Preoperative estimation of cerebral blood flow autoregulation curve for control of cerebral circulation after cerebral revascularization

In this report, the anesthetic management for cerebral revascularization in 3 patients with ischemic cerebral vascular disease was presented. Arterial pressure was maintained above their ordinary level before revascularization. To prevent cerebral hemorrhage or edema due to the breakthrough phenomenon, the arterial pressure was reduced to the lower limit pressure of cerebral blood flow (CBF) autoregulation which was measured preoperatively. The patients did not show any new neurological deficit after the operations.

Haemodynamic effects of nicardipine hydrochloride. Studies during its use to control acute hypertension in anaesthetized patients

Fourteen patients with vascular disease were studied to evaluate the efficacy of nicardipine hydrochloride as a hypotensive agent in the treatment of acute hypertension occurring during anaesthesia. Five patients received a bolus injection of nicardipine hydrochloride 0.5 mg. Another nine patients received bolus injections of nicardipine 1 and 2 mg. Nicardipine 0.5 mg significantly decreased systemic arterial pressure (by about 24%), systemic vascular resistance (SVR), left ventricular stroke work index (LVSWI) and rate-pressure product (RPP). Nicardipine 1 or 2 mg had twice the effect in decreasing arterial pressure as did 0.5 mg, without significant change in heart rate or right and left ventricular filling pressures. Cardiac index and stroke volume index increased and SVR, pulmonary vascular resistance, LVSWI and RPP decreased significantly.

Contractions in normal and atherosclerotic rabbit aortas

Length-tension relationships and contractile responses to agonists associated with cyclic nucleotide levels in aortas from atherosclerotic rabbits were studied. The same number of tissues from healthy rabbits was also studied. Diffuse lesions were produced by denudation of the vascular endothelium of rabbit aorta using a balloon catheter and then feeding these rabbits a high cholesterol diet for two months. Stretch-passive tension curves and length-active tension curves which developed in the presence of 60 mM KCl significantly shifted to the left. The altered length-tension relationships indicate a decreased distensibility in these strips and this is attributed to an enhanced accumulation of collagen. Dose-response curve analysis revealed a marked hypersensitivity to serotonin as indicated by greater pD2 values (negative logarithm of half maximum dose) than seen in the controls. In addition, the mean absolute values of the maximum contraction induced by serotonin and KCl were significantly higher than in the controls. Although cyclic AMP levels in the strips with a pathology were lower and cyclic GMP/cyclic AMP ratios were higher than the controls in the basal state, serotonin induced no marked alterations in the cyclic nucleotides levels in the strips from either the diseased or control rabbits. These mechanical and pharmacological alterations of atherosclerotic vessels may relate to clinical events such as coronary spasm.

[Double-blind comparative clinical study of cefpiramide (SM-1652) and cefsulodin on complicated urinary tract infections due to P. aeruginosa]

The therapeutic efficacy and safety of Cefpiramide (CPM, SM-1652) at a 2 g/day dose were objectively compared with those of Cefsulodin (CFS) at a 2 g/day dose in patients with chronic complicated urinary tract infections (UTI) by P. aeruginosa in a double-blind study at 46 institutions in Japan. The results are as follows: The therapeutic efficacy was analyzed in 254 patients (136 cases administered CPM and 118 cases administered CFS) after excluding 20 cases as drop-out. Among 254 cases, the number of patients with infection of P. aeruginosa was 190 cases (100 cases administered CPM and 90 cases administered CFS), while that with infection of organisms other than P. aeruginosa was 64 cases (36 cases administered CPM and 28 cases administered CFS). By the administration of a 2 g/day dose for 5 days, the overall clinical effective rate of CPM was significantly higher than that of CFS in total patients. When the patients were classified into 2 groups with respect to causative organisms (P. aeruginosa and others), the clinical effective rate of CPM in patients with infections of P. aeruginosa was significantly higher than that of CFS, while the clinical effective rate of CPM in patients with infection of other organisms than P. aeruginosa was the same as that of CFS. As to the bacteriological effect on bacteriuria, the eradication rate of CPM was significantly higher than that of CFS not only against all causative organisms but also against P. aeruginosa. The rate of replacement by S. faecalis was significantly higher in the CFS-treated group than in the CPM-treated group. The same result was obtained on the rate of replacement by other organisms. The MIC values of CPM for isolated organisms before drug administration were lower than those of CFS. The incidence rates of side effects and the abnormal findings of clinical laboratory tests were the same for the CPM- and CFS-treated groups. From the results, it was concluded that CPM is a useful drug for the treatment of patients with chronic complicated urinary tract infections caused by P. aeruginosa.

Detection of air embolism by transesophageal echocardiography

In this study transesophageal echocardiography was utilized for detecting air embolism in dogs in the supine position and in patients undergoing neurosurgery in the sitting position. In dogs, the threshold dose of venous air for detection was determined using either a bolus injection or continuous infusion of air via the jugular vein for up to three minutes. The ability to detect air in the aorta also was determined by a bolus injection into the left ventricular via an arterial catheter. For venous injection of air, the threshold dose by bolus was 0.02 ml/kg. When given by infusion, air could be detected in all cases by both contrast echocardiogram and Doppler sound changes at the rate of 0.05 ml . kg-1 . min-1. When air was injected into the left ventricle, the threshold dose was 0.001 ml/kg using contrast echocardiogram. In the clinical evaluation, air was clearly demonstrated in five of six patients by transesophageal echocardiogram along with appropriate changes in Doppler sounds, pulmonary artery pressure, and end-tidal carbon dioxide concentration. Our results suggest that transesophageal echocardiography may be a more sensitive and accurate method for detecting venous air embolism than other commonly used monitors for patients undergoing neurosurgical procedures in the sitting position. This device may also be able to detect air in the aorta in patients experiencing paradoxical air embolism during surgery due to intracardiac or pulmonary shunts.

Capacitation inducing activity of serum albumin in fertilization of mouse ova in vitro

The role of serum albumin in in vitro fertilization of mouse ova was studied relating to the fertilization inhibitory activity of Zn2+. The time required for mouse sperm capacitation was dependent on the concentration of serum albumin which was added to the medium. The majority of Zn2+ added to the medium was shown to be bound to serum albumin (95% out of 200 microM) by means of equilibrium dialysis. Furthermore, it was suggested that the serum albumin was necessary for the initiation of the sperm capacitation process by the periodic observation of sperm penetration through zona pellucida.

A study of the mechanism of estrogen as an antiatherosclerotic: the inhibitory effect of estrogen on A23187-induced contraction of the aortic wall

Although the antiatherosclerotic effects of estrogen are well known, the mechanisms involved have not been determined. We designed experiments in which strips of thoracic aorta from oophorectomized rabbits were contracted by the calcium ionophore A23187 and the inhibition of the contraction by estrogen and concomitant levels of cyclic nucleotides were determined. A23187 (10(-5) M) increased the tension slowly but progressively, and there was a concomitant decrease in cyclic AMP levels. While a dose-dependent relaxation occurred in strips contracted by A23187 with addition of theophylline (greater than 10(-4) M) or dibutyryl cyclic AMP (greater than 10(-4) M) to the bath, prior addition of these compounds inhibited the contraction. Pretreatment of the strips with estrogen (2 x 1-(-7) M, 2 x 10(-5) M) significantly prevented contraction of the strips, as induced by A23187, and also prevented reduction in cyclic AMP levels, as induced by the ionophore. Cyclic GMP levels remained unchanged throughout. As the contraction of these tissues wall was inhibited by estrogen in an apparent association with a reduction in the levels of cyclic AMP, this might help to explain the antiatherosclerotic effects of estrogen, as reduction in these nucleotide levels has been suggested to induce atherosclerotic lesions in the arterial wall by enhancing vascular permeability.

Changes in the plasma levels of thromboxane B2 and cyclic nucleotides in patients with Takayasu disease

Plasma thromboxane B2 (TXB2), cyclic AMP and cyclic GMP levels in 31 women with Takayasu disease were measured and findings were compared with data on 34 age-matched healthy Japanese. Platelet aggregation determined by the screen filtration pressure (SEP) method and pulmonary lesions assessed by scintillation were studied in 21 patients. Plasma TXB2 levels in patients with Takayasu disease were 265.8 +/- 20.4 pg/ml, which were statistically higher than the levels of 196.3 +/- 10.7 in healthy controls. On the contrary, cyclic AMP levels in the patients were 9.6 +/- 0.7 pmols/ml, statistically lower levels than 13.5 +/- 1.0 seen in the healthy controls. A positive correlation among cyclic AMP, cyclic GMP and TXB2 levels was confirmed only in the controls. SEP values in the patients with pulmonary lesions were significantly higher than in those without lesions and also in the controls. A positive correlation was obtained between SEP and TXB2 levels in healthy controls, but not in the patients. Thus, thromboxane A2 may play an important role in the pathology of Takayasu disease.

Zinc effects on mouse spermatozoa and in-vitro fertilization

The fertilizing ability of mouse epididymal and capacitated spermatozoa was tested by mixing with normal or zona-free ova. In the presence of Zn2+, the epididymal spermatozoa failed not only to penetrate the zona pellucida but also to fuse with zone-free ova, while no effect was observed on capacitated spermatozoa. Zn2+ also inhibited fertilization with spermatozoa preincubated in Ca2+-free medium. However, shortly after the addition of Ca2+ to the preincubated spermatozoa, Zn2+ lost its fertilization inhibitory activity.

Periodate oxidation analysis of carbohydrates. XIII. Simultaneous gas chromatographic determination of the aldehydes in the periodate oxidation products of non-dialyzable urinary carbohydrate materials as diethyl dithioacetals

The aldehydes in the periodate oxidation products of non-dialyzable urinary carbohydrate materials were determined simultaneously by gas chromatography of their diethyl dithioacetal derivatives. The yields of aldehydes for normal male urine varied considerably among subjects, but their molar ratios were almost constant. The average values for glyceraldehyde/glyoxal and lactaldehyde/glyoxal molar ratios were 0.41 and 0.27, respectively. The average amount of L-fucose at the non-reducing terminals of carbohydrate chains, as estimated from the yield of lactaldehyde, was about 5 mg/day.

Photosensitive characteristics of the optical information storage element using M centers in NaF crystals

Effects of M-center concentration and thickness of the M-center layer on the photosensitive characteristics of optical information storage elements using M centers in NaF crystals are presented. It is shown that writing in the disordering mode and reading with crossed polarizers in white light provide good contrast and gray scale images just like conventional silver halide film.