Biochemical studies on rats with insulin-secreting islet cell tumors induced by streptozotocin: with special reference to physiological response to oral glucose load in the course of and after tumor induction

Pancreatic islet cell tumors were induced in 32 of 49 male Wistar rats (73%) surviving 9 months or longer following treatment with streptozotocin alone, with streptozotocin and nicotinamide, or with streptozotocin and picolinamide. Serial oral glucose tolerance tests in rats treated with streptozotocin and nicotinamide showed that the elevation of blood glucose levels after oral glucose load was depressed significantly 7 months after treatment. Plasma insulin responses were distinctly elevated 9 months after treatment. Blood glucose levels remained lower and plasma insulin levels rose markedly after a glucose load in tumor-bearing rats as compared to the response of tumor-free rats. These findings suggest that pancreatic islet cell tumors induced by streptozotocin with and without combined treatment are insulin-secreting, and that streptozotocin itself has oncogenic effects on the rat pancreas. Mean insulin concentration in islet cell tumors amounted to 401 U/g wet wt, whereas the concentration was 14 U/g wet wt in the pancreatic tissue from tumor-free rats.

Bilateral trifid ureters associated with fused kidney, ureterovesical stenosis, left cryptorchidism and angioma of the bladder

The first case of bilateral trifid ureters associated with fused kidney, ureterovesical stenosis, a left undescended testicle and angioma of the bladder is reported. Bilateral ureteroneocystostomy and left orchiopexy were done. The patient is well 3 months postoperatively with no urinary tract infection and stable renal function.

Time-dependency of serum carbamazepine concentration

Serum CBZ concentration was determined by gas liquid chromatographic method in 14 epileptic patients (32 samples) treated initially with CBZ alone, and the following results were obtained: 1. The relationship between serum CBZ concentration and CBZ dose was expressed by a regression line that sloped sharply upwards at first: high serum concentration was obtained from small dose up to the end of three weeks after initiation of CBZ administration. After the 3rd--4th treatment week, regression coefficient was reduced by half, and the regression line had a gentler slope. 2. As the treatment was continued longer, serum CBZ concentration and serum concentration/dose ratio became lower. The relationship between duration of CBZ treatment and serum concentration/dose ratio was expressed by a regression curve representing a quadratic function with negative coefficient, the ratio being high in early stage of the treatment. This regression curve shows that the ratio reached its maximum value at the 10.5 days after initiation of the treatment. The ratio was stabilized at a low level about 3--4 weeks after that. 3. From the results, serum CBZ concentration was confirmed to be more dependent on duration of the treatment than on dose. This was inferred, on the basis of documentary research, to be attributable to the autoinduction of CBZ metabolism, the inference of which seemed to be supported by the results of measurement of time-course change in serum concentration in five cases of the present series. The results in one of the said five cases suggest that serum CBZ concentration varies greatly within 12 hr. 4. On the basis of these results, it is proposed that spontaneous decrease in serum CBZ concentration must be countered not merely by increase in CBZ dose, but by increase in the number of dosages/day for suppression of excessive diurnal change in serum concentration as well.

Biochemical characterization of the neuron. ATPase and acetylcholinesterase activities of neuronal cell bodies isolated in bulk from the pig brain stem

Nerve cell bodies, large and multipolar, were isolated in bulk with the least possible contamination from the pig brain stem. The activities of two neurobiologically important membrane enzymes, Na+, K+-ATPase, and acetylcholinesterase, in the isolated cell bodies were estimated. Na+, K+-ATPase [EC 3.6.1.4], more accurately called ouabain-sensitive ATPase of the nerve cell body, hydrolyzed 94 micronmoles of ATP per h per 100 mg of protein. This activity was one-fourth that in the brain stem. Nerve cell bodies contained a large amount of Ca2+, 275 micronmoles per 100 mg of protein, about half of which was calculated to exist as compounds other than calcium orthophosphate. However, the Na+, K+-ATPase of the nerve cell bodies was not stimulated by EGTA, in contrast to that of the brain stem. Acetylcholinesterase [EC 3.1.1.7] and cholinesterase [EC 3.1.1.8] activities were estimated separately by the use of the specific inhibitors Persidol and BW 284C51 dibromide. Acetylcholinesterase was almost completely responsible for the hydrolysis of acetylcholine in the nerve cell bodies isolated from the brain stem and little cholinesterase activity was detected. 1300-1400 micronmoles of acetylcholine was hydrolyzed per h per 100 mg of protein of the neuronal cell bodies; this activity was about four times higher than that in the brain stem. The differences between the specific activities of Na+, K+-ATPase, and acetylcholinesterase in theneuronal cell bodies and the brain stem are discussed in the light of electron microscopic analysis of the distribution of these enzymes and the preservation of the plasma membrane of the isolated cell bodies.

[A case of paravertebral lumbar meningomyelocele (author's transl)]

A case reported here is one year-old girl, who was admitted to our neurosurgical service because of gradually increasing swelling in the left lumbar region, and maldevelopment and paresis of the left leg since birth. From the level of L-2 to S-1, there was a 8 X 7 xm subcutaneous swelling of lipomatous consistency with well-defined margins. Of particular characteristics was that the swelling didn't cross the midline and was entirely located in the left paravertebral region (Fig. 1). In the spine no gap could be felt between the spinous processes. There was no evidence of hydrocephalus, but she bad marked right sided scoliotic deformity of the lumbar region, and dislocation of hip joint and club-foot on the left side. Rectum-bladder-vaginal fistula with defect of anus and hypoplasia of kidney on the left side were also detected. Skiagram of the lumbosacral spine revealed marked right-sided scoliosis at the level of L-1 and hypoplasia of left pedicles, accompanied with marked dilation of transverse diameter of spinal canal between the level of L-1 to S-2. Defect of laminae of lumbosacral spine was not definately determined. Conray myelogram showed presence of cyst protruding laterally to the left paravertebral region probably through defect of lamina on the left side at the level of L-5 (Fig 2). At operation, it was confirmed that meningomyelocele protruded out laterally through the defect of half of lamina at the level of L-5. Massive lipoma was noted inside as well as outside the dura mater. Neural elements were replaced inside the spinal canal and the dura repaired. The postoperative period was uneventful. Diagram of defect of lamina at the level of L-5 and its relationships to the meningomyelocele sac is shown in Fig. 3. Meningocele or meningomyelocele which lays in the paravertebral lumbar region is very rare (Table 2), but the possibility of this disease should always be considered when we examine the patients with lipomatous or cystic swelling in the paravertebral lumbar region, especially when the patients present the neurological symptoms or signs.

[Six cases of hydroencephalodysplasia (author's transl)]

Six cases of hydroencephalodysplasia were evaluated from the points of clinical signs and symptoms and neuroradiological procedures and diagnostic problems were discussed. All of our cases were characterized by extensive dysplasia of the brain and increased cerebrospinal fluid pressure. Deformity of the head and developmental arrest of the psychomotor function were observed in five cases. The side of the skull deformity was consisted with that of the brain defect. Pneumoencephalography and cerebral angiography are characteristic in this disease, but these procedures have to be carried out with caution in case of poor general condition. Transillumination and brain scan are also useful procedures and RI-cisternography is important for indication of shunting operation. Early rehabilitation for the motor dys function is main therapeutic trial, though the cases with increased intracranial pressure require cerebrospinal fluid shunt.

Progression and prognosis of chronic myelogenous leukemia in the acute stage: hematologic and cytogenetic aspects

Ten patients with Ph1 chromosome-positive chronic myelogenous leukemia entering the acute stage were divided hematologically into two different groups. One was characterized by a predominance of myeloblasts in marrow and was cytogenetic either by diploid or hypodiploid, whereas the other had generally low myeloblast counts without significant differences between the peripheral blood and the bone marrow, and was characterized by hyperdiploidy. It is suggested that an extramedullary acute transformation in the spleen occurs primarily in most cases of the latter group.