66 patients with hepatocellular carcinoma, 32 were treated by intraarterial injection of mitomycin C microcapsules (group A) and 34 patients by intraarterial injection of mitomycin C microcapsules followed by transcatheter hepatic artery embolization (group B). Measurable tumor regression greater than 50% in area on liver image occurred in 28% of group A and 57% of group B (p less than 0.05). A decrease of serum alpha-fetoprotein to less than half the initial level was demonstrated in 59% of group A and 91% of group B (p less than 0.05). The survival rate was better in group B compared with group A (p less than 0.05). These results indicate that arterial chemoembolization with mitomycin C microcapsules plus transcatheter hepatic artery embolization will be an improvement over arterial chemoembolization with mitomycin C microcapsules alone in the treatment of hepatocellular carcinoma.

Portal venous hemodynamics in hepatocellular carcinoma. Effects of hepatic artery embolization

Portal hemodynamics were studied in 55 patients with hepatocellular carcinoma in comparison with 41 normal subjects, using the duplex system that consists of an electronic sector scanner and a pulsed Doppler velocitometer. Changes of portal hemodynamics after transcatheter hepatic artery embolization were also investigated in 15 of the patients with hepatocellular carcinoma. The duplex system showed that 9 of the 55 had no Doppler signal in the portal trunk, suggesting portal vein thrombosis, 2 had hepatofugal flow in the portal trunk indicative of arterioportal shunts, and 44 had hepatopetal flow in the portal trunk. One of the 9 patients with no significant portal venous flow showed hepatopetal flow in collateral veins at the porta hepatis, suggesting cavernous transformation of the portal vein. All of these ultrasound findings were confirmed by subsequent celiac-mesenteric angiography. In 44 of the 55 patients there was no tumor invasion in the portal trunk, and portal venous flow was found to be close to that of normal subjects regardless of the stage or size of tumor, and tumor invasion into relatively large portal branches. After transcatheter hepatic artery embolization, portal venous flow was increased, even on the next day, and it remained increased for at least 2 wk. Thus, the duplex system is useful to study qualitative and quantitative changes of portal hemodynamics in hepatocellular carcinoma. Our observations suggest that the portal venous flow is kept relatively constant by some homeostatic mechanism even in advanced hepatocellular carcinoma until the tumor invades into the portal trunk, and that it increases when hepatic arterial flow is occluded.

Splenic artery and superior mesenteric artery blood flow: nonsurgical Doppler US measurement in healthy subjects and patients with chronic liver disease

The accuracy of the duplex Doppler ultrasound system in the measurement of blood flow in the splenic artery and the superior mesenteric artery was evaluated in seven anesthetized dogs by comparing blood flow recordings obtained simultaneously with the electromagnetic flowmeter, with those obtained with the combination of B-mode and M-mode scanning. Various flow rates were produced by the infusion of dopamine. Splenic artery blood flow and superior mesenteric artery blood flow measured with the duplex system exhibited significant correlations with corresponding values obtained with electromagnetic flow measurements (r = .93 and r = .93, respectively). Changes in splanchnic circulation with the progression of chronic liver disease in humans were then investigated with the use of the duplex system. Splenic artery blood flow and superior mesenteric artery blood flow were significantly increased in patients with cirrhosis compared with patients with chronic hepatitis and healthy subjects. These results indicate that a hyperdynamic circulatory state may develop in the splanchnic circulation of the intestine and spleen in cirrhotic patients.

[Functional improvement produced by transplantation of fetal neuronal cell suspensions in the rat striatum with 6-hydroxydopamine lesions]

Behavior improvement from apomorphine-induced rotation, morphological features of nerve cells and in vivo release of dopamine (DA) were examined after the implantation of neuronal cell suspensions into the striatum of female rats with 6-hydroxydopamine lesions. Apomorphine-induced rotation was significantly suppressed in 11 out of 26 rats from two through ten weeks after the implantation. In 3 out of 26 rats, the rotation was significantly suppressed for four weeks after the implantation, although the suppression was reversed by the fifth week. In the remaining 12 rats, the rotation was not inhibited after the implantation. Behavior improvement was concurrent with extension of neurites from anti-DA immunopositive cells to the host caudate. Anti-DA cells were very scant in the absence of behavior improvement. In vivo release of DA and the metabolites, 3,4-dihydroxyphenylacetic acid and homovanillic acid, was detected in the perfusates of the striatum of the animals that were functionally improved by the transplant. Methamphetamine caused an increase in DA release and a decrease in the release of the metabolites in those animals. These results suggest that grafted neuronal cells which are sensitive to methamphetamine probably innervate neuronal elements in the host caudate, and the release of DA from these grafted cells functionally affects behavior improvement.