Immunoglobulin (Ig)G purified from human sera mirrors intravenous Ig human leucocyte antigen (HLA) reactivity and recognizes one's own HLA types, but may be masked by Fab complementarity-determining region peptide in the native sera

Intravenous immunoglobulin (IVIg) reacted with a wide array of human leucocyte antigen (HLA) alleles, in contrast to normal sera, due possibly to the purification of IgG from the pooled plasma. The reactivity of IgG purified from normal sera was compared with that of native sera to determine whether any serum factors mask the HLA reactivity of anti-HLA IgG and whether IgG purified from sera can recognize the HLA types of the corresponding donors. The purified IgG, unlike native sera, mirrored IVIg reactivity to a wide array of HLA-I/-II alleles, indicating that anti-HLA IgG may be masked in normal sera - either by peptides derived from soluble HLA or by those from antibodies. A < 3 kDa peptide from the complementarity-determining region (CDR) of the Fab region of IgG (but not the HLA peptides) masked HLA recognition by the purified IgG. Most importantly, some of the anti-HLA IgG purified from normal sera - and serum IgG from a few donors - indeed recognized the HLA types of the corresponding donors, confirming the presence of auto-HLA antibodies. Comparison of HLA types with the profile of HLA antibodies showed auto-HLA IgG to the donors' HLA antigens in this order of frequency: DPA (80%), DQA (71%), DRB345 (67%), DQB (57%), Cw (50%), DBP (43%), DRB1 (21%), A (14%) and B (7%). The auto-HLA antibodies, when unmasked in vivo, may perform immunoregulatory functions similar to those of therapeutic preparations of IVIg.

Suppression of blastogenesis and proliferation of activated CD4(+) T cells: intravenous immunoglobulin (IVIg) versus novel anti-human leucocyte antigen (HLA)-E monoclonal antibodies mimicking HLA-I reactivity of IVIg

Activated CD4(+) T cells undergo blastogenesis and proliferation and they express several surface receptors, including β2-microglobulin-free human leucocyte antigen (HLA) heavy chains (open conformers). Intravenous immunoglobulin (IVIg) suppresses activated T cells, but the mechanism is unclear. IVIg reacts with HLA-Ia/Ib antigens but its reactivity is lost when the anti-HLA-E Ab is adsorbed out. Anti-HLA-E antibodies may bind to the peptides shared by HLA-E and the HLA-I alleles. These shared peptides are cryptic in intact HLA, but exposed in open conformers. The hypothesis that anti-HLA-E monoclonal antibodies (mAbs) that mimic HLA-I reactivity of IVIg may suppress activated T cells by binding to the shared peptides of the open conformers on the T cell surface was tested by examining the relative binding affinity of those mAbs for open conformers coated on regular beads and for intact HLA coated on iBeads, and by comparing the effects on the suppression of phytohaemagglutinin (PHA)-activated T cells of three entities: IVIg, anti-HLA-E mAbs that mimic IVIg [Terasaki Foundation Laboratory (TFL)-006 and (TFL)-007]; and anti-HLA-E antibodies that do not mimic IVIg (TFL-033 and TFL-037). Suppression of blastogenesis and proliferation of those T cells by both IVIg and the anti-HLA-E mAbs was dose-dependent, the dose required with mAbs 50-150-fold lower than with IVIg. TFL-006 and TFL-007 significantly suppressed blastogenesis and proliferation of activated CD4(+) T cells, but neither the non-IVIg-mimicking mAbs nor control antibodies did so. The suppression may be mediated by Fab-binding of TFL-006/TFL-007 to the exposed shared peptides. The mAb binding to the open conformer may signal T cell deactivation because the open conformers have an elongated cytoplasmic tail with phosphorylation sites (tryosine(320)/serine(335)).

Effect of an isoflavones-containing red clover preparation and alkaline supplementation on bone metabolism in ovariectomized rats

The aim of this study was to test the combined effect of a quality-controlled red clover extract (RCE) standardized to contain 40% isoflavones by weight (genistein, daidzein, biochanin A, and formononetin present as hydrolyzed aglycones) together with a modified alkaline supplementation on bone metabolic and biomechanical parameters in an experimental model of surgically-induced menopause. Sprague-Dawley female rats were maintained under controlled standard conditions of light and fed with conventional food of standard calcium content and no alfalfa or soybean components. Rats were randomized into four groups: Group A represented normal rats (sham operated) while three other groups were ovariectomized (OVX) and fed for three months as follows: standard food (group B), 6 mg/kg/day food mixed with RCE (Group C), or given 6 mg/kg/day of RCE plus a modified alkaline supplementation (BP) through a nasogastric tube at a dose of 16 mg (group D). The animals were killed 90 days after surgery. As compared to group B, RCE or RCE + BP treatments brought about significantly higher level of estradiol and mitigated the weight loss of the uterus and improved maximum load of the femoral neck. Osteocalcin level showed an over 65% increase in group B but both RCE and RCE + BP treatments prevented such abnormality with a significantly better result in RCE + BP group which virtually normalized such parameter as well as urinary excretion of DPD. Group C and D reduced the over 20% loss of bone mineral density and bone mineral content/body weight ratio observed in untreated post-ovariectomy group. Untreated ovariectomy caused about 48% decrease of cancellous bone mass in the femoral neck while this abnormality was prevented at similar extent by both RCE and RCE + BP treatments. Ovariectomy determined an over 80% increase of bone alkaline phosphatase (BALP) level but both RCE and RCE + BP treatments significantly mitigated such variable. The BALP decrease yielded by the combined RCE + BP treatment was statistically lower than RCE alone. Taken together these data show that red clover preparation in dosages amenable to clinical practice do improve OVX-induced osteoporosis while a mild metabolic alkalosis might further synergize some therapeutic aspects.

Preventive strategy for Candida gut translocation during ischemia-reperfusion injury supervening on protein-calorie malnutrition

OBJECTIVE

The aim of the present study was to test the hypothesis that protein-calorie malnutrition aggravates the gut translocation of Candida albicans triggered by mesenteric ischemia-reperfusion (IR) injury in an experimental model while testing a natural product containing the antifungal anethole/polygodial mixture (Kolorex).

METHODS

MFI strain white mice (n = 90) were randomly allocated to a 4-week dietary regimen: (1) standard pellet diet containing 25% casein; (2) low-protein (2.5%) casein diet; (3) as group 2 plus oral supplementation with 20 microL of a 5% solution of Kolorex during the last 4 days. Twenty rats from each of these groups (termed 1a, 2a and 3a) were orally inoculated with Candida suspension 6 h prior to mesenteric IR injury. Animals of each group but without Candida inoculation (termed 1b, 2b and 3b) served as control. A colon permeability study was carried out as well. Rats were killed prior to the IR injury and 3 h afterwards. Control rats were killed at the same time.

RESULTS

Over 60% of the mesenteric lymph nodes and 30% of kidney samples were positive for C. albicans in the low-protein-fed rats after IR injury. Kolorex significantly decreased that rate of positivity and also significantly reduced the concentration of C. albicans per gram of each positive tissue sample examined. Protein-calorie malnourished animals showed a statistically significant increase in colon permeability and this phenomenon further increased after IR injury. The groups of rats treated with Kolorex compound showed a partial, although significant, improvement of this parameter.

CONCLUSIONS

These results suggest that Kolorex might exert a competitive effect against with C. albicans colonization. The present study represents the first experimental in vivo investigation of the anethole/polygodial-containing compound under the specific conditions of calorie-protein malnutrition and the results have potential clinical interest.

Improvement of isoamyl acetate productivity in sake yeast by isolating mutants resistant to econazole

Sake yeast strains were improved so as to produce larger amounts of isoamyl acetate than the parental strain by isolating econazole-resistant mutants. Econazole, an imidazole antimycotic, directly interacts with unsaturated fatty acids in the yeast cell membrane, where it also inhibits the synthesis of ergosterol and decreases the ratio of unsaturated to saturated fatty acids. In contrast, alcohol acetyltransferase (AATase), which catalyzes the synthesis of isoamyl acetate, is inhibited by unsaturated fatty acids. Fifty econazole-resistant mutants were isolated from a sake yeast, Kyokai no. 701, several of which produced approximately 1.4 to 2.4 times more isoamyl acetate and an almost equal amount of isoamyl alcohol compared with the parental strain. The AATase activities of the mutants in koji extract were 1.2 to 1.4 times higher, and the unsaturated to saturated fatty acid ratios were lower, than in the parental strain.

Metal-induced oxidative damage in cultured hepatocytes and hepatic lysosomal fraction: beneficial effect of a curcumin/absinthium compound

OBJECTIVE

Metals undergo redox cycling and there is increasing evidence of free radical generation and oxidative injury in the pathogenesis of liver injury and fibrosis in metal storage diseases. The aim of the present study was to test a natural hepatoprotective compound in metal-induced liver injury.

METHODS

Hepatocytes were isolated from Wistar rats by collagenase perfusion method and cultured as such and also with alpha-linolenic acid (LNA)-bovine serum albumin (BSA). Hepatocytes were then cultured with a graded dilution of PN-M001 (100 microg/mL and 200 microg/mL), which is a curcuma/absinthium-containing compound, or sylibin (100 microg/mL) dissolved in dimethyl sulfoxide for 10 min before the addition of metallic salts (iron, copper and vanadium). Lysosomal fractions were prepared for lysosome fragility tests in which beta-galactosidase activity and lactate dehydrogenase (LDH) leakage were measured, as well as oxidative damage tests in the presence of hydrophilic and lipophilic free radical generators. Quenching activity by 1,1-diphenyl-2-picrylhydrazyl (DPPH) was also assessed.

RESULTS

Malonildialdehyde accumulation in the medium showed a direct time-course increase with incubation time. Both PN-M001 and sylibin showed a significant protective effect against all challenge metal ions, as expressed by the half inhibition concentration (IC(50)) against lipid peroxidation. However, on a molar ratio, sylibin seemed to be more effective than PN-M001 in Fe-induced peroxidative damage (P < 0.05). Both test compounds, irrespective of the concentration, significantly reduced the LDH and beta-galactosidase concentration in the lysosomal fractions. As compared with untreated lysosomal fractions challenged with the two peroxide radicals generators, either PN-M001 or sylibin exerted significant protection However, PN-M001 was significantly better than sylibin in suppressing acid phosphatase enzyme activity. Both compounds showed comparable and significant DPPH radical-scavenging activity.

CONCLUSION

These data support the potential clinical application of curcumin-containing compounds.

Single-blind follow-up study on the effectiveness of a symbiotic preparation in irritable bowel syndrome

OBJECTIVE

Experimental and clinical studies have shown that a novel symbiotic (known as SCM-III) exerts a beneficial effect on gut translocation and local and systemic inflammatory and microbial metabolic parameters. The present investigation was a preliminary trial on the effectiveness of SCM-III for irritable bowel syndrome (IBS).

METHODS

Sixty-eight consecutive adult patients with IBS who were free from lactose malabsorption, abdominal surgery, overt psychiatric disorders and ongoing psychotropic drug therapy or ethanol abuse were studied prospectively and divided into 2 groups that were comparable for age, gender, body size, education and pattern of presenting symptoms. The 2 groups were blindly given for 12 weeks either SCM-III 10 mL t.i.d or the same dosage of heat-inactivated symbiotic.

RESULTS

Treatment with SCM-III was 'effective' or 'very effective' in more than 80% of the patients (P < 0.01 vs baseline values and control). Less than 5% reported 'not effective' as the final evaluation compared with over 40% of patients in the control group. After 6 weeks of treatment, a significant improvement of pain and bloating was reported in the treatment group compared with control and baseline values. There was also a benefit for bowel habits, mostly for patients with constipation or alternating bowel habits. No overt clinical or biochemical adverse side-effects were recorded.

CONCLUSION

Compared with baseline values and the control group, SCM-III resulted in a significant increase in lactobacilla, eubacteria and bifidobacteria, which suggests that some selected IBS patients could benefit substantially from symbiotics, but the treatment may need to be given on a cyclic schedule because of the temporary modification of the fecal flora.

Scanning electron microscopic study of the muscle fiber ends at the myotendinous junction in the posterior cricoarytenoid and cricothyroid muscles in rats

The fine structural organization of muscle fiber ends at the myotendinous junction in the posterior cricoarytenoid (PCA) and cricothyroid (CT) muscles in adult rats was studied by scanning electron microscopy, after removal of tendon connective tissues using the HCI-hydrolysis method. The muscle fiber ends in the PCA muscle had a relatively simple conical appearance and contained a great number of longitudinal slits on the surface. In the CT muscle, the muscle fiber ends were classified into two types. One type had a conical appearance similar to the PCA muscle with many slits on the surface, while the other type was characterized by a complex arrangement of cylindrical cytoplasmic processes and deep clefts, as seen in common skeletal muscles. These findings suggest that the PCA muscle is evolutionarily primitive, and that the CT muscles represent a transitional form between primitive and evolved muscles.

Scanning electron microscopic study of the neuromuscular junctions of the cricothyroid and thyroarytenoid muscles in rats

Neuromuscular junctions were observed in the cricothyroid (CT) and thyroarytenoid (TA) muscles of adult rats by scanning electron microscopy after removing the intramuscular connective tissue components using the HCI hydrolysis method. Morphologically, the junctions were classified into three types in the CT muscle and two types in the TA muscle, based on the structural characteristics of the subneural apparatuses, including junctional folds. In the CT muscle, type 1 junctions (32%) consisted of more than 15 cup-like depressions with slit-like junctional folds. Type 2 junctions (20%) were characterized by approximately 10 cup-like depressions with a small number of pit- or slit-like junctional folds. Type 3 junctions (48%) had irregular labyrinthine gutters with slit-like junctional folds. In the TA muscle, type 1 (82%) and 2 (18%) junctions had similar structures to type 1 and 2 junctions in the CT muscle, respectively. Histochemical studies using myosin adenosine triphosphatase staining showed that both CT and TA muscles predominantly consisted of type II muscle fibers (78% and 82%, respectively), and that the diameter of type II fibers was larger than that of type I fibers. These findings suggest that the type 2 junction belongs to type I muscle fibers, while both type 1 and type 3 junctions belong to type II fibers, and that the type 3 junction is a structural variation of the type 1 junction. The significance of the structural differences of the subneural apparatuses in the intrinsic laryngeal muscles is discussed briefly.

Postnatal morphodifferentiation of the subneural apparatuses of the posterior cricoarytenoid muscle in rats: a scanning electron microscopy study

The subneural apparatus, i. e., the post-synaptic component of the neuromuscular junction, in the posterior cricoarytenoid muscle of the rat was studied by scanning electron microscopy, with special attention given to its postnatal differentiation along with the functional development of the muscle. Primitive synaptic troughs observed in the first postnatal week consisted of single cup-like depressions 5-6 microm in diameter. On the 7th day, low sarcoplasmic ridges appeared in the trough. In the second postnatal week, muscle fibers could be classified into two groups: large (10-15 microm in diameter) and small (less than 10 microm in diameter). In the large muscle fibers, many low ridges became circular and protruded to transform the single trough into numerous cup-like depressions (2-5 microm in diameter). In contrast, the subneural apparatus in the small muscle fibers consisted of a small number of cup-like depressions. The two types of subneural apparatus differentiated into adult forms by the 28th postnatal day, although they remained smaller in size than those of adults. In the large muscle fibers, the number of pit-like or elongated invaginations increased and gradually transformed into slit-like junctional folds by the 28th postnatal day, while the small muscle fibers still possessed a few pit-like or elongated junctional folds at this point in time. The two types of morphodifferentiation of the subneural apparatus are thought to reflect the two types of muscle fibers in the rat posterior cricoarytenoid muscle.

Postnatal changes in the types of muscle fibre in the canine inferior pharyngeal constrictor

Deglutition is considered to be immature in infants and to mature postnatally. We evaluated postnatal changes in muscle fibre type composition in the canine inferior pharyngeal constrictor muscle, which consists of the thyropharyngeal (TP) and cricopharyngeal (CP) muscles, using ATPase staining with respect to the maturation of deglutition. In the TP muscle type IIA and type IIB fibres, the main components in the adult, were already predominant at 1 week postnatally. The percentage of primitive type IIC fibre showed a rapid reduction and reached the adult level within 6 weeks. In the CP muscle, the majority of fibres were type IIC at 2 weeks. At 2 months, more than 20% of the fibres were still type IIC and the proportion of type I fibres as a main component in the adult was smaller than that of the adult. None of the puppies younger than 9 weeks old had a fibre type composition similar to that of the adult. In the extensor digitorum longus and flexor digitorum superficialis, the compositions of muscle fibre types became similar to that of the adult at 6 and 9 weeks of age, respectively. Thus, the TP muscle matured more rapidly than the limb muscles, while the CP muscle matured more slowly. We speculated that the TP and CP muscles have specific individual differentiation patterns associated with their functional roles before and after birth, compared with the limb muscles.

Effect of the FAA1 gene disruption of sake yeast on the accumulation of ethyl caproate in sake mash

Fatty acid activation gene (FAA1) in sake yeast Kyokai no. 701 (K701) was disrupted to investigate the accumulation of ethyl caproate in sake mash. Ethyl caproate, recognized as an important apple-like flavor in sake, is generated by fatty acid synthesis in yeast cells. The disruptant for the FAA1 gene (K701deltafaa1) exhibited a reduced growth rate in a medium containing cerulenin and myristic acid or oleic acid compared with that of the parental strain (K701). In a sake brewing test in which the rice used was polished to 60% of its original size, the fermentation ability of K701deltafaa1 was inferior to that of K701 but the production of ethyl caproate by K701deltafaa1 was 1.6-fold higher than that by K701. These results suggest that the FAA1 gene in sake yeast plays an important role in sake brewing and the accumulation of ethyl caproate.

Effect of NAD+-dependent isocitrate dehydrogenase gene (IDH1, IDH2) disruption of sake yeast on organic acid composition in sake mash

The ratio of organic acids in sake mash is a very important factor affecting the taste of alcoholic beverages. To alter the organic acid composition in sake and investigate the mechanism of producing organic acids in sake mash, we examined the effect of NAD+-dependent isocitrate dehydrogenase (IDH) activity deficiency in sake yeast by disrupting the IDH1 or IDH2 gene. Two haploid strains (MATa or MATa genotype) isolated from sake yeast Kyokai no. 701 (K701) were disrupted using the aureobasidin A resistant gene (AUR1-C) as a selection marker. These disruptants were defective in the activity of IDH and failed to grow on medium containing glycerol as a sole carbon source. Sake meter, alcohol concentration, and glucose consumption in sake brewed with the disruptants were reduced in comparison with those of the parental strains. The production of citrate (including isocitrate), malate, and acetate by the disruptants was increased, but succinate production was reduced to approximately half in comparison with the parental strains. These results indicate that approximately half the amount of succinate in sake mash is produced via the oxidative pathway of the TCA cycle in sake yeast. While the diploid strain constructed by mating haploid disruptants for the IDH gene exhibited stronger fermentation ability than the haploid disruptants, almost similar profiles of components in sake were obtained for both strains.

Histochemical study of the canine inferior pharyngeal constrictor muscle: implications for its function

The inferior pharyngeal constrictor muscle (IPC), which consists of the thyropharyngeal (TP) and cricopharyngeal (CP) muscles. plays an important role during deglutition. The histochemical properties of the canine IPC muscle were investigated. The motor endplates of the TP muscle clustered at the midlength of the muscle, while those of the CP muscle were scattered diffusely. The glycogen depletion technique suggested that most of the CP muscle fibers terminated into the belly of the muscle and fiber lengths varied. With ATPase stain, type II fibers were shown to be predominant in the TP muscle, while type I fibers were predominant in the CP muscle. The diameter of the TP muscle fibers was significantly larger than that of the CP muscle. Although the histochemical characteristics of these two muscles were markedly different, they gradually changed, resulting in their coordinated physiological movements.

Motor innervation of the guinea pig interarytenoid muscle: reinnervation process following unilateral denervation

The authors investigated the process of denervation and reinnervation of the interarytenoid (IA) muscle in the guinea pig using transmission electron microscopy and glycogen depletion technique after unilateral transection of the recurrent laryngeal nerve (RLN) and superior laryngeal nerve to clarify the innervation pattern of the unpaired IA muscle. Anastomosis between the bilateral arytenoid branches was confirmed in the belly of the IA muscle. Five weeks after transection, all of the IA muscle fibers appeared to have been reinnervated by the contralateral RLN. As the arytenoid branch of the RLN runs together with that of the contralateral RLN in a single intramuscular nerve funiculus, it is possible that collateral sprouting branches grow and extend into the adjacent denervated Schwann's sheaths. The authors conclude that the unpaired IA muscle, as a whole, receives specific motor nerve supply from the bilateral RLNs, although each muscle fiber is innervated unilaterally.

A novel muscle spindle containing muscle fibres devoid of sensory innervation in the posterior cricoarytenoid muscle of the normal adult guinea pig

A novel muscle spindle composed of five thin intrafusal muscle fibres and four thick muscle fibres was encountered in the posterior cricoarytenoid muscle of the normal adult guinea pig. Four intrafusal muscle fibres of the five were innervated by the annulospiral type of sensory ending, but lacked a distinct aggregation of equatorial nuclei such as bags and chains. On the other hand, one intrafusal fibre and four thick fibres between the layers of the spindle capsule absolutely lacked sensory innervation and were almost similar in the fine structural features to neighbouring extrafusal fibres. These fibres are considered to fail to receive the sensory innervation in an early stage of development, and to retain an undifferentiated feature of intrafusal fibre in the intracapsular space into adulthood or to follow the course of extrafusal differentiation between the layers of the spindle capsule. It is suggested therefore that this muscle spindle may be primitive.

Effect of sinus surgery on visual disturbance caused by spheno-ethmoid mucoceles

Fifteen patients suffering from visual disturbance of varying degrees caused by a mucocele of the posterior ethmoid and/or sphenoid sinuses underwent marsupialization of a mucocele into the nasal cavity. Five of the eight patients with severe visual loss worse than 20/200 showed recovery of measurable vision. Two of these five were operated on within 24 hours after the onset of visual loss and showed marked recovery to 20/25 and 20/15. The other seven patients who had relatively mild visual disturbance experienced improvement of visual acuity or remission of subjective complaints such as blurred vision post-operatively. During operation partial bony defect was found in the optic canal in 12 patients and in the skull base in 12 patients. A good understanding of this disease by ophthalmologists and otolaryngologists is essential for early diagnosis and prompt surgical treatment to avoid permanent visual dysfunction and operative sequelae.

Extravesical tumor implantation caused by perforation during transurethral resection of a bladder tumor: a case report

We report a case of invasive bladder cancer in which cancer dissemination occurred through a perforation of the vesical wall during transurethral resection of the tumor. A radical cystectomy was performed 1 month later and several clusters of viable cancer cells were histologically identified in a fibrous foreign body granuloma in the paravesicular adipose tissue of the lymphadenectomy specimen. The patient received adjuvant chemotherapy, but developed right inguinal lymph node metastasis 21 months after cystectomy.

[Diagnostic value of magnetic resonance imaging in postoperative maxillary cyst]

Magnetic resonance imaging (MRI) is superior to conventional X-ray tomography and CT scanning in detecting postoperative maxillary cysts (POMCs). We analyzed the MRI features of 51 cases (72 sides) and compared them with the operative findings of 42 cases (52 sides) of POMC. The total number of cysts diagnosed was 121. Multiple cysts were found in 37 sides (51%) and bilateral cysts were found in 21 cases (45%). According to classification of POMC based on location in the maxilla the central cysts were found in only 38% of all cysts (peripheral ones in 62%). In the 42 patients operated on, 69 of 83 cysts which had been detected by MRI were confirmed, whereas there were two additional cysts which could not be diagnosed preoperatively. Sixty four of 71 cysts were opened to the nasal cavity under endonasal endoscopic control. The other seven cysts (five sides) were operated on via a buccogingival incision. Detailed and accurate diagnosis by MRI and development of endoscopic instruments enabled endonasal surgery in most (91%) sides of the POMC. In five cysts of the superior type which are small isolated and distant from the lateral wall of the nasal cavity, endoscopic endonasal surgery was not indicated. In conclusion, MRI for POMC was extremely helpful in selecting a surgical approach.

[Relationship of Onodi cell to optic neuritis--radiological anatomy on coronal CT scanning]

The relationship of paranasal sinusitis to optic neuritis remains controversial. One of the major sources of this controversy is that there are some reports of rhinogenic optic neuritis (RON) in patients with mild paranasal sinusitis or with almost normal paranasal sinuses. The Onodi cell is a posterior ethmoid cell which pneumatized far laterally and to some degree superiorly to the sphenoid sinus and is intimately associated with the optic nerve. Coronal CT scanning is requisite to detect the Onodi cell; when it is present, an image of the sphenoid sinus just as if it were divided into top and bottom is characteristic. In our material from 200 patients (direct coronal CT scans 10 mm in width), the Onodi cell was observed in 7%. A case of RON whose pathogenesis was considered to be a direct spread of inflammation from the localized infection of the Onodi cell is reported. Ethmoiditis localized to the Onodi cell seems to play an important role in the pathogenesis of RON. Continued careful documentation of the localized posterior paranasal sinus lesion around the optic canal by detailed diagnostic imaging and endoscopic sinus surgery is necessary to resolve the disease entity of RON.

Accessory scrotum with penoscrotal transposition and retrocerebellar arachnoid cyst: a case report

A 2-year-old boy presented with an accessory scrotum associated with penoscrotal transposition and a perineal lipoma. He also had a retrocerebellar arachnoid cyst. The accessory scrotum was resected with concurrent scrotoplasty. The retrocerebellar arachnoid cyst was seen on a subsequent brain computed tomography scan and was left untreated because there was no evidence that the volume was increasing.

[Clinical statistics on in-patients and operations during a 20-year period (1975-1994) at Department of Urology, Kansai Medical University]

The patients, diseases and operations experienced between 1975 and 1994 in our department were statistically analyzed. The numbers of in-patients and operations have been increasing since 1977. During these 20 years, endoscopic surgery has replaced many open surgical procedures. The introduction of extracorporeal shock wave lithotripsy has dramatically changed the therapeutic modality for urolithiasis, and decreased of the necessity of open surgery.

Existence of a muscle spindle on the posterior cricoarytenoid muscle of the guinea pig

We examined a muscle spindle in the posterior cricoarytenoid muscle of the adult guinea pig. The spindle capsule contained three intrafusal muscle fibres. At the equatorial region, three intrafusal fibres did not form a typical aggregation of nuclei such as bags and chains observed in common mammalian muscle spindles. Two intrafusal fibres of the three were innervated by sensory endings which branched and arranged irregularly. These sensory endings lay on the surface of intrafusal fibres in shallow grooves or deeply penetrated into the fibre. The third intrafusal fibre, lacking sensory innervation, showed a similar fine structure to extrafusal fibres. These findings suggest that the muscle spindle in the posterior cricoarytenoid muscle of the guinea pig is strikingly different in the structure of intrafusal fibres and in the arrangement of sensory endings from that in common mammalian skeletal muscles. The occurrence and role of these different structures were discussed.

Occurrence of capillaries with fenestrae in the intrinsic laryngeal muscles of the guinea pig after unilateral denervation

Capillaries in the posterior cricoarytenoid and the arytenoid muscles of the guinea pig were examined by electron microscopy 3 days after transection of unilateral recurrent laryngeal nerve. The denervated posterior cricoarytenoid muscle had neuromuscular junctions (NMJs) lacking terminal axons, while in the unpaired arytenoid muscle, normal and denervated NMJs coexisted among muscle fibres being seemingly normal. Capillaries in both muscles were almost of the continuous type. However, approximately 10% of capillaries around the denervated NMJs and among some muscle fibres in both muscles, often had a small number (< 10) of fenestrae bridged by a single-layered diaphragm. The untreated normal muscles contained only continuous capillaries. These findings suggest that denervation may induce the fenestrated changes of intramuscular capillaries.

Neuromuscular junctions of the posterior cricoarytenoid muscle in the adult rat: a scanning electron microscopical study

Neuromuscular junctions in the posterior cricoarytenoid (PCA) muscle of the adult rat larynx were examined by scanning electron microscopy. Two types of focal junctions were characterized by the nerve endings with terminal varicosities or terminal buttons and by the subneural apparatuses with a group of cup-like depressions (2-5 microns in diameter), not labyrinthine gutters. One type of the subneural apparatuses consisted of a large number (more than 20) of depressions with predominantly slit-like junctional folds. The other type was characterized by a small number (about 10) of depressions with a few junctional folds. From the relative proportions of the two types of muscle fibers and subneural apparatuses in the rat PCA muscle, we suggest that the Type II fibers have the apparatus consisting of numerous small depressions with many junctional folds, while that of the Type I fibers consists of a small number of depressions with a smaller number of junctional folds. It is suggested that the structural differences of the subneural apparatus reflect different types of muscle fibers.

[A patient showing increased T3 and T4 levels due to ALP-interfering substances and heterophilic antibody]

A 73-year-old male, who underwent resection of soft palate cancer and was under treatment for esophageal ulcer at our medical department, complained of palpitation. On the suspicion of hyperthyroidism, enzyme immunoassay (EIA) was performed. T3 and T4 were increased, and FT4 and TSH were normal. However, T3 and T4 measured again by radioimmunoassay (RIA) were normal. Therefore, the patient serum was examined for interfering substances such as antibody against bovine intestinal alkaline phosphatase (ALP) and heterophilic antibody. Substances interfering with ALP and anti-rabbit IgG human antibody were detected. It is necessary to consider the possible presence of these substances when results of EIA are evaluated.

Catecholamine release caused by carbon dioxide insufflation during laparoscopic surgery

PURPOSE

We evaluated plasma catecholamine levels during pneumoperitoneum in laparoscopic surgery.

MATERIALS AND METHODS

Plasma epinephrine and norepinephrine were evaluated in 29 patients who underwent laparoscopic retroperitoneal surgery in a half lateral decubitus position (group 1) or laparoscopic varicocelectomy in a Trendelenburg position (group 2).

RESULTS

The levels of epinephrine and norepinephrine increased significantly 5 minutes after carbon dioxide insufflation compared to levels after Veress needle insertion and just before insufflation. The elevation of catecholamine levels during laparoscopic procedures was greater in group 1.

CONCLUSIONS

Our results indicate that carbon dioxide insufflation may cause catecholamine release during laparoscopic surgery. Careful monitoring of hemodynamics is mandatory at the beginning of the procedure.

[Endoscopic endonasal surgery for postoperative maxillary cyst]

Endoscopic endonasal surgery was performed on 64 patients (69 sides) with postoperative maxillary cyst. We marsupialized the cyst in the inferior and/or middle meatus to enlarge it as much as possible. To facilitate an easier approach to the cyst wall in the inferior nasal meatus, some patients underwent submucous resection of the inferior nasal concha or inferior turbinectomy. Thirty-eight patients (44 sides) were followed for more than six months after surgery and a wide opening was confirmed in 36 (81.8%) of the 44 sides. Whether we should utilize an endonasal approach or a Caldwell-Luc approach depends mainly on the location of the medial wall of the cyst. We classified the cysts into medial, anterolateral and posterolateral types. Drawing a line between the anterior end of the inferior turbinate and the base of the lateral pterygoid process, on the axial plane of CT at the mid level of the inferior meatus, is the first stop. A medial cyst extends toward the midline across this imaginary line. A lateral cyst is subdivided into anterolateral and posterolateral based on the position of the center of cyst. The endoscopic endonasal approach resulted in excellent outcomes in medial and posterolateral cysts, while this approach was not found to be suitable for anterolateral cysts.

[Motor innervation of the guinea pig arytenoid muscle from the standpoint of the reinnervation process]

The innervation pattern of the arytenoid muscle (AR) was studied from the standpoint of the reinnervation process in 32 guinea pigs with typical unpaired AR. In 26 animals the muscle was denervated by cutting the left recurrent laryngeal nerve (RLN). The superior laryngeal nerve was also transected to eliminate the possibility of reinnervation from this nerve. Both light and electron-microscopic examinations in 18 denervated animals and 4 normal animals, and a glycogen depletion experiment in 8 denervated animals and 2 normal animals were carried out on the AR and the posterior cricoarytenoid muscle (PCA). 1. Light microscopic study: Anastomosis with arytenoid branches from the contralateral RLN was observed in the belly of AR. Half of the myelinated fibers in the intramuscular nerve funiculus remained degenerated as of seven days after transection. After three weeks, degeneration of the myelinated fiber was no longer seen, and the number of myelinated fibers had been restored to within the normal range. The muscle fibers of the left PCA degenerated completely, while those of the AR remained intact. 2. Electron-microscopic study. Three days after transection, the nerve terminals of half of the neuromuscular junctions (NMJs) were absent in the AR. Seven days after transection, however, both myelinated and unmyelinated fibers were recognized in the intramuscular nerve funiculus. Half of the NMJs in the AR were normal, one fourth had degenerated and the rest had regenerated. Five weeks after transection, no degeneration or regeneration of the NMJs was seen. Unmyelinated fibers were no longer found in the intramuscular funiculus. 3. Glycogen depletion experiment: As of three weeks after transection, half of the AR fibers stained with PAS despite electrical stimulation of the contralateral (right) RLN. Five weeks after transection, none of the AR fibers stained. Thus, all of the AR fibers appeared to have been the result of reinnervation from the contralateral RLN. The results of the present study indicate that transection of the unilateral RLN facilitates collateral sprouting from the contralateral RLN in guinea pigs. This collateral sprouting occurring between 3 and 7 days following denervation reinnervated the denervated muscle fibers before degeneration. Collateral sprouting branches may easily extend into adjacent denervated Schwann's sheaths, since the arytenoid branch of the RLN runs in contact with that of the contralateral RLN in the identical intramuscular nerve funiculus. Although each muscle fiber in the AR is innervated unilaterally, this unpaired muscle as a whole receives specific motor innervation from both RLNs.

Entropic stabilization of a mutant human lysozyme induced by calcium binding

The stabilization mechanism of the mutant human lysozyme with a calcium binding site (D86/92) was investigated by using calorimetric approaches. By differential scanning calorimetry, the enthalpy change (delta H) in the unfolding of holo-D86/92 was found to be 6.8 kcal/mol smaller than that of the wild-type and apo-D86/92 lysozymes at 85 degrees C. However, the unfolding Gibbs energy change (delta G) of the holo mutant was 3.3 kcal/mol greater than the apo type at 85 degrees C, indicating a significant decrease of entropy (T delta S = 10.1 kcal/mol) in the presence of Ca2+. Subsequently, the Ca2+ binding process in the folded state of the mutant was analyzed by using titration isothermal calorimetry. The binding enthalpy change was estimated to be 4.5 kcal/mol, and delta G was -8.1 kcal/mol at 85 degrees C, which indicates that the binding was caused by a large increase in entropy (T delta S = 12.6 kcal/mol). From these analyses, the unfolded holo mutant was determined to bind Ca2+ with a binding delta G of -4.8 kcal/mol (delta H = -2.6 kcal/mol, T delta S = 2.2 kcal/mol) at 85 degrees C. Therefore, the major cause of stabilization of holo-D86/92 is the decrease in entropy of the peptide chain due to Ca2+ binding to the unfolded protein.

A case of primary hypoparathyroidism complicated by heart failure

We report a case of hypocalcemic heart failure without underlying myocardial disease. Two-dimensional and Doppler echocardiography revealed dilatation and impaired contraction of the left ventricle, but did not show any valvular dysfunction. Cardiac catheterization showed a normal coronary artery, and cardiac muscle biopsy showed morphological changes in mitochondoria and endoplasmic reticulum, which may be due to metabolic changes. This patient was asymptomatic after the serum calcium concentration was normalized.

[A ruptured aneurysm in the hypoplastic proximal anterior cerebral artery (A1 portion); case report]

A case of ruptured aneurysm in the hypoplastic proximal anterior cerebral artery (A1 portion) is reported. This 25-years old man complained of the sudden onset of severe headache and vomiting on January 11, 1989. He was referred to our hospital on the same day, and CT scan revealed subarachnoid hemorrhage. Cerebral angiography on the next day revealed an aneurysm in the hypoplastic A1 portion of the right anterior cerebral artery, and no branch was present at the site of the aneurysmal neck. He was operated on using the right pterional approach. The A1 portion was trapped and the aneurysm was removed successfully. The histology of the aneurysm was that of the usual type of the saccular aneurysm. The post-operative course was uneventful. He was discharged with no neurological deficit two months after the operation. As far as we know, there has been no report on a ruptured aneurysm in the hypoplastic A1 portion. We also reviewed the 55 aneurysms in the A1 portion that have been reported in the literature.

Efficacy and safety of clentiazem in patients with essential hypertension: results of an early pilot test

The purpose of this study was to evaluate the antihypertensive effect of a new calcium antagonist, clentiazem, on inpatients or outpatients with essential hypertension. After blood pressure was stable and greater than 160/95 mmHg with placebo for at least a 2-week observation period, oral clentiazem was administered once daily and dosage was increased stepwise from 10 to 40 mg over 10 weeks. Blood pressure significantly decreased by the second week of the study, and this hypotensive effect was maintained until the eighth week. Cumulative effective rate (percent of patients whose blood pressure decreased in 20/10 mmHg) in 62 outpatients were as follows; 10.3% at 10 mg, 39.6% at 20 mg, 70.2% at 30 mg, 76.6% at 40 mg. There was no significant postural change observed in the blood pressure from supine to standing position. Side effects such as dizziness, general malaise and gait disturbances were observed in 3 (3.9%) of 76 patients. No abnormal changes in clinical laboratory examinations or electrocardiograms were caused by clentiazem. Thus these data demonstrated that clentiazem produces certain antihypertensive effects with sufficient safety.

Localization of chromogranin A-immunoreactivity in bovine gastrointestinal endocrine cells with special reference to Grimelius silver stain

Immunohistochemical studies of the gastrointestinal tract were carried out to characterize the cells exhibiting immunoreactivity for chromogranin A (CGA), a glycosylated protein primarily found in secretory granules of the adrenal medulla. Double immunostaining for gastrointestinal hormones and CGA revealed that in the bovine gastrointestinal tract CGA immunoreactivity occurs in mucosal epithelial cells containing gastrin, glucagon, substance P or motilin, but not in those containing somatostatin. Combined staining with anti-CGA serum and Grimelius' silver demonstrated frequent association of the two stains in a variety of endocrine cells. However, intracellular distribution of the two stains was different: CGA-immunoreactivity was detected in both supra- and infranuclear cytoplasm, whereas Grimelius' silver was mostly localized in the infranuclear region. These results suggest that CGA is the target of Grimelius' silver, as postulated recently (Rindi et al., 1986), but that some subcellular structure-related modification of molecules such as sialation is necessary for the positive Grimelius reaction.

Effects of growth hormone-releasing hormone (GHRH) on densely granulated somatotroph adenomas and sparsely granulated somatotroph adenomas in vitro: a morphological and functional investigation

The effects of growth hormone-releasing hormone (GHRH) were studied on densely granulated somatotroph adenoma cells and sparsely granulated somatotroph adenoma cells in culture by measuring release of growth hormone (GH) as well as ultrastructural morphometrical parameters and comparing them with those of control adenoma cells. Both types of adenoma cells cultured with GHRH showed similar increases of GH release into culture media and exhibited similar increases in cytoplasmic volume densities (CVD) of endoplasmic reticulum and Golgi apparatus and decreases in CVD of secretory granules and secretory granule diameter. These results indicate that (1) both types of somatotroph adenoma cells react similarly to GHRH stimulation, despite their morphologic differences, and (2) GHRH stimulates GH synthesis as well as GH release by somatotroph adenoma cells.

Clinicopharmacological studies of a newly synthesized cardiotonic agent (TA-064) in patients with congestive heart failure

In animal experiments, a new inotropic agent, (-)-(R)-1-(p-hydroxyphenyl)-2-[(3,4-dimethoxyphenetyl)amino] ethanol, designated TA-064 was found to possess a more positive inotropic than chronotropic action. Its effectiveness and lack of significant toxicity make it beneficial for clinical use as a cardiotonic in human heart failure. The effects of TA-064 were investigated in patients with various types of heart disease (n = 29). Cardiac output increased, left ventricular end-systolic dimension decreased, and left ventricular fractional shortening increased for 15 minutes after a single intravenous dose (1 mg). The plasma level of TA-064 at the cessation of infusion was 61.1 +/- 49.6 ng/ml and thereafter declined biexponentially. After a single oral dose (10 mg), TA-064 appeared in the plasma at 30 minutes and reached its peak levels of 13.7 +/- 5.6 ng/ml at 60 minutes. Seven hours later, the plasma level was 5.9 +/- 3.1 ng/ml which was considered to be within the effective range according to the results after intravenous administration. In conclusion, minimal effective plasma levels of TA-064 are obtained by oral administration of 10 mg three times a day.

Myocarditis with multinucleated giant cells detected in biopsy specimens

A 42-year-old woman was transferred to our hospital for evaluation of bradycardia with a complete atrioventricular block. Her pulse was 41 regular beats/min with blood pressure 166/92 mmHg. There were no skin lesions, edema, or lymphadenopathy. The white blood cell count was 6300/mm3. The serum glutamic oxaloacetic transaminase was 21 IU and creatine phosphokinase was 34 IU. C-reactive protein was negative. The level of serum angiotensin converting enzyme was slightly increased at 25.8 IU/l/37.0 degrees C (normal range: 7-24.0). Chest radiography showed congestive heart failure with a cardiothoracic ratio of 54%. There was no bilateral lymphadenopathy or fibrous changes during her clinical course. The coronary arteries were completely normal angiographically. Left ventriculograms revealed slight hypokinesis and dilatation (end-diastolic volume index of 112 ml/m2, ejection fraction of 53%). Left ventricular end-diastolic pressure was slightly abnormal at 16 mmHg. Two right and two left ventricular endomyocardial biopsies were performed. Right ventricular biopsy demonstrated edematous tissue and a slight mononuclear cell infiltration with little fibrosis. Left ventricular specimens showed an extensive area of fibrosis, with large, multinucleated giant cells with an asteroid body and chronic inflammation without epithelioid cells. The less affected areas of another specimen showed mild interstitial fibrosis and degenerative myocytes with vacuolation, and some multinucleated myocytes without an asteroid body were present. This case was diagnosed as cardiac sarcoidosis rather than idiopathic giant cell myocarditis. The patient has been implanted with a permanent pacemaker.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of diltiazem on rheological properties of human blood

The in vitro effects of diltiazem (DTZ), a coronary vasodilator, deacetyldiltiazem (D-M1), one of the metabolites of DTZ, and pentoxifylline (PTF) which is known to improve erythrocyte deformation, on the viscosity of platelet poor blood were compared. Furthermore the change in the viscosity of whole blood from patients with effort angina after intravenous administration of DTZ was examined ex vivo. The addition of DTZ into platelet poor blood at 37 degrees C caused a rapid reduction in blood viscosity and an enhancement of erythrocyte deformability within 5 min, which then diminished in a time-dependent manner. Similar effects were also found by adding D-M1. On the other hand, the effects of PTF appeared after an incubation period of more than 60 min and were enhanced in a time-dependent manner. These actions of PTF, but not those of DTZ and D-M1, paralleled the increase of erythrocyte adenosine-triphosphate content. DTZ and D-M1, but not PTF, had biphasic effects on the osmotic behavior of erythrocytes. Whole blood viscosity was reduced significantly during the period 5-30 min after intravenous administration of 10 mg of DTZ, which diminished with the elimination of plasma DTZ. In conclusion, the action mechanisms involved in the effect of DTZ and D-M1 on blood rheological properties appeared to be different from that of PTF. These effects of DTZ are clinically significant in improving the flow properties of blood in vascular diseases.

Changes of Ca2+-ATPase and cytochrome oxidase activity of myocardial cell under early and late ischemia:--comparison with ultrastructural changes

Using the histo- and cytochemical technique we assessed the Ca2+-transporting function of mitochondria (Mit) and sarcoplasmic reticulum (SR), and the ATP producing function of Mit in the ischemic myocardial cell of a dog's heart. In comparing ultrastructural ischemic changes, cytochrome oxidase (CO) and Ca2+-ATPase were cytochemically and histochemically measured when the myocardium was subjected to the ischemia of left anterior descending coronary artery occlusion for 15 min, and 60 min. After 15 min of occlusion the ischemic alterations consisted of a wide I band, decreased glycogen (G) and Mit swelling with a slight reduction of matrix density. Although CO activity was not reduced, Ca2+-ATPase had decreased mainly in Mit. Sixty min of ischemia resulted in loss of G, intermyofibrillar edema, marked Mit swelling with loss of matrix density and partial disruption of cristae, and dilatation of SR. Ca2+-ATPase activity was significantly reduced in Mit, SR and myofibrils. Although there was Mit swelling with partial disruption of cristae after 60 min of ischemia, CO activity was found to still exist in the remaining cristae. These findings suggest that intracellular organelle dysfunction progresses in the ischemic myocardial cell at different rates, and that disruption of intracellular Ca2+-homeostasis may occur early in the ischemic state.

Correlation between ERG oscillatory potential and psychophysical contrast sensitivity in diabetes

Correlation between the electroretinographic oscillatory potential and psychophysical contrast sensitivity function was examined in patients with different stages of diabetic retinopathy. Contrast sensitivity function was evaluated by Arden's grating test. The amplitude of the oscillatory potential was significantly reduced in cases with low contrast sensitivity (P less than 0.01).

Rheumatic fever and rheumatic heart disease in Japan

Rheumatic fever (RF) is the common cause of rheumatic heart disease (RHD) in the 5-30 age group and is usually preceded by group A streptococcal pharyngitis. The annual mortality caused by RF and RHD has changed remarkably in Japan between 1960 and 1981 according to the report of the Ministry of Health and Welfare. The annual incidence of RF among schoolchildren as surveyed from pediatric clinics of 20 major hospitals between 1952 and 1980 varied year by year, and is now steadily declining. Follow-up studies of 287 patients with carditis over ten years showed that cardiac murmur disappeared in 44.9% of total patients within 4 years through use of antibiotic prophylaxis. Other patients continued to have cardiac murmur 10 years after the first attack of RF. Valvular involvement due to RF was mostly confined to mitral valve and the appearance of mitral regurgitation was particularly common in schoolchildren. Survey of RHD in schoolchildren showed that mitral regurgitation was the most common anomaly, but the prevalence rate of RHD decreased from 4.6/1000 population in 1958 to 0.14/1000 population in 1981. By contrast, mitral stenosis was predominant in adults, according to the records of patients admitted in three university hospitals. Since socio-economic conditions have improved, and penicillin has been introduced to control group A streptococcus, mortality and morbidity from RF and RHD have remarkably decreased in well developed countries. These factors may have contributed predominantly to the sharp decrease in first and recurrent attack of RF in Japan.

Comparative efficacy of high-dose versus low-dose nicorandil therapy for chronic stable angina pectoris

Nicorandil therapy was compared with placebo therapy in 11 patients with chronic stable angina pectoris. A computer-assisted treadmill exercise test was performed after administration of either 10 or 30 mg of nicorandil. Analysis of variance showed a significant difference among placebo and nicorandil treatments (p less than 0.01). Ten milligrams of nicorandil prolonged time to onset of ischemia 36% (p less than 0.05) but increased the exercise duration only 15%. Thirty milligrams of nicorandil prolonged time to onset of ischemia 82% (p less than 0.01) and exercise duration 45% (p less than 0.01). Both time to onset of ischemia and exercise duration increased progressively from the 10-mg to the 30-mg dose (p less than 0.05). Heart rate at rest was significantly higher and systolic pressure at rest significantly lower with 30 mg of nicorandil than with placebo. After administration of 30 mg of nicorandil there was a significant reduction in ST depression associated with a slight decrease in the double product at the end of Bruce stage 2 exercise. The peak double product was greater after administration of 30 mg of nicorandil than after placebo, indicating an increased myocardial oxygen supply to the ischemic area. The plasma concentration of nicorandil averaged 78 +/- 83 ng/ml with the 10 mg and 313 +/- 142 ng/ml with 30 mg. There was an increase in exercise duration of more than 1 minute in 8 of 9 patients who had plasma nicorandil concentrations greater than 100 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

[Vasoconstrictor responses of isolated pig coronary arteries]

In helical strips of pig coronary arteries, histamine, serotonin, acetylcholine and a stable analogue of thromboxane A2 (9, 11-epithio-11, 12-methano TXA2: s-TXA2) produced a dose-dependent contraction. The histamine-induced contraction was suppressed by treatment with chlorpheniramine, suggesting an involvement of H1 receptors. Contractile responses to serotonin were attenuated by not only ketanserin, an S2 antagonist, but also by cinanserin and methysergide. Relaxation induced by serotonin in preparations treated with high concentrations of ketanserin were inhibited by cinanserin and methysergide. Norepinephrine contracted coronary arteries treated with propranolol. Contractile responses to norepinephrine were reversed to relaxations by prazosin, which were abolished by treatment with yohimbine. Contractile responses to histamine were potentiated by treatment with low concentrations of serotonin or s-TXA2. Contractile responses to serotonin were also potentiated by low concentrations of histamine or s-TXA2. Removal of the endothelium from pig coronary arterial strips potentiated contractions induced by serotonin, histamine and norepinephrine. These results suggest that, in addition to damaged endothelium, integrating action of endogenous vasoconstrictors, including histamine, serotonin, TXA2 and norepinephrine, may play an important role in producing coronary vasospasm.

A follow-up study of throat carriers of streptococci among schoolchildren in Otsu City

Studies on the prevalence of beta-hemolytic streptococci in throats among primary school children were performed in Otsu City. In the first study, evidence of streptococcal infections was investigated in 41373 children of first grade of all primary schools for the 13 years from 1970 to 1982. An average of 12.2% of the strains isolated belonged to group A. The order of frequency of the other Groups was B, C and G respectively. The most predominant type of Group A streptococci was Type 12. In the second study, evidence of streptococcal infections was investigated in 87 children of the first grade of one primary school for the 5 years from 1977 to 1982. Throat cultures were repeated four times a year during the period of five years. Entire negative throat cultures over a 5-year period were observed in only 4 children. The prevalence of beta-hemolytic streptococci and Group A streptococci in throats were higher than those observed in the first study. The predominant types of Group A were Types 1, 6 and 28, although the relative predominance of these Types varied at different times during 5 years. High serum ASO titers were observed in the children who harbored Type 6 strains of Group A streptococci in throats. In 5 children Group A streptococci were frequently recovered from throats during the study period, and the same type of strains of Group A streptococci were isolated repeatedly.

The effect of molsidomine on intramyocardial pressure and regional myocardial blood flow in the canine ischemic myocardium

Molsidomine was administered intraduodenally to anesthetized dogs which were instrumented for measurements of aortic and left ventricular (LV) pressures, coronary perfusion pressure, intramyocardial pressure in the subendocardium, and subendocardial and subepicardial myocardial blood flow in the ischemic and non-ischemic regions. The dogs were divided into two groups: group M (n = 9) was administered molsidomine (0.2 mg/kg), group S (n = 10), saline only. Maximum LV systolic pressure decline was 20% in group M and 3% in group S (p less than 0.05). Maximum LV end-diastolic pressure decline was 63% and 35% in groups M and S, respectively (p less than 0.05). There was no difference between mean aortic pressure and coronary perfusion pressure between the two groups. The subepicardial blood flow in the ischemic region was decreased (-23% in group M vs 5% in group S; p less than 0.05), but subendocardial blood flow in the ischemic region increased only slightly in group M. The ratio of subendocardial to subepicardial blood flow increased at 15 and 30 min after administration of molsidomine in the ischemic area (67% in group M vs -10% in group S; p less than 0.05), but did not show any change in the non-ischemic region. Intramyocardial pressure at systole did not show any change but it decreased at end-diastole, (-32% in group M vs -7% in group S; p less than 0.05). Thus molsidomine redistributed the myocardial blood flow from the subepicardium to the subendocardium and from the non-ischemic to the ischemic region. This redistribution was associated with a reduction in both LV end-diastolic pressure and intramyocardial pressure at end-diastole.

Vascular effects of 15-hydroperoxyeicosatetraenoic acid and 15-hydroxyeicosatetraenoic acid on canine arteries

The vascular effects of 15-hydroperoxyeicosatetraenoic acid (15-HPETE) and 15-hydroxyeicosatetraenoic acid (15-HETE) were investigated on isolated helical strips of canine cerebral and coronary arteries. 15-HPETE caused strong concentration-related contraction of cerebral arteries under resting tension. After contraction with prostaglandin F2 alpha (PGF2 alpha), 15-HPETE caused marked relaxation of coronary arteries. The effects of 15-HETE on isolated canine arteries were similar to those of 15-HPETE. The relaxation of coronary arteries caused by both 15-HPETE and 15-HETE was completely inhibited in the presence of aspirin, but not in the presence of tranylcypromine. Preincubation of coronary and cerebral arterial strips with 15-HPETE or 15-HETE resulted in suppression of the production of 6-keto-PGF1 alpha from exogenously added arachidonic acid; and 15-HPETE, but not 15-HETE, enhanced the production of HETE(s) significantly. Aspirin blocked 15-HPETE induced HETE(s) production in coronary arteries. On cerebral angiography, strong contraction of intracranial arteries was observed after intracisternal injection of 15-HPETE. On the other hand, 15-HETE had little effect on intracranial arteries in vivo. The mechanism of the vascular effects of 15-HPETE and 15-HETE will be discussed.