Lumbosacral intersegmental epispinal axons and ectopic ventral nerve rootlets

An epispinal system of motor axons virtually covers the ventral and lateral funiculi of the human conus medullaris between the L-2 and S-2 levels. These nerve fibers apparently arise from motor cells of the ventral horn nuclei and join spinal nerve roots caudal to their level of origin. In all observed spinal cords, many of these axons converged at the cord surface and formed an irregular group of ectopic rootlets that could be visually traced to join conventional spinal nerve roots at one to several segments inferior to their original segmental level; occasional rootlets joined a dorsal nerve root. As almost all previous reports of nerve root interconnections involved only the dorsal roots and have been cited to explain a lack of an absolute segmental sensory nerve distribution, it is believed that these intersegmental motor fibers may similarly explain a more diffuse efferent distribution than has previously been suspected.

Analysis of the intrathecal humoral immune response in Brown Norway (BN) rats, infected with the murine coronavirus JHM

Serum and CSF specimens from clinically healthy Brown Norway (BN) rats inoculated intracerebrally with corona virus JHM were analysed with respect to the state of the blood-brain barrier (BBB) and the intrathecal synthesis and isoelectric distribution of immunoglobulins (Ig). Increased CSF/serum ratios for Ig in the context of an intact BBB were never seen in the absence of intrathecal synthesis of virus-specific antibodies. Affinity-mediated immunoblot analysis revealed a broad pattern of virus-specific antibodies with embedded clusters of restricted heterogeneity, but no signs of oligoclonal Ig production carrying non-viral specificity. From these data it was concluded that BN rats do control the intracerebral spread of JHM virus effectively by a strong local virus-specific antibody response, thereby preventing a clinically apparent disease.

[Correlation of LH and prolactin pulses in normoprolactinemic women with ovulatory disturbances and variation of LH and FSH pulses and secreting capacity by administration of bromocriptine in the same cases]

The difference between prolactin (PRL) basal levels on separate days in the 6 normoprolactinemic women--one case with an anovular cycle and 5 cases with 1 degree amenorrhea--among 14 normoprolactinemic women with ovulatory disturbances, showed significantly variation over 13 ng/ml within the normal range of the PRL basal level. PRL pulse frequencies of the same cases from 0900 h. to 1400 h. increased slightly compared with follicular phase. At the same time, the PRL pulse amplitudes were significantly higher than in the follicular phase but significantly lower than the PRL pulse amplitudes in hyperprolactinemic women. The net increase in PRL to TRH in the 6 cases was over 100 ng/ml. When the PRL net increase to TRH was over 100 ng/ml in normoprolactinemic women with ovulatory disturbances, the case is regarded as latent hyperprolactinemia. And 1 or 2 may be latent hyperprolactinemic syndrome. The LH/FSH basal level and delta LH/delta FSH to LH-RH before administration of bromocriptine increased in these cases compared with the follicular phase. During the administration of bromocriptine, the ratios decreased and approached the ratio in the follicular phase. The effect of clomid was improved by increased E2 in these cases.

Murine coronavirus-induced encephalomyelitis in rats: analysis of immunoglobulins and virus-specific antibodies in serum and cerebrospinal fluid

The humoral intrathecal immune response in coronavirus-induced demyelinating encephalomyelitis in rats associated with an autoimmune reaction to brain antigen, was analysed. The CSF of these animals revealed immune reactions which were directed against coronavirus and other, unknown, antigens. In general, no direct correlation between the disease, the state of the blood-brain barrier (BBB), intrathecal synthesis of Ig and the presence of virus-specific antibodies was detectable, suggesting that the humoral, in contrast to the cellular, immune response does not play a significant pathogenetic role in this CNS disease.

Vascular and neural pathology of lumbosacral spinal stenosis

During a study of the intrinsic vasculature of the lumbosacral spinal nerve roots in cadavers, a typical case of spinal stenosis was encountered. A review of the antemortem anamnesis revealed that this patient had had an intermittent claudication of the cauda equina. Investigation of the concomitant vascular and histopathological alterations of the affected nerve roots suggested that the claudication may have resulted from ectopic nerve impulse discharges elicited by rapid changes in the blood supply following exertion. The unexpectedly slight apparent neural deficit relative to observed root damage may be attributed to a neuronal plasticity within the spinal cord that permitted functional compensations to develop during the slow acquisition of the chronic nerve root pathology.

The intrinsic vasculature of the lumbosacral spinal nerve roots

The observations made in this study strongly support the concept that spinal nerve roots in general and the human lumbosacral spinal nerve roots in particular are structurally, vascularly, and metabolically unique regions of the nervous system. Peculiarities of their intrinsic vasculature and supporting connective tissue may account for suspected "neuroischemic" responses to pathologic mechanical stresses and inflammatory conditions associated with degenerative disease of the lower spine. It is hoped that the newly described features of the radicular vasa nervorum (to avoid confusion with the dissimilar blood supply of peripheral nerves, the term "vasa radiculorum" might be more accurate) may advance the understanding of certain aspects of lower spine symptomatology and provide some basis for much needed future research.

Relapsing subacute demyelinating encephalomyelitis in rats during the course of coronavirus JHM infection

Temperature-sensitive mutants of the murine coronavirus JHM induced a subacute demyelinating encephalomyelitis (SDE) in young rats. Neurological symptoms were associated with marked lesions of primary demyelination in the white matter of the central nervous system (CNS), and developing after an incubation time of several weeks to months. Many rats survived this infection and recovered completely from this CNS disease. Among 43 survivors of SDE, 9 rats developed a relapse 27-153 days after onset of the first attack. Neuropathological examination of these animals revealed areas of fresh demyelination together with old remyelinated lesions. Viral antigens were detectable in the neighbourhood of fresh lesions and in some cases infectious virus was re-isolated from rats revealing low antibody titers to JHM virus. These results demonstrate that mutants of JHM virus can induce a relapsing demyelinating disease process, associated with a persistent infection, which possesses some similarities to chronic experimental allergic encephalomyelitis.

[A case of localized lipomatosis in the pancreatic head presenting a lipoma-like appearance]

A 63-year-old woman with localized lipomatosis in the pancreatic head is reported. She was diagnosed to have a lipoma by clinical data including CT scanning. Histopathological examination of the extirpated mass revealed that the lesion was mostly composed of mature fatty tissue without any lobulation or encapsulation by connective tissue, there was a small amount of scattered pancreatic parenchyma at the peripheral and deeper parts of the mass. No Langerhans' islets were detected. Based on these findings, the lesion was diagnosed as localized lipomatosis in the pancreatic head.

Treatment of complete acromioclavicular separation by coracoacromial ligament transfer

There is still discussion concerning the methods for treating Type 3 dislocations of the acromioclavicular joints. Since 1969 the authors have treated 41 patients with Type 3 dislocations by transfer of the coracoacromial ligament, with favorable results. The advantages of the method are as follows: (1) The replaced coracoacromial ligaments substitute for the strong coracoclavicular ligaments, reproducing a construction that closely resembles a physiologically and anatomically normal state. (2) There is no fear of rupture if transplanted tendon or wire is used. A concentrated force will not occur in this system because of dispersion in the tendon, and no injury is produced in the clavicle. (3) The operation can be performed under the same visual field, and the technique is relatively simple.

Pressure gradient and blood flow in human arm veins--a proposed explanation of the pumping mechanism

In a patient with mitral stenosis we previously found a negative periphero -central pressure gradient (P-C PG) despite a forward peripheral venous blood flow velocity ( PVBFV ) during supine leg exercise. The present study was undertaken to confirm this finding and elucidate its mechanism. In 6 patients with congestive heart failure, P-C PG was reversed from -2.4 to -18.7 cm H2O for 1 to 5 minutes during exercise. PVBFV , measured simultaneously with peripheral venous pressure (Pv) in 8 subjects, remained positive; 5 of these were patients with a negative P-C PG. The effect of intravenous lidocaine(1-26 mg) was studied in 13 patients: In 4 of 13 patients the change in Pv by saline injection was smaller than that after lidocaine (2-5 mg) injection (-0.5 +/- 0.5, 3.9 +/- 0.8 cm H2O, mean +/- SE, respectively) (p less than 0.02). In 13 patients Pv rose after a small dose of lidocaine. After a larger dose the rate of rise of Pv decreased or Pv dropped. No significant change was observed in the central venous pressure. In 6 patients who performed Valsalva's maneuver, the rate of rise of Pv during the test decreased or unchanged after lidocaine injection. The probability of a pumping mechanism in superficial human arm veins was discussed.

Virological and immunological aspects of coronavirus induced subacute demyelinating encephalomyelitis in rats

Infection of rats with the murine coronavirus JHM led to acute or subacute encephalitis. Viral and host factors greatly influenced the outcome of the infection. A number of temperature-sensitive (ts) mutants was obtained which differed widely in their capacity to induce lesions of the central nervous system (CNS) in rats. Under defined conditions a subacute demyelinating encephalomyelitis ( SDE ) with pronounced clinical signs was observed 14-160 days post infection (p.i.). A number of rats, which showed a remission of SDE later developed a relapse of the disease accompanied by neurological symptoms. Neuropathological examination of such animals revealed lesions of active demyelination and extended remyelinated areas. The presence of viral antigen or infectious virus in the CNS of these rats demonstrated that they were persistently infected. Further investigations indicated that this virus infection triggers a cell mediated immune response against basic myelin protein which may contribute to the development of subacute to chronic encephalomyelitides .

A new anti-mycotic drug tioxaprofen and its uncoupling effect on isolated mitochondria

An oxazole compound, tioxaprofen, exerted a strong anti-mycotic activity against Trichophyton mentagrophytes and T. rubrum, which were major dermatophytes from patients. It was found that tioxaprofen was a potent uncoupling agent of mitochondrial respiration.

Chlorination-induced enhancement of biological activities in imidazole antimycotics. A possible explanation to the molecular mechanism for their antimycotic activities

The effect of imidazole antimycotics (clotrimazole, econazole, and miconazole) on mitochondrial functions were compared by the experiment with isolated rat liver mitochondria and it was found that their potencies in the uncoupling effect on oxidative phosphorylation, in the stimulation of latent ATPase activity, and in the induction of swelling in mitochondria were enhanced by the increased chlorination of the molecule, i.e. miconazole greater than econazole greater than clotrimazole.

Neurovirulence of murine coronavirus JHM temperature-sensitive mutants in rats

The murine coronavirus strain JHM is highly neurotropic in rats and has a marked tendency to cause demyelinating central nervous system diseases after intracerebral inoculation. The clinical diseases observed range from an acute encephalomyelitis occurring within 2 weeks postinfection to a subacute demyelinating encephalomyelitis developing several weeks or months postinfection. Uncloned wild-type virus induced both acute and subacute diseases, whereas cloned JHM virus grown in tissue culture caused only acute disease without the pronounced lesions of primary demyelination. In contrast, temperature-sensitive mutants selected from that clone were capable of inducing subacute demyelinating encephalomyelitis after prolonged incubation times. Viruses recovered from diseased animals were still temperature sensitive. Inoculation of temperature-sensitive mutants into suckling rats (age, 10 to 15 days) produced high rates of subacute demyelinating diseases running a more chronic course; these diseases often were not fatal. Those rats which did not show clinical signs frequently revealed inflammatory demyelinating lesions. These findings indicate that the rate and type of clinical disease are dependent on the neurovirulence of the virus mutant used for inoculation and the age of the animals at the time of infection.

The effect of pyrrolnitrin on mitochondrial reactions: the induction of swelling

An antifungal antibiotic, pyrrolnitrin, was found to show very similar biological activities to those of imidazole antimycotics on isolated mitochondria. Pyrrolnitrin caused drastic swelling of mitochondria in isotonic solutions of alkali metal salts and of sucrose without any addition of substrate for the respiratory chain in mitochondria. The swelling induced by pyrrolnitrin was characterized by a biphasic swelling process; a very fast initial swelling and thereafter a very slow speed secondary swelling. The increase of pyrrolnitrin concentration exponentially increased the magnitude of over-all rapid swelling. Pyrrolnitrin enhance the latent ATPase activity of mitochondria at the similar range of concentrations to those needed for the induction of the swelling. The concentrations of pyrrolnitrin where mitochondrial swelling was induced were found to be far lower than those needed for the exhibition of inhibitory effect on the electron transport system of mitochondria.

Coronavirus JHM-induced demyelinating encephalomyelitis in rats: influence of immunity on the course of disease

Disease processes of the central nervous system (CNS) accompanied by demyelination may be the result of a viral infection or the consequence of an immunopathological reaction directed against myelin. In acute viral infections, the infection of oligodendroglial cells, leading to cell destruction, may be the main mechanism for inducing this neuropathological lesion. In the case of a persistent virus infection in oligodendroglia cells, however, it is conceivable that functional impairment of oligodendroglia cells, or the induction of an immune reaction to the agent that may cross-react with brain antigens, could eventually cause demyelination. Therefore, pathogenic studies on subacute or chronic demyelinating encephalomyelitides in association with viral infections may provide information on the mechanisms involved in demyelination. In rats, depending on the biological property of the virus material used, the genetic background and immune response of the host, a subacute or late demyelinating encephalomyelitis can be induced, accompanied by primary demyelination. This provides a model for analysis of the virus and host factors interacting in the pathogenesis of these diseases.

Adoptive transfer of EAE-like lesions from rats with coronavirus-induced demyelinating encephalomyelitis

Viruses have been found to induce inflammatory demyelinating lesions in central nervous system (CNS) tissue of both animal and man, either by natural infections or after vaccination. At least two different pathogenic mechanisms have been proposed for these changes, a cytopathic viral infection of oligodendroglia cells with subsequent cell death, and a host immune reaction against virus and brain antigens. We now report the occurrence of cell-mediated immune reactions against basic myelin proteins in the course of coronavirus infections in Lewis rats. Infection of rats with the murine coronavirus JHM leads to demyelinating encephalomyelitis developing several weeks to months postinfection. Lymphocytes from these diseased Lewis rats can be restimulated with basic myelin protein (BMP) and adoptive transfer of these cells leads to lesions resembling those of experimental allergic encephalomyelitis (EAE) in recipients, which can be accompanied by a mild clinical disease. This model demonstrates that a virus infection in CNS tissue is capable of initiating an autoimmune response which may be of pathogenic importance.

Effect of bone-derived growth factor on DNA, RNA, and proteoglycan synthesis in cultures of rabbit costal chondrocytes

Calvariae and chondrocytes in culture have been reported to release growth factors which stimulate bone and cartilage growth respectively. In the present studies, we examined the effects of bone-derived growth factor (BDGF) on DNA, RNA and proteoglycan synthesis in cultured rabbit chondrocytes. Two partially purified fractions of BDGF were tested, one with an approximate molecular weight (MW) of 20-30,000 and with greater activity on calvarial DNA labeling (BDGF I) and another with an approximate MW 6-13,000 and greater activity on bone collagen labeling (BDGF II). Both fractions had a similar effect and increased the incorporation of -3H-uridine into acid insoluble residues in chondrocytes and the incorporation of 35SO4(2-), 3H-glucosamine and 3H-serine into proteoglycans. However, BDGF II had a greater stimulatory effect on the incorporation of 3H-thymidine than BDGF I. These findings suggest that factor(s) released by bone cells are capable of stimulating cartilage metabolism and growth.

Regional distribution of cholinergic neurons in human spinal cord transections in the patients with and without motor neuron disease

Regional distribution of enzymic activities in acetylcholine (ACh) metabolism was examined on thinly-sectioned transverse slices of human spinal cords obtained during autopsy of 5 motor neuron disease (MND) and 5 control patients without MND. Choline acetyltransferase (ChAT) activity was highly concentrated in the ventral horn regions (gray and white matters) of cervical, thoracic and lumbar spinal cord of non-MND patients. This enzyme activity was found to be remarkably low in the ventral gray and white matter of MND patients compared with that of the controls. Although the distribution of acetylcholinesterase (AChE) activity was found to be high in both ventral and dorsal gray matter of the spinal cord, little difference was observed between each corresponding region of MND and control patients, except relatively low enzyme activity in the cervical ventral horn region of MND patients. Muscarinic cholinergic receptors, examined as specific [3H]quinuclidinylbenzilate ([3H]QNB) binding, was also highly concentrated in the ventral and dorsal gray matter of the control spinal cord, and was strongly reduced in the ventral horn region of MND patients, indicating a quite similar distribution pattern of ChAT activity. These biochemical changes of cholinergic transmission system may be paralleled to the morphological degeneration of the spinal lower motor neurons in MND patients. Activity of 2',3'-cyclic nucleotide-3'-phosphodiesterase (CNPase), a marker enzyme of central myelin structure, was evenly distributed throughout the whole spinal cord section, without regard to the gray and white matter, of both MND and control patients.

Simultaneous bilateral renal artery reconstruction and intraoperative renal protection. A case report

A 22-year-old Japanese man with bilateral renal artery stenosis associated with hypertension underwent successful surgery of simultaneous bilateral renal artery reconstruction under conditions of intraoperative renal perfusion with St. Thomas Hospital solution which is used for cardioplegia in open heart surgery. Circulation in the left kidney was interrupted for 58 minutes and that of the right kidney for 35 minutes. The patient fully recovered with no serious impairment of renal function. In addition to these stenotic lesions of the renal artery, there were medial necrosis of the aorta and fibromuscular dysplasia of the superior mesenteric artery. Administration of SQ14,225, an angiotensin I converting enzyme inhibitor, was effective in controlling hypertension during the preoperative period.

In vitro carcinogenesis of hepatocytes obtained from acetylaminofluorene-treated rat liver and promotion of their growth by phenobarbital

The hepatic cells of rats being fed acetylaminofluorene were transferred into culture at various times. Proliferative hepatocytic foci were obtained from animals treated with the carcinogen for more than 9 weeks. These hepatocytic foci became transplantable and capable of growth in soft agar after 4 to 12 months in culture. Phenobarbital markedly enhanced the growth of these hepatocytes in culture.

Mechanisms of inhibition by simultaneously administered phenobarbital of 3'-methyl-4-(dimethylamino)azobenzene-induced hepatocarcinogenesis in the rat

The mechanisms of inhibition by simultaneously administered phenobarbital of 3'-methyl-4-(dimethylamino)azobenzene (3'-Me-DAB)-induced hepatocarcinogenesis in the rat were studied. Weanling rats were fed a diet containing 0.06% 3'-Me-DAB or 0.06% 3'-Me-DAB and 0.05% phenobarbital for 3 weeks, followed by either basal diet or a diet containing 0.05% phenobarbital as a promoter. The number and the size of enzyme-altered islands and the number of tumors larger than 5 mm in diameter were scored at week 12 and week 40, respectively. The simultaneous feeding of phenobarbital and 3'-Me-DAB resulted in a significant decrease in the number and size of enzyme-altered islands and in the number of tumors, in comparison with those scored in animals fed 3'-Me-DAB alone. It was concluded that the simultaneous feeding of phenobarbital inhibits both the initiation of carcinogenesis and also the promotive action of the carcinogen resulting from its selective toxicity on the liver tissue.

Dissecting aneurysm during pregnancy and the puerperium

According to Schnitker, Mandel, Hirst and their associates, approximately half of the dissecting aneurysms in women under 40 years of age are associated with pregnancy. This significant relationship between dissecting aneurysm and pregnancy has been discussed by considering hemodynamic stress and also the hormonal changes of pregnancy. In this report, we describe five patients with dissecting aneurysm during pregnancy or the puerperium, review the literature and discuss the influence of pregnancy on the pathogenesis of this disease.

Induction of gamma-glutamyl transpeptidase activity by dietary phenobarbital in "spontaneous" hepatic tumors of C3H mice

Biochemical features of spontaneous hepatic tumors in C3H mice were studied histochemically in comparison with those of neoplastic lesions developed in animals fed dietary phenobarbital (PB) continuously or treated with diethylnitrosamine (DEN) during 11 approximately 14 weeks of age. All 42 spontaneous hepatic tumors that developed in control mice by 74 weeks of age were completely negative for gamma-glutamyl transpeptidase (gamma-GTPase) activity. Dietary phenobarbital enhanced hepatic tumorigenesis remarkably, and 32 out of 43 tumors found at 70 weeks showed multifocal gamma-GTPase activity. DEN induced gamma-GTPase-positive islands of hepatocytes, but 12 out of 13 tumors larger than 5 mm in diameter that developed by 60 weeks were gamma-GTPase-negative. The phenomenon of induction of gamma-GTPase activity by PB in "spontaneous" hepatic tumors appears to be important both for elucidating the mechanism of promotion by PB and also for analyzing multisteps of carcinogenesis.

Induction by parathyroid hormone of ornithine decarboxylase in rabbit costal chondrocytes in culture

The activity of ornithine decarboxylase (ODC) in rabbit costal chondrocytes in culture markedly increased after addition of parathyroid hormone (PTH), reaching a maximum 4 to 5 h after PTH addition. The effect of PTH was dose-dependent both in the presence and absence of fetal calf serum. Addition of cycloheximide or actinomycin D prevented the induction of ODC by PTH. Calcitonin, 1,25-dihydroxyvitamin D3, and vitamin A had no stimulatory effect on the activity of ODC, and did not inhibit the induction of ODC by PTH, when added with PTH.

[Postoperative spinal canal stenosis (author's transl)]

Four cases of postoperative spinal canal stenosis were presented in which compression of cauda equina was observed. The lesion was found in 5.8% of operated spinal stenosis (four out of 69 cases). One must pay attention to differentiate the lesion from the recurrence of initial disorder, because the symptoms of the postoperative spinal stenosis is no always typical but sometimes resemble to the symptoms of the initial disorder which needed the operation. Myelography is the only reliable method to decide the extent of the spinal canal stenosis.

[Effects of a proteolytic-enzyme preparation used concomitantly with an antibiotic in osteoarticular infections (author's transl)]

Studies were performed in 8 patients with osteoarticular infections to examine the concentrations of sulbenicillin in the venous blood and exudate following administration and the concentrations of the antibiotic in the exudate when serratiopeptidase was orally administered concomitantly with the antibiotic. The results of the examination indicated that the transfer of sulbenicillin into the exudate tended to increase when 30 mg/day of serratiopeptidase was concomitantly given for 6 days, though further examination was thought necessary by increasing number of subjects and elaborating on the methodology.