The prognosis of fetuses with transient nuchal translucency in the first and early second trimester

OBJECTIVE

The purpose of this study was to evaluate the prognosis of fetuses with transient nuchal translucency before 15 weeks of gestation.

STUDY DESIGN

A nuchal translucency's measurement of > or = 5 mm was considered abnormal. In the period from 1994 to 1995, twelve fetuses were diagnosed at our institution with nuchal translucency. The fetuses all underwent karyotyping and a complete ultrasonographic search for any associated anomalies and a resolution of nuchal translucency at 1-2 week gestational age intervals.

RESULTS

Five cases ('Transient NT') demonstrated transient nuchal translucency. Seven cases ('Persistent NT') demonstrated persistent nuchal translucency. The 984 cases with no or less than 5 mm of nuchal translucency (control group) gave birth at the same time. The mean initial week of diagnosis was 12.0 +/- 1.6 weeks in 'Transient NT', and 13.6 +/- 1.8 weeks in 'Persistent NT'. The mean maternal age was 30.8 +/- 6.3 years old in 'Transient NT', 28.9 +/- 3.0 years old in 'Persistent NT', and 30.5 +/- 43 years old in the control group. Abnormal karyotypes were detected in one case in 'Transient NT', and in four cases in 'Persistent NT'. Structural malformations were detected in two cases (40%) in 'Transient NT', seven cases (100%) in 'Persistent NT', and 30 cases (3.0%) in the control group.

CONCLUSIONS

Regardless of the spontaneous resolution of abnormal nuchal translucency, there was a high association with both karyotypical and structural abnormalities, and the prognosis of such cases was generally poor, especially persistent NT's prognosis.

[Successful treatment of interstitial pneumonia with lipo-PGE1 and pentoxifylline in a patient with dermatomyositis]

Interstitial pneumonia complicated with dermatomyositis sometimes shows a resistance to high dose steroid therapy and a fatal course particularly in patients without showing the elevation of creatine kinase. We experienced a 48 year old woman who developed heliotrope rash, Gottron's sign, multiple cutaneous ulcers, and dyspnea on exertion. These symptoms were resistant to low dose steroid therapy. Serum levels of creatine kinase were normal. Anti-nuclear antibodies and anti-Jo-1 antibody were negative. High resolution CT scan of the chest showed areas of multiple air space consolidation and subpleural linear shadows. Lung biopsy performed under video-assist thoracosurgery revealed diffuse alveolitis with scattered lymphoid folicules and mild accumulation of macrophages in the alveolar spaces. There were no honey-combing. These features were compatible with "non-specific interstitial penumonia" proposed by Katzenstein, 1995. The patient was treated with 10 micrograms lipo-PGE1, PGE1 incorporated in lipid microspheres, and 300 mg pentoxifylline, which resulted in a dramatic improvement of both interstitial pneumonia and cutaneous ulcers. The present case suggested a novel strategy for the treatment of interstitial pneumonia.

Inhibitory effects of glibenclamide and pertussis toxin on the attenuation of ischemia-induced myocardial acidosis following ischemic preconditioning in dogs

Ischemic preconditioning is known to be mediated by several humoral factors, such as adenosine, norepinephrine, and bradykinin. We examined intracellular signal transduction of ischemic preconditioning following receptor stimulation. Alterations in the pH of the ischemic bed were monitored to assess the response of control and ischemic-preconditioned myocardium to glibenclamide and pertussis toxin. Pentobarbital-anesthetized open-chest dogs were subjected to 40 min of ligation of the left anterior descending coronary artery. Ischemic preconditioning was elicited by 25-min periods of coronary ligation followed by 5 min of reperfusion before a 40-min period of ligation. Glibenclamide (0.3 mg/kg)was given i.v. 20 min before the onset of ischemic preconditioning. Pertussis toxin (6-10 micrograms/kg) was given i.v. 3 days before the experiment. Tissue myocardial pH was measured by a glass micro-pH electrode. Ischemia for 5 min decreased myocardial pH and reperfusion returned it to the preischemic levels. Ischemia for 40 min decreased the myocardial pH from 7.43 +/- 0.06 to 6.43 +/- 0.08. Ischemic preconditioning significantly attenuated the decrease in myocardial pH (6.57 +/- 0.06) induced by 40 min of ischemia. Pretreatment with either glibenclamide or pertussis toxin completely abolished the effect of ischemic preconditioning on ischemic myocardial acidosis. Ischemic preconditioning can attenuate ischemia-induced myocardial acidosis in dogs, and this effect is mediated by activation of adenosine triphosphate-sensitive potassium channels and pertussis toxin-sensitive guanosine triphosphate-binding protein.

Glutamate in opioid dependence

The present review will concentrate on a discussion of recent investigations which implicate a critical linkage of three facets of the central nervous system mediation of opioid dependence, as evidenced by expression of acutely-precipitated withdrawal events. These are the kappa-opioid receptor subtype, the glutamatergic neuronal system and a specific brain locus, the locus coeruleus. The impetus for this line of investigation derives from a recognition that opioid analgesics, such as butorphanol (Stadol), exhibit a markedly different profile of activity at opioid receptors than does morphine yet have abuse liability and cause dependence readily. Emphasis will be placed on demonstration of a rodent model in which butorphanol administration induces dependence through a unique (in comparison with morphine) activation of the kappa-opioid receptor. The use of in vivo microdialysis techniques clearly identifies, in this model, that acutely-precipitated withdrawal from dependence on butorphanol results in focal increases in extracellular levels of glutamate within the locus coeruleus, and that the withdrawal syndrome can be mimicked by intracerebroventricular administration of exogenous glutamate, acting through the N-methyl-D-aspartate glutamate receptor subtype. The data confirm the participation of glutamate as a general phenomenon in opioid dependence, identify the locus coeruleus as a primary site for glutamatergic mediation of dependence, and suggest novel aspects to the neuropharmacology of opioid dependence with respect to the role of the kappa-opioid receptor.

Fibroblasts of spinal ligaments pathologically differentiate into chondrocytes induced by recombinant human bone morphogenetic protein-2: morphological examinations for ossification of spinal ligaments

To elucidate the process of ossification in spinal ligaments, an aqueous solution containing recombinant human bone morphogenetic protein (BMP)-2 (40 micrograms/100 microL) was injected into murine ligamenta flava, and the ossification process was analyzed morphologically. In the control group, the solution administered lacked the protein; these flattened ligamentous fibroblasts possessing BMP receptors type IA and type II existed among type I collagen bundles. In the week immediately following the injection of BMP-2, ligamentous fibroblasts began to proliferate, differentiating into alkaline phosphatase-positive chondrocytes surrounded by an extracellular matrix composed of type I and II collagen. By the second week, differentiated chondrocytes of various stages were observed in type II collagen-rich matrix. These chondrocytes showed an abundance of BMP receptors type IA and II. The pathologically induced cartilage was resorbed by chondroclasts, permitting migration of blood vessels and osteogenic cells, as well as providing a site for endochondral ossification. By the third week, BMP-induced ossification had compressed the spinal cord, and by the sixth week, the ligamentous tissue had been almost completely replaced by bone. Ligamentous fibroblasts appeared to possess BMP receptors, as well as the potentiality to differentiate into chondrocytes. BMP receptors were upregulated during chondrification of ligamentous fibroblasts induced by exogenous BMP-2, suggesting that BMPs may play an important role in ossification of spinal ligaments.

Role of NMDA receptors in pentobarbital tolerance/dependence

Effects of continuous pentobarbital administration on binding characteristics of [3H]MK-801 in the rat brain were examined by autoradiography. Animals were rendered tolerant to pentobarbital using i.c.v. infusion of pentobarbital (300 micrograms/10 microliters/hr for 7 days) by osmotic minipumps and dependent by abrupt withdrawal from pentobarbital. The levels of [3H]MK-801 binding were elevated in rats 24-hr after withdrawal from pentobarbital while there were no changes except in septum and anterior ventral nuclei in tolerant rats. For assessing the role of NMDA receptor in barbiturate action, an NMDA receptor antagonist (MK-801, 2.7 femto g/10 microliters/hr) was co-infused with pentobarbital. The pentobarbital-infused group had a shorter duration of pentobarbital-induced loss of righting reflex (sleeping time) than that of the control group, and MK-801 alone did not affect the righting reflex. However, co-infusion of MK-801 blocked hyperthermia, and prolonged the onset of convulsions induced by t-butylbicyclophosphorothionate (TBPS) in pentobarbital withdrawal rats. In addition, elevated [35S]TBPS binding was significantly attenuated by co-infusion with MK-801. These results suggest the involvement of NMDA receptor up-regulation in pentobarbital withdrawal and that the development of dependence can be attenuated by the treatment of subtoxic dose of MK-801.

Apolipoprotein E Sendai (arginine 145-->proline): a new variant associated with lipoprotein glomerulopathy

Lipoprotein glomerulopathy (LPG) is a novel disease characterized by proteinuria, lipoprotein thrombi in the glomeruli, and increased concentration of plasma apolipoprotein (apo) E. It is believed that a genetic disorder of apo E may be present and associated with the disease. Three patients with LPG were examined in this study. The patients' DNA sequences were analyzed, and a nucleotide G to C point mutation in exon 4 of the apo E gene was confirmed in each patient. This missense mutation denotes amino acid substitution of the proline residue for arginine residue at position 145 of apo E. This variant (apo E Sendai) may cause a marked molecular conformational change of the apo E. These findings suggest that a novel variant is etiologically related to LPG.

Increased release of excitatory amino acids in rat locus coeruleus in kappa-opioid agonist dependent rats precipitated by nor-binaltorphimine

Extracellular fluid levels of glutamate and aspartate in the locus coeruleus (LC) during nor-binaltorphimine (nor-BNI)-precipitated withdrawal from butorphanol, (5alpha,7alpha,8beta)-(+)-N-methyl-N-[7-(1-pyrrolidiny l)-1-oxaspiro [4,5] dec-8-yl]-benzeneacetamide (U-69,593), or morphine were measured in rats. When the microdialysis probe was located in the core of the LC, increases in glutamate and aspartate were noted after nor-BNI (48 nmol/50 microl, LC)-precipitated withdrawal in rats that had been intracerebroventricularly infused with butorphanol (26 nmol/1 microl/h) or U-69,593 (26 nmol/10 microl/h) for 3 days. The glutamate and aspartate levels in the LC markedly increased in the butorphanol- or U-69,593-dependent rats within 60 min following administration of nor-BNI. However, there was no significant increase in levels of glutamate, and only a slight increase in levels of aspartate, after nor-BNI treatment of the morphine (26 nmol/1 microl/h)-infused rats. Behavioral signs of withdrawal (teeth-chattering, wet-dog shakes, etc.) were observed following nor-BNI challenge in the butorphanol- or U-69,593-infused rats, with only minimal signs in the morphine-infused rats, and none in the saline-infused controls. These results directly suggest that kappa-opioid receptors and excitatory amino acids within the LC mediate withdrawal in animals dependent on butorphanol or U-69,593, but not on morphine.

An evaluation of neuromuscular reversal with edrophonium in a patient with malathion intoxication

We evaluated the neuromuscular reversal with edrophonium using peripheral nerve stimulator and recorder in a patient with malathion intoxication. Edrophonium 10 mg i.v. caused an increase in single twitch tension by 76% of the control during the recovery phase from an acute cholinergic crisis 16 days after ingestion of malathion solution. The present study indicated that edrophonium test seems to be a reliable monitoring in evaluating neuromuscular reversal in the patient with acute malathion insecticide poisoning.

Expression and distribution of cortical type aromatase mRNA variant in the adult rat brain

Our previous study showed that a relatively high level of the aromatase mRNA existed in the cerebral cortex (CC) of the rat, where the aromatase activity was reported to be little or absent. To elucidate the identity of the aromatase mRNA in the CC of the rat, we investigated the 5'-region of the aromatase mRNA in the rat CC. When the sequence of the 5'-region of the cortical message was analysed by the 5'-rapid amplification of cDNA ends (5'-RACE) with the antisense primer for exon II using the RNA extracted from the CC, no clone could be isolated. However, the upstream sequence from the 5'-end of exon IV of the aromatase clones, isolated from the CC by RACE with the antisense primers for exon V, was different from that on the aromatase mRNA encoding the full translated region. The new sequence of the cortical type message, called the cortical type aromatase mRNA variant, was located on the intron upstream of exon IV in the genomic cDNA. Distribution of the brain aromatase message with exons III-V and the cortical type aromatase mRNA variant were analysed by the reverse transcription-polymerase chain reaction (RT-PCR) using total RNAs extracted from the hypothalamus-preoptic area (HPOA), amygdala (AMY) and CC. The PCR products with primers for exons III-V were generated from the HPOA and AMY, but not from the CC. On the other hand, the PCR products with primers for exon IIIv (cortical type aromatase mRNA variant specific)-V were detected in significant amounts in the CC as well as the HPOA and AMY. These results indicate the existence of the aromatase mRNA variant lacking exons I-III in the adult rat brain. This cortical type mRNA variant seemed to be widely distributed in the tissues.

Impaired left ventricular diastolic filling occurs in diabetic patients without atherosclerotic coronary artery disease

Using left ventriculography, left ventricular diastolic function was studied in 24 diabetic patients who had angina pectoris without atherosclerotic large-vessel coronary artery diseases (group A, 14 patients with exercise-induced ischemic ST-T changes as seen during electrocardiogram; group B, 10 patients without such changes). In groups A and B, the global peak filling rate was significantly less than that in control patients without diabetes or cardiac diseases. The ratio of the global time to the peak filling rate to the diastolic time was higher in both groups A and B than in the control groups. However, the total of time differences, defined as the sum of the time differences between global time to the peak filling rate and each of the three regional time to the peak filling rate, was greater in group A than in either group B or the control patients. Total time difference was similar in group B and the controls. Left ventricular diastolic filling was impaired in diabetic patients without large-vessel coronary artery disease. Impaired diastolic filling was present regionally in patients with ischemic ST-T change but globally in those without such change.

Immunolocalization of tissue non-specific alkaline phosphatase in mice

Immunolocalization of tissue non-specific alkaline phosphatase (TNAP) was examined in murine tissues, employing a specific antiserum to TNAP on frozen sections, 50-micron tissue slices, and paraffin sections. TNAP was detected at high levels in hard tissues including bone, cartilage, and tooth. In bone tissue, the TNAP immunoreactivity was localized on the entire cell surface of preosteoblasts, as well as the basolateral cell membrane of osteoblasts. It was also localized on some resting chondrocytes and most of the proliferative and hypertrophic cells in cartilage. In the incisor, cells of the stratum intermedium, the subodontoblastic layer, the proximal portion of secretory ameloblasts, and the basolateral portion of odontoblasts showed particularly strong immunoreactivity. Immunoreactivity was observed in other soft tissues, such as the brush borders of proximal renal tubules in kidney, on cell membrane of the biliary canalicula in liver and in trophoblasts in the placenta. These immunolocalizations were quite similar to enzyme histochemical localizations. However, neither the submandibular gland nor the intestine, which both exhibited alkaline phosphatase activity by enzyme histochemistry, revealed immunoreactivity for TNAP. Therefore, immunocytohistochemical studies for TNAP enabled us to localize the TNAP isozyme, thus distinguishing it from other isozymes.

Vitamin K2 enhances osteocalcin accumulation in the extracellular matrix of human osteoblasts in vitro

The role of vitamin K in osteocalcin accumulation in the extracellular matrix of normal human osteoblasts in culture was investigated by using a human intact osteocalcin-specific assay system. Human osteoblasts produced osteocalcin by treatment with 10(-9) M 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) for 20 days in culture. With the addition of vitamin K2 (1.5-5.0 microM), osteocalcin accumulation in the extracellular matrix of the osteoblasts was increased, but the osteocalcin content in the conditioned medium decreased, in comparison with that treated with 10-9 M 1,25(OH)2D3 alone. The enhancement of osteocalcin accumulation induced by vitamin K2 was dependent on the duration of the treatment. The vitamin K2 plus 1,25(OH)2D3-induced osteocalcin accumulation was blocked by the addition of warfarin 2 days before the vitamin treatment. At that time, warfarin significantly reduced the mineralization by osteoblasts in vitro. Osteocalcin accumulated in the extracellular matrix was almost completely precipitated by a low concentration of hydroxyapatite, 10 mg/ml. Moreover, the gamma-carboxyglutamic acid (Gla)-containing osteocalcin level was increased by the vitamin K2 plus 1,25(OH)2D3 treatment. These results proved that vitamin K2 increased Gla-containing osteocalcin, which accumulated osteocalcin in the extracellular matrix, and facilitated mineralization in vitro. Vitamin K2 also enhanced the 1,25(OH)2D3-induced osteocalcin mRNA level, but vitamin K2 alone did not show osteocalcin mRNA expression. We thus demonstrated that vitamin K2 enhanced not only the accumulation of Gla osteocalcin, but also the osteocalcin production induced by 1,25(OH)2D3 in human osteoblasts in culture.

[Successful surgical treatment of aortic regurgitation due to annuloaortic ectasia and mitral regurgitation caused by tendon rupture in a case of osteogenesis imperfecta]

A 54-year-old man presented with osteogenesis imperfecta complicated with both aortic regurgitation due to annuloaortic ectasia and mitral regurgitation secondary to tendon rupture. He had spinal and carpal deformities in his childhood, and heart murmurs were identified at the age of 25. He was admitted complaining of dyspnea on effort. His height was 142 cm and his weight was 46 kg. He had kyphosis, scoliosis and carpal deformity. Blue sclera was not observed. Chest radiography showed cardiomegaly and lung congestion. Echocardiography showed annuloaortic ectasia, mild aortic regurgitation, and serious mitral regurgitation due to postero-apical tendon rupture. Bone deformity and his statues were indicative of osteogenesis imperfecta. He received modified Bentall and mitral valve replacements.

Vitamin K2 promotes 1alpha,25(OH)2 vitamin D3-induced mineralization in human periosteal osteoblasts

The effect of vitamin K on mineralization by human periosteal osteoblasts was investigated in the absence and presence of 1alpha, 25 dihydroxyvitamin D3 (1,25(OH)2D3). Vitamin K1 and K2, but not vitamin K3, at 2.5 microM enhanced in vitro mineralization when cells were cultured with vitamin K for 20 days after reaching confluence in vitro. Vitamin K2 (2-methyl-3-all-trans-tetraphenyl-1, 4-naphthoquinone : menatetrenone) was the most potent of these vitamin K analogs; it slightly inhibited alkaline phosphatase (ALP) activity. Human osteoblasts were mineralized and showed the enhanced ALP activity on treatment with 10(-9) M of 1,25(OH)2D3 for 20 or 25 days after confluence. Vitamin K2 promoted the 1,25(OH)2D3-induced mineralization, but slightly inhibited the 1,25(OH)2D3-induced ALP activity. Moreover, vitamin K2 enhanced the 1,25(OH)2D3-induced osteocalcin accumulation in the cells and the extracellular matrix (cell layer), but inhibited the osteocalcin content in the medium produced by the 1,25(OH)2D3 treatment. However, vitamin K2 alone did not induce osteocalcin production in the human osteoblasts. On Northern blot analysis, osteocalcin mRNA expression on 1, 25(OH)2D3-treated cells was enhanced by vitamin K2 treatment, but vitamin K2 alone did not induce osteocalcin mRNA expression. Warfarin blocked both the 1,25(OH)2D3-induced osteocalcin production and the accumulation in the cell layer, and also blocked the 1, 25(OH)2D3 plus vitamin K2-induced osteocalcin production and the accumulation in the cell layer. The 1,25(OH)2D3-induced mineralization promoted by vitamin K2 was probably due to the enhanced accumulation of osteocalcin induced by vitamin K2 in the cell layer. However, we concluded that the mineralization induced by vitamin K2 alone was due to the accumulation of osteocalcin in bovine serum on the cell layer, since osteocalcin extracted from the cell layer was not identified by specific antiserum against human osteocalcin, which does not cross-react with bovine osteocalcin. These results suggest that the mechanism underlying the mineralization induced by vitamin K2 in the presence of 1,25(OH)2D3 was different from that of vitamin K2 alone, and that osteocalcin plays an important role in mineralization by osteoblasts in vitro.

Ovarian epithelial borderline tumor and carcinoma in young women

To clarify the influence of age on clinical and histologic features, young women with ovarian epithelial borderline tumors and carcinomas were analyzed. A retrospective review of 93 patients with ovarian common epithelial borderline tumors and carcinomas was performed. Twenty-one of 93 patients (22.6%) were under age 40. Predominant symptoms in young patients were abdominal pain or abdominal distention, but 4 (19%) patients had no symptom. Eleven (11/21; 52.4%) patients were nulliparous and six patients received conservative surgery to preserve fertility. The rate of histologic type and stage did not significantly differ between the young and older groups. Although overall survival between young and older patients did not significantly differ, the survival of young patients with advanced disease (stage III and IV) was significantly worse than in older patients with advanced disease. (p < 0.05).

Expansive cervical laminoplasties--observations on comparative changes in spinous process lengths following longitudinal laminal divisions using autogenous bone or hydroxyapatite spacers

Expansive laminoplasty is devised to preserve the posterior structures, including the original length of the spinous process which anchors the nucheal muscles, in order to prevent the postoperative development of instability and cervical kyphosis due to structural loss and poor tone of the nucheal muscles, which can result in late neurological regression after laminectomy for cervical myelopathy. We retrospectively compared the length of the spinous process at the time of follow-up with that within 3 months postoperatively using CT images. The shortening was observed in 80% of 60 spinous processes in 13 patients, where a hydroxyapatite (HA) block was used as a spacer placed between the two sides of the split spinous process. The incidence was 9% of 22 spinous processes in six patients where auto bone graft (ABG) was used as a spacer, and the difference was significant (P < 0.01, Chi-square test). Although the usage of HA has the advantage of being less invasive than ABG, it may jeopardize the biomechanical function of nucheal muscles due to reduction in the original length of the spinous process.

Programmed cell death of chondrocytes and aberrant chondrogenesis in mice homozygous for parathyroid hormone-related peptide gene deletion

In previous work we showed that the chondrodysplastic phenotype of mice homozygous for a null mutation of the PTH-related peptide (PTHrP) gene was due in part to reduced proliferation and aberrant differentiation of growth plate chondrocytes. In the present study we have extended those observations by examining chondrocytes for evidence of PTH/PTHrP receptor expression, proliferation, and programmed cell death. Receptor messenger RNA and protein were expressed in chondrocytes in the resting and proliferative zones of both wild-type and mutant mice. In normal animals, expression was abundant in the area of transition between proliferative and hypertrophic chondrocytes and absent from cells in the lower hypertrophic region. On the other hand, the hypertrophic zone in mutant mice contained nonhypertrophic chondrocytes, which exhibited characteristics of proliferating cells, including PTH/PTHrP receptor expression, [3H]thymidine incorporation, and expression of proliferating cell nuclear antigen. In contrast to the situation in normal animals, some cells adjacent to the zone of vascular invasion in mutant growth plates showed biochemical and morphological evidence of programmed cell death. In addition to these alterations in the maturation of growth plate chondrocytes, homozygous mutants demonstrated signs of aberrant differentiation of periosteal precursor cells. In some specimens, clusters of chondrocytes embedded in a cartilaginous matrix were observed between the layers of periosteal osteoblasts and the bony collar in the sterna and tibiae of mice homozygous for a null mutation of the PTHrP gene. Taken together, these observations indicate that PTHrP plays a pivotal role in the orderly progression of chondrocytes through stages of proliferation, differentiation, and programmed cell death in the epiphyseal growth plate and may also facilitate the commitment of precursors to cells of the chondrocytic or osteoblastic lineages.

Precipitated kappa-opioid receptor agonist withdrawal increase glutamate in rat locus coeruleus

Extracellular fluid levels of excitatory amino acids (glutamate, Glu; and aspartate, Asp) in the locus coeruleus and the behavioral signs during naloxone-precipitated withdrawal from kappa-opioid receptor agonists, butorphanol and (5 alpha, 7 alpha, 8 beta) -(+)-N-methyl-N-[7-(1-pyrrolidinyl)-1-oxaspiro[4,5]dec-8-yl]-be nzaneacetamide (U-69,593), were investigated by in vivo microdialysis. Increases in levels of Glu, but not of Asp, were noted after naloxone (12 or 48 nmol/5 microliters, locus coeruleus)-precipitated withdrawal in the rats which had been intracerebroventricularly infused with butorphanol (26 nmol/1 microliters/h) or U-69,593 (26 nmol/10 microliters/h) for 3 days. The Glu levels in the locus coeruleus increased following administration of naloxone before and during the first 15-min sample after the precipitation of withdrawal in the butorphanol- or U-69,593-dependent rats. Furthermore, behavioral evidence of withdrawal (teeth-chattering, wet-dog shakes, etc.) was detected following the naloxone challenge in the butorphanol- and U-69,593-infused rats, but not in saline-infused controls. These results provide direct evidence to support the role of excitatory amino acids within the locus coeruleus in butorphanol or U-69,593 withdrawal.

The untranslated first exon 'exon 0S' of the rat estrogen receptor (ER) gene

Recently, we have isolated the untranslated first exon 'exon ON' of the rat estrogen receptor (ER) gene from the liver by the use of the 5'-rapid amplification of cDNA ends (5'-RACE) method. To investigate the existence of other untranslated first exon(s), we further analyzed the 5'-untranslated region (UTR) of ER mRNA in the rat liver in this study. Total RNA from the livers of 8-week-old male Wistar rats was subjected to 5'-RACE with the antisense primers located in exon 1 of the rat ER gene. The inserts of four clones (clones 3, 4, 7 and 8) were sequenced. The nucleotide sequences of the clones revealed the existence of a previously unidentified untranslated first exon (we termed it 'exon OS') which was spliced onto exon I of the rat ER mRNA. The distribution of ER mRNA containing 'exon OS' (ER mRNA (OS-1)) in several brain regions and various peripheral tissues of 8-week-old male and female Wistar rats was further analyzed by the use of the reverse transcription-polymerase chain reaction. ER mRNA (OS-1) was found to be widely distributed in the rat brain and peripheral tissues. The distribution of the message was different from that of ER mRNA containing exon 0 (the first reported 5'-UTR form of rat ER mRNA) or of ER mRNA with exon ON which was reported in our recent report. These results indicate that (1) 'exon OS' is a novel untranslated first exon of the rat ER gene, (2) rat ER mRNAs possess at least three forms of 5'-UTRs which are exon 0, exon ON, and exon OS, (3) the tissue specific expression of ER is regulated, at least in part, by the usage of differential promoters in the rat.

Fertilization and development of mouse oocytes injected with isolated sperm heads

To determine whether spermatozoa must be structurally intact before microsurgical injection into oocytes for normal fertilization, intact spermatozoa, as well as sperm heads separated from tails by sonication, were individually injected into oocytes. When whole spermatozoa were injected immediately after their immobilization, the majority of the oocytes were fertilized and developed normally. Sonication in the presence or absence of Triton X-100 decapitated more than 95% of spermatozoa. Although all decapitated spermatozoa were diagnosed as "dead" by live/dead sperm staining, separated sperm heads (nuclei) could participate in normal embryo development when injected into the oocytes. The ability of isolated sperm heads (nuclei) to participate in normal embryo development was maintained under cryopreservation conditions that were not suitable for the survival of plasma membrane-intact spermatozoa. These results indicate that 1) spermatozoa do not need to be structurally intact for intracytoplasmic injection, 2) the plasma and acrosomal membranes and all tail components are not essential for normal embryo development, at least in the mouse, and 3) the cryopreservation conditions required for maintenance of the genetic integrity of sperm nuclei are less stringent than those necessary for keeping plasma membrane-intact spermatozoa alive.

Effects of BIBR-277, an angiotensin II type 1 receptor antagonist, on stunned myocardium in dogs

BACKGROUND

Angiotensin converting enzyme inhibitors can protect the myocardium from ischaemic damage. We examined the effect of BIBR-277, an angiotensin II receptor type 1 antagonist, on myocardial stunning in dogs.

METHODS

Pentobarbital-anaesthetized open-chest dogs were subjected to 20 min ligation of the left anterior descending coronary artery, followed by reperfusion for 60 min. Saline or 0.3, 1 or 3 mg/kg body weight BIBR-277 was injected intravenously 10 min before coronary ligation. The myocardial contractile function was measured by ultrasonometry. The tissue levels of energy metabolites in the 60 min reperfused heart were determined.

RESULTS

Myocardial contractile function assessed in terms of percentage segment-shortening in the saline-treated group decreased during ischaemia and returned towards the pre-ischaemic level during reperfusion but incompletely (myocardial stunning). A significant and dose-dependent improvement in the percentage segment-shortening during reperfusion was observed in the BIBR-277-treated groups. The levels of ATP, ADP and AMP in the reperfused heart were not modified by BIBR-277 treatment compared with those in the saline-treated group.

CONCLUSION

BIBR-277 ameliorates the myocardial contractile dysfunction during reperfusion after ischaemia, although it did not bring about any improvement in the high-energy phosphate levels in the reperfused heart.