[A roentgenological study of Chilaiditi's syndrome]

The studies on Chilaiditi's syndrome reported in Japan have been mostly case reports on one or two cases. There have been studies on 356 cases in all. We have selected 262 cases with detailed data takes from the above 356 cases, together with 116 further cases of Chilaiditi's syndrome that we have encountered up to 1990, i.e. since our previous report in 1965. We also investigated roentgenograms, complications, interpositions and age distribution. The syndrome was mostly found in middle-aged and elderly patients of 50 years or older. More male patients were involved than female, however this is not necessarily true if the total number of patients under study is taken into account. Among the complications, gastric and duodenal diseases (ulcer and carcinoma) were most frequently found, accounting for 20.6% of the total reported cases in Japan. In our own study, the percentage was as high as 33.7% because radiography with contrast medium was positively conducted on the digestive tract. Of the interpositions, the colon accounted for 93.1% of our cases, and 72.9% of the total reported cases in Japan. The involved sites were mostly the right hepatic flexure of the colon and the transverse colon. From the reports by other researchers in the past and our data from 1965, 1975 and 1977, it appears that the incidence is about 0.003-0.03%. There were no subjective symptom specific to Chlaiditi's syndrome, and there may be various factors accounting for the occurrence of the syndrome. The symptoms were primarily based on the underlying diseases, and Chilaiditi's syndrome merely indicates the condition where the digestive tract interposes between the diaphragm and liver. Therefore, we regard this as a radiographical sign rather than a syndrome, and we propose that this should be called "Chilaiditi's sign". We also emphasize that the digestive tract must be strictly examined if this sign is to be noted.

Usefulness of ophthalmic examination in postnatal observation in teratology studies

Pregnant rats were irradiated with soft x-ray at a dose of 635 r or 1270 r on Day 9 or 11 of gestation. The eyes of F1 offspring were examined by indirect ophthalmoscopy and slit lamp biomicroscopy in postnatal weeks 3 to 7. Ophthalmoscopic examination of offspring irradiated at a dose of 635r or 1270r on Gestational Day 9 revealed iris and choroidal coloboma together with microphthalmia and anophthalmia at Postnatal Week 3 or later. Choroidal coloboma, an anomaly that cannot be detected by the common external observation method, was found ophthalmoscopically in one rat without any external ocular abnormalities. This fact suggests that ophthalmoscopy in postnatal observation can be useful to detect ocular teratogenic potential of test compounds in preclinical safety studies.

Differential regulation of manganese and copper/zinc superoxide dismutases by the facial nerve transection

The effects of unilateral nerve transection on manganese and copper/zinc superoxide dismutase (Mn-SOD and Cu/Zn-SOD) mRNA levels in the facial nucleus were studied by in situ hybridization. An increase of Mn-SOD mRNA levels was first seen in the ipsilateral facial nucleus 12 h after axotomy, and was most pronounced at 4-7 days after this procedure; by 56 days, the increase disappeared. There was no change in Cu/Zn-SOD mRNA levels at any time after axotomy. We further confirmed, by immunohistochemistry, that the increase in Mn-SOD transcription was followed by protein synthesis. These results are suggestive of an important role for Mn-SOD in defense, regeneration and recovery responses following nerve transection.

Menotropin stimulation after prolonged gonadotropin releasing hormone agonist pretreatment for in vitro fertilization in patients with endometriosis

Two protocols were scheduled for in vitro fertilization and embryo transfer (IVF-ET) in patients with various stages of endometriosis who were resistant to conventional therapies. In the ultralong protocol (21 patients), gonadotropin releasing hormone agonist (Gn-RHa) was administered for at least 60 days prior to ovarian stimulation along with menotropin until human chorionic gonadotropin was injected. In the long protocol (11 patients), Gn-RHa was started at the midluteal phase and exogenous gonadotropin was commenced between the third and the seventh day of the menstrual cycle after pituitary suppression. The estradiol response and the number of retrieved oocytes, fertilized oocytes, cleaved oocytes, and transferred embryos were similar in both groups but the clinical pregnancy rate per transfer was superior in the ultralong protocol (67 vs 27%). The miscarriage rate was 14% (2/14) in the ultralong protocol. Prolonged Gn-RHa suppression of ovarian function before superovulation may overcome some causes of infertility in patients with endometriosis.

Co-expression of glycine receptor beta subunit and GABAA receptor gamma subunit mRNA in the rat dorsal root ganglion cells

We examined the expression of the beta subunit mRNA of the glycine receptor and the gamma subunit mRNA of the GABAA receptor in the rat dorsal root ganglion (DRG) using in situ hybridization histochemistry with oligonucleotide probes. About 44% and 37% of the all DRG neurons were labeled by the probes for glycine receptor beta subunit and GABAA receptor gamma subunit mRNAs. Labeled neurons were mostly large cells that simultaneously expressed both glycine receptor beta subunit and GABAA receptor gamma subunit mRNA as demonstrated using consecutive sections. Thus, we suggest the possibility that both GABA and glycine presynaptically regulate the activity of neurons involved in low-threshold mechanoreception at axo-axonic synapses in the spinal cord.

Synaptic contacts between CGRP-immunoreactive terminals and enkephalin-immunoreactive neurons in the central amygdaloid nucleus of the rat

An immunoelectron microscopic method combined with immunofluorescence double staining was carried out to examine the relationship between calcitonin gene-related peptide (CGRP)-like immunoreactive (LI) axon terminals and enkephalin (ENK)-LI neurons in the central amygdaloid nucleus (Ce) of the rat. The latter method showed that many ENK-LI cell bodies are densely surrounded by CGRP-LI axons in the lateral subdivision of the Ce (CeL). After taking fluorescence micrographs, the immunoperoxidase technique was used to examine the CGRP-LI axonal profiles under an electron microscope. CGRP-LI terminals were frequently found to form axo-somatic synaptic contacts with ENK-LI neurons in the CeL.

Localization of Mn-superoxide dismutase (Mn-SOD) in cholinergic and somatostatin-containing neurons in the rat neostriatum

We used rabbit antisera against manganese (Mn)-superoxide dismutase for immunohistochemical studies of localization in the rat neostriatum. Immunostaining was intense in large-sized neurons and several medium-sized neurons, but it was moderate to weak in other cells. Double immunostaining with monoclonal antibody to choline acetyltransferase or somatostatin demonstrated large-sized, Mn-SOD immunoreactive neurons to be cholinergic, and some medium-sized neurons which were intensely immunoreactive for Mn-SOD to contain somatostatinergic.

Intense immunoreactivity for Mn-superoxide dismutase (Mn-SOD) in cholinergic and non-cholinergic neurons in the rat basal forebrain

The immunohistochemical localization of manganese (Mn)-superoxide dismutase (Mn-SOD) was studied in the rat basal forebrain using polyclonal antibodies to Mn-SOD. Neurons of the basal forebrain exhibit a high density of Mn-SOD immunoreactivity. Double immunostaining with a monoclonal antibody to choline acetyltransferase demonstrated that both cholinergic and non-cholinergic neurons in the basal forebrain are intensely immunoreactive for Mn-SOD.

Spiny and aspiny types of neuropeptide Y immunoreactive neurons in the monkey neostriatum

The present study demonstrates the existence of two types of neurons with neuropeptide Y (NPY) immunoreactivity in the neostriatum of the monkey (Macacus fuscatus) by using the avidin-biotin-immunoperoxidase method. One type, accounted for about 80% of striatal NPY cells, corresponded to the medium-sized aspiny type neurons. The other type resembled the medium-sized, spiny type II neurons. These findings suggest that there are at least two functional subpopulations of NPY neurons in the monkey neostriatum.

Striatal calcitonin gene-related peptide-like immunoreactive afferents from the regions ventral and medial to the medial geniculate nucleus of rats

The sources of fibers with immunoreactivity to calcitonin gene-related peptide in the caudal portion of the caudate-putamen were investigated in animals treated by a knife cut, a tracer injection, or an electrolytic lesion of regions ventral and medial to the medial geniculate nucleus. Hemitransection of the brain just caudal to the caudate-putamen decreased ipsilaterally calcitonin gene-related peptide-like immunoreactivity in the caudal portion of the caudate-putamen, suggesting that calcitonin gene-related peptide-like immunoreactive fibers in the caudate-putamen originated from neurons in the area caudal to the caudate-putamen. Some calcitonin gene-related peptide-like immunoreactive neurons in the regions ventral and medial to the medial geniculate nucleus, including the peripeduncular, posterior intralaminar and suprageniculate nuclei, were labeled ipsilaterally with a retrograde tracer after an injection into the caudal portion of the caudate-putamen. In addition, an electrolytic lesion of calcitonin gene-related peptide-like immunoreactive neurons in the regions ventral and medial to the medial geniculate nucleus decreased the number of calcitonin gene-related peptide-like immunoreactive fibers in the ipsilateral caudal portion of the caudate-putamen. These results suggest that some cells containing calcitonin gene-related peptide in several posterior thalamic nuclei project to the caudal caudate-putamen.

Calcitonin gene-related peptide (CGRP) immunoreactivity in the afferents to the caudate-putamen and perirhinal cortex of rats

The posterior caudate-putamen and perirhinal cortex are innervated by fibers immunoreactive to calcitonin gene-related peptide (CGRP). We investigated the origins of these fibers by using immunohistochemistry combined with lesion experiments and fluorescent dye tracers. Lesions of the posterior thalamus surrounding the medial geniculate nucleus, in which groups of CGRP-like immunoreactive (CGRP-LI) cells exist, decreased the number of ipsilaterally CGRP-LI fibers in the posterior caudate-putamen and partly in the perirhinal cortex. Some of CGRP-LI neurons in several posterior thalamic nuclei surrounding the medial geniculate nucleus were labeled with both Fast blue injected into the posterior caudate-putamen and fluoro-gold administered into the anterior perirhinal cortex. Our results indicate that CGRP-LI cells in the posterior thalamus, such as posterior intralaminar, lateral subparafascicular and subparafascicular nuclei, project either separately or simultaneously to innervate the posterior caudate-putamen and perirhinal cortex.

Distribution of galanin-immunoreactive nerve fibers in the rat nasal mucosa

Galanin-like immunoreactivity was found in nerve fibers beneath and within the epithelium of the rat mucosa by the use of immunohistochemical techniques. Immunoreactive fibers were also noted close to blood vessels and seromucous glands in the lamina propria. Fast blue applied to the nasal mucosa underwent retrograde transport to some immunoreactive neurons of the trigeminal ganglion. Thus, the rat nasal mucosa was shown to be innervated by galanin-containing sensory nerves.

Correlation of heart rate and radionuclide index of left ventricular contraction and relaxation

Since the cardiac function indices derived from radionuclide ventriculography (RNV) are considered to depend on the heart rate, we studied the relationship between systolic or diastolic indices and heart rates in patients with normal RNV and devised a method of correcting these indices according to the heart rate. For the systolic indices, the heart rate showed significant correlation with ET (r = -0.640), PER (r = 0.791) and TPE (r = -0.401) but not with EF, 1/3 EF, MNSER or 1/3 MNSER. For the diastolic indices, the heart rate correlated with FT (r = -0.938), RFT (r = -0.736), SFT (r = -0.803), 1/3 FF (r = -0.758), PFR (r = 0.759), 1/3 PFR (r = 0.742) and TPF (r = -0.389) but not with AFT, 1/3 MNDFR or AFF. These results indicate that many systolic and diastolic indices derived from RNV are affected by the heart rate. So when cardiac function is evaluated with the use of radionuclide indices, those which are independent of the heart rate should be used, or they should be corrected for the heart rate. As a method of correction, we proposed a rotating method obtained by manipulation of the regression equation of heart rates and indices. This new method is certain and easier to use when the correcting equations are set into a computer program.

Immunocytochemical localization of manganese superoxide dismutase (Mn-SOD) in the hippocampus of the rat

The immunocytochemical distribution of manganese superoxide dismutase (Mn-SOD) was determined in the rat hippocampus. The enzyme was localized in the mitochondria. CA1 pyramidal cells were weakly immunostained, whereas CA3 pyramidal cells were strongly reactive. These differences in the intensity of the Mn-SOD immunostaining reactions may relate to variations in the sensitivity of subfields of the hippocampus to ischemia.

[Regional myocardial blood flow measurements in resting and dipyridamole induced vasodilative state by Xenon-133 clearance method]

Myocardial imaging with Xenon-133 and a gamma camera was employed to evaluate the relationship between angiographically demonstrated coronary artery stenosis and regional myocardial blood flow (r-MBF) in 22 patients with ischemic heart disease and 9 control subjects. After a left anterior oblique cineangiogram was obtained, the cinecamera was replaced by the mobile gamma camera in the same plane and location over the pericardium of patients. Then, 370 MBq (10 mCi) of 133Xe was injected into the left coronary artery as a bolus. After the first measurement of r-MBF in resting state, a second injection was made 3 minutes after intravenous injection of 0.56 mg/kg of dipyridamole for 4 minutes. The r-MBF in different regions of the heart was calculated by Kety formula. Coronary flow reserve (CFR) was defined the rMBF ratio between resting and dipyridamole induced vasodilative state. In the resting state, good correlation (r = 0.711) was observed between pressure rate product and the r-MBF at the areas perfused by non stenotic vessels. The r-MBF of the areas perfused by severe stenotic vessels (greater than 90%) was smaller than that of the areas perfused by non stenotic vessels, however there was overlapping of flow. In the dipyridamole induced vasodilative state, the r-MBF of the areas perfused by intact vessels increased approximately 2.4 times of the resting state, and showed good correlation with pressure rate product. In contrast, the r-MBF of the areas perfused by stenotic vessels did not correlate with pressure rate product, but depended on the degrees of coronary stenosis (50-75% stenosis; 1.9 times, greater than 90% stenosis; 1.3 times, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of nipradilol on myocardial energy metabolism in the dog ischaemic heart

The effect of nipradilol, a newly developed beta-adrenoceptor blocking agent with a vasodilatory action, on myocardial energy metabolism has been examined in the dog ischaemic heart, and compared with that of propranolol. Ischaemia was induced by ligating the left anterior descending coronary artery. Either saline, nipradilol (0.3 mg kg-1), or propranolol (1 mg kg-1) was injected intravenously 5 min before coronary ligation. After 3 or 30 min of coronary ligation, the ischaemic region of the myocardium was removed, and the endocardial portion used to determine the levels of adenosine triphosphate (ATP), adenosine diphosphate (ADP), adenosine monophosphate (AMP), creatine phosphate (CrP) and lactate. Ischaemia decreased the levels of ATP and CrP, and increased the levels of ADP, AMP and lactate. Immediately after the injection of nipradilol, rapid falls in blood pressure and heart rate were observed. Pretreatment with nipradilol lessened the decreases in the levels of ATP and CrP and the increases in the levels of AMP and lactate, caused by 3 min of ischaemia, to the same extent as propranolol. However, after 30 min of ischaemia, nipradilol had no effect on myocardial metabolism unlike propranolol. These results indicate that nipradilol can reduce ischaemic influences on myocardial metabolism as well as propranolol, but only in the early stages of ischaemia.

Substance P afferents have synaptic contacts with dopaminergic neurons in the ventral tegmental area of the rat

Synaptic contacts were found between dopaminergic neurons and substance P (SP)-immunoreactive axon terminals in the ventral tegmental area (VTA), by means of the immunoelectron microscopic mirror method. SP-immunoreactive terminals were found to make synaptic contact with VTA neurons exhibiting tyrosine hydroxylase immunoreactivity.

Histaminergic neurons receive substance P-ergic inputs in the posterior hypothalamus of the rat

The synaptic connections between histaminergic neurons and substance P (SP) afferents in the caudal magnocellular nucleus (CM) of the hypothalamus were examined using an immunoelectron microscopic mirror method. SP-immunoreactive (SP-IR) terminals made synaptic contacts with the somata, somatic spines and dendrites of histidine decarboxylase immunoreactive (HDC-IR) neurons. This suggests that SP afferents exert monosynaptic influence on the central histaminergic neuronal system.

[Utility of reinjection method in stress Tl-201 myocardial scintigraphy to assess viability of the infarcted myocardium]

To assess viability of the infarcted myocardium, we performed stress Tl-201 myocardial scintigraphy using reinjection method in 37 patients with old myocardial infarction, and in 13 patients of them, Tl myocardial imagings were performed in resting state on the other day within 4 weeks after this examination. In this method, 111 MBq (3 mCi) of thallium was injected at the peak of exercise and initial and delayed images were acquired, then additionally 37 MBq (1 mCi) of thallium was injected after delayed scanning (reinjection) and we obtained post-reinjection images. Delayed images showed redistribution in 15 patients (41%), and no redistribution in 22 patients (59%). In post-reinjection images, 7 (19%) of 15 patients with redistribution and 3 (8%) of 22 patients without redistribution showed improvement of thallium uptake, in total 10 patients (27%) had additional thallium uptake in infarcted regions. And the degree of thallium uptake in post-reinjection images were almost equal to that in resting images. In conclusion, myocardial imaging using thallium reinjection method may be useful for the assessment of viability of the infarcted myocardium.

In situ hybridization analysis of the somatostatin-containing neuron system in developing cerebellum of rats

We used in situ hybridization histochemistry to examine the postnatal development of the somatostatin (SRIF) synthesizing system in the cerebellum of rats. There are numerous hybridizing neurons from 1 to 9 days after birth. These occur throughout the cerebellum including the developing medulla and cortex except in the external granular cell layer. The lateral cerebellar nucleus also contains SRIF gene-containing cells. The intensity of the signals for SRIF mRNA in the cerebellum decreases with age. There is a drastic decrease in SRIF mRNA in the lateral cerebellar nucleus. SRIF cells cannot be detected in the lateral cerebellar nucleus of adult rats, whereas a small, yet significant number of SRIF cells are scattered in the cerebellar medulla. However, the cerebellum of adult rats still contains a significant number of labeled cells in the granular cell layer, although the intensity for SRIF mRNA decreases from 14 days after birth to adulthood. SRIF gene-expressing cells in the cerebellar cortex are located primarily in the granular cell layer and appear to correspond to Golgi cells judging from their characteristic features. These results are consistent with our previous immunohistochemical study on the decrease of SRIF immunoreactivity in the cerebellum of adult rats. These findings, together with a recent study of transient SRIF receptor-expressing cells in the developing cerebellum suggest that SRIF acts during cerebellar development.

[Evaluation of transient dilation of the left ventricle on exercise thallium-201 scintigraphy]

We have noted that some patients with ischemic heart disease have a pattern of transient dilation of the left ventricle on the immediate post exercise images as compared with 3 hour redistribution images. We assessed correlation between transient dilation of the left ventricle and coronary arteriographic findings in 32 patients with ischemic heart disease and 15 controls. Initial and delayed conventional short axis tomographic images were obtained after reconstruction of 20 projections acquired over 180 degrees. Thirty six radii by every 10 degrees were generated from the center of the middle myocardial images of the short axis. An area surrounded by thirty six points of maximal count on each radius was calculated in initial and delayed images. Transient Dilation Index (TDI) as an index of dilation was determined by dividing an area in initial image by an area in delayed image. There was no difference in TDI between patients with 1 vessel disease and controls, but TDI in patients with two vessel disease and patients with three vessel disease was larger than that in controls. Thus, transient dilation of the left ventricle on exercise Tl scintigraphy was likely to be related to number of stenotic vessel. We concluded that TDI as a simple quantitative index of transient dilation of the left ventricle was useful for detecting multi vessel stenosis.

[An examination of left ventricular peak filling rate and ventricular relaxation rate by simultaneous acquisition of radionuclide ventriculography and left ventricular pressure]

We investigated whether peak filling rate (PFR) obtained from ECG gated radionuclide ventriculography (RNV) reflects left ventricular (LV) relaxation rate or not. Five patients with angina pectoris, 5 patients with old myocardial infarction and 6 controls were studied by simultaneous acquisition of RNV and LV pressure. RNV was performed in modified left anterior oblique position before and during angiotensin II (A II) infusion to elevate their blood pressure about 25 mmHg (A-1) and 50 mmHg (A-2). The data were acquired in a list mode and LV volume curves were reconstructed by forward and backward gating from the R wave of ECG. Actual PFR and corrected PFR by stroke volume (/SV), by end diastolic volume (/EDV), by instantaneous volume (/IV) were calculated from LV volume curve and its first differential curve. LV pressure was simultaneously measured by the catheter-tip micromanometer, and the time constant (T) of assumed exponential decline in LV pressure was calculated as index of LV relaxation rate. Although there was no correlation between actual PFR and T, corrected PFR (/EDV) and PFR (/IV) correlated with T. PFR (/EDV) decreased and T increased during A-1 and A-2. Decrease of PFR (/EDV) corresponded with increase of T. Thus, corrected PFR (/EDV) obtained from RNV reflects the rate of LV relaxation, and was considered to be an useful index to evaluate LV diastolic function.