Development of human fetal muscles: a comparative histochemical analysis of the psoas and the quadriceps muscles

The development of human muscle can be divided into three distinct phases on the basis of the enzyme histochemistry (Dubowitz 1965). On the other hand, muscles can be classified into trunk muscles innervated by the motoneurons in the anteromedial nucleus of the anterior horn and limb muscles innervated by those of the lateral nucleus. We compared histochemically the development of the psoas muscle as a trunk muscle with the quadriceps. Four legally aborted fetuses and sixteen autopsied preterm or full-term infants with conceptional ages ranging from sixteen to fourty-two weeks, served as subjects. Serial crossly cut frozen sections of the psoas and the quadriceps were stained with HE, modified Gomori-trichrome, NADH-TR, myofibrillar ATPase (routine, preincubation at pH 4.6, 4.3), and analyzed quantitatively. In the psoas and the quadriceps, all muscles consisted of undifferentiated type IIC fibers before the eighteenth week of gestation. Type I fiber began to appear around the eighteenth week in both muscles. Before the thirtieth week, both muscles comprised a great number of smaller type IIC fibers and scattered large type I fibers. The psoas had already a little more type I fibers than the quadriceps in this phase. After the thirtieth week, the percentage of type I fibers increased greatly to about 50% at term in the psoas, gradually to 20-23% at term in the quadriceps. Type IIA and IIB fibers appeared suddenly around the thirty-seventh week. Total percentage of these two type fibers increased at term to about 50% and 70% in the psoas and the quadriceps, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Serum group I pepsinogen (PG I) levels and their changes in the healing process of the ulcer in patients with and without unoperated recurrent ulcer

We measured serum group I pepsinogen (PG I) levels in subjects with endoscopically normal gastric and duodenal mucosa and patients with peptic ulcer. The release mechanism of PG I into blood stream was also investigated. The mean (+/- S.E.) serum PG I level in 136 subjects with endoscopically normal mucosa was 61 +/- 2 ng/ml and the normal range was calculated to be 30-109 ng/ml from the frequency distribution. In the patients with unoperated recurrent duodenal ulcer, the serum PG I levels remained high with the healing process of the ulcer. On the other hand, in the patients with non-recurrent duodenal ulcer and those with recurrent or non-recurrent gastric ulcer, the serum PG I levels decreased with the healing process of the ulcer gradually and significantly from the value in the active stage. These findings suggest that duodenal ulcer patients with high levels of serum PG I throughout the healing process of the ulcer tend to have the recurrence. Therefore, the serial measurements of serum PG I with the healing process will be helpful for the prediction of ulcer recurrence. Administration of atropine caused a significant decrease in serum PG I in the patients with duodenal ulcer, which suggests the vagal control of PG I release in duodenal ulcer patients.

Effects of various levels of dietary calcium during pregnancy on maternal calcium utilization and fetal growth in rats

The effects of calcium-free and normal (0.6%) and high (1.0%) calcium diets on the transfer of calcium from pregnant mothers to fetuses were investigated by balance experiments. Pregnant rats receiving calcium-free, normal and high calcium diets ate totals of 353, 324 and 280 g of the diet, respectively, during pregnancy, and the food consumption of the latter two groups decreased near term. The group on calcium-free diet was able to maintain pregnancy and produce normal fetuses by using calcium resorbed from the dam's bones. The calcium retentions due to pregnancy in rats on normal and high calcium diets were 116 and 128 mg, respectively, during the first 15 days, and -9 and -109 mg, respectively, during the last 6 days of pregnancy. Fetuses contained about 130 mg of calcium at term and most of this calcium was supplied from the dam's bones, in which extra calcium were retained during early-mid pregnancy. Unexpectedly, the true rate of calcium absorption was appreciably lower during late pregnancy than during early-mid pregnancy in both dietary groups. Thus, extra calcium retention during early-mid pregnancy seemed to be physiological adaptation to a decrease in either food consumption or calcium absorption during late pregnancy. Phosphorus absorption and its balance were examined in relation with the dietary calcium levels.

The occurrence of serotonin-containing cells in the esophageal epithelium of the bullfrog Rana catesbeiana: a fluorescence histochemical and immunohistochemical study

Fluorescence histochemical examination of biogenic amines of the frog esophageal mucosa revealed that a serotonin-like monoamine exhibiting an yellow fluorescence was present in a certain type of cells. The new type of cells was specifically stained by the immunohistochemical method using anti-serotonin antiserum. From these observations, it is suggested that the new cell type in the esophageal mucosa probably contains 5-hydroxytryptamine (serotonin). The serotonin-containing cells were argentaffin, but negative for Grimelius' silver stain.

Neurotrophic influences are not affected by miniature end-plate potentials

We investigated whether or not miniature end-plate potentials (MEPPs) play a part in neurotrophic influences. The sciatic nerve of mice, which supplies the extensor digitorum longus muscles, was cut either close to, or far from, the muscle. Denervation changes were evaluated using the resting membrane potential and dose-response curves obtained by plotting acetylcholine-induced contractures of muscles denervated 3 days earlier. The cessation of MEPPs and the manifestation of denervation changes occurred significantly later in muscles with long nerve stumps than in those with short nerve stumps. A single administration of ethidium bromide, a specific inhibitor of mitochondrial protein synthesis, accelerated the cessation of MEPPs in muscles with long nerve stumps without affecting the manifestation of denervation changes. We therefore conclude that MEPPs do not have neurotrophic effects.

Prevalence of diabetes mellitus in a rural area of Japan: by 75 g OGTT

Tests for DM using the 75 g OGTT method (NDDG diagnostic criteria) were performed on 3145 persons living in rural areas of 8 different geographical regions of Japan (from Tohoku to Kyushu regions). Considerable regional difference was observed with western Japan tending to have higher DM and IGT rates than eastern Japan. The DM and IGT prevalence rates (for rural areas in Japan) were 3.9% and 6.9% respectively, and the DM detection rate was 2.8%. Comparison between normals and disturbance of glucose tolerance group (DM and IGT) on the basis of risk factors for atherosclerotic angiopathy showed that those with abnormal findings were definitely more numerous in the disturbance of glucose tolerance group.

A 10 year follow-up of diabetes in a rural area of Japan using the 50 g oral glucose tolerance test

We performed a 10 year follow-up study on diabetics using the 50 g oral glucose tolerance test in a rural area of Japan. In untreated borderline diabetics, high or normal insulin responders became normal for glucose tolerance 10 years later. However, low insulin responders became overt diabetics or remained borderline diabetics. Therefore, insulinogenic index was considered to be one of the most valuable indexes in the prospective investigation of untreated borderline diabetics.

Human leukemic cells contain transforming growth factor

A transforming growth factor was found in the extracts of leukemic cells obtained from the peripheral blood of 11 patients with leukemia. This factor stimulated the colony formation of anchorage-dependent BALB/c 3T3 cells in soft agar. The high levels of colony-stimulating activities were observed in the cell extracts from patients with chronic myelogenous leukemia in blastic crisis (CML BC), acute myelogenous leukemia and CML in chronic phase. The factor from a CML BC patient was heat- and acid-labile, relatively stable to dithiothreitol treatment and inactivated by pronase treatment. Molecular size of the factor seems more than 10,000 daltons.

Effect of protein synthesis inhibitors on the trophic action of the nerve stump

We report that protein synthesis inhibitors exert an inhibitory effect on the trophic action of the nerve stump. The sciatic nerve innervating the extensor digitorum longus muscles of mice was cut either as close to, or as far from, the muscle as possible. Denervation changes in the muscle were evaluated using the resting membrane potential and dose-response curves obtained by plotting acetylcholine-induced contractures. Actinomycin D (2 micrograms/kg, i.p.), ethidium bromide (10 micrograms/kg, i.p.), cycloheximide (1 or 5 mg/kg, i.p.), or chloramphenicol (100 mg/kg, p.o.) administration was immediately after neurotomy and continued daily until the day preceding muscle removal. Although denervation changes occurred significantly later in muscles with a long rather than a short nerve stump, the administrated antibiotics, excluding cycloheximide, accelerated the manifestation of denervation changes in muscles with long nerve stumps without affecting those in muscles with short nerve stumps.

Characteristics of decrease of plasma gastrin by glucagon in man

Exogenously administered glucagon causes a decrease of plasma gastrin concentration, but the mechanism has not been fully elucidated. We measured antral gastrin concentrations and plasma gastrin levels before and during glucagon infusion in nine patients free of gastrointestinal diseases. In addition, we measured plasma gastrin levels in both the renal artery and renal vein in six patients with normal renal function before and during glucagon infusion. Glucagon caused a significant increase of antral gastrin concentration concomitant with a significant decrease of plasma gastrin level and a significant decrease of percent extraction of gastrin in the kidney. These observations suggest that glucagon causes the decrease of plasma gastrin level by inhibiting the release of gastrin from the antrum, but not by accelerating the renal extraction of gastrin.

Disturbances of the alimentary tract motility and hypermotilinemia in the patients with diabetes mellitus

Lower esophageal sphincter pressure (LESP), gastric emptying, small bowel transit time and plasma motilin levels were measured in diabetics and normal subjects in order to investigate the disturbances of the alimentary tract motility and the participation of motilin in these motility disorders. Hypermotilinemia was observed in all diabetics with or without autonomic neuropathy. Low response of LESP to tetragastrin found in diabetics with autonomic neuropathy could not be explained by motilin. Gastric emptying was highly correlated with fasting plasma motilin levels and a significantly accelerated gastric emptying observed in diabetics without complications or diabetics with diarrhea was considered to be due to hypermotilinemia. On the contrary, no significant correlation was observed between small bowel transit time and plasma motilin levels, suggesting no participation of endogenous motilin in the regulation of small bowel transit.

Angiographic study of vasospasm following subarachnoid hemorrhage in monkeys

A model for producing chronic cerebral vasospasm in monkeys by injecting autologous blood into the basal cistern is described. Spasm/narrowing was observed by angiography one hour after SAH in 8 out of 10 monkeys and in 5 of these 8, spasm was observed both one and two weeks later. No narrowing of the vessels was observed in the control cases. In monkeys that showed spasm one week after SAH, narrowing of the extracranial vertebral arteries was also observed. Repeated injections of blood at intervals of one and two weeks caused intensification of spasm in the intracranial portion of vertebral arteries and the basilar arteries. It is suggested that cerebral vasospasm following SAH may in part be mediated by a central control mechanism acting through the sympathetic nervous system in that extracranial vessels remote from direct contact with blood showed reactive narrowing.

Clinical significance of glucagon provocation test in the diagnosis of hypergastrinemia

Glucagon provocation test was performed in the patients with hypergastrinemia and hyperchlorhydria to investigate its diagnostic value. A paradoxical response of plasma gastrin level in the patients with the Zollinger-Ellison syndrome and a marked decrease of plasma gastrin level in the patients with gastric ulcer, duodenal ulcer, excluded gastric antrum, multiple endocrine adenomatosis, pernicious anemia and chronic renal failure were demonstrated by glucagon infusion. Glucagon provocation test, therefore, was considered to be of great value in the diagnosis of the Zollinger-Ellison syndrome, particularly, in the case of an excluded gastric antrum in which secretin provocation test caused the false positive result because of a marked increase of pancreatic secretion. Glucagon provocation test in combination with secretin provocation test, therefore, is at present the most preferable diagnostic procedure for detecting the Zollinger-Ellison syndrome.U

Adaptive least-squares method applied to structure--activity correlation of hypotensive N-alkyl-N''-cyano-N'-pyridylguanidines

A method using an adaptive least-squares (ALS) technique has been developed for the discrimination of ordered categorical data. The method (ALS method) has the advantages of simultaneously considering any number of classes and of producing a single discriminant function which can place patterns in several classes. The ALS method was compared with linear discriminant analysis (LDA) in application to the problem of discriminating three-class hypotensive therapeutic indices of 76 N-alkyl-N''-cyano-N'-pyridylguanidines using nine descriptor variables. With the full data set and in the five leave-out runs, it was shown that the ALS method was superior and more stable in recognition and prediction. The structure--activity relationship is discussed on the basis of discriminant functions formulated.

[Significance of computed tomography in therapeutic diagnosis of brain tumors (author's transl)]

Because of its noninvasive property of direct imaging of the size and shape of the lesion, CT scan is significant not only for the diagnosis of the brain tumors, but also for the assessment of its chronological and/or therapeutic change in size. Contrary to the conventional cerebral angiography and contrast encephalography, CT scan is feasible to detect the tumor repeatedly at short intervals. From March 1976 to October 1977, 197 cases of brain tumors were examined by CT, 6 tumors (1 pineal tumor, 2 cerebellar vermian tumors and 3 supratentorial tumors) of which were radiated after the initial CT scan and re-examined by CT at every 400-1,000 rads radiation, and their grade of radiosensitivity could be evaluated. Immediately after the radiation of 400 rads for five days to the large pineal tumor of a 16-year-old boy, CT exactly showed the markedly diminished size of the tumor, and the tumor disappeared on CT after the 4,000 rads radiation. Cerebellar vermian tumors suspected of medulloblastoma were also diminished in size on CT after the 600 rads radiation. One supratentorial tumor was radiosensitive and disappeared at the end of radiation therapy. Other supratentorial tumors were not changed on CT during the radiation. Procedures for the therapeutic diagnosis, when combined with CT, can easily indicate whether the tumor is radiosensitive or not, without any invasive examination and/or operation.

Computed tomography of the head: clinical experience of the first 3000 scans with EMI scanner

Computer tomography (CT) findings obtained from the first 3,000 scans on 2,031 patients were analyzed and discussions were made on various kinds of neurological diseases, especially from the neurosurgical point of view. CT showed an excellent resolution for three-dimensional morphological pattern of intracranial lesion with a high percentage of diagnostic accuracy as reported from other institutes, resulting in making much earlier morphological diagnosis of intracranial lesion possible than any other examination. Scan methods consisted of plain CT, contrast enhanced CT, and metrizamide CT cisternography. Sequential delayed enhanced CT offered more useful information for high diagnostic accuracy, particularly for nature of brain tumor. Metrizamide CT cisternography was performed for the evaluation of cerebrospinal fluid dynamics and diagnosis of skull base tumors. CT is a new, epoch-making and non-invasive diagnostic approach in neuroradiology and contributes to obtain the better achievement of neurosurgical results.

Sequential delayed enhanced CT in brain tumors

Delayed enhanced CT was performed in 53 cases and these findings are compared with those of delayed radioisotope scan and with operative and histopathologic findings. We have classified the results of enhancement into four types as follows: (1) immediate enhancement pattern due to rich vascular bed, typical in meningiomas; (2) delayed enhancement pattern due to exudation, often seen in cystic astrocytomas; (3) intermediate sustained pattern due to both mechanisms in glioblastoma multiforme; (4) no enhancement pattern as in diffuse astrocytomas. The results of delayed enhanced CT correlated well with those of radioisotope scan.

A histopathological study on the islets of Langerhans and ductal epithelial metaplasia in atrophic lobuli of pancreas

In autopsy material isolated islets of Langerhans are frequently encountered in the fatty or the fibrous tissue replacing the pancreatic lobuli. The incidence of isolated islets of Langerhans was 27.0% in the file of a series of randomly selected 100 autopsy cases and increased with advancing age. Fifteen cases of these 27 showed multiple foci and the total number of foci counted 60. Fifty-two foci (86.7%) were found in the subcapsular area. Clusters of elastic fibers were found in 36 foci (60.0%). Small pancreatic ducts with goblet cell metaplasia were found in 29 foci (48.0%) in the surrounding tissue of the remaining islets of Langerhans. Squamous metaplasia was identified in only 1 focus (0.2%), and luminal dilatation of the duct was found in 4 foci (0.7%). Serial sections showed that the small duct ended without connection to acinar cells. "The isolated islets of Langerhans" should be the result of the atrophy of pancreatic lobuli subsequent to disappearance of acinar cells.

[A case of hemangioblastoma associated with spina bifida occulta, persistent metopic suture, thyroid adenocarcinoma, vertebro-occipital anastomosis and erythrocytosis (author's transl)]

We presented a case of hemangioblastoma associated with spina bifida occulta, persistent metopic suture, thyroid adenocarcinoma, vertebro-occipital anastomosis and erythrocytosis. We have not found a hemangioblastoma with these associations, as far as we have seen in the literature. 36-year-old male was admitted with complaints of nausea, vomiting and ataxic gait in June, 1970. On admission, the examination revealed no evidence of increased intracranial pressure except for elevated CSF pressure by lumbar puncture and incoordination. The peripheral blood count disclosed slight erythrocythemia. Vertebral angiography revealed a vascular lesion of 2.0 cm in diameter situated almost in the midline of caudal cerebellum receiving its blood supply from the right posterior inferior cerebellar artery. In addition, a right vertebro-occipital anastomosis was visualized. Plain reoentgenograms showed persistent metopic suture and spina bifida occulta of C 5 - 6. After admission, installation of Ommaya reservoir and decompressive suboccipital craniectomy were performed, and a thyroid papillary adenocarcinoma was totally removed. After discharge, he had been well for two years until a month previously to the second admission, when he commenced to have again headache, nausea, and vomiting with ataxic gait. Vertebral angiography showed the tumor enlarged in size measuring 4.0 X 5.0 cm and the tumor stain was more irregular and less homogenous than 3 years before. Brain scan revealed an increased uptake in the midline of the posterior fossa. After readmission, in April, 1973, he gradually developed dysphagia, disturbance of articulation and inactivity of mentality and died from pneumonia in October, 1974. Autopsy revealed a vascular tumor originated from the medial portion of the right cerebellum and the tumor showed multiple cyst formation in the rostral part in contrast to the caudal solid mass. Histologically the tumor tissue was composed of capillaries supported by fine argyrophilic fibers, large clear interstitial cells containing lipid granules and hemosiderin pigment. Carcinoma of the right lobe of the thyroid was found with metastasis to the bone marrow, lungs and anterior cervical lymphnodes and lymphnodes at the left supraclavicular angle. Bone marrow showed marked erythropoiesis. The case reported here provides an evidence to suggest that there is more than a random relationship between hemangioblastoma, dysraphic state and thyroid carcinoma. The other association, the vertebrooccipital anastomosis may result from the enhanced demand of blood supply by hemangioblastoma but this speculation needs further examination.

Natural history of diabetes mellitus with special reference to age of onset and vascular complications

Age and sex distribution of diabetics, seasonal incidence of diabetes, grade of hyperglycemia, frequency of vascular complications and daily living conditions were studied of 2771 diabetic patients experienced at five clinics. The cases consisted of 1587 male and 1184 female diabetics. The distribution of age of diabetes onset revealed that males predominate among diabetics but females predominate among child diabetics, and that the precentage of child was extremely low. This pattern was emphasized as characteristic of Japanese diabetic population. Distribution of fasting blood sugar at the diagnosis of diabetes was compared among the age groups of diabetes-onset and the results showed that percentage of the value exceeding 300 mg/100 ml was highest in the under 10 year-onset cases and decreased with age. The frequency of diabetic retinopathy and of ischemic ECG changes was analysed from the view point of age of diabetes onset and also the duration of the disease. The frequency of the retinopathy at the diabetes-onset was zero in the under 10 year-onset cases, 4.2% in the 10s-onset cases and increased with age. The longer the duration of the disease the higher the frequency of the retinopathy was. This increase along with the duration was most remarkable in the 10s- and 20s-onset cases and less remarkable in the 30s-onset cases. The retinopathy was significantly more frequent in female diabetics. Daily of the patients were studied by a questionnaire and the analysis of 1022 cases with diabetes of more than three years revealed that cases of patients working uneventfully and/or feeling fit were most frequent among the 30s- or 40s-onset cases and that cases of bed-disability were frequent among the cases whose diabetes was found in their twenties or younger. This study showed that the prognosis of the patients is quite different according to whether their diabetes occurred before of after 30 years of age.

Two cases of pseudoaldosteronism (Liddle's syndrome) in siblings

Two cases of Liddle's syndrome were found in a brother and sister. Both showed typical hypokalemic hypertension without hyperaldosteronism. These cases showed similar responses in various pharmacological tests and their symptoms of hypokalemic and hypertension were relieved by triamterene. And in a family survey, the father appeared to be affected. This seems to be the first report on this syndrome in Japan.