Endotoxin-induced hypercoagulability: a possible aggravating factor of alcoholic liver disease

The present experiments were designed to study the effect of chronic ethanol consumption on endotoxin toxicity. The intravenous injection of endotoxin produced a more pronounced increase of serum AST and ALT activities in chronic ethanol-fed rats, when compared to controls. The activities of hepatic mitochondrial enzymes, succinate dehydrogenase and cytochrome oxidase, were also distinctly decreased by endotoxin treatment in chronic ethanol-fed rats. Consistent with these biochemical alterations, light and electron microscopic examinations revealed severe liver injury after endotoxin injection in chronic ethanol-fed rats. Furthermore, the increase of blood BUN and creatinine levels accompanied by the degeneration of the renal tubulus and slight infiltration of neutrophils into the glomerule were produced by endotoxin treatment and were more conspicuous in chronic ethanol-fed rats than controls. Therefore, the biochemical and histological evidence indicates that endotoxin markedly potentiates organ injury after chronic ethanol consumption. In addition, a more pronounced decrease in blood antithrombin III activity accompanied by an increase in fibrin degradation product level in blood was recognized in chronic ethanol-fed rats receiving endotoxin, when compared to controls receiving endotoxin. This increase of blood fibrin degradation product level correlated well with the decrease of antithrombin III activity (r = -0.6116; p less than 0.005). These findings of blood antithrombin III activity and fibrin degradation product level indicate that the coagulation-fibrinolysis system is more activated by endotoxin treatment after chronic ethanol consumption. Furthermore, the activation of the coagulation-fibrinolysis system was well correlated with biochemical and histological alterations representing hepatorenal involvement.(ABSTRACT TRUNCATED AT 250 WORDS)

[An experimental study on the severe type of alcoholic liver disease--a pathogenetic role of potentiated activation of complement system by endotoxin after chronic ethanol consumption]

Endotoxemia frequently appears in severe type of alcoholic liver disease. However, we have little knowledge how endotoxin influences the progression of alcoholic liver injury. Thus, to study the causal mechanism for the progression to the severe type of alcoholic liver diseases, endotoxin (0.2 mg/100 g BW, E. Coli O26:B6) was intravenously injected in chronic ethanol-fed rats and controls, and then, rats were sacrificed after 16 hours of endotoxin treatment. The elevation of serum GOT and GPT activities induced by endotoxin was significantly higher in chronic ethanol-fed rats than controls, and these biochemical changes were well correlated with the grade of necrosis of liver histology. Furthermore, in chronic ethanol-fed rats, endotoxin treatment tremendously increased blood BUN and creatinine levels and produced the degeneration of renal tubuli with neutrophil infiltration into glomerulus. These experimental findings are very similar to the severe type of alcoholic liver disease. On the other hand, endotoxin significantly decreased serum values of CH50 in chronic ethanol-fed rats, but not in controls. Such alterations of CH50 induced by endotoxin were well correlated with the several parameters indicating the injury of liver and kidney. Therefore, the present study may indicate that chronic ethanol ingestion aggravates endotoxin-induced organ injury, and that the activation of complement system may associate with such progression of organ injury.

Heparin and heparan sulfate partially inhibit induction of acetylcholine receptor accumulation by nerve in Xenopus culture

It has been demonstrated that ACh receptors in Xenopus nerve-muscle cultures migrate in the membrane to the nerve contact area during junction formation (Anderson et al., 1977) and that "diffusion trapping" is the major mechanism for nerve-induced receptor accumulation (Kidokoro and Brass, 1985; Kuromi et al., 1985; Kidokoro et al., 1986). A crucial remaining question is how the nerve induces the trap for randomly diffusing ACh receptors. In this study we examined the effect of various glycosaminoglycans in the culture medium on the nerve-induced receptor accumulation and found that heparin and heparan sulfate partially inhibited nerve-induced receptor accumulation, but similar molecules, chondroitin sulfate type A and type C, did not. By chemical modification of heparin we also showed that N-sulfate residues and a large-molecular-weight molecule are essential for this inhibitory effect. Heparin did not affect ACh receptor clustering (hot-spot formation) in myocytes cultured without nerve. By changing the time and duration of heparin application, we found that heparin was effective in inhibiting nerve-induced receptor accumulation only when it was present in the culture medium during the period that neurites are actively forming contact with muscle membrane.

[Usefulness of partial splenic embolization (PSE) in hepatocellular carcinomas showing a risk of gastrointestinal bleeding after transcatheter arterial embolization (TAE)]

We have examined 103 patients with a hepatocellular carcinoma (HCC) who were treated by transcatheter arterial embolization (TAE) with a partial splenic embolization (PSE) (n = 5) or without a PSE (n = 98). It was found that gastrointestinal (GI) bleeding after TAE occurred in 10 (10.2%) out of the 98 TAE patients and within 10 days after the TAE. In these GI bleeding after TAE patients, the platelet counts were significantly low and marked splenomegaly was seen. It also was found that there was a risk of GI bleeding after TAE in cases showing thrombocytopenia (less than 50,000/microliters) and marked splenomegaly with a splenic index of more than 50. In 5 patients with a high risk of GI bleeding, for whom a PSE was performed, the platelet counts were markedly increased even four weeks after the TAE. The survival rate of TAE patients given a PSE was significantly higher than in TAE patients manifesting a risk of GI bleeding. From these results, it would seem that TAE patients given a PSE is the better therapy for HCC patients manifesting a risk of GI bleeding.

Characteristics of L- and T-type Ca2+ currents in canine cardiac Purkinje cells

Two types of Ca2+ currents were recorded in single dialyzed canine cardiac Purkinje cells using a whole cell voltage clamp technique. T-type current was easily separated from L-type current, because its voltage dependence of inactivation and activation was more negative and it decayed rapidly. L-type current was available at more depolarized holding potentials, activated at more positive voltages, and decayed slowly. In 2 mM extracellular Ca2+ concentration [( Ca]o), the average peak T- and L-type current density was 1.70 and 2.87 pA/pF, respectively. T-type current was relatively insensitive to modification by Ca2+, nifedipine, Cd2+, BAY K 8644, or isoproterenol. T-type current was more sensitive to block by Ni2+ and amiloride. Replacement of Ca2+ by Ba2+ or Sr2+ did not increase T-type current. Changes in the Ca2+ or Ba2+ concentration caused parallel shifts in the voltage dependence of several kinetic parameters for L- and T-type current. In 2 mM [Ca]o, the V1/2 (Boltzmann fit) for inactivation of T-type current was -68 mV with a slope of 3.9, and for L-type current the V1/2 was -31 mV with a slope of 5.5. Recovery from inactivation of L- and T-type current was voltage dependent, and for similar conditions L-type current recovered from inactivation more rapidly than T-type current. These findings show that T- and L-type currents are large in cardiac Purkinje cells, and they can easily be separated by their voltage, kinetic, and pharmacological differences. Both may have important physiological roles.

Lithocholate in liver tissue with obstructive jaundice

The existence of tissue-bound lithocholate in liver tissue was first suggested by Nair et al. (Lipids 1988;12:922-929). Since lithocholate is well known to be cholestatic, we investigated whether tissue-bound lithocholate, if present, can be correlated to liver dysfunction in obstructive jaundice. Tissue-bound lithocholate in liver tissues of 7 patients with obstructive jaundice was analyzed using gas chromatography-mass spectrometry-selected ion monitoring. We found no accumulation of lithocholate, including tissue-bound form, indicating that the role of lithocholate in inducing hepatic dysfunction in obstructive jaundice is minimal, if any.

[Focal sparing around the gallbladder in fatty liver: an useful sign in the diagnosis of borderline cases by CT]

The role of CT in the diagnosis of fatty liver is well established. CT has been proved to be a useful noninvasive tool for the demonstration of fatty infiltration of the liver. The characteristic finding is a diffuse decrease in the attenuation within the liver compared with that of the spleen. Commonly, fatty infiltration of the liver is generalized and both CT scans and sonograms can easily demonstrate changes related to this condition. Sometimes, fatty infiltration of the liver is focal and occasionally, it is generalized with focal sparing of the normal liver tissue creating some problems in the diagnosis. Recently, some reports have mentioned the appearance of a focal sparing area in the generalized fatty liver. We often found a high attenuation region around the gallbladder bed in the fatty liver patients on CT examination. There appears to be some relationship between the high density around the gallbladder area and the fatty liver. A retrospective study was undertaken to evaluate the relationship. In this paper, we presented the CT scans of 57 fatty liver cases and compared them with the CT scans of 50 normal patients to discuss the possible cause of the phenomenon and its usage in the diagnosis of the fatty liver.

[Alteration of prostaglandin metabolism in alcoholic liver disease: its association with platelet dysfunction after chronic alcohol ingestion]

Recently, hepatic microcirculation has been focused on as an important pathogenic factor in progression of alcoholic liver disease (ALD). Therefore, blood levels of several prostaglandins, which are associated with organ microcirculation, were determined in various liver diseases, including ALD. Blood thromboxane B2 (TXB2) level was significantly increased in ALD, when compared to other types of liver diseases, whereas both 6-keto prostaglandin F1 alpha (6-keto PGF1 alpha) and prostaglandin E were not changed. These consequences resulted in the imbalance of 6-keto PGF1 alpha to TXB2, which might promote platelet aggregation and blood vessel contraction. Indeed, the increase of beta-thromboglobulin and platelet factor 4 in blood was observed in ALD. Furthermore, in ALD, the rate of arachidonate-induced platelet aggregation was prominently enhanced, and malondialdehyde production in platelet, which was well correlated with blood TXB2 levels, significantly increased. Thus, the present study may indicate that, in ALD, hyper-aggregability of platelet is produced, because of the derangement of prostaglandin metabolism and platelet dysfunction.

[Accumulation of 99mTc-phosphorous compounds in primary hepatic tumors associated with hypercalcemia]

In present study, in two cases with hepatocellular carcinoma and cholangioma associated with hypercalcemia, the accumulations of 99mTc labeled phosphorous compound in the primary lesion were demonstrated and its mechanism was discussed.

Enzyme-catalyzed synthesis of a bioactive oligopeptide in nearly anhydrous solvents with polyethylene glycol-modified proteases

An oligopeptide, L-arginyl-glycyl-L-aspartyl-L-serine, having cell attachment activity was synthesized from the respective aminoacids carrying suitable protecting residues, by using carboxymethyl polyethylene glycol (PEG)-modified proteases in organic solvents. Papain, trypsin, and alpha-chymotrypsin were modified with PEG. Organic solvents used were 1,1,1-trichloroethane, chloroform and chloroform/ethyl cellosolve (1:1) mixture. Identification of the products was done by gel permeation chromatography (GPC) and thin layer chromatography (TLC).

[Experimental Candida albicans chorioretinitis]

The long term (12 months) clinical and histopathological features of experimental chorioretinitis induced by intravenous injection of Candida albicans (5-10 x 10(6) spores) in pigmented rabbits were reported. Nine of 26 animals developed bilateral and 11 of 26 animals unilateral chorioretinal lesions. The lesions were round, yellow-white spots initially growing with a fluffy border, and breaking into the vitreous body. Finally, the lesions became chorioretinal scars with bridging strands in the vitreous body. Histologically, the initial lesions were subretinal microabscesses of pseudoeosinophils with PAS-positive spores, then macrophages invaded and typical granuloma with epithelioid and multinucleated giant cells developed. One year after the inoculation, focal chorioretinal scars with vitreous strands were found.

Biochemical changes before and during oral calcium tolerance test in calcium stone formers

116 normocalcemic and 8 primary hyperparathyroid (PHPT) patients with calcium (Ca) nephrolithiasis and 10 normal controls underwent 1 g of oral Ca tolerance test following 4 days of Ca restricted diet (400 mg/day). On the basis of urinary Ca/creatinine (Cr) ratio obtained by the test, the 116 patients with normocalcemic nephrolithiasis were divided into 3 groups (normocalciuric nephrolithiasis; NN, absorptive hypercalciuria; AH, renal hypercalciuria; RH) according to our criteria which were slightly modified from Pak et al. Changes in urinary Ca/Cr ratio, and those in serum Ca and phosphorus (P), tubular maximum reabsorption of phosphate/glomerular filtration rate (TmPO4/GFR), nephrogenous adenosine 3',5'-monophosphate (NcAMP) and plasma immunoreactive parathyroid hormone (iPTH) were determined. As a result, the 116 patients were divided into 82NN, 13AH and 21RH. In general, a rise in serum Ca and fall in NcAMP were seen first, followed by rises in urinary Ca/Cr ratio, serum P and TmPO4/GFR although the changes were small. The group PHPT showed abnormality in the changes of TmPO4/GFR, NcAMP and plasma iPTH. The former one decreased constantly during the test and the latter two did not fall to within the normal range, suggesting parathyroid autonomy or abnormal suppressibility. Regarding the normal controls, all the changes were smallest among the 5 groups and clear parathyroid suppression was not observed while it was seen in the groups NN, AH and RH. In conclusion, oral Ca tolerance test is useful not only to separate NN, AH and RH, but also for the diagnosis of PHPT by demonstrating parathyroid autonomy or abnormal suppressibility assessed by NcAMP and/or TmPO4/GFR.

Barium-induced automatic activity in isolated ventricular myocytes from guinea-pig hearts

1. A suction-pipette whole-cell clamp technique was applied to single ventricular myocytes isolated from guinea-pig hearts, in order to investigate the ionic mechanism underlying Ba2+-induced automatic activity. 2. The application of 0.1 mM or less Ba2+ to the myocytes caused a depolarization of the resting membrane potential without inducing spontaneous activity. The stimulated action potential showed a prolonged repolarization phase followed by an after-hyperpolarization. 3. Concentrations of Ba2+ of 0.2 mM or greater produced further depolarization of the resting membrane potential and induced spontaneous activity. Spontaneous activity developed from the slow diastolic depolarization preceded by after-hyperpolarizations of spontaneous or stimulated action potentials. 4. Under voltage-clamp conditions, a decaying outward or inward current in response to hyperpolarizing clamp steps from depolarized potentials appeared in the presence of Ba2+. The Ba2+-induced current decay showed a faster time course with increasing hyperpolarizing clamp pulses and reversed its polarity at around -90 mV, the presumed equilibrium potential for K+ (EK). In the late current-voltage (I-V) relation, Ba2+ almost eliminated the inward-rectifying property. These effects on the cardiac membrane are consistent with a time- and voltage-dependent blocking action of Ba2+ on inward-rectifying K+ currents as reported for other excitable tissues. 5. The concentration- and voltage-dependence of the steady-state block of the inward rectifying K+ current (IK1) was fitted by a simple model assuming 1:1 binding of Ba2+ to a site within the membrane. The apparent dissociation constant at the holding potential of 0 mV (K(0] was 0.3 mM, and the parameter for the membrane potential dependence of Ba2+ blockade (mu) was approximately 0.5. 6. A computer model of the ventricular action potential proposed by Beeler & Reuter (1977) was modified, based on the recent experiments using single cardiac myocytes. The modifications include (1) the current-voltage relationship of IK1, (2) time courses of activation and inactivation of the Ca2+ current (ICa), (3) the activation voltage range for the delayed outward K+ current (IK). 7. The time- and voltage-dependent blocking action of Ba2+ on IK1, including the experimentally determined values for K(0) and mu, were incorporated into the modified version of the action potential model. The computer model reproduced an after-hyperpolarization at doses of Ba2+ lower than 0.1 mM and automatic activity at doses higher than 0.15 mM.(ABSTRACT TRUNCATED AT 400 WORDS)

Destructive calcium pyrophosphate dihydrate temporo-mandibular arthropathy (pseudogout)

A case of a 57-year-old man with destructive calcium pyrophosphate dihydrate (CPPD) arthropathy (pseudogout) together with pseudotumor formation in the temporomandibular joint (TMJ).

Analysis of 3-sulfated and nonsulfated bile acids by one-step solvolysis and high performance liquid chromatography

A facile solvolysis procedure of 3-sulfated bile acid was devised using trifluoroacetic acid, tetrahydrofuran, and methanol. The sulfate esters were completely solvolyzed within only 2 hr by the present method. The clinical utility of the solvolysis procedure and high performance liquid chromatography using immobilized 3 alpha-hydroxysteroid dehydrogenase was demonstrated in the analysis of bile acids in serum of patients with obstructive jaundice. The quantities of 3-sulfated bile acids were calculated from the difference in the amount of bile acids before and after solvolysis. A significantly large proportion of 3-sulfated glycochenodeoxycholic acid, i.e., 21.9 to 31.3% of total glycochenodeoxycholic acid, was found in the serum of patients with obstructive jaundice. Thus, the present method permits simultaneous quantitation of 3-sulfated as well as nonsulfated bile acids in biological samples.

Effect of acetylcholine on aconitine induced delayed afterdepolarisation in the frog atrium and ventricle

The effect of acetylcholine on the aconitine induced delayed afterdepolarisation and triggered electrical activities under nominally calcium free conditions were studied in frog atrium and ventricle. The changes in intracellular potassium activity were also examined. The aconitine induced delayed afterdepolarisation and triggered electrical activities in atrial muscles were transiently suppressed by acetylcholine. This inhibition was correlated with the time course of the development of hyperpolarisation in the resting membrane potential during acetylcholine application. Propranolol did not abolish the transient inhibition of delayed afterdepolarisation during continuous application of acetylcholine, whereas atropine completely inhibited this effect of acetylcholine. Intracellular potassium activity decreased with time after acetylcholine application, whereas the resting potential became hyperpolarised at an early stage, showing slow recovery thereafter. These results indicate that the transient inhibition of delayed afterdepolarisation by acetylcholine is associated with transient hyperpolarisation of the membrane potential, which is assumed to be caused by potassium accumulation or desensitisation of the muscarinic receptor, or both.

[Liver metastasis of thymoma--report of two cases]

We experienced two cases of liver metastasis resulting from thymoma, which is reported to be rare in Japan. Case 1 was a 57-year-old man who was admitted because of hepatomegaly. US, CT and angiography revealed multiple tumors in the liver which were thought to be liver metastasis from an unknown origin. He died of cardiac tamponade one year later. An autopsy revealed thymoma with metastasis to the liver, lung and pericardium. Case 2 was a 32-year-old female who visited our hospital complaining of right hypochondriac pain, US detected several large hyperechoic masses in the liver. A us-guided liver biopsy confirmed metastasis from thymoma. Histological tests of the liver of these two cases showed epithelial type of thymoma.

Development of capillary networks from rat microvascular fragments in vitro: the role of myofibroblastic cells

A new model useful for studying capillary growth in vitro is described. When the microvessel fragments and accompanying single cells (myofibroblastic cells) from rat epididymal fat pads were co-cultivated, the myofibroblastic cells initially began to grow and reached confluence. A few days later, endothelial cells started to sprout from the vessel fragments, forming cellular cord networks on and in the multilayered myofibroblastic cells. Ultrastructurally, the lumina, surrounded by the endothelial cells having intercellular junctions, were observed at cross-sectioned cellular cords. The growth of cellular cords from the fragments always occurred after the myofibroblastic cells had reached confluence. The medium conditioned to isolated rat myofibroblastic cells stimulated not only the proliferation of the endothelial cells from the bovine capillary and human vein but also the migration of bovine capillary endothelial cells in vitro. Moreover, the extracellular matrix produced by rat myofibroblastic cells modulated the morphology of bovine capillary endothelial cells to a cordlike shape. These observations strongly suggest that the formation of the capillary in vitro is induced by myofibroblastic cells.

Aconitine-induced delayed afterdepolarization in frog atrium and guinea pig papillary muscles in the presence of low concentrations of Ca2+

Aconitine will induce arrhythmias after the fiber has been completely repolarized. This arrhythmia is generally facilitated in the presence of high Ca2+ solution, yet the aconitine-induced arrhythmia occurs even in the presence of low Ca2+ solutions. We studied aconitine-induced arrhythmia (particularly the amplitude of delayed afterdepolarization) in the frog atrium or guinea-pig papillary muscles in Ca2+-free solution, in the presence or absence of Ca2+ channel blocking agents. In Ca2+-free solution, aconitine (10(-5) g/ml) decreased the resting potential, overshoot, Vmax, and shortened the duration of the 90% action potential, before the onset of delayed afterdepolarization in frog atrial preparations. Tetrodotoxin (TTX) (2 X 10(-7) g/ml) blocked these aconitine-induced electrical changes. Verapamil (10(-6) g/ml) in nominally Ca2+-free solution blocked neither the generation of delayed afterdepolarization nor the triggered activity, while LaCl3 (0.5 mM) or TTX halted it. Delayed afterdepolarization appeared following the aconitine-induced transient increase in twitch tension. This transient increase in twitch tension was blocked by LaCl3 and TTX but not by verapamil. Delayed afterdepolarization in Ca2+-free solution demonstrated the voltage dependence of a U shape between -40 and -80 mV and was inhibited by low Na+ and high K+. Under the influence of aconitine in the guinea pig papillary muscle exposed to the Ca2+-free solution, depolarizing clamp pulses produced a transient inward current, and here the sigmoid time- and voltage-dependent characteristics were similar to those seen in the case of digitalis intoxication. These results suggest that intracellular Na+ loading plays an important role in the aconitine-induced delayed afterdepolarization and transient inward currents in low Ca2+ solution.

New abnormalities in the morphology, cell surface receptors, and electrolyte metabolism of In(Lu) erythrocytes

The In(Lu) phenotype is inherited as an autosomal dominant trait and is characterized by suppression of the Lutheran, P1, i, and Aua erythrocyte blood group antigens. We have developed a monoclonal antibody (L21) that strongly agglutinates all erythrocytes except In(Lu), and we have identified eight In(Lu) individuals among 42,000 blood donors tested. Studies of two families confirmed the dominant mode of inheritance and revealed several new features of this phenotype. The erythrocytes of all five affected individuals from the two families exhibited diminished hemagglutination by the lectin concanavalin A, although they reacted normally with several other lectins. The erythrocytes of two affected individuals in one family exhibited marked acanthocytosis. The erythrocytes of the proposita of the other family exhibited a mild degree of poikilocytosis, but the cells of the other two affected individuals in this family had normal morphology. The osmotic fragility of fresh In(Lu) erythrocytes was normal, but after incubation for 24 hours at 37 degrees C in plasma the In(Lu) cells exhibited a marked increase in resistance to osmotic lysis. During the incubation period the erythrocytes lost K+ and their total cation content was diminished. These data indicate that in addition to the suppression of blood group antigens noted previously, the In(Lu) phenotype includes a variety of morphological abnormalities and a defect in electrolyte metabolism. The use of L21 and similar monoclonal antibodies provides a more sensitive means of detecting In(Lu) erythrocytes than typing with human anti-Lub antisera.

Possibility of elevated parathyroid function in patients with calcium-containing nephrolithiasis as compared with normal controls

109 patients with calcium-containing nephrolithiasis and 10 normal controls underwent oral calcium load test. After thorough examination, 6 of the 109 patients were diagnosed as having primary hyperparathyroidism (PHPT) and the remainder as having normocalcemic nephrolithiasis without PHPT. Following the oral calcium load test, the latter were operationally divided into 3 groups - normocalciuric nephrolithiasis (NN), n = 78; absorptive hypercalciuria (AH), n = 10, and renal hypercalciuria (RH), n = 15 - according to the criteria reported by Pak et al. Before the oral calcium load test, nephrogenous adenosine 3',5'-monophosphate (NcAMP), urinary adenosine 3'-5'-monophosphate (urinary cAMP), and plasma immunoreactive parathyroid hormone (iPTH) were determined to evaluate parathyroid function. This function, as assessed by mean basal NcAMP in the NN, AH and RH groups as well as the PHPT group, was significantly increased as compared with that in the normal controls. Within the NcAMP-elevated 4 groups, the mean basal NcAMP was highest in the PHPT group followed by the RH, AH and NN groups. In view of the mean basal NcAMP, disregarding the PHPT group, the NN and AH groups seemed to be intermediate types between the normal controls and the RH groups. Similar, but less distinctive results were obtained in the determination of urinary cAMP and plasma iPTH. On the other hand, when leaving the PHPT group out, the mean basal urinary calcium creatinine ratio (Ca/Cr) was highest in the RH group followed by the AH and NN groups, and lowest in normal controls, suggesting that the NN and AH groups were intermediate between normal controls and the RH group. The mean basal urinary Ca/Cr ratio in the PHPT group was moderately elevated but not remarkable. Almost similar tendencies were observed in 24-hour urinary calcium excretions on a calcium-restricted diet. A weakly positive correlation (r = 0.232, p less than 0.05) between basal NcAMP and basal urinary Ca/Cr ratio was observed in accumulated cases of the NN, AH and RH groups, whereas a negative correlation (r = -0.664, p less than 0.05) was obtained in normal controls. It is concluded that a possible abnormal calcium metabolism is suggested in stone formers without PHPT. Additionally, it is speculated that 'relative hypercalciuria' in NN and hypercalciuria in AH and RH might be accounted for in a single line of a primary renal leak of calcium.

Changes in passive electrical properties of guinea-pig ventricular muscle exposed to low K+ and high Ca2+ conditions

Changes in passive electrical properties of guinea-pig papillary muscle exposed to low K+, high Ca2+ conditions were examined using a single sucrose gap technique. While quiescent preparations exposed for 5 mins did not develop delayed afterdepolarizations, those placed in the test solution for 30 mins with or without stimulation developed afterdepolarizations. Changes occurring during a short exposure to low K+, high Ca2+ solution were increases in membrane resistance, membrane time constant and space constant by 47%, 83% and 17% compared with the control, respectively. There were no significant changes in internal longitudinal resistance and membrane capacity. During long exposure to the test solution (30 mins), delayed afterdepolarizations developed. There were similar increases in membrane resistance and in time constant as found during the short exposures. Internal longitudinal resistance was calculated to have increased by 24% during the long exposure. A 19% increase in membrane capacity was also found during the test condition. High Ca2+ or low K+ alone did not cause a significant increase in internal longitudinal resistance. The conduction velocity in the longitudinal direction decreased from 107 +/- 23 cm/s during the control to 80 +/- 7 cm/s during the test period for 30 mins. These results suggest that, in addition to the abnormal impulse formation based on afterdepolarizations, low K+, high Ca2+ solution changes the passive electrical properties of the fibers, resulting in a lower rate of impulse conduction.

Changes in K+ currents induced by Ba2+ in guinea pig ventricular muscles

Effects of Ba2+ on the K+ currents of guinea pig ventricular muscle were studied using the single sucrose-gap voltage-clamp technique. Ba2+ decreased the late (1- or 2-s) current at any potential level, with stronger suppression in the slope conductance at resting potential level than at depolarized voltages above 0 mV. During depolarizing pulses beyond -40 mV, Ba2+ reduced both the time-dependent and time-independent current components, indicating suppression of both outward and background K+ currents (IK and IK1, respectively), whereas tail currents after repolarization to -40 mV increased, with their time courses having double exponentials. These apparent conflicting results between IK and the tail current could not be explained by extracellular K+ fluctuation, because 20 mM Cs+ alone depressed both factors, but an additional application of Ba2+ caused an increase in both components compared with those in the former condition. On hyperpolarization below -60 mV, a time-dependent decrease in the inward current was observed after Ba2+ application without an activation of If. The decrease was stronger and faster at negative potential levels. These results are compatible with a time- and voltage-dependent blocking action of Ba2+ on the inward rectifier K+ current reported in other cardiac and noncardiac tissues. In two components of the tail currents after repolarization from depolarizing voltage steps during Ba2+ application, the faster one can probably be attributed to this blocking action of IK1, whereas the slower one can be attributed to the deactivation of IK. This time-dependent component of IK1 may contribute to the generation of Ba2+-induced automaticity at the depolarized state.

[Recent advances in mammographic diagnosis with respect to its technical aspects]

Technological advance has made remarkable improvements in image quality in the field of X-ray mammography which ensure to successful management of breast cancer in Japan. We convince simple mammographic technique is the state of arts in early detection of the curable breast cancer, however, attempts for further progress with respect to technology and its medical applications should be performed. Our fundamental and clinical works on this theme were presented here.

Effect of spironolactone on fluid volumes and adrenal steroids in primary aldosteronism

Plasma volume (PV) and extracellular fluid volume (ECF) were determined in 7 patients with essential hypertension (controls) and in 10 patients with primary aldosteronism, while on a high Na diet (342 mEq/day) and on a low Na diet (12 mEq/day). The volume studies were repeated in 6 of the primary aldosteronism patients during treatment with spironolactone for over 3 months. Plasma renin activity (PRA), plasma aldosterone concentration (PAC), cortisol concentration, and serum Na and K concentrations were measured in all patients while on a Na-restricted diet (85 mEq/day) as well as on high-Na and low-Na diets. There were no significant changes in arterial pressure during different Na diets in any groups of patients with essential hypertension, or primary aldosteronism with and without spironolactone therapy. Spironolactone treatment normalized the arterial pressure in patients with primary aldosteronism at all Na intakes. These patients had greater values for PV and ECF than did those with essential hypertension. Spironolactone treatment reduced PV during the low-Na diet, but did not alter it during the high-Na diet. Spironolactone did not produce significant changes in ECF during either the high-Na or low-Na diets. Although there were no changes in PV and ECF in patients with primary aldosteronism due to changes in Na intake, both PV and ECF were significantly less in these patients during spironolactone treatment and in patients with essential hypertension during low-Na intake than during high-Na intake. With primary aldosteronism, PRA was depressed and PAC was elevated when compared to essential hypertension, these were not altered by different Na diets in the patients with primary aldosteronism as they were in those with essential hypertension. During treatment with spironolactone the PRA was restored to normal and showed normal changes with variations in dietary Na, but PAC remained elevated during spironolactone. Plasma cortisol was the same among those with essential hypertension and patients with untreated and spironolactone-treated primary aldosteronism. Serum K was less in untreated primary aldosteronism during all Na diets than in essential hypertension, but during spironolactone it was restored to normal. These results suggest that in primary aldosteronism the reduction in arterial pressure by spironolactone treatment does not occur simply by reductions in body fluid volumes. The long-term treatment of patients with primary aldosteronism with spironolactone does not inhibit the production of aldosterone, possibly because of enhanced activity of the renin-angiotensin system and an increase in serum K.

Circus-movement tachycardia in frog atrium monitored by voltage-sensitive dyes

Circus-movement tachycardia was studied using voltage-sensitive merocyanine-rhodanine dyes (dye XVII and NK2761). Excitatory waves were optically measured simultaneously from eight different regions of a ring of tissue formed from frog atrium. Application of acetylcholine in Ca2+-free solution (10(-10)-10(-9) g/ml) shortened the duration of optical action signals to cause nonuniform change in optical signal durations in about 60% of the preparations. Circus-movement tachycardia was produced by proper reduction and regional nonuniformity of optical signal durations. Under these circumstances it is easy to evoke circus-movement tachycardia by giving an extra stimulus to the site that shows a difference in optical signal durations.