[Treatment of refractory hypoxemia due to right-to-left interatrial shunt complicating right ventricular infarction: successful short-term percutaneous catheter closure of the patent foramen ovale]

Refractory hypoxemia as a complication of right ventricular infarction is rare. A 74-year-old man developed persistent hypoxemia due to right-to-left interatrial shunting through a patent foramen ovale during the acute phase of right ventricular infarction. Short-term percutaneous transvenous closure of the patent foramen ovale with a large balloon occlusion catheter was life-saving.

Neural activity of chorda tympani mechanosensitive fibers during licking behavior in rats

The chorda tympani nerve, supplying the anterior two-thirds of the tongue, contains gustatory and mechanosensitive afferent fibers. We have analyzed discharge patterns in rats of various fibers recorded from dissected nerve filaments during licking behavior of which 4 were taste-sensitive and 12 mechanosensitive. The incidence of these two types were estimated electrophysiologically under anesthesia and their conduction velocity measured. Recordings in freely moving animals showed that the mechanosensitive fibers innervating the dorsal part of the tongue gave two burst discharges per lick, suggesting that contact of the tongue with the upper incisors and/or lip occurred during tongue protrusion and retraction. The fibers from the tip of the tongue showed one burst discharge per lick, which was the response to contact with a drinking spout. No rhythmical discharges synchronized with lick signals were observed in the fibers from the lateral part of the tongue or the taste-sensitive fibers. Such mechanoreceptor discharges were difficult to detect in recordings from the whole chorda tympani nerve. This masking of responses was due mainly to activation of a small number of mechanosensitive fibers by licking-induced mechanical stimulation. The lubricating action of saliva also decreased mechanoreceptor sensitivity. Despite their small number, the mechanosensitive fibers had axons with faster conduction velocities (larger diameter) than the taste-sensitive fibers. This was probably the reason why dissected nerve bundles more frequently showed mechanical than taste responses in conscious rats.

[Transrectal portal scintigraphy for evaluation of portal hemodynamics before and after TIPS]

In order to evaluate portal venous hemodynamics before and after TIPS, transrectal portal scintigraphy was performed in 8 patients. In all 8 patients, scintigram before TIPS demonstrated hepatofugal flow in the portal vein and less accumulation of radioisotope in the liver. In the scintigrams for follow-up of TIPS, the flow direction in the portal vein changed to be hepatopedal. In 3 of the patients in whom stent shunt was occluded after TIPS, the portal blood flow was turned to be hepatofugal again. It is concluded that transrectal portal scintigraphic studies of the TIPS patients provide noninvasive evaluation of portal hemodynamics.

Inhibitory effect of sympathetic stimulation on activities of masseter muscle spindles and the jaw jerk reflex in rats

1. To evaluate sympathetic effects on jaw muscles, the discharges of masseter muscle spindle afferents, jaw muscle electromyographic (EMG) activities and blood flow changes were compared in anaesthetized decerebrate rats before and during electrical stimulation of the cervical sympathetic trunk. 2. To eliminate the possibility of efferent control from the trigeminal motoneurones, muscle spindle activity was recorded from the cut peripheral end of the masseter nerve. The absence of a sympathetic component in the masseter nerve was confirmed by the horseradish peroxidase method. 3. Electrical stimulation of the sympathetic nerve at frequencies within the physiological range reduced muscle spindle afferent discharges evoked by passive jaw opening. 4. Sympathetic stimulation also reduced the EMG activity evoked by the jaw jerk reflex, which may reflect a sympathetic effect on spindle afferents. After cessation of stimulation, a transient increase in EMG activity was observed, which may be due to efferent supply from the trigeminal motoneurones. During rhythmical jaw movements, no sympathetic effect on EMG activity was detected. 5. The above sympathetic effect on muscle spindle afferents and EMG activity was independent of blood flow changes.

Prolonged incubation with neuropeptide Y upregulates beta-adrenoceptors yet does not cause supersensitivity of beta-adrenoceptor signaling

In neonatal rat ventricular myocytes prolonged incubation with 1 microM neuropeptide Y (2 h-48 h) increased beta-adrenoceptor density 16-24% (n = 4--8, all p < 0.05), an effect prevented by pertussis toxin pretreatment. Prolonged incubation with neuropeptide Y had no effect on adenylycylclase activity stimulated by 5'-guanylylimidodiphosphate or (-)-isoprenaline, probably because of a neuropeptide Y-induced decrease in affinity of the beta-adrenoceptor for agonist. Thus, chronic incubation with an inhibitory agonist does not inevitably lead to supersensitivity of the adenylylcyclase pathway.

[Transjugular intrahepatic portosystemic shunt for patients with hepatoma]

Nine patients with hepatoma, 5 with massive ascites, 3 with rupture of esophageal varices and 1 with hematoemesis, successfully underwent TIPS without technical complications. Two of the patients died 3 and 5 months, respectively, after TIPS due to hepatic failure and/or tumor extension. Another patient in whom hepatoma ruptured 1 month after TIPS was experienced. It is concluded that TIPS is a useful and safety treatment for portal hypertension even in patients with hepatoma which was not existed through the puncture route. However TIPS should be performed in patients in whom hepatoma has been controlled by hepatic embolization and/or ethanol injection therapy.

Decreased mitogenic and osteogenic responsiveness of calvarial osteoblasts isolated from aged rats to basic fibroblast growth factor

Osteoporosis seen in aged individuals is represented by the reduced bone mass most likely resulting from decreased bone formation by osteoblasts. To examine whether aging causes a decrease in osteoblast activity, calvarial osteoblasts were isolated from aged rats (AOB) and studied for the capacity of the cells to form mineralized bone-like nodules in comparison with that of fetal calvarial osteoblasts (FOB). There were no significant differences in basal mineralized bone-like nodule formation determined by quantifying the size of the nodules which were formed in the cultures of AOB and FOB. However, the responsiveness of AOB to growth factors was profoundly reduced. AOB showed only marginal increase in mineralized bone-like nodule formation and growth in response to basic fibroblast growth factor (bFGF). On the other hand, bFGF markedly promoted mineralized bone-like nodule formation and proliferation in FOB. These results suggest that decreased responsiveness to local osteotropic growth factors such as bFGF might account for the reduced bone formation by aged osteoblasts, which in turn leads to the loss of bone mass characteristic for senile osteoporosis.

[MR pyelography using fast spin echo technique in hydronephrosis]

MR pyelography using the fast spin echo technique and and a body coil were performed in ten patients with hydronephrosis. In all cases, pyelograms of the dilated urinary tract were obtained by this method, although they were obtained in only two cases by drip infusion pyelography. MR pyelography is an effective method with which to obtain images of dilated urinary tract non-invasively, and in a relatively short time. This method was also useful to evaluate intraureteral structure.

[Usefulness of MR cholangiography with flex coil]

Fast SE MR cholangiography was performed in 10 healthy volunteers and 10 patients with biliary disease, using body, shoulder and flex coils. Surface coils provided better images than the body coil. Although high SNR images were obtained near surface coils, signal intensity decreased in areas distant from the shoulder coil. The flex coil greatly improved image quality, especially in intrahepatic bile ducts, compared with the shoulder coil. The application of a flex coil to MR cholangiography is a highly useful method to evaluate the biliary system.

Differences in taste responses to Polycose and common sugars in the rat as revealed by behavioral and electrophysiological studies

Behavioral and electrophysiological experiments were performed to examine the suggestion that rats have two types of carbohydrate taste receptors, one for polysaccharides (e.g., Polycose) and one for common sugars (e.g., sucrose). Qualitative difference between the tastes of Polycose and sugars including sucrose, maltose, glucose, and fructose was surveyed by means of a conditioned taste aversion paradigm in which the number of licks for 20 s to each taste stimulus was measured. Aversive conditioning to Polycose did not generalize to sugars, while aversive conditioning to sucrose generalized to other sugars, but not to Polycose. In the electrophysiological study, taste responses of the whole chorda tympani were recorded. A proteolytic enzyme, pronase E, suppressed nerve responses to both Polycose and sugars to less than 50%. A novel anti-sweet peptide, gurmarin, strongly suppressed responses to sugars, but had essentially no effect on Polycose responses. On the other hand, KHCO3 enhanced responses to sugars to about 300%, but had little effect on Polycose responses. These results have confirmed the notion that rats can differentiate the tastes between Polycose and common sugars and that rats have two types of carbohydrate receptors.

Effects of a traditional Chinese herbal medicine, Kanzo-bushi-to, on the resistance of thermally injured mice infected with herpes simplex virus type 1

The protective effect of Kanzo-bushi-to (TJS-038) was investigated on the opportunistic infection of herpes simplex virus type 1 (HSV) in thermally injured mice (TI-Mice). We have previously reported that TI-Mice were approximately 100 times more susceptible to HSV infection than normal mice (N-Mice) and that CD8+ suppressor T (ST)-cells induced by burn injury were involved in causing this increased susceptibility of TI-Mice. Increased susceptibility of TI-Mice to the infection was reversed to the levels observed in N-Mice when TI-Mice were treated intraperitoneally with TJS-038 at a dose of 5 mg/kg 1 and 4 days after thermal injury. The activity of ST-cells was greatly decreased in TI-Mice treated with TJS-038. The generation of Vicia villosa lectin-adherent CD4+ CD28+ TCR-alpha/beta+ contrasuppressor T (Contra-ST)-cells associated with the appearance of ST-cells was expanded and occurred earlier in spleens of TJS-038-treated TI-Mice as compared with that of untreated TI-Mice. The improved resistance of TJS-038-treated TI-Mice to the infection was transferred to untreated TI-Mice by adoptive transfer of Contra-ST-cells prepared from TJS-038-treated TI-Mice. These results suggest that TJS-038 may restore the resistance of TI-Mice to the HSV infection through the expanded generation of Contra-ST-cells.

[Arterial infusion chemotherapy with human tumor necrosis factor (TNF): an experimental study using rabbits bearing VX2 tumor]

To evaluate the direct effects of TNF on tumor vessels, three groups of Japanese white rabbits bearing VX2 tumor received 5000 U, 25000, U, and 5000 U of TNF respectively. Angiograms were obtained before, and at 1, 15 and 30 minutes after arterial TNF injection. At 1 minute after TNF injection, dilated tumor vessels and dense tumor stains, depending on the dose of TNF, were demonstrated. At 30 minutes after injection these findings had disappeared However, there were no changes in normal vessels. It is suggested that arterial TNF injection influenced tumor vessels without damaging on normal vessels, indicating that it is effective as cancer therapy.

Ca2+ influx initiates death of hepatocytes injured by activation of complement

To clarify the role of cytosolic Ca2+ in hepatocellular death, we exposed cultured hepatocytes to human serum and a monoclonal antibody directed against rat liver plasma membranes to produce complement-mediated cell injury. The change in cytosolic Ca2+ concentration was measured by fura2 and fluo3 fluorescence. With the addition of monoclonal antibody, an increase in cytosolic Ca2+ was observed, followed by cell death. Both the increase in intracellular Ca2+ and cell death were prevented by intracellular Ca2+ chelation or removal of extracellular Ca2+. We conclude that an increase in cytosolic Ca2+ plays a major role in hepatocellular injury induced by exposure of the cell membrane to monoclonal antibody.

[Transjugular intrahepatic portosystemic shunt--early experience in eleven liver cirrhosis patients]

Eleven liver cirrhosis patients with variceal bleeding and/or ascites were treated by transjugular intrahepatic portosystemic shunt. Four of the patients were combined with hepatoma, and 2 had portal thrombosis. Ten of the patients were successfully achieved TIPS, but one patient who had portal thrombosis was failed because of portal vein occlusion; success rate of 90%. An average decrease of 14mmHg in portal vein pressure was measured in the 10 patients. All of the successful patients including 4 with hepatoma were observed the disappeared or diminished varices and ascites without technical complication. Mild encephalopathy was encountered in 2 patients but who responded well to medical therapy. Three dimension MRA before TIPS was helpful for understanding the anatomical relationship between portal vein and hepatic vein. It is concluded that TIPS is an effective and safe treatment, indicating for the patients who have uncontrollable variceal bleeding and/or ascites even with hepatoma.

Effect of salivation on neural taste responses in freely moving rats: analyses of salivary secretion and taste responses of the chorda tympani nerve

The outer surface of the mammalian taste receptor cell is usually covered with saliva, which may affect the initial process of gustation. To ascertain the interaction between salivation and gustation, salivary secretion from the submandibular and parotid glands and taste responses to the chorda tympani nerve were analyzed in the rat, during grooming, eating, and licking of the four standard taste stimuli (sucrose, NaCl, HCl, and quinine hydrochloride). Regions of the tongue surface bathed by saliva secreted from the each gland were examined, and it was found that: (1) Rats frequently groomed, and the anterior part of the tongue, innervated by the chorda tympani nerve, was usually covered with a mixture of submandibular saliva and substances on the body surface. (2) Licking of acceptable sucrose and NaCl solutions elicited initial phasic and long-lasting tonic taste responses, and did not evoked saliva enough to wash away the stimuli from the oral cavity. Licking of rejectable quinine evoked only a small phasic taste response and was followed by taste rejection behavior, accompanied by maximum salivation which could wash out the stimuli. (3) When taste responses were compared under awake and anesthetized (the tongue adapted to water) condition, sucrose response was larger, while responses to other taste stimuli were smaller under the awake condition. Rise time of the phasic NaCl response was longer under the awake condition. These taste response alterations may reflect the effects of prolonged adaptation of the tongue to the mixture of submandibular saliva and body surface substances, and flow rate of licked taste stimuli on the tongue surface.

Administration of a branched-chain amino acid preparation during hepatic failure: a study emphasizing ammonia metabolism

We administered a branched-chain amino acid (BCAA) infusion to 16 patients with hepatic failure and two healthy subjects, and then evaluated its effects on ammonia metabolism and amino acid metabolic pool. Immediately after the BCAA infusion, the venous blood ammonia concentration increased in 12 of 15 patients with hepatic failure and in both two healthy subjects. Glutamine (Gln) also rose in all cases following the BCAA infusion, and this rise was particularly marked in the hepatic failure group. The increase in Gln due to the BCAA infusion and the arteriovenous difference in the pre-administration ammonia concentration showed a good correlation. These results suggest an increase in glutamine cycle capacity in patients with hepatic failure.

[The effects of sevoflurane anesthesia with hypothermia on ischemic brain cellular respiration]

We examined the effects of sevoflurane anesthesia with hypothermia on ischemic brain cellular respiration using Wistar strain rats. Ischemia was induced by decapitation. L/P in brain increased during no anesthesia-normothermia-ischemia (1), then gradually, but not fully recovered during 2.5% sevoflurane anesthesia-normothermia-ischemia (2) and during 2.5% sevoflurane anesthesia-hypothermia-ischemia (3). Energy charge decreased during (1) and slight recovery was observed during (3). Respiratory control ratio in brain mitochondria decreased during (1) and recovery during (2) and (3) was slight. No recovery was observed in ADP/O. These findings indicate that during sevoflurane anesthesia with hypothermia, ischemic brain energy metabolism has an effect not on the mitochondrial energy producing processes but on the consuming system.

[Percutaneous arterial prostheses of femoro-femoral bypass: using a new method of Modified Seldinger technique]

An experimental study of percutaneous arterial prostheses of femoro-femoral bypass was performed in 3 dogs using Modified Seldinger technique. Modified Seldinger technique with an arc needle was a newly designed method to penetrate the arterial wall due to introduce a bypass graft into the artery percutaneously. In all dogs, the bypass graft was successfully placed and proved to be effective in excellent blood flow. No significant complication was encountered. It is concluded that this method is feasible in the dog model.

Intravenous digital subtraction angiography of the internal jugular veins

92 patients with various head-related symptoms were underwent study with IV-DSA. The width and density of the internal jugular veins were compared with the width and density of the common carotid arteries. The right internal jugular vein was more than twice as broad as the common carotid artery in 58 patients (63%), and was denser than the common carotid artery in 14 patients (15%). On the other hand, the left internal jugular vein was broader than the common carotid artery in 76 patients (83%) and more than twice as broad as the common carotid artery in 19 patients (21%). However, the left jugular vein was narrower than the common carotid artery in 12 patients (13%), and in 5 patients (5%) could not be demonstrated. If it is recalled that the internal jugular veins are sometimes congenitally aplastic or hypoplastic as developmental variations of the confluence of sinuses, the occurrence of complications associated with retrograde catheterization can be minimized.

[Experimental study on protective effect of prostaglandin I2 derivative (OP-41483) on damage of warm ischemic kidney]

The protective effect of prostaglandin I2 derivative (OP-41483), which has actions of antiaggregation of platelets and vasodilatation, to damage by warm ischemia was investigated in rabbit kidneys. Experiment 1) Two weeks after the right nephrectomy, the left renal artery and vein were temporarily clamped for 180 minutes. Before and/or after the clamp was released, OP-41483 was given by i.v. drip (100-1,000 ng/kg/min) for 10 minutes. Renal blood flow (cortical flow and medullary flow) was measured before and after warm ischemia. Changes of blood urea nitrogen and serum creatinine level were measured after warm ischemia. Experiment 2) Bilateral renal arteries and veins were clamped for 180 minutes. OP-41483 (300 ng/kg/min) was administered before and/or after clamping the aforementioned vessels. The left kidney was removed after warm ischemia of 180 minutes, the other one was removed 60 minutes after the clamp was released, and histological examination was studied. Results were as follows: The blood urea nitrogen and serum creatinine level of OP-41483 treated group were lower than that of non-treated group. The best protective effect was seen when 1,000 ng/kg/min OP-41483 was administered before and after the ischemia. No significant decrease of the renal blood flow was demonstrated after the warm ischemia in the OP-41483 treated group. Histopathologically, OP-41483 has the inhibit effect on detachment of tubular cell from the basal lamina, Bowman's space exudate and swelling of mitochondria.

The Effect of sevoflurane on rat liver mitochondrial respiration

The effect of sevoflurane on rat liver mitochondrial respiration has been investigated with a Clark type oxygen electrode at 25 degrees C, pH 7.4. The higher susceptibility of NADH-linked substrate (glutamate) oxidation (with respect to succinate oxidation) to the damages by sevoflurane has been confirmed.

Intra-arterial digital subtraction portography with a blood-isotonic, non-ionic, dimeric contrast medium

Intra-arterial digital subtraction portography (IA-DSP) with a blood-isotonic, non-ionic, dimeric contrast medium was carried out in 27 patients with hepatocellular carcinoma. It was possible to obtain images of excellent or good quality of the portal vein and its bilateral main branches in all patients. The third-order branches of the portal vein in the right lobe could be identified in all patients, and images of excellent or good quality were obtained in a mean of 80.2% of patients. Images of third-order branches in the left lobe were of lower quality than those of third-order branches in the right lobe; in particular, images obtained were of poor quality for 27.3% of the medial branches of the left lobe. It was impossible to identify the caudal branches in almost all patients. The side effects of IA-DSP, pain and sensations of heat were very mild: only one patient complained of mild pain, while 18 patients (69.2%) complained of no sensations of heat whatsoever.

CDPcholine:1,2-diacylglycerol cholinephosphotransferase from rat liver microsomes. I. Solubilization and characterization of the partially purified enzyme and the possible existence of an endogenous inhibitor

The solubilization and partial purification of cholinephosphotransferase (CDPcholine:1,2-diacylglycerol cholinephosphotransferase, EC 2.7.8.2) from rat liver microsomes were examined in the presence of ionic (sodium deoxycholate), nonionic (Triton X-100, n-octylglycoside), or zwitter ionic (CHAPS) detergents. Among the four detergents tested, only sodium deoxycholate was found to be an efficient solubilizer of cholinephosphotransferase activity from microsomal membranes, whereas the other three detergents caused irreversible inactivation of the enzyme at the solubilization step. Addition of phospholipids at the solubilization step, or after solubilization of the membrane proteins, could not preserve or reconstitute activity to any extent. The sodium deoxycholate-solubilized activity was partially purified by gel permeation chromatography (Superose 12HR). The partially purified preparation appeared to consist of a large aggregate containing phospholipids; further dissociation of the protein-phospholipid complex caused complete inactivation of the enzyme. The partially purified cholinephosphotransferase showed a specific activity of 100-130 nmol/min/mg protein, which is the highest activity reported to date from any tissue source; this amounts to a 4-fold enrichment of cholinephosphotransferase activity from the original KCl-washed rat liver microsomes. Ethanolaminephosphotransferase (CDPethanolamine:1,2-diacylglycerol ethanolaminephosphotransferase, EC 2.7.8.1) activity was copurified and 6-fold enriched with a total recovery of 60%. During the purification of cholinephosphotransferase activity, a putative endogenous inhibitor of cholinephosphotransferase was also solubilized and was isolated from the microsomal membranes. This heat-labile, nondialyzable inhibitor was shown to act specifically on cholinephosphotransferase and not on ethanolaminephosphotransferase. Further characterization of the inhibitory activity revealed that it may act at the binding step of the cholinephosphotransferase to its lipid substrate, diacylglycerol.