Catecholamine response to stress: age related modifications in tail-suspended rats

The catecholamine response to acute stress has been shown to change with age. However, alterations under chronic stress conditions have not been established. This study attempted to determine whether aging modifies the catecholamine response to chronic stress load in rats subjected to tail suspension. Urinary excretions of epinephrine (E) and norepinephrine (NE) were monitored before and during the tail suspension experiments in rats at two different ages: 5 weeks old (young) and 18 months old (aged). Basal excretions of E and NE before the suspension were higher in the aged rats, indicating that sympathetic-adrenal medullary activities increase with age under resting conditions. The chronic stress load elicited E responses in the aged rats similar to those in the young rats. The NE responses, however, were completely different in that tail suspension caused a greater increase in NE excretion in the young rats than in the aged rats. This finding suggests that the sympathetic response to chronic stress load changes with age.

Changes in the markers of bone metabolism following skeletal unloading

To elucidate the mechanism in disuse bone atrophy induced by skeletal unloading, we studied the indices of bone resorption and bone formation in the femur of tail-suspended rats. The duration of the suspension ranged from 1 to 14 days. Tartrate-resistant acid phosphatase mRNA, an index used to evaluate bone resorption, increased significantly more than the controls for the first 3 days of the tail-suspension experiments, compared those in controls. Osteocalcin and alkaline phosphatase, two common markers for bone formation, were also monitored. Osteocalcin mRNA started to decrease after 3 days of suspension. Five days later, alkaline phosphatase mRNA showed a decrease. Levels of both of these mRNAs remained low for the remaining suspension period. Sequential changes in the markers for bone metabolism indicate that the transient increase in bone resorption preceded the decrease in bone formation in the development of disuse bone atrophy induced by skeletal unloading.

Applicability of the latissimus dorsi muscle in situ as a biomechanical energy source

The purpose of this study was to assess the applicability of the latissimus dorsi muscle in situ as an energy source for a circulatory assist device. A pneumatic chamber, devised by the authors, was inserted beneath the muscle and compressed by contractions of the muscle so that muscle contractile power was converted into pneumatic pressure. The optimal insertion position of the chamber beneath the latissimus dorsi muscle, and the influence of chamber size on generated pneumatic pressure, were investigated. The pneumatic chamber functioned better when it was placed in a proximal position (third intercostal space) than in a middle or distal position. Using a mock circuit, the performance of the pneumatic chamber as an energy source for a circulatory assist device was evaluated. The pneumatic chamber was able to generate power sufficient to drive a right ventricular assist device as far as stroke work was involved. When the pneumatic chamber was operated with a high afterload, it could even be an energy source for aortic counterpulsation.

Thermal conditions in the bathroom in winter and summer, and physiological responses of the elderly during bathing

Thermal conditions in the bathroom and physiological responses were examined during winter and summer. The subjects were 22 male and 20 female elderly people, between 65 and 88 years old living in 25 houses in Gunma Prefecture, Japan. Heart rate, blood pressure, skin temperature and thermal sensation were measured during bathing. Changes in thermal sensation due to bathing were assessed in the living room and dressing room on a 9-point scale. Then they were asked about the purposes of bathing and the facilities of bathroom and dressing room. The results are summarized as follows: 1. The purpose of bathing in winter was to warm up for more than 80% of the subjects. In summer, all subjects felt refreshed by bathing. Eighty-five percent of the subjects took a bath every other day in both seasons. 2. Fifty-two percent of the bathrooms had no ventilating fans and 32% had no exclusive dressing rooms. 3. The average room temperature in the dressing rooms was 13-14 degrees C in winter. Thermal sensation was 'cool', 'slightly cold' or 'cold' for more than two-thirds of the subjects when they were partially nude, and there were no heaters in most dressing rooms. 4. The heart rate increased steadily, and reached a maximum value in a partially dressed condition in both seasons. 5. In winter, a marked increase of systolic blood pressure was observed in the partially nude condition. There was a significant difference between the before bathing condition and partially nude condition in winter.(ABSTRACT TRUNCATED AT 250 WORDS)

Differential effects of aging on motoneurons and peripheral nerves innervating the hindlimb and forelimb muscles of rats

We examined the number and size of ulnar (forelimb) and medial gastrocnemius (MG, hindlimb) motoneurons in middle-aged (9 months of age) and aged (27 months of age) male Fischer 344 rats. Morphological properties of the ulnar and the MG nerves were also studied. No significant difference was found in the mean number of the ulnar motoneurons between the two age groups, while that of MG motoneurons was significantly less in aged animals. A decrease in the number of myelinated fibers (including both afferent and efferent fibers) in the ulnar nerves was less than that in the MG nerves, although the age difference was not significant in either of the nerves. Soma atrophy of aged motoneurons was found in both MG and ulnar motor nuclei. The mean fascicular areas and myelinated fiber diameters were significantly increased in both the MG and the ulnar nerves in aged rats, but these were less pronounced for the ulnar nerve. The results indicate that most ulnar motoneurons, unlike MG motoneurons, survive at least to the age of 27 months. Morphological changes in the peripheral nerves were also less for the ulnar nerve than for the MG nerve. Thus, we conclude that the effects of aging on motoneurons and peripheral nerves innervating MG muscle of the hindlimb are greater than those innervating forelimb muscles.

Fos induction in the medullary dorsal horn and C1 segment of the spinal cord by acute inflammation in aged rats

In order to elucidate the effect of aging on nociceptive neurons in the central nervous system, c-fos was used as a marker of excitability of neurons in the medullary dorsal horn (MDH) and the first spinal segment (C1) following noxious stimulation of the lateral face of young and aged rats. The distribution of c-fos-positive cells was dense in the superficial laminae and sparse in the deep laminae of the MDH and C1 in both young and aged animals following subcutaneous injection of formalin into the lateral face, whereas few c-fos-positive cells were labeled after saline injection. The distribution of c-fos-positive cells in the superficial laminae of the aged rats was found to be denser and more rostro-caudally expanded compared to that in the young rats. C-fos-positive cells were distributed more rostro-caudally in aged than in young rats. There was no difference between young and aged rats in the distribution of c-fos-positive cells in the deep laminae. Substance P (SP), 5-HT and calcitonin gene-related peptide-like immunoreactive (CGRP-LI) fibers and varicosities showed similar distribution density in the MDH and C1. Furthermore, many 5-HT-LI aberrant fibers and varicosities were observed in the MDH and C1 of the aged rats. The SP-LI and CGRP-LI cells in the trigeminal ganglion of aged rats were larger than those of young rats. These findings suggest that a deficit of the descending 5-HT inhibitory system produces the increment of c-fos-positive cells in the MDH and C1 of aged rats, resulting in the recruitment of a larger number of neurons in the superficial laminae of the MDH and C1 for conveying nociceptive sensory information to the central nervous system.

Body movements of the elderly during sleep and thermal conditions in bedrooms in summer

The frequency of body movement in the elderly and young people during sleep was measured in order to investigate the effect of hot thermal environments on sleep in summer. Simultaneously, room temperature and humidity were also measured. In the morning after measuring body movements, the subjects completed a questionnaire about their night's sleep. The results obtained were as follows: 1) The time of going to bed and rising in the elderly was significantly earlier than the young. 2) The elderly had a tendency to judge their sleep as "good", however, there were no significant differences between the two groups. 3) The room temperature for the elderly during sleep ranged from 25 to 28 degrees C (mean 26.5 degrees C). On the other hand, it was between 20 and 30 degrees C (mean 27.1 degrees C) in the young, which was significantly higher than that of the elderly. 4) Body movement in the elderly during sleep was significantly greater than those in the young. 5) A significant relation between body movement and room temperature was found within each group. Under conditions of less than 28 degrees C of room temperature, there were significantly higher rates of body movement in the elderly.

[Experimental study on organ perfusion by intraaortic balloon counterpulsation with double balloon catheter]

Newly-developed catheter for the intraaortic balloon counterpulsation with cardio-renal assist was examined on animal model. The catheter consists of two balloon segments between which the celiac trunk, the superior mesenteric artery and the renal artery are to be placed. Statistical comparison on each hemodynamic element was carried out between the catheter (DBC), conventional single balloon catheter (SBC) of the same balloon volume as DBC and no assist (None) groups. There were no significant changes between SBC and DBC in cardiac output, femoral arterial flow and central venous pressure. Renal arterial flow and urinary output were significantly increased in DBC (None 14.4 +/- 3.9, SBC 22.6 +/- 5.6, DBC 31.0 +/- 6.9 ml/min in renal arterial flow, None 33 +/- 9, SBC 64 +/- 14, DBC 78 +/- 20 ml/h in urinary output, p < or = 0.05). After the remodeling adjust to the human stature, a clinical application would be considered.

Clinical use of low porosity woven ultrafine polyester fiber grafts

A woven fabric graft made of ultrafine polyester fibers (UFPF) (Toray Graft, water porosity: 100 ml/min/cm2:120 mm Hg H2O) was clinically applied in 81 cases (28 thoracic aortic aneurysms, 6 thoracoabdominal aortic aneurysms, 42 abdominal aortic aneurysms, and 5 atherosclerotic obstructions of the peripheral arteries). Eight patients died after surgery due to causes unrelated to the graft. The other 73 patients were in good condition after surgery. For operations requiring extracorporeal circulation, the graft was presealed with human albumin. For the abdominal aortic aneurysms, the graft was preclotted in situ with nonheparinized autoblood after the completion of the proximal anastomosis. It took about 2 min to complete the preclotting. A nonsealed graft was used for the reconstruction of peripheral arteries for the intraaortic balloon pumping procedure. The graft was easy to handle. There was no cut edge fraying problem with the graft in any direction of cutting. Even after presealing, the graft was soft and pliable enough to enable easy adaptation and anastomosis. Just after implantation, bleeding was minimal from the graft wall, anastomotic sites, and suture pores, and it stopped spontaneously. These clinical data showed that the woven UFPF graft exhibited both easy handling despite in spite of low porosity and safe application in the reconstruction of arterial systems even under totally heparinized conditions during extracorporeal circulation.

Glucocorticoids potentiate the action of atrial natriuretic polypeptide in adrenalectomized rats

Adrenal insufficiency in human and rat is associated with an impairment of the diuretic response to water load, and only glucorticoids (GCs) restore this deficit. Our observation that GCs potentiate atrial natriuretic polypeptide (ANP)-stimulated cGMP production in cultured renal cells prompted us to examine the possibility that GCs may restore the diuretic response through the potentiation of ANP action. Initially, changes in urine volume and ANP levels were studied in adrenalectomized (Adx) and sham-operated intact rats after an oral water load of 5 ml/100 g BW. Urine volume after water load was 4.5 +/- 0.5 ml/30 min in the intact rats, whereas it was 0.8 +/- 0.2 ml/30 min in the Adx rats. In the intact rats, a significant increase in plasma ANP level was observed 30 min after the water load, whereas no increase was observed in Adx rats. This defective ANP response may be involved in the impairment of the diuretic response in Adx rats. Indeed, pretreatment of Adx rats with dexamethasone (Dex, 20 micrograms/100 g BW) increased plasma ANP levels even before water load and improved diuretic response. Subsequently, effect of iv administration of human or rat ANP at a pharmacological dose (2.5 micrograms/100 g BW) on urine volume, osmolarity, and urinary excretion of cGMP, and sodium was studied in Adx rats that received an oral water load 30 min before ANP. Dex treatment was achieved by per os administration 3 h before the ANP injection. In Adx rats, the urine volume after ANP administration was 1.2 +/- 0.1 ml/30 min, and pretreatment with Dex markedly increased the urine volume to 6.3 +/- 0.4 ml/30 min. Dex also increased ANP-induced osmolar and sodium excretion by 2.6- and 2.9-fold, respectively. Although urinary excretion of cGMP was increased in Adx rats by ANP administration, a further significant increase was observed by the pretreatment with Dex. Injection of (Bu)2cGMP to Adx rats pretreated with Dex resulted in a significant increase in urine volume and osmolar and sodium excretion. However, no significant increase in urine volume was observed in Adx rats not pretreated with Dex. The present study suggests that GCs restore the diuretic response to acute water load not only by increasing the secretion of ANP but also by potentiating ANP-stimulated cGMP production. Furthermore, GCs may augment ANP action at one or more steps other than cGMP formation because administration of (Bu)2cGMP to Adx rats did not correct the diuretic response to water load.

In vitro reconstruction of hybrid arterial media with molecular and cellular orientations

A hybrid medial tissue composed of a type I collagen gel, into which smooth muscle cells (SMCs) derived from bovine aortic media were 3-dimensionally (3D) embedded, was constructed around an elastomeric silicone tube (outer diameter: 8 mm). Subsequently, hybrid tissues thus prepared were subjected to three modes of mechanical stimulation in the medium: one was subjected to flotation with no disturbance (isotonic control), the second was kept isometrically (static stress) and the third was subjected to continuous periodic stretch by inflation of the embedded silicone tube which stimulated arterial pulsation (dynamic stress, amplitude: 5% in inner diameter; frequency: 60 RPM). After a 5-day culture period, hybrid tissues were morphologically investigated. In control gels, polygonal SMCs and extracellular collagen fiber bundles were randomly oriented. On the other hand, upon static or dynamic stress loading, bipolar spindle-shaped SMCs and dense collagen fiber bundles were aligned circumferentially around the silicone tube, which proceeded with time. The orientations of SMCs and collagen fibers were more prominent in dynamically stressed hybrid tissues than those in statistically stressed ones. The pulsatile stress-loaded hybrid medial tissue mimicked the media of native muscular arteries in terms of cellular and molecular orientations.

A targeting model of boron neutron-capture therapy to hepatoma cells in vivo with a boronated anti-(alpha-fetoprotein) monoclonal antibody

We described previously that 10B atoms delivered by monoclonal antibody (mAb) exerted a cytotoxic effect on AH66 cells in a dose-dependent manner upon thermal neutron irradiation in vitro. In the present study, the delivering capacity of boronated anti-(alpha-fetoprotein) (AFP) mAb to carry 10B atoms to AFP-producing tumor xenografts in nude mice was determined. Boronated mAb was prepared by conjugating 50 mM 10B compound to an anti-AFP mAb (2 mg/ml) using N-succinimidyl-3-) (2-pyridyldithio) propionate. The number of 10B atoms conjugated directly to the mAb was estimated to be 459/antibody by prompt gamma-ray spectrometry. Boron concentrations in tumor tissue obtained 12, 24, 72, and 120 h after injection of 3.0 mg 10B-conjugated anti-AFP mAb were 11.10 +/- 3.12 (SD, n = 6). 29.30 +/- 5.11, 33.02 +/- 11.8, and 12.91 +/- 5.62 ppm respectively. For control 10B-conjugated anti-dinitrophenol (DNP) mAb, the values were 9.59 +/- 0.99, 10.37 +/- 2.86, 10.00 +/- 2.95, and 8.83 +/- 4.71 ppm respectively. The concentrations in blood were less than 0.40 +/- 0.10 ppm with anti-AFP mAb and less than 0.51 +/- 0.15 ppm with anti-DNP mAb at each sampling time (12, 24, 72, and 120 h). The number of 10B atoms delivered to the tumor cells was calculated to be 0.62 x 10(9), 1.63 x 10(9), 1.84 x 10(9) and 0.72 x 10(9) at each sampling time after injection of 10B-anti-AFP mAb. The amount of 10B atoms necessary for effective boron neutron-capture therapy was estimated to be 10(9)/tumor cell. We were able to carry 1.84 x 10(9) 10B atoms to AH66 tumor cells by using 10B-anti-AFP mAb. The accumulation reached its peak 72 h after injection. These data indicated that the 10B-conjugated antitumor mAb could deliver a sufficient amount of 10B atoms to the tumor cells to induce cytotoxic effects 72 h after injection upon thermal neutron irradiation.

Mechanical stress-induced orientation and ultrastructural change of smooth muscle cells cultured in three-dimensional collagen lattices

The effect of tensile stress on the orientation and phenotype of arterial smooth muscle cells (SMCs) cultured in three-dimensional (3D) type I collagen gels was morphologically investigated. Ring-shaped hybrid tissues were prepared by thermal gelation of a cold mixed solution of type I collagen and SMCs derived from bovine aorta. The tissues were subjected to three different modes of tensile stress. They were floated (isotonic control), stretched isometrically (static stress) and periodically stretched and recoiled by 5% above and below the resting tissue length at 60 RPM frequency (dynamic stress). After incubation for up to four wk, the tissues were investigated under a light microscope (LM) and a transmission electron microscope (TEM). Hematoxylin and eosin-stained LM samples revealed that, irrespective of static or dynamic stress loading, SMCs in stress-loaded tissues exhibited elongated bipolar spindle shape and were regularly oriented parallel to the direction of the strain, whereas those in isotonic control tissues were polygonal or spherical and had no preferential orientation. In Azan-stained samples, collagen fiber bundles in isotonic control tissues were somewhat retracted around the polygonal SMCs to form a random network. On the other hand, those in statically and dynamically stressed tissues were accumulated and prominently oriented parallel to the stretch direction. Ultrastructural investigation using a TEM showed that SMCs in control and statically stressed tissues were almost totally filled with synthetic organelles such as rough endoplasmic reticulums, free ribosomes, Golgi complexes and mitochondria, indicating that the cells remained in the synthetic phenotype. On the other hand, SMCs in dynamically stressed tissues had increased fractions of contractile apparatus, such as myofilaments, dense bodies and extracellular filamentous materials equivalent to basement membranes, that progressed with incubation time. These results indicate that periodic stretch, in concert with 3-D extracellular collagen matrices, play a significant role in the phenotypic modulation of SMCs from the synthetic to the contractile state, as well as cellular and biomolecular orientation.

Cytologic evaluation of phyllodes tumors as compared to fibroadenomas of the breast

In an attempt to better understand the cytopathologic features of phyllodes tumors (PTs) and to differentiate PTs from fibroadenomas (FAs) of the breast, cytologic smears prepared from 17 and 19 histologically diagnosed cases of PT and FA, respectively, were reviewed. PT cases were histopathologically graded as benign, borderline and malignant. Cytologically, hypercellularity of stromal cells with recognizable cytoplasm was observed in 6 of 7 borderline and malignant PT cases, but none of the benign PT or FA cases revealed such hypercellular stroma. Between all PT and FA cases, no statistically significant differences could be obtained in the nuclear size of stromal cells, folding of epithelial cell sheets or number of foamy macrophages. The study revealed that the abundance of stromal cells with cytoplasm, not naked nuclei, was strongly suggestive of borderline and malignant PT, but the differentiation between benign PT and FA was difficult on the basis of the cytopathologic findings.

Recent advances in basic aging research on the nervous system in Japan

Recent studies on aging of the nervous system are reviewed with special reference to neuronal cell death, compensatory reaction, trophic factors, brain cholinergic systems and the autonomic nervous system. Studies on spinal motoneurons labeled with a tracer substance transported retrogradely demonstrated differential age effect on different types. Compensatory reactions were also seen among surviving motoneurons. Motoneuronal survival appears to be correlated with the amount of activity. However, the causal relationship between them is not yet conclusive. The effects of nerve growth factor on sympathetic and dorsal-root ganglion cells seem to be well preserved in the aged, although there are some controversial findings on the ratio of NGF-dependent neurons versus NGF-independent neurons. It has been shown that acidic fibroblast growth factor or other substances may prevent degeneration of the basal forebrain cholinergic neurons and improve memory and learning performance in aged animals. The cholinergic system also regulates the regional cerebral blood flow, and this function seems to be well maintained in aged rats. Microneurography techniques have revealed increased activity of postganglionic sympathetic nerves innervating muscles in aged human subjects. The activity of preganglionic sympathetic nerves innervating the adrenal gland and the section rate of noradrenaline have been shown to increase in the aged rat. These changes might cause high blood pressure in the aged, although some species differences have been noted between humans and rats.

Developmental alterations in NMDA receptor-mediated [Ca2+]i elevation in substantia gelatinosa neurons of neonatal rat spinal cord

Using spinal cord slices prepared from neonatal rats, the intracellular free Ca2+ concentration ([Ca2+]i) in neurons located in the dorsal horn substantia gelatinosa (SG) was measured with microscopic fluorometry by loading fura 2-AM into neurons. Developmental alterations in the elevation of [Ca2+]i elicited by the glutamate analogs, NMDA and AMPA, were investigated from postnatal day (PNDs) 1 to 17. During the 1st week of postnatal life, when neuronal maturation of the SG is known to take place, the NMDA response remained large or even slightly increased. It subsequently showed a gradual decline. This pattern of postnatal changes is consistent with previously reported autoradiographic studies on NMDA-binding sites. The affinity of receptors for NMDA was found to decrease constantly during the period examined. The AMPA response and resting [Ca2+]i showed no significant developmental changes. Neonatal treatment with capsaicin, which has been shown to degenerate fine primary afferent fibers terminating in the SG, delayed the developmental decline in the NMDA-induced [Ca2+]i response. It is suggested that the number and the molecular properties of NMDA receptors expressed in the SG change during early postnatal neuronal maturation. The temporal coincidence between postnatal alteration in NMDA-induced [Ca2+]i elevation and neuronal maturation of the SG may indicate that intracellular Ca2+ regulated by NMDA receptor activation is related to postnatal neuronal maturation. Activation of fine primary afferent fibers may contribute to the observed developmental alterations in the NMDA response of SG neurons.

Development of a vascular prosthesis for a growing child. A graft expandable in vivo

Specially designed vascular prostheses that can be dilated after implantation using a percutaneous transluminal angioplasty (PTA) balloon catheter have been developed. The grafts are made of woven polyester fiber fabrics, the circumferential yarns of which consist of two different types of polyester fiber bundles: One is a straight weak bundle, the other is a strong bundle wound around the former. The graft with an initial diameter of 6 mm could be dilated to 9 mm by luminal inflation of the balloon four to five times at 10 atmospheres (atm) in vitro. After disrupting the weak bundle by the dilatation procedure, the strong bundles were straightened, which maintained the enlarged diameter of the new caliber. Grafts of 6 mm in initial diameter implanted into the thoracic aortas of mongrel dogs for 3 months also could be dilated in vivo by inflating the PTA four to five times at 15 atm, as found in the vitro study. Macroscopic observation revealed that, around the dilated grafts, only a tiny hematoma was formed and nominal subsequent bleeding was observed, which indicated that the dilatation procedure was performed safely. The graft, which enables adaptation of the hydrodynamic property of the graft to the increased blood flow by PTA after implantation, is applicable in a growing child.

Highly oriented, tubular hybrid vascular tissue for a low pressure circulatory system

A hierarchically structured hybrid vascular tissue was prepared from vascular cells and collagen. First a hybrid medial tissue was prepared by pouring a cold mixed solution of bovine aortic smooth muscle cells (SMCs) and Type I collagen into a tubular glass mold composed of a mandrel and a sheath (inner diameter, 1.5 mm; outer diameter, 7 mm; length, 7 cm). An SMC incorporating collagenous gel was formed with incubation at 37 degrees C. After the sheath of the mold was removed, the resulting fragile tissue cultured in the medium shrank in a time dependent manner to form an opaque, dense tissue. Seeding at a higher cell density and a lower concentration of collagen resulted in rapid and prominent shrinkage. Morphologic investigation showed that with time, bipolarly elongated SMCs and collagen fiber bundles became positioned around the mandrel. When the mandrel was removed, a tubular hybrid medial tissue was formed. A hybrid vascular tissue with a hierarchical structure was constructed by seeding endothelial cells onto the inner surface of the hybrid medial tissue. Prepared tissues tolerated luminal pressures as great as 100 mmHg and mechanical stress applied during the anastomotic procedure. This method allowed the authors to prepare hybrid medial tissues of predetermined size (specifically inner diameter, wall thickness, and length) and mechanical property, which all depend on the mold design, SMC seeding density, initial collagen concentration, and incubation period. Hybrid vascular tissues may provide physiologic functions such as antithrombogenicity and regulation of vasomotor tone when implanted into a venous system.

Boron neutron capture therapy of malignant melanoma using 10B-paraboronophenylalanine with special reference to evaluation of radiation dose and damage to the normal skin

A treatment regimen for boron neutron capture therapy of malignant melanomas is described using 10B-paraboronophenylalanine as the tumor-targeting compound. As a therapeutic dose, we adopted the maximum tolerable dose for the skin regardless of tumor 10B concentration. In practice, the maximum neutron fluence should be decided prior to starting irradiation. For this purpose, the kinetics of the concentration of 10B in the blood and skin and the skin-to-blood ratios were analyzed in the six patients who received 170 mg/kg of the compound intravenously, and skin concentrations during irradiation were predicted using a standard skin factor curve. This yields a skin concentration at time T based on the blood concentration at time 0. We calculated the maximum tolerable fluence yielding but not exceeding 18 RBE-Gy by assuming that the RBE of 14N(n,p)14C and 10B(n, alpha)7Li reaction for skin damage is 2.5. Actual skin reactions in three of five patients treated with the therapy were, as predicted, within tolerable limits, and we were able to obtain complete tumor regression in four cases. The results indicate that application of our logical approach will be useful for subsequent cases and further development of this therapy.

[Manometric study of the biliary sphincter zone: a comparison between the length of phasic activity and the narrow distal segment]

Motor activity of the sphincter of Oddi has been evaluated in 26 patients who underwent ERCP examination. Manometric recordings from the common bile duct and the sphincter of Oddi were performed with a single end-lumen perfused catheter. The number of successive 3 mm spaced black marks, observed during the pull-through from the first appearance of the proximal sphincter activity to that of duodenal pressure, was used to measure the length of the sphincter zone. In 14 of 26 patients, the length of phasic activity zone of the sphincter of Oddi was 9 mm. However, the narrow distal segment of the common bile duct was 15.1 +/- 3.6 mm in length. In same patients, the length of phasic activity zone was shorter than the anatomical one. The mean sphincter of Oddi pressure (SOP) at the distance of 6 mm from the papillary pore (77.8 +/- 22.1 mmHg) was greater than that of 9 mm (58.4 +/- 27.0 mmHg) and 12 mm (51.0 +/- 16.9 mmHg). These results suggest that the location of the orifice of catheter should be taken into consideration when comparing the SOP.

Behavior of arterial wall cells cultured on periodically stretched substrates

Cells in vital tissues align to form the most efficient configuration for functioning. Vascular cells of arterial walls are constantly exposed to fluid shear stress and pressure-induced periodic strain component, both of which are induced by pulsatile flow. In the present study, the effect of cyclic strain on the cellular orientation response and morphological changes of bovine arterial wall cells such as endothelial cells (ECs), smooth muscle cells (SMCs) and fibroblasts (FCs) was studied. Cells seeded onto transparent elastomeric films were subjected to periodic stretch-relaxation under various amplitudes ranging from 5 to 20% and at frequencies ranging from 15 to 120 RPM for up to 24 h. Time-lapse video-recorded images of stress-loaded cells were analyzed by a computer-aided morphometric system to quantitatively evaluate the cellular orientation responses and morphological changes. The stress-loaded cells tended to align perpendicularly to the direction of stretch with time, regardless of cellular species. More pronounced orientation was attained under operating conditions with higher amplitude and frequency of stretching. The response of SMCs and FCs advanced more rapidly than that of ECs. Meanwhile, little morphological change was observed, irrespective of stress-loading or nonloading. Understanding of mechanically induced orientation response provides a fundamental basis on tissue engineering and biomechanics.

[Factors effecting medication errors]

The purpose of this paper is to reveal factors that may occur or that may prevent medication errors, and to consider some measures of patients' safety. For this aim, we explored the characteristics of each ward and the characteristics of each nurse as well as their experiences about medication errors. The investigation was conducted at a approximately 650-bed university hospital located in a large urban center in Tokyo, and at a approximately 150-bed private hospital located in a suburb of Tokyo. Questionnaires were distributed in October 1991 and asked nurses to identify medication errors in which they had been personally committed within the past one-month. A response rate was approximately 70%. We were informed other information of each unit from head nurses--such as the unit size, case mix, nurse staffing and working schedule of nurses. Results indicate that on the questionnaires the nurses reported 10 times medication errors than they reported to head nurses. 56 percent of 155 nurses (except nurses who were working at an ICU and a mental ward) stated they had made medication errors or near misses during the 1-month reporting period. 30 percent of 155 stated they actually dealt with medication errors occurred by others. Several factors that effect medication errors have been identified by a stepwise discriminant analysis. The proportion of serious patient and the bed occupancy rate influenced the occurrence of medication errors. The educational career of a nurse, especially whether the nurse had been offered an assistant nursing program or not, related to dealing with and/or preventing medication errors.(ABSTRACT TRUNCATED AT 250 WORDS)

Suppression of rabbit VX-2 subcutaneous tumor growth by gadolinium neutron capture therapy

VX-2 tumors growing in hind legs of New Zealand White rabbits (n = 4) were exposed to thermal neutrons for 40 min (2.1 x 10(12) neutrons cm-2) while one of two hind leg tumors of each rabbit was infused continuously with meglumine gadopentetate through a branch of the left femoral artery. The contralateral (uninfused) tumors served as controls. Although no differential distribution of gadolinium was achieved between the tumor and its adjacent normal tissue, the gadolinium concentration in the infused tumor was approximately 5-6 fold higher than that in the contralateral tumor. Growth of gadolinium-infused tumors was significantly inhibited compared to that of control tumors (P < 0.05) between the 16th and 23rd days after treatment.

Phenotypic modulation of smooth muscle cells in intima-media incorporated hybrid vascular prostheses

Hierarchical hybrid vascular grafts were constructed with an endothelial cell (EC) monolayer and hybrid medial layer composed of smooth muscle cells (SMCs) and type I collagen gel. The grafts, implanted into canine carotid arteries for up to 12 weeks, were ultrastructurally examined with a transmission electron microscope. Before implantation, SMCs incorporated into hybrid media were round and intracellularly filled with synthetic organelles such as rough endoplasmic reticula, mitochondria, free ribosomes, and Golgi complexes. Two weeks after implantation, bipolar spindle shaped SMCs still remained in a synthetic phenotype. At 12 weeks, circumferentially aligned SMCs were abundant in contractile apparatus such as myofilaments, dense bodies, and basement membranes. In a morphometric evaluation, the populations of three phenotypic SMCs (synthetic, intermediate, and contractile SMCs) were quantified. At 2 weeks, the proportions were 50.5, 41.8, and 7.7% for synthetic, intermediate, and contractile phenotypes, respectively. At 12 weeks, they were 9.9, 26.2, and 63.8%. These findings indicated that SMCs incorporated into hybrid grafts were transformed from a synthetic to a contractile phenotype under pulsatile stressed conditions after 12 weeks in vivo. Thus, the intima/media incorporated hybrid graft reconstructed a vessel wall similar to a native one in terms of structure and function.