Ingestion of medium chain fatty acids by lactating dairy cows increases concentrations of plasma ghrelin

The purpose of this study was to elucidate the effects of medium-chain fatty acids (MCFAs) on plasma ghrelin concentration in lactating dairy cows. Five early-lactating Holstein cows were randomly assigned to 2 dietary treatments in a crossover design with 2-wk periods. Treatments consisted of diets supplemented or not (control) with calcium salts of MCFAs (MCFA-Ca; 1.5% dry matter). Plasma hormone and metabolite concentrations in blood samples taken from the jugular vein were measured on the morning of feeding on day 14 of each period. Dry matter intake, milk protein, and lactose content of cows fed the MCFA-Ca diet were decreased compared with controls, but with no change in milk yield. Plasma ghrelin concentrations were higher in cows fed the MCFA-Ca diet; however, no significant effect was found on glucagon-like peptide-1 concentrations in plasma. Plasma insulin concentrations decreased, but plasma glucagon concentrations remained unchanged in cows fed the MCFA-Ca diet. The concentrations of nonesterified FAs, total cholesterol, and β-hydroxybutyrate in plasma increased in these cows. In conclusion, dietary MCFAs increase the plasma ghrelin concentrations in lactating dairy cows.

Effects of calcium salts of long-chain fatty acids and rumen-protected methionine on plasma concentrations of ghrelin, glucagon-like peptide-1 (7 to 36) amide and pancreatic hormones in lactating cows

Our objective was to determine the effects of calcium salts of long-chain fatty acids (CLFAs) and rumen-protected methionine (RPM) on plasma concentrations of ghrelin, glucagon-like peptide-1 (7 to 36) amide, and pancreatic hormones in lactating cows. Four Holstein cows in midlactation were used in a 4 by 4 Latin square experiment in each 2-wk period. Cows were fed corn silage-based diets with supplements of CLFAs (1.5% added on dry matter basis), RPM (20 g/d), CLFAs plus RPM, and without supplement. Jugular blood samples were taken from 1 h before to 2 h after morning feeding at 10-min intervals on day 12 of each period. CLFAs decreased dry matter intake, but RPM did not affect dry matter intake. Both supplements of CLFAs and RPM did not affect metabolizable energy intake and milk yield and composition. Plasma concentrations of NEFAs, triglyceride (TG), and total cholesterol (T-Cho) were increased with CLFAs alone, but increases of plasma concentrations of TG and T-Cho were moderated by CLFAs plus RPM. Calcium salts of long-chain fatty acids increased plasma ghrelin concentration, and the ghrelin concentration with CLFAs plus RPM was the highest among the treatments. Plasma concentrations of glucagon-like peptide-1, glucagon, and insulin were decreased with CLFAs, whereas adding RPM moderated the decrease of plasma glucagon concentration by CLFAs. These results indicate that the addition of methionine to cows given CLFAs increases plasma concentrations of ghrelin and glucagon associated with the decrease in plasma concentrations of TG and T-Cho.

Characteristics of developmental changes in the kinetics of glucose and urea in Japanese Black calves: Comparison with Holstein calves1

The current study was conducted to clarify the characteristics of glucose and urea kinetics in male Japanese Black calves, using a glucose and urea dilution method with stable isotopes, at preweaning (3 wk of age) and postweaning (13 and 26 wk of age) stages, in comparison with the kinetics of glucose and urea in male Holstein calves. Six Japanese Black and 6 Holstein calves were arranged in a 2 (breed) x 3 (stage) factorial block design. These 12 suckling calves were fed only whole milk, offered concentrate and or chardgrass hay after 3 wk of age, and weaned at 6 wk of age. Under steady-state conditions, glucose challenges (1.0 mg/kg of BW; [U-13C]d-glucose) and urea challenges (both 2.2 mg/kg of BW; [13C]urea and [15N2]urea) were performed at the 3 stages examined. There were no significant differences in plasma glucose concentrations between Japanese Black and Holstein calves at any stage, but the glucose concentrations at 3 wk of age were greater (P <0.05) than those at 13 wk of age in both breeds. The glucose pool size in Japanese Black calves was smaller (P <0.05) than that in Holstein calves at all stages. Within each breed, there were no significant differences between the glucose pool sizes at 3 and 13 wk of age, but the glucose pool size was larger (P <0.05) at 26 wk of age. Moreover, Japanese Black calves had greater glucose irreversible loss rates (P <0.01) than Holstein calves at 3 wk of age, and the glucose irreversible loss rates were less (P <0.05) on and after 13 wk of age in both breeds. Japanese Black calves had greater plasma urea N concentrations (P <0.05) than Holstein calves at all stages, and in both breeds, the urea N concentrations increased (P <0.05) with age. The urea pool size was smaller (P <0.01) in Japanese Black calves than in Holstein calves at all stages, and in both breeds, the urea pool size increased (P <0.05) with age. In comparison with Holstein calves, Japanese Black calves had greater urea irreversible loss rates (P <0.05) on and after 13 wk of age and greater urea recycling rates (P <0.05) at 26 wk of age. In addition, in both breeds, urea irreversible loss rates and urea recycling rates increased (P <0.05) with age. We conclude that Japanese Black calves have partially different glucose and urea kinetics from Holstein calves and that the kinetics of these metabolites in both Japanese Black and Holstein calves are strongly influenced by weaning.

Plasma Lipid Concentrations in Preruminant Calves Fed Whole Milk with Whey Protein Isolate

The objective was to investigate the acute effects of retinol acetate added to whey protein isolate (WPI) on postprandial changes in plasma retinol (experiment 1) and the acute effects of milk fat added to WPI on triglyceride (TG), chylomicrons and very low density lipoprotein (VLDL), and fatty acid concentrations (experiment 2) in suckling calves at 1 and 6 wk of age. In experiment 1, 16 Holstein male calves were alloted to 2 equal groups. On the days of measurement, the calves were fed at 0900 h whole milk [4% of body weight (BW)] mixed with vitamin A acetate (500,000 IU) with or without WPI (0.04% of BW). At 1 wk of age, significantly higher postfeeding concentrations of plasma retinol were observed in the calves fed milk with WPI. At 6 wk of age, no differences in the plasma retinol concentrations were observed between 2 groups. On the days of measurement in experiment 2, 16 male calves were fed at 0900 h whole milk (4% of BW) with added milk fat prepared by centrifugation from whole milk (2% of BW) with or without WPI (0.04% of BW). The milk supplemented with fat was prepared on the day before the measurement. At 1 wk of age, significant higher postfeeding concentrations of plasma TG concentrations were obtained in the calves fed WPI than in the control calves, immediately after the meal or from 7 h later onward. Plasma chylomicrons and VLDL concentrations at 1 wk of age were significantly higher in the WPI-fed group than in the control group at 8 h postfeeding. In the calves with the WPI diet, plasma concentrations of myristic, palmitic, stearic, oleic, and linoleic acids at 1 wk of age were significantly higher than those in the control calves at 8 h after feeding. However, chylomicrons and VLDL, and fatty acid concentrations did not differ between the 2 groups after feeding at 6 wk of age. Results indicate that WPI increases plasma lipid concentration of preruminant calves only at 1 wk of age. These data are interpreted to indicate that WPI enhances mainly lipid uptake in the intestines of neonatal calves.

Hormonal and Lactational Responses to Growth Hormone-Releasing Hormone Treatment in Lactating Japanese Black Cows

Ten multiparous lactating Japanese Black cows (beef breed) were used to evaluate the effects of bovine growth hormone-releasing hormone (GHRH) analog on milk yield and profiles of plasma hormones and metabolites. The cows received 2 consecutive 21-d treatments (a daily s.c. injection of 3-mg GHRH analog or saline) in a 2 (group) x 2 (period) Latin square crossover design. The 5 cows in group A received GHRH analog during period 1 (from d 22 to 42 postpartum) and saline during period 2 (from d 57 to 77 postpartum), and those in group B received saline and GHRH analog during periods 1 and 2, respectively. Mean milk yield decreased in saline treated compared with that during the 1-wk period before treatment 7.4 and 19.1% during periods 1 (group B) and 2 (group A), respectively. Treatment with GHRH analog increased milk yield 17.4% (period 1, group A) and 6.3% (period 2, group B). Treatment with GHRH analog induced higher basal plasma concentrations of growth hormone (GH), insulin-like growth factor-1 (IGF-1), insulin, and glucose compared with saline-treated cows. In glucose challenge, the GHRH analog-treated beef cows had greater insulin secretion than the saline-treated beef cows. In insulin challenge, however, there were no significant differences in the areas surrounded by hypothetical lines of basal glucose concentrations and glucose response curves between GHRH analog- and saline-treated cows. These results demonstrate that GHRH analog treatment facilitates endogenous GH secretion in lactating Japanese Black cows, leading to increases in milk yield and plasma concentrations of IGF-1, insulin, and glucose.

Metabolic and lactational responses during recombinant bovine tumor necrosis factor-alpha treatment in lactating cows

This study examined the effects of recombinant bovine tumor necrosis factor-alpha (rbTNF) administration on metabolic and hormonal responses and lactational performance in dairy cows. Twelve lactating Holstein cows were injected subcutaneously with rbTNF (2.5 microg per kg per d) or saline (3 ml per head per d) at 1200 h daily for 7 d (d 0-6) and used in a crossover design. The rbTNF treatment induced increases in plasma haptoglobin, nonesterified fatty acid, cortisol, and growth hormone levels compared with the control levels. The rbTNF-treated cows had lower triiodothyronine and insulin-like growth factor-1 concentrations than control cows. In a somatoliberin challenge on d 6, the somatotropin response to somatoliberin (0.25 microg/kg) was smaller in the rbTNF group than in the control. The rbTNF treatment also produced increases of the nitrite plus nitrate concentration in plasma and milk during the period between d 1 and 7. Milk yield was reduced by rbTNF administration from d 1 to 8. The percentage of milk fat was increased on d 1-7 by rbTNF treatment, but milk protein content in the rbTNF group was decreased on d 5 and 7 as compared with that in the control group. These results support the possibility that tumor necrosis factor-alpha is responsible for the changes in hormone secretion, milk production and composition, and inflammatory parameters observed during coliform mastitis.

Alterations in lipid metabolism induced by recombinant bovine tumor necrosis factor-alpha administration to dairy heifers

Endotoxin induces marked changes in lipid metabolism via its effects on cytokines. To evaluate the role of tumor necrosis factor-alpha (TNF) in mediating changes of lipid metabolism in ruminants, we performed a crossover saline-controlled study in Holstein heifers (n = 8; 394.0 kg average BW), investigating the metabolic effects of a single intravenous administration of recombinant bovine TNF (rbTNF, 5.0 microg/kg). Blood samples were taken from a jugular vein at 0 (1100, just before injection), 0.5, 6, 12, and 24 h after each treatment. Dry matter intake in the heifers was not affected by single administration of the rbTNF. The rbTNF produced early as well as later hypertriglyceridemia (P < 0.05) in dairy heifers. The rbTNF also induced an early and sustained rise (P < 0.05) in the plasma NEFA concentration. Plasma retinol concentration was decreased (P < 0.05) at 24 h after rbTNF injection, whereas the a-tocopherol concentration was not significantly affected by rbTNF treatment. At 0.5 and 24 h, there was an increase (P < 0.05) in the plasma concentration of the very-low-density lipoprotein (VLDL) fraction in rbTNF-treated heifers. Between 6 and 24 h after rbTNF treatment, concentration of the low-density lipoprotein fraction declined (P < 0.05) but the high-density lipoprotein fraction was not altered in the rbTNF-treated heifers. These results indicate that TNF produces a hypertriglyceridemic response associated with an increase of the VLDL fraction and a disturbance of retinol metabolism in dairy heifers.

Effect of beta-lactoglobulin on plasma retinol and triglyceride concentrations, and fatty acid composition in calves

Beta-lactoglobulin (beta-lg) is the main protein of ruminant milk whey. Although beta-lg can bind in vitro to a variety of hydrophobic substrates, mainly retinol and long-chain fatty acids, its physiological function is still unknown. In Exp. 1, we investigated the effect of beta-lg on the plasma retinol concentration in preruminant calves. Holstein male calves (n = 20) were fed Holstein whole milk at 40 g/kg body weight (BW) plus vitamin A acetate (500,000 i.u.) with or without beta-lg (0.4 g/kg BW). The plasma retinol concentration of 10-d-old calves was greater (P < 0.05) in the beta-lg-fed group) than in the control group during the period from 8 to 12 h and at 24 h after the feeding. The postprandial change of plasma retinol in 40-d-old calves fed milk with beta-lg was higher (P < 0.05) than that in the control calves only at 12 h after the feeding. In Exp. 2, Holstein male calves (n = 18) were used to investigate the effect of beta-lg on plasma triglyceride concentration and fatty acid composition. Calves were fed Holstein whole milk at 40 g/kg BW plus milk fat prepared from whole milk at 2 g/kg BW with or without beta-lg (0.4 g/kg BW). Plasma triglyceride concentration at age 10 d was higher (P < 0.05) in the beta-lg-fed group than in the controls during the periods from 1 to 2 h and from 7 to 11 h after the feeding. At age 40 d, plasma triglyceride in the beta-lg-fed group was higher (P < 0.05) than in the control group only at 9 h. Ratios of palmitic, stearic, and oleic acids to total plasma lipids were higher (P < 0.05) in the calves fed beta-lg milk than in the control calves at age 10 d. These results suggest that beta-lg enhances the intestinal uptake of retinol, triglyceride, and long-chain fatty acids in preruminant calves.

Profiles of growth hormone and insulin secretion, and glucose response to insulin in growing Japanese Black heifers (beef type): comparison with Holstein heifers (dairy type)

Nine Japanese Black and 10 Holstein heifers ranging from 1 week (wk) to 18 months (mo) old received a single bolus intravenous injection of GH-releasing factor (GRF, 0.25-microg/kg BW), glucose (112.5-mg/kg BW) or insulin (0.2-U/kg BW) at various stages through 18 mo of age. The GH secretory response to exogenous GRF in Japanese Black heifers was lower than that in Holstein heifers at all stages of growth. While insulin secretory function was not very different in both breeds from 1 to 12 mo of age, the insulin response was much higher in Japanese Black heifers than in Holstein heifers after sexual maturation. The degree of decrease in plasma glucose following insulin injection was similar in both breeds at each stage of growth. It is concluded that compared with Holstein heifers, Japanese Black heifers have lower GH and higher insulin secretory functions, and that the two breeds have similar glucose response to insulin.

Lumbar posterolateral fusion alone or with transpedicular instrumentation in L4--L5 degenerative spondylolisthesis

We retrospectively reviewed 57 patients with L4--L5 degenerative spondylolisthesis (L4--L5 DS) who underwent posterior decompression and posterolateral fusion of L4--L5 without (Group A) or with (Group B) transpedicular screw instrumentation at least 2 years earlier. The clinical results and fusion rate were similar between Groups A and B, that is, a 72.4% satisfactory outcome with a fusion rate of 82.8% in Group A versus 82.1% satisfactory outcome with a 92.8% fusion rate in Group B. Screw instrumentation reduced postoperative low back pain and resulted in a lordotic slip angle of L4--L5. However, in patients with radiologically excessive segmental motion showing a translational motion of 3 mm or more, flexion angulation of -5 degrees or less, and a slip angle of -5 degrees or less at the site of spondylolisthesis (L4--L5), the kyphotic slip angle (L4--L5) tended to increase after surgery. In the future, in patients with radiologically excessive segmental motion, this point should be considered, and surgical techniques should be evaluated. Our results suggest that the validity of the general addition of screw instrumentation to L4--L5 fusion for L4--L5 degenerative spondylolisthesis is low.

Insulin resistance induced in dairy steers by tumor necrosis factor alpha is partially reversed by 2,4-thiazolidinedione

The aim of this study was to determine whether 2,4-thiazolidinedione (2,4-TZD) influences the effects of peripheral insulin action in steers given recombinant bovine tumor necrosis factor (TNF) alpha (rbTNF). Steers were treated once daily for 9 d (d0 - d8) with either s.c. injection of rbTNF (2.5 microg/kg), rbTNF + i.v. injection of 2,4-TZD (2.0 mg/kg), or s.c. injection of saline (control). The plasma glucose, NEFA, and insulin concentrations in the rbTNF-treated group increased compared to those in the control and rbTNF + 2,4-TZD groups, whereas glucagon concentration decreased. A single i.v. injection of insulin (0.2 U/kg), glucose (112.5 mg/kg), or growth hormone (GH)-releasing hormone (GHRH) (0.25 microg/kg) was performed on d4, d6, and d8, respectively. In the insulin challenge, the net area under the glucose curve (AUC) was smaller in the rbTNF group than in the control and rbTNF + 2,4-TZD groups. In the glucose challenge, the net insulin AUC was smaller in rbTNF + 2,4-TZD group than in rbTNF group. In the GHRH challenge, there was no difference in GH responses to GHRH between the rbTNF and rbTNF + 2,4-TZD groups, respectively. We conclude that 2,4-TZD treatment partially reverses the impairment of peripheral insulin action caused by rbTNF injection in steers.

Effects of long-term administration of recombinant bovine tumor necrosis factor-alpha on glucose metabolism and growth hormone secretion in steers

OBJECTIVE

To investigate the effects of long-term administration of recombinant bovine tumor necrosis factor-alpha (rbTNF) on plasma glucose and growth hormone concentrations, and to determine whether treatment with rbTNF causes insulin resistance in steers.

ANIMALS

5 steers treated with rbTNF and 5 steers treated with saline (0.9% NaCl) solution (control).

PROCEDURES

In experiment 1, rbTNF (5.0 microg/kg of body weight) or saline solution (5 ml) was administered SC daily for 12 days. Blood samples were obtained before treatment, and plasma was harvested for determination of glucose, insulin, and growth hormone (GH) concentrations. In experiment 2, insulin, glucose, or growth hormone-releasing hormone (GHRH) was administered IV on days 7, 9, and 11, respectively, after initiation of rbTNF or saline treatment in experiment 1. Plasma glucose and insulin concentrations were measured before and at various times for 4 hours after insulin or glucose administration. Plasma GH concentrations were measured at various times for 3 hours after GHRH administration.

RESULTS

In experiment 1, administration of rbTNF resulted in hyperinsulinemia without hypoglycemia and decreased plasma GH concentrations. In experiment 2, plasma glucose concentrations were higher in steers treated with rbTNF and insulin than in controls. Plasma GH concentrations were lower in steers treated with rbTNF and GHRH than in controls.

CONCLUSIONS AND CLINICAL RELEVANCE

Prolonged treatment with rbTNF induced insulin resistance and inhibited GHRH-stimulated release of GH in steers. Results indicate that rbTNF is a proximal mediator of insulin resistance and inhibits release of GH during periods of endotoxemia or infection.

Administration of recombinant bovine tumor necrosis factor-alpha affects intermediary metabolism and insulin and growth hormone secretion in dairy heifers

Four experiments were conducted to clarify the effect of intravenous (i.v.) administration of recombinant bovine tumor necrosis factor alpha (rbTNF) on selected metabolites and on hormone secretion in Holstein heifers (n = 6; 347.0 kg average BW). In Exp. 1, rbTNF was injected at three dosage levels in a Latin square; 0 (CONT), 2.5 (TNF2.5), or 5.0 (TNF5) microg/kg BW. Plasma glucose and triglyceride concentrations were at first elevated (P < .05) by rbTNF treatment and then were decreased (P < .05) by TNF2.5 and TNF5. Plasma NEFA concentrations were increased (P < .05) in rbTNF-treated groups. The injection of rbTNF resulted in an increase in plasma insulin levels (P < .05 with TNF5) during the period between 2 and 24 h, except for the period between 6 and 8 h, after the treatment. In Exp. 2, 3, and 4, each heifer received i.v. injections of glucose (.625 mM/kg BW) + rbTNF (5 microg/kg) or glucose + saline (10 mL) (Exp. 2), insulin (0.2 U/kg) + rbTNF or insulin + saline (Exp. 3), and GHRH (0.25 microg/kg) + rbTNF or GHRH + saline (Exp. 4) at 1-wk intervals. In Exp. 2, rbTNF inhibited (P < .05) glucose-stimulated insulin secretion during the initial phase. Thereafter, plasma insulin was higher (P < .01) with the glucose + rbTNF treatment than with the glucose + saline treatment. Treatment with rbTNF inhibited the insulin-stimulated glucose utilization (Exp. 3) and GHRH-stimulated GH secretion (Exp. 4) during the initial phase. These results suggest that rbTNF directly and(or) indirectly affects the intermediary metabolism and hormone secretion in Holstein heifers.

Potentiation by neurotensin of carbachol-induced tension development in beta-escin-skinned smooth muscle of guinea-pig ileum

Effect of neurotensin (NT) on carbachol(CCh)-induced tension development due to Ca2+ release from intracellular stores was investigated in beta-escin-skinned smooth muscle of guinea-pig ileum. NT (10 nM) increased the tension development in response to CCh. NT also increased the tension response to caffeine, another store-Ca2+ releaser. NT did not exert such an effect in pertusis toxin (PTX)-treated preparations. Treatment with isoprenaline to elevate endogenous cyclic AMP levels or with dibutyryl cyclic AMP did not affect the effect of NT. A nonpeptide NT antagonist, SR 48692, failed to block the effect of NT. NT shifted the pCa-tension relationship in the lower direction of Ca2+ concentration. NT was incapable of releasing Ca2+ from intracellular stores. The results suggest that NT may cause an increase in Ca2+ sensitivity of contractile elements to potentiate the CCh-induced tension development due to release of stored Ca2+ and that the effect is mediated by SR 48692-insensitive NT receptors linked to a PTX-sensitive G protein which works with no relation to a change in cytosolic cyclic AMP levels.

Graft damage after a single lung transplantation for pulmonary hypertension in a rat model

The hemodynamic effect and degree of damage in grafts of single lung transplants for pulmonary hypertension were studied in rats with monocrotaline-induced pulmonary hypertension. Inbred male Lewis rats (weight 200-230 g) were divided into two groups. Group 1 (control group, n = 16) underwent isogenic left lung transplantation, while group 2 (n = 15) received an intravenous administration of monocrotaline (80 mg/kg i.v.) and underwent isogenic left single lung transplantation 3 week later. Hemodynamic evaluations were performed prior to transplantation, at 1 h postoperatively, and on days 3 and 7 after transplantation. Mean pulmonary arterial pressure (mPAP) rapidly declined after transplantation in group 2, from 39.3 +/- 8.7 mmHg to 18.5 +/- 3.0 mmHg 1 h after transplantation, and remained stable on day 7 after transplantation. No significant difference in the mPAP between the two groups was observed after transplantation. The extravascular lung water volume (ELWV: dry/wet ratio) in the right lung of group 2 significantly increased on day 3 (0.86 +/- 0.02) (P < 0.01), and subsequently decreased to control levels on day 7 (0.83 +/- 0.02). There was no significant difference in the ELWV in the grafted lungs between the two groups (0.84 +/- 0.03 vs 0.86 +/- 0.04), but there was tendency toward an increase in ELWV in group 2 on days 3 and 7. These data thus demonstrated that a hemodynamic improvement was obtained by single lung transplantation; however the degree of graft damage was remarkable in the pulmonary hypertension group.

[Clinical treatment with cisplatin (CDDP) in pleural cavity for carcinomatous pleurisy--study of intraarterial concentration]

We investigated the intraarterial concentration of CDDP following continuous hyperthermic pleural perfusion (CHPP, 43 degrees C for 30 to 60 minutes) with 100 mg CDDP diluted in distilled water or saline in 6 lung cancers (2 pleural dissemination, 1 malignant pleural effusion, 3 positive wash cytology), 2 metastatic lung cancer (from breast cancer, 1 rhabdomyosarcoma with pleural dissemination), and 1 metastatic pleural tumor (adenocarcinoma, unknown origin). The level of CDDP was 9.16 to 24.1 micrograms/ml (average 16.1) in perfusion fluid, 0.3 after 5 minutes, 0.41 to 0.85 after 60 minutes and 0.15 to 0.27 (average 0.22) after 24 hours. There were no severe side effects nor any difference in effects by dilution fluid between distilled water and saline. Only 1 patient suffered pleural effusion after this treatment. The results suggested that CHPP with CDDP diluted by saline was effective for prevention and treatment of pleural dissemination.

Sports-related spinal cord injury in Japan (from the nationwide spinal cord injury registry between 1990 and 1992)

The Injury Prevention Committee of the Japan Medical Society of Paraplegia (JMSoP) conducted a nationwide epidemiological survey on spinal cord injury (SCI) using postal questionnaires for 3 years periods from 1990 to 1992, and the annual incidence of the spinal cord injury was estimated as 40.2 per million. From this registry, we investigated SCI related to sports activities. In 3 years, 528 patients were registered and 374 of them had neurological deficits. The incidence was 1.95 per million per annum. Mean age at injury was 28.5 years (10-77), and 88.1% of the patients were males. Diving was the commonest cause of SCI (21.6%), which was followed by skiing (13.4%), football including rugby, American football and soccer (12.7%), sky sports (7.0%), judo (6.8%) and gymnastics (6.6%). Mean age at injury was higher than 30 years in skiing (38.6 years) and sky sports (38.2 years). Cervical injury was predominant in all but sky sports and accounted for 83.5% of SCI. Motor complete paralysis was reported in 35.0% of the patients. Bony injury was observed in 55.9% of the patients; most of the patients who sustained the SCI in diving and sky sports had bony injury, and no bony injury was detected in more than a half of the patients who sustained injuries in skiing, judo or gymnastics. Although the percentage of sports-related SCI was small in the present study as compared to the data from previous reports, it is not difficult to imagine the increase in the number of sports-related SCI. We have launched an injury prevention campaign and are planning to conduct a similar study in future to evaluate the effect of the campaign as well as the changes in the incidence and pattern of SCI.

Prolongation of lung xenograft survival in rats with a short course of deoxyspergualin and cyclosporin A

The efficacy of 15-deoxyspergualin (DSG), cyclosporin A (CyA), and splenectomy--alone or in combination--in prolonging the survival of concordant lung xenotransplants was studied in the hamster-to-rat model. In the untreated group, rejection occurred within 3 days, with an elevation of lymphocytotoxic antibody titers. The rejected lung revealed that ED1 + cells were more prevalent than MRC OX8 + cells in the perivascular infiltrates. In the DSG group, the antibody response was suppressed and median survival increased to 7.5 days. The rejected lungs demonstrated a highly significant depression in ED1 + cellular infiltration and a moderate MRC OX8 + cellular infiltration. When maintenance CyA was combined with a short course of DSG, survival dramatically increased to beyond 100 days. There were no deposits of IgM, IgG, or C3 or of any cell infiltrate in the grafts of two animals sacrificed 107 and 119 days post-transplantation. We conclude that initial treatment with DSG combined with continuous CyA can suppress acute rejection in the hamster-to-rat lung xenograft model, resulting in long-term graft survival.

[Resection and reconstruction of full thickness chest wall]

Nine patients underwent full thickness chest wall resection and reconstruction in our department between January 1981 and December 1994. There were chest wall recurrence of breast cancer in 5 cases, primary chest wall chondrosarcoma in 2, primary chest wall malignant fibrous histiocytoma in 1 and metastatic sternal renal cell carcinoma in 1. Seven of 9 cases underwent partial sternal resection. Sizes of chest wall defects were from 10 x 7 cm to 15 x 14 cm. In eight cases of 9, chest wall reconstruction was by double Marlex mesh repairs and various flaps (major pectoral muscle in 3, major pectoral myocutaneous flap in 2, latissimus dorsi myocutaneous flap in 1 and pedicled omentum in 1). The last case underwent repair with rectus abdominis myocutaneous flap without mesh. There was no operative death. Postoperative complications occurred in 4 patients: partial skin necrosis in 2, skin dehiscence in 1 and respiratory failure in 1. Eight cases are alive now from 9 months to 14 years and 8 months after chest wall reconstruction. One patient with metastatic renal cell carcinoma died of recurrence 3 years after operation. Full thickness chest wall resection and reconstruction is a safe operation and may provide a long-term survival.

Long-term follow-up of cervical spondylotic myelopathy treated by canal-expansive laminoplasty

We have studied 29 patients for at least five years after canal-expansive laminoplasty for cervical spondylotic myelopathy. The short- and long-term clinical results were compared, and successive radiographs assessed. The long-term clinical outcome was excellent in five patients, good in 12, fair in 11 and poor in one. The mean short- and long-term improvements were 54.4% and 48.5% but patients with focal kyphotic, kyphotic and S-shaped cervical spines did less well, as did those who had a decrease in the index of curvature of the cervical spine of more than 10 at follow-up. Canal-expansive laminoplasty with reconstitution of the posterior soft tissues may help to prevent postoperative malalignment and late neurological deterioration.

Long-term follow-up of cervical spondylotic myelopathy treated by canal-expansive laminoplasty

We have studied 29 patients for at least five years after canal-expansive laminoplasty for cervical spondylotic myelopathy. The short- and long-term clinical results were compared, and successive radiographs assessed. The long-term clinical outcome was excellent in five patients, good in 12, fair in 11 and poor in one. The mean short- and long-term improvements were 54.4% and 48.5% but patients with focal kyphotic, kyphotic and S-shaped cervical spines did less well, as did those who had a decrease in the index of curvature of the cervical spine of more than 10 at follow-up. Canal-expansive laminoplasty with reconstitution of the posterior soft tissues may help to prevent postoperative malalignment and late neurological deterioration.

A nationwide epidemiological survey of spinal cord injuries in Japan from January 1990 to December 1992

This survey of traumatic spinal cord injuries in Japan from January 1990 to December 1992 was carried out by a statistical method of the nationwide epidemiological study. The number of the registered patients during these 3 years was 9752 and the mean response rate of every of the 47 prefectures was 51.4%. The registered patients with neurological deficits (Frankel A-D) were 7471 and the annual spinal cord injury incidence was 40.2 per million. The ratio of cervical cord injuries to more caudal SCI was 3:1. The age distribution and the causes of spinal cord injuries are presented in detail. From the results of this study, the prevention campaign should be focused mainly on the following topics: sports and motorcycle accidents involving young people; traffic accidents involving adults; falling accidents involving aged people.

Simultaneous quantification of an anti-inflammatory compound (DuP 697) and a potential metabolite (X6882) in human plasma and urine by high-performance liquid chromatography

A high-performance liquid chromatographic (HPLC) method using fluorescence detection has been developed for the simultaneous analysis of low nanogram concentrations of an anti-inflammatory drug, 5-Bromo-2-(4-fluorophenyl)-3-[4-(methylsulfonyl)phenyl]thiophene (DuP 697), and a potential metabolite (X6882) in human plasma and of DuP 697 in human urine. This assay method used an EM Separations Lichrospher C18 endcapped column. The mobile phase was acetonitrile-water (75:25, v/v). The detection of DuP 697 and X6882 was by fluorescence at excitation and emission wavelengths of 256 and 419 nm, respectively. The chromatographic system could separate DuP 697 from X6882, the external standard (anthracene), and other endogenous substances present in human plasma. In human plasma the limits of quantification for DuP 697 and X6882 were 3 and 20 ng/ml, respectively; the limit of quantification for DuP 697 in human urine was 5 ng/ml. These compounds were shown to be stable in frozen (-20 degrees C) human plasma and urine for at least 9 weeks. The assay described has been used to characterize DuP 697 pharmacokinetics after oral administration in humans.

Spinal cord injuries in Japan: a nationwide epidemiological survey in 1990

To survey the situation of traumatic spinal cord injuries (SCI) in Japan, the SCI Prevention Committee of the Japanese Medical Society of Paraplegia sent out by mail study charts in the form of questionnaires to institutions nationwide. Using the statistical method of the nationwide epidemiological survey described by Hashimoto et al,1 the annual estimated incidence was obtained from the number of patients registered, and from the questionnaire reply rate at each prefecture. The number of registered patients in 1990 was 3465 and the mean reply rate was 56.6%. There were 2665 registered patients with a neurological deficit (Frankel A-D) and the annual SCI incidence was 39.4 per million. The male:female ratio was 4.3:1 and the ratio of cervical cord injures to those caudal to the cervical cord was 2.9:1. The mean age at the time of injury was 48.5 years. The cause most frequently seen was traffic accidents, the second most frequent being falls from a height. Besides those two, sports injuries and falls on level ground were the third most frequent causes of SCI in the young generation and in elderly people respectively.

[A case of benign mixed tumor of the trachea]

A very rare case of benign mixed tumor of the trachea was reported. A 52-year-old male was admitted to our hospital because of hemoptysis, slight dyspnea and stridor. Bronchoscopic examination revealed a polypoid tumor which arose from the anterior wall of the upper trachea, obstructing about 70% of the tracheal lumen. For the purpose of getting pathological specimen and securing the air way in anesthesia, endoscopic polypectomy (2/3 of the tumor) was done by using GIF-XP 20. Circumferential resection of the trachea (4 rings) with end-to-end anastomosis was performed one month after polypectomy. To our knowledge, this was the 7th reported case in Japan. Clinical studies and operative procedures of this disease were briefly discussed.

[A case of idiopathic fibrous mediastinitis with superior vena caval obstruction]

Uncommon case of superior vena caval obstruction secondary due to idiopathic fibrous mediastinitis was reported. A 38-year-old female was admitted in our hospital with the complaint of dyspnea and facial edema. Venography revealed occlusion of vena cava. Venous pressure showed 30 cmH2O in the external carotid vein. Mediastinal computed tomogram revealed no tumor but calcification in the anterior mediastinal fatty tissue. Therefore, with a 12 cm EPTFE, left brachiocephalic vein-right atrium bypass operation was performed. Facial edema was disappeared dramatically in early postoperative stage. She is uneventful 20 months after the operation.

[A case of accidental pneumatic rupture of the esophagus]

A case of pneumatic esophageal rupture secondary to distension from compressed air was reported. The patient, a 69-year-old man who was repairing an automobile tire suddenly exploded. The blast was directed into the open mouth. He was admitted to our hospital 12 hours after the onset with the complaint of chest pain and dyspnea. Subcutaneous emphysema was seen in the neck. The chest roentgenogram revealed a partial right hydropneumothorax. The diagnosis of esophageal rupture was established by Gastrographin swallowing study. Operation was performed 46 hours after the onset. Primary closure of the middle thoracic esophagus was judged to be impossible because of a 6 cm longitudinal laceration with contaminated pyothorax. Thereafter, total esophagectomy was indicated. Esophageal reconstruction using the pediculated gastric tube was performed throughout the retrosternal route. The leakage of esophagogastrostomy in the cervical area occurred in early postoperative stage. Re-esophagogastrostomy was successfully carried out 6 weeks after the first surgery. He is uneventful 6 months after the operation. We have not found any reports of surgical cases with pneumatic esophageal rupture treated by this approach in the literature.

Microangiographic study of spinal cord injury and myelopathy

Post-mortem microangiography has been performed in 12 patients with traumatic cervical cord injury, 2 patients with myelopathy, and one patient with post-traumatic syringomyelia. Microangiography defined 4 zones in the injured spinal cord. In traumatic injury, the size and extent of the non-filling area (Zone 1) was directly related to the injury force. Subsequently these areas became cavitated. Surrounding the non-filling area, widely extending areas demonstrated filling of capillaries but showed damaged neurons and axons (Zone 2). In the chronic stage, Zone 2 replaced by gliomesenchymal tissue. The capillaries in the gliomesenchymal scars revealed a distorted abnormal arrangement (Zone 3). In a case with myelopathy, the hypervascular areas (Zone 4) were observed just around the chronically compressed area. The vascular increases were considered to be a reaction against chronic compression. In a patient with post-traumatic syringomyelia, the vascular network of the posterior grey matter disappeared and the central arteries were distorted by the distending forces of the syrinx. The microangiographs suggested that vascular factors might play a significant role in original cavity formation; but in cavity extension, these factors were not primary.

[Causes of death after an early gastric cancer operation]

From April, 1972 to December, 1984, 329 early gastric cancer case were operated on by this department. Results of these operations have revealed the following statistics: The 5-year survival rate of those with an m-cancer was 97.6% and for those with an sm-cancer, 92.6% and, the 10-year survival rate of m-cancer was 91.6% and sm-cancer, 89.9%, respectively. Twenty-nine postoperative deaths were recognized in this series, and the causes of death in each case have been analysed. Prophylactic measures to prevent postoperative death also are discussed.

Cervical myelopathy treated by canal-expansive laminaplasty. Computed tomographic and myelographic findings

The operation known as canal-expansive laminaplasty has the following advantages over wide laminectomy: (1) osseous protection of the spinal cord is retained, (2) the invasion of the cord by scar tissue is minimized, and (3) the stability of the spine is retained. We are reporting the clinical, computed tomographic, and computed myelographic findings before and after this operation in twenty-four patients with cervical myelopathy due to cervical spondylosis, spinal stenosis, or ossification of the posterior longitudinal ligament. The clinical results were excellent in four patients, good in eighteen, and fair in two. Symmetrical expansion of the spinal canal was clearly demonstrated by computed tomograms, and the metrizamide ring on the myelograms had a normal rounded curvature.

The effect of ozone and photochemical oxidants on the interferon production by tonsillar lymphocytes

In order to elucidate the biological effects of photochemical smog on the tonsil, lymphocytes from human tonsil were exposed to ozone and rabbits were exposed to ozone or photochemical oxidants. The tonsillar lymphocytes were studied for interferon production by Newcastle disease virus and blastoid transformation by PHA. Both interferon production by and blastoid transformation of the human tonsillar lymphocytes decreased markedly on exposure to ozone. Tonsillar lymphocytes from rabbits exposed to photochemical oxidants showed a significant decrease in interferon production. The decrease in interferon production in tonsillar lymphocytes from the rabbit exposed to photochemical oxidants was greater in magnitude than the decrease in interferon production in tonsillar lymphocytes exposed to ozone or non-irradiated automobile exhaust gas. The difference in blastoid transformation between the exposed groups and controls was not significnat. The results suggest that exposure to photochemical oxidants causes some functional changes in tonsillar lymphocytes.