Cell-to-cell communication in cultured rat thyroid monolayer cells is inhibited dose-dependently by methimazole.

We performed monolayer culture of rat thyrocytes and studied gap junctional communication by measuring intercellular fluorescence redistribution after photobleaching. Cell-to-cell communication among thyrocytes gradually developed during the culture. This communication was demonstrated in approximately 60 percent of the cells cultured for 8 days, while it could not be detected in the remaining 40 percent of the cells even after longer culture. When thyrocytes were cultured in the presence of methimazole, the fluorescence recovery after photobleaching was inhibited dose-dependently. Thyroid-stimulating hormone did not affect the fluorescence recovery. We provided, for the first time, that methimazole inhibited the development of cell-to-cell communication of thyrocytes dose-dependently.


Influence of a stable prostacyclin analogue, Cicaprost, on the response to prostaglandin F2 alpha in the perfused human placenta.

Because a balance between the vasodilator effect of Prostacyclin and the vasoconstrictor effect of Prostaglandin F2 alpha (PGF2 alpha) may be necessary for the regulation of utero-placental-fetal blood flow, a study was designed to assess the influence of a stable prostacyclin analogue, Cicaprost, on the response to Prostaglandin F2 alpha in the perfused human placenta. Cicaprost produced a dose-dependent inhibition of the pressor response of 50 mcg of PGF2 alpha. The decrease in PGF2 alpha-induced pressor response by 0.1 mcg of Cicaprost was not significant, only 6.95 +/- 8.2%. However, 0.5 mcg and 1.0 mcg of Cicaprost significantly attenuated the pressor response of PGF2 alpha by 36.6 +/- 9.5% and 46.8 +/- 8.3%, respectively (MEAN +/- S.E.).


Quantitative determination of 17 beta-estradiol and progesterone in cellular fractions of term placentae of normal and hypertensive patients.

During pregnancy the placenta is both the source and target for the actions of steroid hormones. In fact, an intact feto-placental unit is capable of elaborating increasing levels of a wide variety of steroid hormones and many other substances. The falling levels of steroid hormones, like estrogens and progesterone in serum and urine have been reported during pregnancy induced hypertension and/or preeclampsia. The purpose of this study was to determine the concentration of 17 beta-estradiol and progesterone in cytosol, nucleic fraction and particulate fraction of term placentae of normal and hypertensive patients by radioimmunoassay. Data from this study reveal the concentrations of 17 beta-estradiol (E2) and progesterone (P) in various cellular fractions from six placentae of normal patients (NP) and five placentae of hypertensive patients (HP). In HP overall concentrations of E2 (75.8 ng/gm) and P(46.5 micrograms/gm) is greater than those in NP, 32.6 ng/gm and 25.0 micrograms/gm respectively. The concentration of E2 in nuclear fraction of NP and HP remains unchanged while P concentration of nuclear fraction of HP (25.4 micrograms/gm) is much greater than those of NP (8.8 micrograms/gm). Moreover, the E2 concentration (55.5 ng/gm) in cytosol of HP is much greater than those of NP (12.3 ng/gm). Therefore, this study indicates that the abnormal concentrations of E2 and P of placentae are associated with pregnancy induced hypertension.


Inhibition of [3H]-MK801 binding and protection against NMDA-induced lethality in mice by a series of imipramine analogs.

A series of imipramine analogs were tested for inhibition of [3H]-MK801 binding and for their ability to protect against NMDA-induced lethality in mice. The structure-activity relationship (SAR) for the inhibition of [3H]-MK801 binding found primary amines on short linkers to be optimum. For protection against NMDA lethality, compounds containing an unsaturated link to a cyclic amine were the most potent analogs tested. Possible explanations for the lack of correlation observed are briefly discussed.


Serum and organ indices of the mdx dystrophic mouse.

Duchenne muscular dystrophy (DMD) is a fatal disease for which there is no effective treatment. The cause of death in patients with DMD is often cardiovascular and pulmonary dysfunction. This clinical observation, combined with experimental findings, suggests that other non-muscle organ systems may be affected in the dystrophic disease state. To test this hypothesis, the present study investigated liver and kidney function in the mdx mouse. Serum chemistries and the hepatic cytochrome P-450 system in normal and dystrophic mdx mice were investigated at two different ages. Increases in serum lactate dehydrogenase (LDH), alkaline phosphatase (AP), aspartate transaminase (AST), and cholesterol levels, combined with an increase in liver weight and a decrease in cytochrome P-450, suggests the possibility of hepatic dysfunction. Increases in serum uric acid and phosphorus, and decreased kidney weight suggest hepatic dysfunction.


Plasma concentration of furosemide versus specific gravity of urine in predicting dose of administration in race horses.

This study was undertaken to determine the applicability of plasma concentration of furosemide and specific gravity (SG) of urine in regulating the use of furosemide administered 4 hours prior to race time in Exercise-Induced Pulmonary Hemorrhage (EIPH) race horses. Nonbleeders (CTL) and certified bleeders (FUR) actively racing in Illinois (IL) and Pennsylvania (PA) were used in the study. Various doses (less than 250, 250, 300, 350, 400 and 500 mg) were administered either as a single intravenous (IV) dose or as a combination (IV-IM) of IV and intramuscular (IM) administrations 4 hours before race time. Plasma and urine samples were obtained post race for determination of furosemide concentration in plasma and measurement of SG of the urine in both CTL and FUR groups. Plasma samples were analyzed for furosemide using High Performance Liquid Chromatography with Fluorescence Detection. SG was measured using a digital refractometer. The results indicate a significant difference (p less than 0.0001) in the SG of the urine samples between the CTL and FUR groups irrespective of the route of administration (IV versus IV-IM). However, SG values of the urine in some CTL samples were lower than those in some FUR samples and vice versa. Thus, the use of SG alone is not reliable for predicting either the dose or the administration of furosemide to race horses. The plasma concentrations of furosemide following the administration (IV) of 250 mg or 500 mg 4 hours prior to race time were indistinguishable (25.91 +/- 4.45 versus 28.12 +/- 6.99 ng/ml, respectively); the majority of the horses in the groups had a plasma concentration of less than 40 ng/ml. When taken in total, plasma concentration of furosemide can only be used as a guide in regulating the administration of furosemide to race horses.


The effects of xanthoangelol E on arachidonic acid metabolism in the gastric antral mucosa and platelet of the rabbit.

The effects of a new chalcone derivative, xanthoangelol E, isolated from Angelica keiskei Koidzumi, on arachidonic acid metabolism in the gastric antral mucosa and platelet of the rabbit were examined. When gastric antral mucosal slices were incubated with xanthoangelol E (0.05-1.0 mM), there was no significant effect on the production of prostaglandin (PG) E2, PGF2 alpha and their metabolites. On the other hand, this compound inhibited effectively the production of thromboxane B2 and 12-hydroxy-5,8,10-heptadecatrienoic acid from exogenous arachidonic acid in platelets, and the concentration required for 50% inhibition (IC50) was approximately 5 microM. The formation of 12-hydroxy-5,8,10,14-eicosatetraenoic acid was also reduced by this drug (IC50, 50 microM). These results suggest that xanthoangelol E has the potential to modulate arachidonic acid metabolism in platelets and that this action may participate in some pharmacological effect of the plant.


Toxic response of linoleic acid anilide in female rats.

The toxicity of linoleic acid anilide (LAA) and heated linoleic acid anilide (HLAA) was studied in female rats. Female Sprague-Dawley rats were given 250 mg/kg of LAA or HLAA in mineral oil, by gavage, on alternate days for two weeks. Control rats received an equal volume of mineral oil. The animals were sacrificed at day 1, 7 and 28 following the last dose. Organ-to-body weight ratio was increased for spleen in both LAA and HLAA treated rats at day 1. Lung, kidney and brain showed increases in this ratio at some time point, whereas, thymus in the HLAA group showed a decrease at day 28. Among blood parameters, red blood cells and hemoglobin content decreased in both LAA and HLAA treated groups at day 1 and in the LAA group at day 7. Serum IgA levels increased throughout the study in both treatment groups and were more pronounced in HLAA treated rats. Splenic T-helper lymphocyte numbers decreased in the HLAA group at day 1, whereas, other cell types were not affected. The changes observed in female rats are comparable to our previous findings in male rats and relatively minor in relation to sex differences. These results further support that hemopoietic system is an early target of fatty acid anilide toxicity.


Direct membrane damage and miconazole lethality.

Physicochemical membrane damage is presumably the cause of growth phase-dependent lethal miconazole action. In support of this, we showed that as stationary phase inoculum cells of Candida albicans progress into early logarithmic phase, susceptibilities to lethal action and to miconazole-induced release of K+ increase together.


Na(+)-Ca2+ exchange influences halothane and caffeine contractures of malignant hyperthermic skeletal muscle.

These experiments sought to determine the influence of sarcolemmal Na(+)-Ca2+ exchange on halothane and on caffeine contractures of malignant hyperthermic (MH) skeletal muscle. Fiber bundles excised from MH susceptible pigs (Pietrain) were exposed to halothane (3%) and caffeine (0.5-8.0mM) while Na(+)-Ca2+ exchange was inhibited by reducing extracellular Na+ from 100% to 50, 25 and 0% of control. Halothane contracture magnitude was not altered by 50 or 25% Na+ whereas 0% Na+ increased the contractures by 51%. 0 and 25% Na+ increased the magnitude of caffeine contractures (2-8mM) by 53-176%. These results suggest that external Na+ and the Na(+)-Ca2+ exchange mechanism influences contractures of MH skeletal muscle.


Bioartificial endocrine pancreas: foreign-body reaction and effectiveness of diffusional transport of insulin and oxygen after long-term implantation of hollow fibers into rats.

Foreign body reaction of the liver, kidney, and subcutaneous tissue of rats after implantation of hollow fibers (HF) for 1, 3, 6, and 12 months and its influence on the effectiveness of diffusional transport of insulin and oxygen were investigated. The highest degree of fibrosis was observed after subcutaneous implantation of HF and the lowest degree after implantation into the kidney. Histochemical staining of the fibrous capsule showed a tissue-dependent domination of the collagenous fibrils. After 90 min of perfusion 33% of the insulin contained in HF diffused out of the nonimplanted fiber, after 120 min, 73% and after 180 min, 100%. Hollow fibers, which were removed with a surrounding connective capsule after an implantation period of 1 year, showed even better permeability for insulin than nonimplanted HF. The tension of oxygen in the lumen of the implanted hollow fibers was 42 mm Hg after implantation into the kidney and 30 mmHg after implantation into the liver. The oxygen present inside an HF that is implanted into a kidney and liver was consumed by 100 islets in 3.9 and 2.8 min, respectively. It was concluded that to achieve acceptable results in the construction of bioartificial pancreas more research activities should be performed on the diffusion and consumption of oxygen in the bioreactor.


beta-Alanyl-L-histidinato zinc prevents hydrocortisone-induced disorder of bone metabolism in rats.

The preventive effect of beta-alanyl-L-histidinato zinc (AHZ) on osteopenia was investigated in rats treated with hydrocortisone. Rats received hydrocortisone (75 mg/kg body weight per day) s.c. for 30 days. The steroid treatment caused a significant increase in serum alkaline phosphatase activity and parathyroid hormone (PTH-c) level, while serum calcium, inorganic phosphorus, and zinc concentrations were not significantly altered. The femoral-diaphyseal alkaline phosphatase activity, deoxyribonucleic acid (DNA), and calcium contents were significantly decreased by the treatment of steroid, although the bone zinc content was not appreciably altered. When AHZ (10, 30, and 100 mg/kg per day) was administered p.o. for 30 days to rats giving the steroid, the dose of AHZ (30 and 100 mg/kg) completely prevented the increases in serum alkaline phosphatase activity and PTH-c level and the decreases in femoral-diaphyseal alkaline phosphatase activity, DNA, and calcium contents caused by the steroid treatment. The dose of AHZ (10, 30, and 100 mg/kg) significantly increased zinc content in the femoral diaphysis. Present results indicate that the dose of AHZ can prevent the disorder of bone metabolism caused by hydrocortisone treatment. AHZ may have a therapeutic role in the steroid-induced osteopenia.


Effect of isoproterenol on regional myocardial segment work, O2 consumption, and oxygen balance.

We tested the hypothesis that positive inotropic stimulation by isoproterenol alters the relationship between regional segment work and regional myocardial oxygen consumption. Regional parameters were compared with external cardiac work and global LV oxygen consumption. In anesthetized open-chest dogs, regional myocardial segment length (ultrasonic dimension crystals) and force development (miniature force transducer) were measured. The integrated multiples of myocardial shortening by corresponding force during an averaged beat expressed segment work (area under the systolic portion of the length-force loop). External cardiac work was calculated from aortic blood pressure and cardiac output. Global and regional myocardial MVO2 were evaluated at baseline and during intravenous infusion of isoproterenol (0.5 and 1.0 micrograms/kg per min). Regional coronary blood flow was measured with radioactive microspheres, and microspectrophotometry of frozen myocardial biopsies was used to evaluate O2 saturation in small arteries and veins. These parameters were used to calculate regional MVO2. Arterial and coronary sinus O2 saturation was used to calculate global LV O2 consumption. Regional myocardial O2 balance was estimated by measurement of NADH redox level using surface fluorometry. It was found that 0.5 micrograms/kg per min isoproterenol increased regional segment work/minute from 4650 +/- 495 to 6750 +/- 750 mm.g/min. Corresponding regional oxygen consumption was disproportionately increased from 5.43 +/- 0.61 to 15.24 +/- 1.37 ml/min per 100 g. External cardiac work was found to decrease from 728 +/- 13 to 562 +/- 25 mmHg.1/min (due to decreased aortic blood pressure), whereas global myocardial O2 consumption increased. Regional myocardial O2 extraction and NADH fluorescence were elevated, indicating impaired tissue oxygenation. Regional MVO2 was increased by 153 +/- 56%, but regional work by only 45.3 +/- 33% (P < 0.05). These results indicate that regional contraction efficiency was markedly reduced by isoproterenol.


Cardiac glycosides in the treatment of experimental overdose with calcium-blocking agents.

The ability of digitalis compounds to counteract calcium antagonist overdose was studied in anesthetized dogs (n = 6, 13.5 +/- 0.7 kg) and isolated trabeculae from human hearts (n = 7). Digitalis caused by increasing intracellular cytosolic Ca2+ concentration through Na+/Ca(2+)-exchange across the cell membrane, was postulated to overcome the detrimental effects of excessive slow calcium-channel blockade. In anesthetized dogs, an infusion of verapamil (40 mg/30 min, i.v.) decreased mean arterial pressure from 88 +/- 6 to 66 +/- 6 mm Hg (P < 0.05), reduced systemic vascular resistance (SVR) from 3838 +/- 916 to 2200 +/- 669 dyne.s/cm5 (P < 0.05), and induced total atrio-ventricular (A-V) block in three animals. Stroke volume (SV) remained unchanged. Administration (i.v.) of NaCl (0.9%, 200 ml) and calcium gluconate (100 mg)--to increase the availability of Na+ and Ca(2+)--together with atropine (0.2 mg)--to block the parasympathetic effects of digoxin on A-V conduction--increased left ventricular contractility (15%) but had no significant effects on blood pressure, SV, or A-V block. Digoxin (0.125 mg) returned sinus rhythm in all dogs and, by increasing SVR (P < 0.05) and left ventricular contractility (P < 0.05), returned arterial pressures to baseline. Because of increased afterload, SV decreased slightly (15%) despite increased cardiac contractility. In experiments with isolated trabeculae from diseased human hearts, TA 3090 (Clentiazem) depressed contractile force and ouabain, another glycoside, restored contractile force within 30 min.(ABSTRACT TRUNCATED AT 250 WORDS)


Simulated weightlessness and bone metabolism: gravitational stimulation enhances insulin sensitivity.

The effect of simulated weightlessness on bone metabolism was investigated in skeletal unloading for 4 days. Skeletal unloading was designed using the model of hindlimb hang in rats. Skeletal unloading with hindlimb hang cased a significant decrease of alkaline phosphatase activity, deoxyribonucleic acid (DNA) content, and glucose consumption in the femoral diaphysis, but not in the calvaria. When femoral-diaphyseal tissues were cultured in the presence of insulin (10(-8) M), the hormone produced a significant increase of alkaline phosphatase activity and decrease of glucose consumption in the femoral-diaphyseal tissues obtained from normal rats. This hormonal effect was not seen in the femoral diaphysis, but in the calvaria, of rats with skeletal unloading. However, insulin effect was seen in the femoral diaphysis obtained at 3 days after the removal of skeletal unloading. Meanwhile, the presence of other bone-regulating factors (10(-8) M parathyroid hormone [1-34] and 10(-4) M zinc sulfate) revealed an appreciable effect on alkaline phosphatase activity in the femoral diaphysis from rats with skeletal unloading. These results suggest that gravitational stimulation can directly enhance a specific insulin sensitivity in the regulation of bone metabolism.


Gastric mucosal blood flow distribution in the CCl4-induced cirrhotic rat--a model of portal hypertensive gastropathy?

Because the carbon tetrachloride-induced cirrhotic rat model is considered to be the closest to the clinical situation of the cirrhotic patient, the discovery of congestive gastropathy in such rats would enable the development of a useful research model. By the use of laser-Doppler technology, gastric mucosal blood flow was assessed on 14 defined points of the stomach in 16 cirrhotic and 16 matched healthy rats, in an effort at in vivo mapping of the gastric mucosal microcirculation. Our findings of mucosal congestion in the cirrhotic stomach (reduced mucosal blood flow in the gastric corpus) are well matched with the distribution of gastric mucosal blood flow in the cirrhotic patient. These findings suggest that a rat's gastric mucosa could be used for studies of portal hypertensive gastropathy.


Genetic variation in resistance to parasitic infection: experimental approaches and practical applications.

Parasitic infections remain a major threat to the successful maintenance of domestic livestock. Control is still centered around management and husbandry, and the use of chemotherapeutic compounds. However, the spread of drug resistance in many important protozoal and helminth infections is placing an increasing emphasis on the development of alternative forms of control. At the present time vaccination is available for only a limited number of parasites, and may never be practical or cost-effective for some of the most important infections. This review examines current views of the mechanisms, control and likely value of genetically determined differences in resistance to parasitic infection. There is an extensive literature dealing with experimental analyses of genetic variation to parasitic infection in both laboratory and domestic species, and a growing interest in the application of this information in the field of practical parasite control.


Transdiaphragmatic pressure measurement in cattle: technical data.

Techniques and methods required for accurate and reproducible measurements of transdiaphragmatic pressure (Pdi), were studied in seven-week and five-month-old calves. Since reliable pleural pressure measurement in cattle has already been described, separate experiments were conducted to compare retrodiaphragmatic pressures measured (i) with balloon-catheters and needle catheters, (ii) before and after eructation and (iii) in the ruminal and in the peritoneal cavities. Whereas respiratory-induced pressure changes were equally transmitted throughout the rumen content, a marked anteroposterior damping was observed as the recording site in the abdominal cavity was moved away from the diaphragm (P < 0.0001). It was concluded that the most appropriate and accurate way to measure Pdi changes in polygastric animals is to measure the pressure changes existing in the mid-thoracic portion of the oesophagus and in the liquid content of the rumen with balloon-tubing units. Neither growth- and diet-related rumen enlargement nor eructation, which are two typical characteristics of ruminants, altered the reliability of retrodiaphragmatic pressure measurements in the two age groups studied.


Application of a diagnostic DNA probe for the differentiation of the two types of Mycoplasma mycoides subspecies mycoides.

Contagious bovine pleuropneumonia (CBPP), which is caused by Mycoplasma mycoides subspecies mycoides, is still a serious disease in some parts of the world. There is also a commonly occurring mycoplasma which is sufficiently related to the CBPP organism to bear the same name, even though this organism does not cause CBPP. Thus it is very important to be able to distinguish between these organisms and identify either with certainty. Fragments derived from M mycoides subspecies capri by restriction enzyme digestion of genomic DNA were cloned into the vector M13mp8. One resulting clone CAP-21, with a 1.5 kb insert was used as a probe in Southern hybridisation assays where genomic DNA was digested with the restriction endonuclease TaqI. This probe could differentiate a strain of M mycoides subspecies mycoides which does not cause CBPP. Subsequent tests on 14 other strains from cattle and goats showed that although they were isolated from diverse geographical areas, CAP-21 could clearly differentiate between these two types of M mycoides subspecies mycoides.


Interspecies variations in plasma half-life of ampicillin, amoxycillin, sulphadimidine and sulphacetamide related to variations in body mass.

The relationships between the half-lives during the elimination phase (t1/2 minutes) of ampicillin, amoxycillin, sulphadimidine and sulphacetamide and body mass (W, kg) between species of mammals and birds were examined using data from the authors' experiments and collected from the literature. Linear regression of the log half-lives of ampicillin, amoxycillin and sulphadimidine following intravenous injection on the log body mass for a variety of species of mammals and birds revealed significant correlations (r = 0.7709, n = 8, r = 0.7712, n = 8, r = 0.7749, n = 10). The interspecies relationships were described by the allometric equations t1/2 = 31.3 W0.16, t1/2 = 32.7 W0.12 and t1/2 = 129.2 W0.28, respectively. These equations may be of value for estimating dose intervals in species for which no relevant pharmacokinetic data are available.


Validation of the monofrequency forced oscillation technique for pulmonary function investigation in calves: an in vitro and in vivo study.

This study was to investigate whether the monofrequency forced oscillation (MFO) technique could be accurately used for pulmonary function testing in calves. The airflow resistance measured by this technique was compared to the resistance measured by the classical reference method by an in vitro study, using an artificial lung model, and by an in vivo study, using 11 healthy calves. The effect of the reference impedance of this oscillation equipment was also investigated. The results show linear relationships (r2 > 0.924, P < 0.001) in the resistance ranges 0 to 0.7 kPa litre-1 s and 0 to 1.0 kPa litre-1 s with a reference impedance of 1.0 kPa litre-1 s and 2.0 kPa litre-1 s, respectively. The MFO resistance values lower and higher than 0.4 kPa litre-1 s are slightly overestimated and underestimated, respectively. It was shown that, if some technical requirements are met, the MFO technique is a simple, reproducible, fast and accurate method which allows measurement of airflow resistance even in field conditions.


Effects of oral sunflower oil and olive oil on serum and cutaneous fatty acid concentrations in dogs.

The effects of dietary fatty acids on serum and cutaneous fatty acids of healthy dogs were evaluated under controlled conditions. Beagle puppies (n = 12) were fed a standard diet supplemented with sunflower oil (group A), olive oil (group B) or no supplementation (group C) for 12 weeks. There were no significant differences in food intake or growth rates between the three groups. Dogs in group A had significant increases (P < 0.05) in serum 18:2n6 (linoleic acid) and 20:3n6 (dihomo-gamma-linolenic acid), and cutaneous 18:2n6 with significant decreases in serum 20:4n6 (arachidonic acid) and cutaneous 18:1n9 (oleic acid) and 18:3n3 (alpha-linolenic acid). Dogs in group B had significant increases in serum 18:1n9, 20:3n6 and cutaneous 18:1n9 with decreases in serum 20:4n6, 22:4n6, 22:5n3 and 22:5n6, and cutaneous 18:2n6, 18:3n3 and 20:4n6. There were no significant changes in serum or cutaneous fatty acids for the dogs in group C. This study demonstrates that fatty acid supplements can be used to alter the serum and cutaneous fatty acid compositions of dogs.


Comparative behaviour of Brucella abortus strains 19 and RB51 in the pregnant mouse.

Pregnant BALB/c mice received various doses of either Brucella abortus strain 19, a smooth vaccine strain, or B abortus strain RB51, a stable rough organism, intraperitoneally on day 9 of gestation to compare the relative pathogenicity of the two attenuated strains. Nine days after inoculation, spleens and placentas were collected for bacteriological and histopathological examination. A dose of 10(7.5) and strain 19 organisms produced a severe necrosuppurative placentitis occasionally accompanied by fetal death. This dose resulted in a 10-fold higher level of splenic infection than did a dose of 10(9.5) strain RB51 organisms, which produced only mild to minimal placentitis not associated with fetal death. Strain 19 infected mice showed seroconversion in the standard tube agglutination test in contrast to the seronegative titre of strain RB51 infected mice. The results of this study corroborate previous investigations on the relative pathogenicity and the serological response of the non-pregnant mouse to strain RB51.


In vitro production of specific antibody by equine peripheral blood mononuclear cells using tetanus toxoid as a recall antigen.

Anti-tetanus toxoid (TT) antibody (Ig) levels in the supernatant of cultured, pre-immunised equine peripheral blood mononuclear cells (PBMC) were measured by an indirect enzyme-linked immunoabsorbent assay (ELISA). Optimal anti-TT Ig production occurred at concentrations of stimulating, purified TT of between 0.001 and 0.1 micrograms ml-1, which varied depending on the cell concentration. Optimal anti-TT Ig production was most consistently produced when the cell concentration was 5 x 10(6) ml-1. At this cell concentration maximal anti-TT Ig was induced using 0.1 micrograms ml-1 TT. At a cell concentration of 5 x 10(6) ml-1 and a TT concentration of 0.1 micrograms ml-1 anti-TT Ig was first detectable in supernatant on day 5 of stimulation. Maximal levels of anti-TT Ig were present in the supernatant by day 10. No anti-TT Ig was produced in cultures of PBMC from non-immune animals.


Antipyrine, erythromycin and oxytetracycline disposition in experimental fasciolosis.

The effects of fasciolosis on drug disposition were studied by administration of antipyrine, erythromycin and oxytetracycline to sheep and cattle. Fasciolosis was produced by administration of 200 or 400 metacercariae (MC) of Fasciola hepatica to sheep and 500 MC to cattle. The disease was subsequently confirmed by determination of plasma glutamate dehydrogenase and gamma-glutamyl transferase and identification and quantitation of mature flukes in the liver at necropsy. Acute or subacute fasciolosis in sheep was accompanied by a significant decrease in the elimination rate constant (beta) and increase in the elimination half-time (t 1/2) for antipyrine and erythromycin when compared with controls or infected sheep which had been treated with the anthelmintic luxabendazole. An increase in apparent volume of distribution (Vd) was seen only for erythromycin in sheep given 400 MC. There were no changes in the disposition of oxytetracycline in sheep with either acute or subacute infection and no effects on disposition of the three test drugs in chronically infected sheep. With early chronic disease in calves, only the disposition of oxytetracycline was affected; not that of antipyrine or erythromycin.


Analysis of complex cytogenetic alterations in three canine mammary sarcomas.

Cells of mammary sarcomas in three dogs were analysed cytogenetically. In an osteoidsarcoma, hyperdiploidy with a range of 92 to 98 chromosomes, and several structural aberrations (for example, a derivative chromosome 1, isochromosome 13 and several bi-armed markers) were observed. Isochromosome 13 was also present in a case of an osteoidchondrosarcoma. In a case of chondro-osteosarcoma both hypodiploidy with a chromosome range of 60 to 66 and hyperdiploidy with a range of 115 to 128 and several centric fusions were observed.


Pathophysiology of the periparturient egg rise in sheep: a possible role for IgA.

The relationship between anti-parasite IgA antibody levels in plasma and the periparturient egg rise in sheep was investigated. Ostertagia circumcincta larvae (5000 third stage larvae three times weekly) were administered to three groups of seven adult immune ewes from 12 weeks before until three weeks after lambing (group 1) or from six (group 2) or 14 (group 3) weeks before until three weeks before lambing. Seven additional ewes were not challenged (group 4 controls). Ewes in groups 1, 2 and 4 received anthelmintics 14 weeks before lambing. Challenge of the pregnant ewes with O circumcincta larvae resulted in substantial increases in faecal egg counts only during the periparturient period regardless of the larval dosing regimen. Furthermore, the periparturient rise in faecal egg counts was closely associated with a significant increase in anti-parasite IgA antibody levels in plasma. This rise in IgA antibody levels occurred at a time when IgA is transported from the gut to milk during early lactation. It is postulated that this may lead to a temporary reduction in abomasal antibody levels of ewes and hence permit the establishment of larvae and, or, the emergence and development of inhibited larvae and thereby lead to the periparturient rise in faecal egg count.


Effect of colostrum intake on alpha-lactalbumin concentrations in serum of calves.

Seven Friesian calves were fed colostrum for four days beginning within 24 hours of birth, and milk thereafter. The concentration of alpha-lactalbumin in serum was measured by specific radioimmunoassay and compared to IgG assayed by electroimmunodiffusion. Serum concentrations of alpha-lactalbumin peaked at 387 +/- 85 ng ml-1 within eight hours of initial intake of colostrum, declining to 12 +/- 3 ng ml-1 by day 6. IgG rose steadily to 17 mg ml-1 by 48 hours of birth and remained relatively constant thereafter. The temporal pattern of alpha-lactalbumin in serum following colostrum intake confirms previous studies suggesting reduced absorption of colostral proteins between 24 and 36 hours. The presence of variable amounts of alpha-lactalbumin in serum even after 17 days, however, indicates limited transfer of milk-derived proteins across the gut at this time. The data further show that cessation of maximal gut transfer does not relate to molecular weight of transferred protein.


Tropical theileriosis in Bos taurus and Bos taurus cross Bos indicus calves: response to infection with graded doses of sporozoites of Theileria annulata.

This work extends basic knowledge of tropical theileriosis in taurine and crossbred cattle. Infection of Bos taurus and Bos taurus cross Bos indicus (Sahiwal) calves with graded doses of sporozoites of Theileria annulata (Hissar), an Indian stock of the parasite, showed the following to be dose dependent in both cattle types: the time to appearance and population size of macroschizonts, microschizonts and piroplasms, time and severity of pyrexia, anaemia manifested by erythrocyte counts and haematocrit. All infections were accompanied by a prompt and severe panleucopenia. This effect was dose related in both the taurine and the Sahiwal crossbred calves. Lymphocyte counts returned to preinfection levels in the blood of animals which recovered, but death from theileriosis was characteristically accompanied by a persistent and severe lymphocytopenia. Flow cytometry using monoclonal antibodies to bovine mononuclear cells was used to identify the lymphocyte subsets involved in lymphocytopenia. The outcome of infection was dose dependent in the crossbred calves but not in taurine calves. Although the results obtained did not differ qualitatively between the two cattle types, they provided some preliminary evidence for resistance to tropical theileriosis in Sahiwal crossbred calves.


Testing meningeal strains of Streptococcus suis to detect M protein genes.

Previous reports have suggested that the surface proteins found in meningeal strains of Streptococcus suis might be similar to the M protein of group A streptococci. Fifty-five strains of S suis, including human and swine meningeal and pneumonic isolates, were tested for M protein genes by DNA probes representing the constant domain of the 3' end of the group A, M protein gene. None of the S suis strains examined was positive, indicating that these organisms either lack M protein genes or harbour different genes, not expressing the constant domains of protein M from group A.


Effect of wetting a chicken's feathers on the effectiveness of electrical stunning.

Chickens were electrically stunned either when their bodies and feathers were wet or when they were dry. The time to recovery of muscular activity following stunning with 81 mA was assessed, and it was found that it was quicker in the wet birds. When hens which had previously been implanted with electroencephalogram electrodes were stunned with 119 mA it was found that the prevalence of somatosensory evoked responses during the first 60 seconds after applying the current was not significantly influenced by the wetness of the birds. It was concluded that electrical stunning with low currents in wet birds leads to a lower prevalence of ventricular fibrillation at stunning and a shorter lasting stun in the non-fibrillated birds. This effect is possibly due to some of the current tracking over the bird's wet body rather than through the brain.


Identification of the surface components of Trypanosoma evansi.

125I-labelling was used to characterise the surface components of five stocks of Trypanosoma evansi. Two components of 67 and 60.5 kD were labelled in two of the stocks, a single 60.5 kD component in two other stocks and no components in the remaining stock. These differences are probably related to the labelling method and biochemical differences between the stocks.


Quantifying by monoclonal antibodies of specific IgG, IgM and IgA in the serum of minipigs experimentally infected with Actinobacillus pleuropneumoniae.

Fifteen minipigs were infected intratracheally with three different doses (10(8), 10(5) or 5 x 10(3) colony forming units) of the reference strains of serotypes 2 or 4 of Actinobacillus pleuropneumoniae, and three remained as controls. The titre of specific IgG, IgM and IgA in the serum was measured weekly for 15 weeks with an indirect ELISA using monoclonal antibodies specific for each isotype. IgG attained the highest titres, IgM lower and IgA the lowest, being only detected in four animals. Serotype 4 evoked significantly higher titres than serotype 2 (P < or = 0.01). In general the highest IgG titres were attained at four to six weeks after infection. Some of the minipigs were reinfected after seven weeks but this evoked an increased titre in only two instances.


Erythrocyte protoporphyrin concentrations in clinically normal cats and cats with lead toxicity.

Erythrocyte protoporphyrin (EPP) and blood lead concentrations were determined in 91 clinically healthy cats living in the inner suburban area of Sydney, Australia. The mean EPP concentration was 223.4 +/- 186.1 micrograms litre-1 whole blood and the mean blood lead concentration 0.62 +/- 0.25 mumol litre-1. EPP concentrations were also monitored in three cats with confirmed lead toxicity--at the time of diagnosis and one week and one month after chelation therapy with calcium EDTA. EPP concentrations were elevated in two cats and within the normal range in the third cat at the time of diagnosis. EPP concentration were higher in two cats one week after treatment than at the time of diagnosis. One month after chelation therapy, EPP concentrations were normal in two cats but still substantially elevated in the third cat although its blood lead concentration had returned to normal and all clinical signs of lead toxicity had resolved. It was determined that the predominant form of protoporphyrin present in cats with lead toxicity was zinc protoporphyrin. The EPP assay may have limited value in the diagnosis of acute lead toxicity and in monitoring the success of chelation therapy in cats.


Pharmacokinetics of carprofen administered intravenously to sheep.

Carprofen was administered intravenously to sheep at two dose rates (0.7 and 4.0 mg kg-1), and the pharmacokinetics of the drug studied. Plasma concentrations of the drug were measured by high performance liquid chromatography. Carprofen had a small volume of distribution (Vd[area], 95.5 and 118.4 ml kg-1), a prolonged elimination half-life (t1/2 beta, 26.1 and 33.7 hours) and a slow body clearance rate (Clb, 2.5 ml kg-1 h-1) in sheep.


Culture of sheep Chlamydia in a sheep fibroblast cell culture.

Abortion and enteric isolates of Chlamydia psittaci from sheep differed in their growth in a fibroblastic cell culture derived from the small intestine of a lamb. Twenty abortion isolates, each from a different farm, produced large inclusions which could be passaged several times whereas 10 enteric isolates each from different farms (but from some of the farms of origin of the abortion isolates) produced sparse inclusions which could not be passaged. This appears to be a rapid method of distinguishing abortion and enteric isolates and may indicate different nutritional requirements or be related to the invasiveness of the isolates.


Effect of incomplete immersion of the head in waterbath stunners on the effectiveness of electrical stunning in ducks.

Ten ducks were subjected to electrical stunning with their heads completely immersed in the water of a waterbath, and 10 ducks received the same current while only the bill and skin over the crop made contact with the water. The effect on visual evoked responses in the brain was examined. A higher proportion of birds had lost their visual evoked responses immediately following the current with whole head immersion. It is suggested that crop and bill immersion is less effective in disturbing brain function than whole head immersion.


Plasma and extracellular volume in calves: comparison between isotopic and 'cold' techniques.

While isotopic techniques have largely superseded traditional markers for the determination of the volume of fluid compartments in vivo, they are not always convenient, especially with diarrhoeic animals. A direct comparison was therefore made in week-old calves between Evans blue and radio-iodinated serum albumin as measures of plasma volume and thiocyanate or 24sodium as measures of extracellular fluid space. The correlation coefficients were excellent (1.00, 0.96; P < 0.001) and the calves had plasma and extracellular fluid volumes of 72 +/- 2 and 438 +/- 2 ml kg-1, respectively. The latter value is, though high, typical of young animals and comparable with other data in calves.


Diagnosis and prognostic factors in malignant pleural mesothelioma: a retrospective analysis of sixty-five patients.

This report is an analysis of the medical records of 83 patients registered between 1960 and 1980 at Helsinki University Central Hospital as having malignant pleural mesothelioma. 65 of 83 patients had histologically confirmed malignant mesothelioma, and are the focus of this analysis. The remaining 18 (22%) patients were excluded because malignant mesothelioma was only confirmed cytologically, or because the primary tumor was not a mesothelioma. The ratio of men to women was 2:1.30 of 65 (46%) patients were not known or not likely to have been exposed to asbestos. The main symptoms at presentation were dyspnea, cough, chest pain, fatigue and weight loss. The median survival from diagnosis was 12 months, and from the onset of symptoms 18 months. Clinical stage and performance status were significant prognostic factors. Hematogenous metastases were present at autopsy in most cases. Disease and performance status therefore need to be well established and documented in clinical trials involving mesothelioma.


Structural characterization of the bronchial epithelium of subjects with chronic bronchitis and in asymptomatic smokers.

A morphometric study was carried out on biopsy specimens taken from 40 smokers (27 with chronic bronchitis and 13 asymptomatic) submitted to bronchoscopy to identify and quantify the possible structural differences between the two groups. The chronic bronchitic group had a mean age of 65.67 years and 57.04 pack-years of smoking, the asymptomatic group had a mean age of 44.69 years and 22.62 pack-years of smoking. 70 biopsy specimens (45 from chronic bronchitics and 25 from asymptomatic smokers), in which large areas of best-preserved and perpendicularly cut epithelium were present, were considered suitable for the study and examined by light and transmission electron microscopy. The mean thickness of surface epithelium (p < 0.001), the number of layers of basal cells (p < 0.001), the intercellular space of the superficial zone of the epithelium (p < 0.05) and the percentage of abnormal bronchial cilia (p < 0.05) were significantly greater in patients with chronic bronchitis than in asymptomatic smokers. No significant difference between the two groups was observed in the thickness of the lamina reticularis of the basement membrane. Goblet cell hyperplasia was more marked in chronic bronchitics than in the asymptomatic smokers (p < 0.001), whereas the frequency of epidermoid metaplasia did not show a significant difference. The morphological study of the bronchial epithelium has allowed the identification of transitional cells, which gives rise to the concept that epidermoid metaplasia may result from conversion of mucous cells. This finding suggests that the different histologic types appearing in lung tumours may originate from one undifferentiated pluripotential stem cell, which is able to differentiate into different histogenetic types.


Immediate effects of ethanol on mucociliary clearance in healthy men.

A recent experimental study has shown that ethanol concentrations below 1% increase ciliary beat frequency in preparations of sheep trachea. This study was designed to investigate whether low ethanol concentrations also increase mucociliary clearance in man. Mucociliary clearance was measured using inhaled, radiolabelled particles. Clearance was measured in normal men for 30 min under baseline conditions. The subjects then ingested 28 g of ethanol, and clearance was measured for a further 40 min. The subjects reached a mean plasma concentration of 0.04% 30 min after ethanol intake. The mean half-life of the radioactive particles in the lung was 160 min under basal conditions and 257 min after ethanol ingestion. The difference was not statistically significant. We conclude that low ethanol concentrations do not increase mucociliary clearance in man.


Comparative assessment of a new breath-actuated inhaler in patients with reversible airways obstruction.

Twenty-five patients with reversible airways obstruction inhaled salbutamol (200 micrograms) from the standard press and breathe-metered dose inhaler or a new breath-actuated metered dose inhaler (Aerolin in the Autohaler inhalation device; 3M Health Care Ltd.) in a single dose, double-blind, double-dummy, 2-period, cross-over study. Forced expiratory volume in 1 s, forced vital capacity and peak expiratory flow rate were measured in the 4-hour period after inhalation. The equivalence of the two inhaler devices was determined by analysis of the peak change and time to peak, with reference to the initial recorded baselines of the measured parameters. The efficacy of the two devices was very similar. The breath-actuated device is likely to benefit inhaler users who suffer from poor co-ordination of actuation and inhalation with a standard inhaler.


Nalbuphine analgesia preserves ventilation after thoracotomy despite a reduction in inspiratory drive.

The respiratory effects of analgesia with nalbuphine were studied in 9 patients after thoracotomy. The pain score was measured by a visual analogue scale. Ventilatory pattern and occlusion pressure (P0.1) were studied during spontaneous breathing and during CO2 rebreathing, before and 0.5, 1, 2.5, 3.5 and 6 h after a 0.3-mg.kg-1 dose of intravenous nalbuphine. Compared to baseline values obtained before the injection, nalbuphine produced a decrease in the pain score (p < 0.001) during the 6-hour experiment period. In spontaneous breathing, P.01 was reduced by 15% in 1 h and remained decreased during 3.5 h (p < 0.05), whilst PaCO2 and ventilation (VE) remained unchanged. The P0.1 responsiveness to CO2 was decreased from 0.5 to 2.5 h after the nalbuphine injection (p < 0.05), but the VE responsiveness to CO2 was reduced only after 1 h (p < 0.01). This study shows that, while post-thoracotomy pain was reduced by analgesia, neuromuscular inspiratory drive and chemosensitivity to CO2 were weakened, without any change in spontaneous ventilation. A partial improvement in the thoracopulmonary mechanics induced by the reduction in chest pain could explain the maintenance of ventilatory level in spite of a decreased neuromuscular inspiratory drive.


Changes of circulating atrial natriuretic peptide and antidiuretic hormone in obstructive sleep apnea syndrome.

Patients with obstructive sleep apnea (OSA) syndrome are known to exhibit nocturnal natriuresis/diuresis. We studied plasma and urinary levels of atrial natriuretic peptide (ANP), a potent natriuretic hormone released from the heart, and plasma antidiuretic hormone (ADH) levels in patients with OSA during awake and sleeping periods, to compare with those of normal subjects. Seven patients with OSA and 6 normal subjects were studied. Arterial blood samples were drawn during the awake and the sleeping period, while in patients with OSA, blood samples were obtained during the apneic period. Urine samples were collected over two 12-hour periods (9 a.m.-9 p.m. and 9 p.m.-9 a.m.) In patients with OSA, plasma ANP as well as urinary ANP excretion increased during the apneic period compared with the awake period. There was a significant negative correlation between plasma levels of ANP and ADH in patients with OSA. On the other hand, normal subjects had no apparent differences in plasma and urinary ANP levels between the two periods. It is suggested that nocturnal increase in ANP and decrease in ADH are responsible for the nocturnal diuresis and natriuresis associated with OSA.


Associations between atopy, asthma history, respiratory function and non-specific bronchial hyperresponsiveness in unselected young asthmatics.

We evaluated the relationship between bronchial hyperresponsiveness and atopic status, clinical symptoms and airway calibre in a group of Italian conscripts who reported having bronchial asthma. 126 subjects were studied. Bronchial responsiveness was measured by the methacholine test, and atopic status was assessed by skin tests. A measurable PC20 was detected in 106 subjects. On the basis of the methacholine threshold concentration the sample was divided into four categories. Subjects with a low threshold response had an earlier onset of the disease and tended to take more drugs. The four categories also differed in lung function and skin reactivity towards Dermatophagoides pteronyssinus whereas no difference was found in skin reactivity towards grasses or the overall panel of tested allergen extracts. In conclusion, we found that bronchial hyperresponsiveness is related to both clinical history and lung function, whereas the relationship with atopic status seems to be allergen specific.


Massive bilateral pleural effusion as the only first presentation of systemic lupus erythematosus.

A rare case of systemic lupus erythematosus (SLE), with massive bilateral pleural effusions as the first manifestation, is described. The patient was a previously healthy 20-year-old soldier. Initial investigations were unrevealing, but after 3 months the patient developed the full-blown syndrome. He responded well to corticosteroids and cyclophosphamide with resolution of the pleural effusions and improvement of the clinical picture. SLE should always be considered in cases of massive pleural effusions, even in the absence of other overt stigmata of the disease.


Obstruction of upper airways complicating tracheostomy and use of neodymium Yag laser.

Mucoid impaction of tracheobronchial tree is a common condition which may complicate tracheostomy. Here we describe a case of a 72-year-old man, status after tracheostomy, who presented to the hospital with an acute upper airways obstruction and respiratory arrest due to a tracheal cast. The cast was successfully dislodged by the Nd-Yag laser.


Pulmonary capillary hemangiomatosis: report of a case and review of the literature.

We describe a case of pulmonary capillary hemangiomatosis in a 60-year-old woman with a 1-year history of progressive exertional dyspnea. Four years before admission a diagnosis of breast cancer was made, and she underwent mastectomy plus radiation therapy and treatment with oral antiestrogens. The chest X-ray showed bilateral interstitial infiltrates. Pulmonary function studies revealed a severe restrictive pattern. Abundant red blood cells were found in the bronchoalveolar lavage fluid. On the basis of open lung biopsy, interstitial fibrosis was diagnosed. Cardiac catheterization revealed pulmonary hypertension. Steroids were prescribed, but the patient's condition continued to deteriorate and she died approximately 3 years after presentation. The identification of proliferating and invasive capillaries, which are unique to pulmonary capillary hemangiomatosis, led to the correct diagnosis at autopsy.


Mediastinal fibrosis and radiofrequency radiation exposure: is there an association?

A 45-year-old officer, working for a period of 18 years at a military radar base, presented with progressive exertional dyspnea, dry cough, and hemoptysis. Subsequent evaluation demonstrated a left pulmonary artery occlusion as well as a left upper lobe bronchus stenosis, due to a dense fibrotic mediastinal mass. Histologically, this proved to be idiopathic mediastinal fibrosis (IMF). The development of IMF in a man exposed for a long period to radio-frequency radiation (RFR) is unique in the literature in English. The possible association of radiation exposure with IMF is discussed.


A localized pleuropulmonary lesion induced by long-term therapy with amiodarone.

Pulmonary toxicity is an important adverse effect of amiodarone therapy that usually manifests as an acute or chronic diffuse lung disease; in rare cases localized lesions have also been described. We observed a solitary mass localized in the left lung base and involving the adjacent pleura in a 69-year-old man who had been treated for 1 year with amiodarone (cumulative dose 52 g). Cytological and histological examination showed that the lesion consisted of fibrotic tissue and a massive macrophagic infiltration. Following suspension of amiodarone and surgical excision, there was a complete recovery and the mass did not relapse. We confirm that respiratory complaints can occur in patients treated by long-term amiodarone therapy and that lung involvement can manifest with a solitary localized (fibrotic) lesion.


Influence of OM-85 BV on different humoral and cellular immune defense mechanisms of the respiratory tract.

To clarify the mode of action of an oral bacterial extract (OM-85 BV) on local airway immunity pre- and posttherapeutic washings from bronchoalveolar lavage (BAL) fluid of 28 adult patients with nonobstructive chronic bronchitis were analysed. In comparison to healthy controls, an elevation of total cell count due to an increased number of PMN leukocytes, and an impaired activity of the alveolar macrophages measured by the chemiluminescence response to opsonized zymosan was observed in patients with chronic bronchitis. After treatment with OM-85 BV, the BAL CD4+/CD8+ lymphocyte ratio and BAL interferon-gamma levels were increased. The alveolar macrophage activity was normalized and the BAL IgA was regulated from a reduced or hyperelevated to a moderately increased level.


Adhesion molecules in antibacterial defenses: effects of bacterial extracts.

Adhesion of polymorphonuclear leukocytes (PMN) to vascular endothelium is one of the first events in their response against local bacterial infection. Different adhesion molecules sequentially mediate PMN adherence to endothelium and extravasation into inflamed tissues. We show that bacterial extracts OM-85 BV and OM-89 increase the expression of adhesion molecules at the surface of PMN and we suggest that this upregulation could be linked to the beneficial effect of bacterial extracts in the prevention of respiratory tract infections.


Clinical experience with OM-85 BV in upper and lower respiratory tract infections.

The preventive effect of OM-85 BV on recurrent ENT and respiratory tract infections has been documented in a series of clinical trials. This article reviews the more significant controlled clinical trials investigating the efficacy and safety of OM-85 BV in airway infections. The literature reviewed covers all age groups. In summary, the administration of OM-85 BV was associated with a decrease in the number of acute exacerbations, with an increase in the number of patients remaining free from infections and with a decrease in antibiotic consumption. These results indicate the efficacy of oral immunostimulation with the bacterial extract OM-85 BV in all age groups and demonstrate its protective effect against recurrent airway infections.


Mucosal immunology of the upper respiratory tract.

The palatine tonsils and nasopharyngeal adenoids represent the predominant immunocompetent tissue of the upper respiratory tract. Its major function is as a first line of defense against viral, bacterial, and food antigens that enter the upper aerodigestive system. Another major function of the tonsils and adenoids is to supply the local mucosal immune system of the upper respiratory tract with dimeric IgA-producing B cells. Secretory IgA has particular hydrophilic properties and is capable of preventing adsorption and penetration of bacteria and/or viruses into the upper respiratory tract mucosa. In addition, the role of the indigenous flora of the upper respiratory tract, particularly the viridans streptococci has been emphasized as providing a valuable source of bacterial interference to the colonization of potential pathogens.


Familial occurrence of combined pigment epithelial and retinal hamartomas associated with neurofibromatosis 2.

Combined pigment epithelial and retinal hamartomas are rare lesions that usually occur sporadically in individuals without systemic abnormalities. However, they have been reported in isolated patients with neurofibromatosis 1 and 2. No familial cases have been reported. The cases of four patients with unilateral macular lesions from three consecutive generations of a single family are presented: two of the patients also have neurofibromatosis 2. The ophthalmoscopic appearance of their ocular lesions resembles combined pigment epithelial and retinal hamartomas. The morphologic differences in the lesions of these 4 patients, whose ages are 8 months, 5 years, 29 years, and 65 years, may serve to demonstrate the evolution of this type of hamartoma.


Subretinal neovascularization secondary to choroidal septic metastasis from acute bacterial endocarditis.

The clinical features of an infective embolic choroidopathy are described, from its early onset to late complications in a 45-year-old man with acute Staphylococcus aureus endocarditis of the aortic valve. Initial fundus examination revealed, in addition to fresh choroidal lesions, stigmata of a previous embolic episode secondary to endocarditis from Actinobacillus actinomycetemcomitans. The choroidal lesions were extremely asymmetrical, with a clear preference for localization in the left eye. Similar ocular findings were seen in a 78-year-old female with mitral valve prolapse and acute S. aureus endocarditis. In this case, however, choroidal involvement from septic emboli spread was bilateral and roughly symmetrical. Choroidal neovascular membranes arising in scars from choroidal septic emboli occurred in the macular area of the left eye of both patients, 10 months and 5 years after embolization, respectively.


The frequency of subretinal fluid drainage and the reattachment rate in retinal detachment surgery.

The reattachment rate and the frequency of subretinal fluid drainage were reviewed in 771 eyes with rhegmatogenous retinal detachment that had undergone transscleral retinal detachment surgery between January, 1980 and December, 1989. During this period, the frequency of drainage decreased from 63.6% in 1980 to 14.1% in 1989. This decrease has not been accompanied by any change in the reattachment rate. The difference between visual acuity in eyes that underwent the operation when drainage was performed in only certain selected cases and visual acuity in eyes operated on when drainage was performed more frequently was not statistically significant (P = 0.966). It is suggested that the decrease in the frequency of drainage was due to a carefully followed method of patient management, including preoperative bed rest, use of criteria to establish nondrainage operation, use of transilluminator, and control of intraocular pressure.


Digital overlay of fluorescein angiograms and fundus images for treatment of subretinal neovascularization.

A system for comparing sequential fundus photographs and angiograms has been developed using a personal computer and commercially available image processing software. This process provides rapid results and a high degree of accuracy in image correlation, even when images come from different cameras with different magnifications. Though no concentrated effort was made to compare the superiority of this method to the manual technique, the value of the manual results is fully acknowledged, and this technique is offered as another method of achieving the same end. This technique can be used to determine the adequacy of treatment of subretinal neovascularization, recurrence of subretinal neovascularization in subsequent angiograms, pigment epithelial creep, and changes in fundus lesions.


Pathologic findings in pathologic myopia.

A retrospective study was conducted of 308 eyes with pathologic myopia obtained from 202 patients (23 surgical eyes; 285 post mortem eyes) over a 67-year period. Histopathologic findings and percentage of eyes affected, in decreasing order of frequency, were myopic configuration of the optic nerve head, 37.7%; posterior staphyloma, 35.4%; degenerative changes of the vitreous, 35.1%; cobblestone degeneration, 14.3%; myopic degeneration of the retina, 11.4%; retinal detachment, 11.4%; retinal pits, holes, or tears, 8.1%; subretinal neovascularization, 5.2%; lattice degeneration, 4.9%; Fuchs spot, 3.2%; and lacquer cracks, 0.6%. The reasons for enucleation in the surgically obtained eyes included, in decreasing order of frequency: degeneration after retinal detachment; secondary glaucoma; endophthalmitis; postsurgical epithelial ingrowth; expulsive hemorrhage; degeneration after cataract extraction; and presumed intraocular tumor. Clinicopathologic correlations are discussed.


Experimental studies of the combined use of vitreous substitutes of high and low specific gravity.

The combined use of high and low specific gravity liquid vitreous substitutes has been studied in the rabbit. Eyes having undergone 1) vitreous replacement with silicone liquid combined with a perfluoropolyether liquid of high viscosity; 2) replacement with the perfluoropolyether or silicone alone; or 3) vitrectomy only (control) were compared under conditions of a cell-injection model of traction retinal detachment. Some of the control eyes (3 out of 9) and silicone-filled eyes (2 out of 10) developed total retinal detachments involving all quadrants; in the silicone-filled eyes the detachments extended behind the silicone globule. Conversely, in the eyes undergoing replacement with the two liquids or with the perfluoropolyether liquid alone, retinal detachments never extended to the inferior quadrants underlying the perfluoropolyether globule. In other experiments, the tendency toward emulsification of a low-viscosity perfluorocarbon liquid was reduced when it was used in combination with silicone liquid, in comparison to when this liquid was used alone.


A new magnifying indirect stereo ophthalmoscope.

A new magnifying indirect stereo ophthalmoscope had been designed, built, and tested. Magnification is achieved by means of Keplerian telescopic systems mounted in each eyepiece. Schmidt or Pechan prisms are incorporated to shorten the length of the telescopic systems. Using a +20 diopter condensing lens, the total retinal magnification achieved with this system varies from 5.6x at a 40-cm observation distance to the aerial image to 9.4x at a 25-cm observation distance. When the fundus is viewed through a dilated pupil extraordinary stereopsis is obtained. When combined with the magnification, this stereopsis greatly enhances the view of the posterior segment of the eye.


Peripapillary subretinal neovascularization. A review.

Peripapillary choroidal neovascularization is an important feature in the pathogenesis and treatment of a number of disorders affecting the optic nervehead and adjacent chorioretinal areas. Although less well understood than its macular counterpart, peripapillary subretinal neovascularization possesses characteristic clinical and histopathologic features that directly affect its prognosis and management. This review provides a summary of the diseases in which peripapillary subretinal neovascularization occurs and an overview of studies on the natural history, clinicopathologic findings, and therapy. In addition, a pathogenetic model of peripapillary subretinal neovascularization is discussed based on these findings.


A method for induction of posterior vitreous detachment during vitrectomy.

Complete surgical removal of the posterior vitreous requires the presence of a posterior vitreous separation from the retina. Although a partial or complete posterior vitreous detachment is usually present before surgery, occasionally this separation must be induced during the course of a pars plana vitrectomy. A simple method for creation of a posterior vitreous detachment during surgery is described. This alternative technique seems to be an efficient and safe method for achieving this important surgical objective.


Laser treatment of eccentric leaks in central serous chorioretinopathy resulting in disappearance of untreated juxtafoveal leaks.

In central serous chorioretinopathy (CSCR) laser treatment of leaking points close to the macular center should be avoided because of the possibility of producing juxtafoveal scotoma and stimulating choroidal neovascularization. Nine eyes of nine consecutive patients with CSCR had two or more leaking points within a macular detachment, one of which was foveal or near to the fovea. Photocoagulation with green argon laser was performed in all eyes, treating all the leaking points except for the central one. Visual symptoms regressed after treatment, and the serous detachment was resolved 10 days to 4 weeks after photocoagulation in all cases. Fluorescein angiography showed no leakage at either the central leakage point or the leakage point that had been treated. These results led us to believe that the central or dependent leak in our cases was not sufficient to maintain the serous detachment by itself. An alternative hypothesis is that the untreated leak did not represent real fluid movement but only diffusion of fluorescein molecules, or a false leak. In cases of CSCR with multiple leaks within a single macular detachment, we believe that a foveal leak may be a dependent or false leak and that direct treatment is not necessary.


[A case of aconitine poisoning accompanied by bidirectional ventricular tachycardia treated with lidocaine].

A rare case of aconitine poisoning accompanied by bidirectional ventricular tachycardia was reported. A 67-year-old male ate several leaves of a wild plant which had been collected in Fukushima Prefecture, Japan. About 90 minutes later, he felt numbness and weakness of the limbs and vomiting took place, and he was admitted to our hospital. The blood pressure was 80/60mmHg, and the electrocardiogram showed multiple premature ventricular contractions and bidirectional ventricular tachycardia. After bolus injection of lidocaine, continuous administration of the drug was started. Immediately after starting the treatment, the arrhythmia disappeared and hemodynamic changes improved. Thereafter the wild plant was ascertained to be a species of Aconitium. Diagnosis of aconitine poisoning was made. According to the fact that aconitine acts as a agonist of Na-channel receptor, antiarrhythmic agents which belong to Vaughan-Williams' classification I might be the first choice for the therapy of aconitine induced arrhythmias.


[A case of painless myocardial injury probably caused by coronary artery spasm].

A 53-year-old male was admitted to the hospital due to electrocardiographic ST-segment elevation in V1-4 with ST-segment depression in the inferior leads, which suggested acute myocardial infarction. He had a cough and a slight fever without chest pain. Serum creatine kinase and its myocardial band were slightly elevated but creatine kinase value did not exceed twice the normal upper limit. Emergent coronary arteriography (CAG) revealed intact coronary arteries. The CAG in a chronic stage again revealed intact coronary arteries. Intracoronary administration of acetylcholine of 100 micrograms to the left coronary artery and 50 micrograms to the right coronary artery provoked diffuse spasm in the right and left coronary arteries. The electrocardiogram (ECG) during the right coronary artery spasm revealed ST-segment depression in the inferior leads with ST-segment elevation in V2 and V3, which resembled the ECG finding at the time of the patient's admission. With intracoronary isosorbide dinitrate, the spasm and ST-segment elevation were resolved. These findings strongly suggest that coronary spasm can cause myocardial injury indicated by a slight elevation of serum creatine kinase value.


[False aneurysm formation during the chronic phase of myocardial infarction at the margin of a previously-detected true aneurysm].

The patient was a 59-year-old man who had acute extensive anterior myocardial infarction in October, 1989. One month later, he was transferred to Kyoto University Hospital and underwent cardiac catheterization. Left ventricular aneurysm and significant stenosis in the proximal portion of the left anterior descending artery were documented. Because he experienced chest pain on slight exertion accompanied by a slight increase in the depth of the negative T wave on electrocardiogram, percutaneous transluminal coronary angioplasty (PTCA) was performed. Thereafter, chest pain disappeared, and the patient was discharged. Three months later, he was re-admitted to Kyoto University Hospital for a repeat cardiac catheterization after PTCA. PTCA site was found to be restenosed, and a small diverticulous aneurysm was found at the margin of the previously-detected ventricular aneurysm. As the diverticulous aneurysm was considered likely to precipitate the ventricular aneurysm into rupture, expeditious left ventricular aneurysmectomy was performed to prevent cardiac rupture. Ventricular aneurysms, common complications in myocardial infarction, are of two types, either true or false. Most aneurysms develop during the acute phase of myocardial infarction, and rupture of true aneurysms during the chronic phase of myocardial infarction rarely occurs. However, in the present case, a small diverticulous aneurysm, which was not demonstrated at the initial cardiac catheterization, developed during the chronic phase of myocardial infarction. Pathological examination revealed that the diverticulous aneurysm was a false aneurysm due to incomplete rupture. When the common pathogenesis of ventricular aneurysms in myocardial infarction is considered, the present report might represent an extraordinary rare case.(ABSTRACT TRUNCATED AT 250 WORDS)


[A case of myxedema heart with serial endomyocardial biopsy].

We report a case of middle-aged woman with myxedema heart who presented congestive heart failure due to myocardial damage caused by myxedema, and showed reversible and irreversible myocardial change proven by serial endomyocardial biopsy. She was admitted to our hospital because of facial, peripheral edema and dyspnea. On admission, chest X-P revealed severe cardiomegaly (CTR 70%) and bilateral pleural effusion. Electrocardiogram showed low voltage. Echocardiogram and chest CT revealed a large amount of pericardial effusion. No significant stenosis was observed on a coronary arteriogram. Laboratory data showed elevated TC, CPK, LDH values and immunological test indicated high titer of thyroid test and microsome test. Thyroid function test revealed primary hypothyroidism with low T3, low T4 and high TSH levels. Replacement therapy for hypothyroidism in addition to digitalis and diuretics++ has been started. Seven months after initial evaluation, this therapy has resulted in dramatic clinical improvement. Transvenous right ventricular endomyocardial biopsy demonstrated vacuolated degeneration on admission and improvement of vacuolated degeneration with a slight degree of fibrosis after therapy. This pathological finding suggests that myxedema heart is able to produce both reversible and irreversible myocardial damage.


[A case of adult pulmonary supravalvular membranous stenosis which was successfully treated by percutaneous transluminal balloon dilatation].

We report a case of adult pulmonary supravalvular stenosis which was successfully treated with percutaneous transluminal balloon dilatation (PTBD). A 42-year-old man was admitted for a heart murmur and abnormal findings in the screening chest roentgenogram. Having no symptoms on admission, his physical activity was evaluated as Class I according to the classification of the New York Heart Association. A systolic murmur (Levine III/VI) with split second sound was audible at the left sternal border in the 3rd intercostal space. Chest roentgenogram revealed 57% of the cardio-thoracic ratio and no signs of increased pulmonary vascular markings. ECG showed incomplete right bundle branch block. Echocardiography and right ventriculography visualized the supravalvular membranous structured stenosed pulmonary artery 1cm above the pulmonic valve. Systolic pressure gradient between the right ventricle and the distal main pulmonary trunk was 54mmHg. The patient was diagnosed as having pulmonary supravalvular membranous stenosis. PTBD was applied using Inoue balloon catheter, where inflation was initiated from approximately 120% of pulmonary arterial diameter and terminated at 150%. This procedure decreased systolic pressure gradient from 54mmHg to 36mmHg without complication. After PTBD right ventriculography demonstrated that a part of the membranous structure had become floppy and movable. Pulmonary arterial diameter was unchanged. We considered that PTBD tore the membranous structure, which consequently resulted in the decrease of systolic pressure gradient. Systolic murmur diminished to Levine II/VI. Six months later, cardiac catheterization showed no change in systolic pressure gradient compared with that immediately after PTBD. This is the first report on pulmonary supravalvular membranous stenosis successfully treated with PTBD.(ABSTRACT TRUNCATED AT 250 WORDS)


[A case of rectus sheath hematoma].

The following is a rare case of rectus sheath hematoma. The patient was a 78-year-old man with a past history of axillo-femoral bypass operation. He contracted a cold, and when he coughed severely, acute lower abdominal pain occurred. Abdominal echography and CT scanning confirmed the presence of a hematoma in the rectus abdominis muscle. Before, patient was diagnosed as acute abdomen and surgery was performed. Recently, accurate diagnosis has been made easily by echography or CT.


[A case of nonobstructive hypertrophic cardiomyopathy associated with ventricular tachycardia and sick sinus syndrome].

We examined, a 64 year old man with hypertrophic nonobstructive cardiomyopathy (HNCM) accompanied with dizziness. Twenty-four hour ECG monitoring showed sinus bradycardia and sinoatrial block. Electrophysiologic study demonstrated inducible sustained ventricular tachycardia (VT) by continuous rapid high right atrum pacing during which systolic blood pressure fell to 40 mmHg. Induced VT degenerated into ventricular fibrillation in ten seconds. We implanted a DDD pacemaker for sick sinus syndrome (SSS) and administrated 90mg/day of diltiazem for VT. Treadmill exercise test was carried out while the patient was taking diltiazem and no arrhythmia was induced. This case of HNCM is rare in that he presented both sick sinus syndrome and sustained VT.


[An experimental study of determining the appropriate frequency of radiofrequency catheter ablation in vitro and in vivo for ventricular tachycardias].

The purpose of this study was to examine the appropriate frequency of radiofrequency catheter ablation (RFA) for ventricular tachycardia. Radiofrequency energy generated by a device in which the frequency could be changed, was delivered from an electrode catheter with an electrode tip-width of 4 mm. RFA was performed for 10 seconds with 20W (50V x 0.4A) using 7 different frequencies from 10 to 500 kHz on ventricular myocardium in vitro and in anesthetized dogs. The ablated lesion was significantly larger with RFA of 200-300 kHz in both surface area and depth (p less than 0.05). The appearance of ventricular arrhythmia during RFA increased as the frequency decreased, and one dog applied with RFA of 100 kHz had spontaneous ventricular fibrillation resulting in death. All dogs with frequency less than 100 kHz had a muscle cramp during RFA. We conclude that appropriate frequency seems to be 200-300 kHz to obtain a large ablated lesion, and a frequency higher than 300 kHz seems suitable to avoid arrhythmia. We also conclude that a frequency under 100 kHz should not be used.


[Postural changes in finger and toe pulse waves].

Finger and toe pulse waves were simultaneously recorded in medical students and outpatient hypertensive patients. The delay of the rise of toe pulse to that of finger pulse (t) was almost halved in students on postural change from the supine position to the sitting position. This was mainly due to an increase in the pulse wave velocity in the aorta, which was thought to be induced by the increase in hydrostatic pressure in the aorta. In students a marked dicrotic wave was observed in both finger and toe pulse waves. That the interval between the main and dicrotic waves (T) was shorter for finger pulse than toe pulse also seems to be ascribable to the influence of the intraaortic pressure: Pulse was transmitted faster in the systolic phase than in the diastolic phase. The features of pulse waves of hypertensive patients were that (t) was short even in the supine position, and that dicrotic wave was small or absent especially for toe pulse. These differences were considered to be accounted for by the high blood pressure and the structural change of arterial wall in the hypertensive patients.


[Myocardial infarct size and left ventricular function in diabetic patients].

We determined the relationship between myocardial infarct size (MIS) estimated by electrocardiographic measurements of infarct size (QRS score) and left ventricular function estimated by angiographically left ventricular ejection fraction (EF). MIS estimated by QRS score were the same in both DM and NDM (5.2 +/- 0.5 vs 4.3 +/- 0.4: p greater than 0.05), but EF in DM was significantly lower than in NDM (43.1 +/- 1.4 vs 51. +/- 1.1%: p less than 0.05). There was clear linear correlation between MIS and EF in NDM (r = -0.71) but not in DM. EF was much lower in DM than in NDM even at the same QRS score level. There were no differences in blood pressure, serum lipid levels, age, and the site of the myocardial infarction. The most likely explanation for this appears to be due to a previous left ventricular disease in DM.


[Abnormalities in the signal-averaged electrocardiogram in Ebstein's anomaly].

Abnormalities in the signal-averaged electrocardiogram (SAECG) of patients with Ebstein's anomaly were studied. A SAECG was obtained in 4 patients with Ebstein's anomaly, aged 3 to 25 years. The control groups included 8 patients with atrial septal defect (ASD group), 10 with right bundle branch block (RBBB group), 8 with Wolff-Parkinson-White (WPW) syndrome (WPW group), and 40 normal subjects (Normal group). The SAECG was calculated by the vector-magnitude method using the VCM-3000. The root-mean-square during the initial 20 msec of the filtered QRS (i-RMS) was very small in 2 older patients with Ebstein's anomaly compared to the ASD group, the RBBB group and the Normal group, and was as small as that in the WPW group. This probably was affected by the delta wave associated with Ebstein's anomaly or concealed accessory pathway. The root-mean-square during the terminal 40 msec of the filtered QRS (t-RMS) was small in the patients with Ebstein's anomaly and the RBBB group. Two patients with Ebstein's anomaly had a smaller t-RMS than the RBBB group, suggesting pathological changes of an atrialized right ventricle. In conclusion, SAECG is useful for evaluating patients with Ebstein's anomaly, especially older patients.


[Effects of Nd:YAG laser irradiation on ventricular myocardium in dogs using an artificial sapphire tip contact laser catheter].

To apply Nd:YAG laser irradiation through a new sapphire tip contact laser method to catheter ablation in treatment of tachy-arrhythmias, effects of laser irradiation on ventricular myocardium were investigated in 10 mongrel dogs. Nd:YAG lase (1064nm) discharges were delivered to different sites on the endomyocardium at power of 5, 10, 15, 20 or 25w with duration of 3, 5, or 10 seconds (sec.) respectively in closed beating hearts. Histopathologically, the lesion irradiated was clearly demarcated from the normal myocardium by the construction band necrosis zone. The depth of injured myocardium was less than 2mm with 3 sec. irradiations, with 5 sec. from 1 mm to 4 mm in proportion to power increase, with 10 sec. from 3mm to 8 mm in proportion to the power from 5w to 15w and could not be measured in cases of more than 20w irradiations. Although with every irradiation duration, the depth of injury increased in proportion to the power increase. With the same total energy, a longer time of irradiation produced deeper injury than a shorter time. This method makes it easier to keep the laser positioned to target than bare laser, and is suitable for use in catheter ablation.


[Haemodynamic effects of intravenous isosorbide dinitrate in congestive heart failure].

The effects of intravenous infusion of isosorbide dinitrate (ISDN) were evaluated in 22 patients with congestive heart failure. These patients did not receive vasodilator therapy before this study. Seven of these patients (two bolus groups of 5.0 mg and 7.5 mg each) were infused bolusly. The mean PA, PCWP and mean RA decreased for 5 min and, after 60 min, they were back to the original levels. The mean Ao had an accentuated change when the 7.5 mg bolus was injected, but, apart from that, changes were minimal. The CI changed little and upwardly. ISDN was infused continuously in 10 patients (two infusion groups of 5.0 mg/hr and 7.5 mg/hr each) whose mean PA, PCWP and mean RA decreased for 15 min and continued downwardly but mildly for 120 min. The mean Ao did not change much and the CI slightly increased. Five of the 22 patients (bolus+infusion group of 5.0 mg and 5.0 mg/hr) showed rapid response but the parameters only slightly changed. Since this group included severe heart failure patients, the results observed were milder. The response of all 5 groups receiving ISDN infusion were confirmed by the serum ISDN concentration curve. These results indicate that continuous infusions of 7.5 mg/hr ISDN or bolus infusions of 5.0 mg and infusion of 5.0 mg/hr improved haemodynamics in patients with congestive heart failure.


[Cardiac performance in total anomalous pulmonary venous connection].

Cardiac performance in 54 patients with total anomalous pulmonary venous connection was investigated by cardiac catheterization before and after surgery. 51 patients underwent intracardiac repair, and 17 of them died during or immediately after operation. According to the preoperative study, the left ventricular ejection fraction (LVEF) of surviving patients was significantly higher than that of patients who died, and the pulmonary arterial mean pressure of surviving patients was significantly lower than that of patients who died. However, there was no significant difference between the left ventricular end-diastolic volume (LVEDV), right ventricular ejection fraction (RVEF), and right ventricular end-diastolic volume (RVEDV) in surviving patients and those who died. Post-operative catheterization studies showed significant increases of LVEF and LVEDV compared to pre-operative figures. RVEF and RVEDV and pulmonary arterial mean pressure decreased significantly after surgery. It was concluded that preoperative cardiac performance of surviving patients was better than that of those who died, and post-operative cardiac performance of surviving patients was basically normal.


[Electrophysiologic effects of flecainide on guinea pig atrium].

We investigated the effects of flecainide on guinea pig atrial muscle. Using Langendorff's method, the whole heart of a guinea pig was perfused with Tyrode's solution containing acetylcholine (3 x 10(-7) M). Then, with right atrial extrastimulus and high frequency pacing method, the following values were measured before and after administration of flecainide (10(-7)-10(-5) M). A) Effective refractory period (ERP); the longest coupling interval which failed to produce right atrial activity at premature stimulus. B) Interatrial conduction time (ACT); After right atrial stimuli by trains at PCL 200 ms for 5 min the interval from the stimulation to the first deflection of the left atrial activity. C) Atrial fibrillation threshold (AFT); the minimal amount of current required to induce atrial fibrillation lasting for more than 30 sec by 50 Hz high frequency stimulation. Flecainide lengthened ERP (> or = 3 x 10(-5) M) and ACT (> or = 10(-7) M). Flecainide (10(-5) M) significantly increased AFT which correlated well with ERP (r = 0.81, p < 0.002) and ACT (r = 0.84, p < 0.002). In conclusion these effects of flecainide on guinea pig atrium might explain in part the clinical effectiveness of the drug on paroxysmal atrial fibrillation.


[Prophylactic use of antibiotics for fever following fiberoptic bronchoscopy and bronchography].

To evaluate the effect of bacampicillin hydrochloride on fever following fiberoptic bronchoscopy and bronchography, we conducted multi-institutional randomized study. In bronchographic examinations, the rise of body temperatures in the bacampicillin group (0.82 +/- 0.13 degrees C: mean +/- SE) was significantly smaller than that in the control group (1.39 +/- 0.25 degrees C) on the second day of examination. Bacterial infection may contribute to the rise of temperature on the day following bronchography, but no pneumonia or sepsis was observed. There was no differences in the rise of body temperature on the first, third or fourth day. In fiberoptic bronchoscopic examinations, there was no difference between the two groups. We conclude that there is no clinical indication of the value of prophylactic use of antibiotics in either fiberoptic bronchoscopy or bronchography.


[The acute and chronic effects of bunazosin on exercise capacity estimated by the anaerobic threshold in patients with chronic congestive heart failure].

To study the effect of bunazosin on exercise capacity in patients with congestive heart failure (NYHA II-III), anaerobic thresholds (AT, VO2, ml/min/kg) were measured before (control) and after initial 1 = 2mg administration of bunazosin (acute phase; N = 14) and after two weeks of bunazosin therapy (3mg/day, 1mg t. i. d., chronic phase; N = 6). AT were determined by Wasserman's V-slope method during ergometer exercise test with a ramp loading (10 watt/min). AT increased significantly from control during both acute (14.2 +/- 2.7 to 16.9 +/- 3.6 ml/min/kg p < 0.005) and chronic (13.6 +/- 2.5 to 16.7 +/- 1.0 p < 0.05) phase. Additionally, work (watt) attained at AT increased significantly from control during both acute (33.6 +/- 19.2 to 52.6 +/- 30.2 p < 0.005) and chronic (35.8 +/- 25 to 49.3 +/- 15 p < 0.05) phase. Pressure-rate-products (PRP, x 10(2) mmHg/min) at AT increased significantly from control during the acute phase (119 +/- 35 to 240 +/- 50 p < 0.005) alone. In the chronic phase, PRP decreased significantly at the work level equal to AT during control (from 207 +/- 41 to 187 +/- 39 p < 0.05). These data suggest that bunazosin has favorable acute and chronic effects on exercise capacity in patients with congestive heart failure.


[A clinical study of postinfarction angina (PIA): the significance of electrocardiographic ST segment changes during anginal attacks].

We studied the clinical significance of electrocardiographic ST segment changes during PIA attacks. Of 478 AMI patients admitted to the CCU of our hospital within 48 hours after onset, we evaluated 73 (15.3%) with PIA. According to electrocardiographic ST segment changes during PIA attacks, the patients were divided into three groups, namely ST elevation at the same infarction site (same site elevation group), ST depression at the same site (same site depression group), and ST depression at other sites (other site depression group), and their pathological condition was studied. There were 33 patients (45.2%) in the same site elevation group, 19 (26.0%) in the same site depression group, and 21 (28.8%) in the other site depression group. The predominant infarction areas were anteroseptal and inferior wall in the same site elevation group, NTMI in the same site depression group, and inferior wall in the other site depression group. PIA usually occurred within 4 days after the onset of infarction in the same site elevation group, and within 5-7 days in the other site depression group, but no uniform trend was observed in the same site depression group. With respect to the number of vessels showing disease, cases of single-vessel disease tended to predominate in the same site elevation group, while cases of three-vessel disease tended to predominate in the same site depression group and the other site depression group. Stenosis rates in the vessels responsible for infarction were high in the same site elevation group in the acute period. Prognoses were poorest in the same site depression group.(ABSTRACT TRUNCATED AT 250 WORDS)


[A case of hypereosinophilic syndrome exhibiting left ventricular systolic dysfunction].

A 16-year-old woman suffering from bronchial asthma since 2 years previously was admitted to the hospital because of high grade fever, dyspnea, skin eruption and arthralgia. Laboratory data revealed pronounced eosinophilia with elevated immunoglobulin E value. A chest X-ray film showed cardiomegaly with pulmonary congestion. Left ventriculograms showed diffusely reduced motion of the left ventricle (LV). Various clinical symptoms and laboratory data were resolved shortly after the administration of corticosteroids, but the LV dysfunction persisted for at least three months. Left ventriculograms 2 years later disclosed a marked improvement of the LV wall motion. In both the acute and the chronic phase, endomyocardial biopsy of both ventricles revealed non-specific histological findings comprising disarrangement of myocytes and interstitial fibrosis, suggesting post-myocarditis. This case was characterized by LV dysfunction possibly due to eosinophilic myocarditis associated with hypereosinophilic syndrome, and by its functional improvement with long-term corticosteroid therapy.


[Two cases of hypothyroidism with echocardiographic features similar to cardiomyopathy: one simulates hypertrophic and the other dilated cardiomyopathy].

Two cases of hypothyroidism with echocardiographic features similar to cardiomyopathy were presented. In case 1 (a 68 year-old woman), moderate pericardial effusion and myocardial hypertrophy were observed on admission. In case 2 (a 69 year-old woman), dilation of the left ventricle, hypokinesis of the interventricular septum and the left ventricular free wall, and reduced left ventricular systolic function were observed on admission. These echocardiographic findings were similar to hypertrophic or dilated cardiomyopathy. In the two cases, after recovery to euthyroid state, these echocardiographic abnormalities returned to normal. We concluded that hypothyroidism led to a reversible hypertrophic or dilated cardiomyopathy, and that echocardiographic study was useful for diagnosis and for following up cardiac manifestations of hypothyroidism.


[A case of nonbacterial thrombotic endocarditis presenting positive findings by two-dimensional echocardiography].

A 55-year-old woman was admitted to our hospital because of left hemiparesis. Brain CT and cerebral angiography demonstrated cerebral embolism due to occlusion of the sphenoidal part of the right middle cerebral artery. Two-dimensional echocardiography revealed mitral valve vegetation measuring 10 x 7 mm and slight mitral-valve regurgitation. Blood cultures were negative. She developed disseminated intravascular coagulation. Chest roentgenography and abdominal ultrasonography showed multiple liver and lung tumors, but she died before the primary lesion was detected. At autopsy, adenocarcinoma of the gall bladder was found. Friable vegetation was attached to the auricular surface of the mitral valve. Microscopic examination confirmed the diagnosis of nonbacterial thrombotic endocarditis. Although echocardiography is an important tool for diagnosing nonbacterial thrombotic endocarditis, few reports have described echocardiographic detection of nonbacterial thrombotic endocarditis. Because vegetation of nonbacterial thrombotic endocarditis is smaller than that of infective endocarditis (less than 3 mm), it is difficult for echocardiography to detect nonbacterial thrombotic endocarditis. Thus, a negative examination does not exclude the possibility of nonbacterial thrombotic endocarditis. To make an antemortem diagnosis of nonbacterial thrombotic endocarditis, we must perform echocardiography carefully in cases of cerebral infarction with carcinoma and/or DIC.


[A case of an unusual type of coarctation of the aorta terminating in the complete obstruction].

A 19 year-old girl with an unusual type of coarctation of the aorta terminating in complete obstruction is presented. At the age of 5 years, she was diagnosed by aortography to have coarctation of the aorta of type IV C according to Edward's classification. No surgical treatment was performed at that time because her growth was good and she didn't have hypertension. During the follow-up period, marked hypertension developed, and she was readmitted. The aortogram revealed a bicuspid aortic valve and total obstruction of the descending thoracic aorta at the site where coarctation was noticed previously. The abdominal aorta distal from the obstruction site was filled through rich collateral circulation. As these angiographic interval changes are very rare, we discussed the genesis of obstruction and operative indication by reviewing the literature.


[Are the first repetitive reentrant VPCs a trigger or an initiation of reentrant circuit for VPCs?: Evaluation by Holter ECG in patients with reentrant sustained ventricular tachycardia].

To evaluate whether the first repetitive reentrant VPCs are a trigger or an initiation of a reentrant circuit for VPCs, we studied Holter ECGs in 13 patients with sustained ventricular tachycardia, the morphology of reentrant VPCs, the relationship between the coupling interval (N-V) and the first ventricular cycle length (V-V), and the relationship of the coupling interval (N-V) between single VPC and repetitive VPCs. In 7 patients who showed episodes of repetitive VPCs more than twice on one recording of Holter ECG, most of VPCs in the first and second beats were the same in shape (1195 out of 1466 episodes, 82%). No obvious relationship between the coupling interval (N-V) and the first ventricular cycle length (V-V) was found in 5 patients, whereas a weak inverse relationship (r = 0.32) was found in one patient, and a weak positive relationship (r = 0.38) was found in another patient. In addition, the coupling interval in repetitive VPCs was longer than that in single VPCs in 4 out of 7 patients. These results imply that, in most cases, the first VPC is the expression of initiation of a reentrant circuit for repetitive reentrant VPCs developing spontaneously.


[Detection of ventricular late potentials comparison of 4 commercial high-resolution systems].

The purpose of this study was to evaluate the methodologic problems of noninvasive registration of ventricular late potentials. we compared the results obtained in the same patients with four different systems which were Marquette MAC1, MAC12, ART LP101 and FUKUDA VCM 3000. Filtering was employed digital forward direction, 100-300 Hz in MAC1, digital FFT, 40-250 Hz in MAC12, digital, bidirectional, 40-250 Hz in ART and analogue, forward direction 40-300 Hz in FUKUDA VCM 3000. DEFINITION OF LATE POTENTIALS (LPs): Filtered QRS duration (FQRSD) was 120 msec or more, root mean square voltage in the last 40 msec (RMSV) was 15 microV or less in MAC12 and ART. FQRSD was 130 msec or more, RMSV was 15 microV or less in FUKUDA. FQRSD was 20 msec or more after QRS obtained from low resolution leads in MAC1. 163 patients [control 13, PVCs 23, myocardial infarction 55, others 51, IVCD (RBBB, LBBB, IVCD) 21] were included in this study. 17.6% of all patients (except for IVCD) showed LPs with MAC12, 20.0% with ART, 30.3% with FUKUDA, and 14.1% with MAC1. 23.1% of the control group showed LPs with MAC12 and FUKUDA, but no cases showed LPs with ART and FUKUDA. 4.3% of the PVC group showed LPs with MAC12, 13.0% with ART and FUKUDA, but no cases showed LPs with MAC1. 25.5% of the myocardial infarction group showed LPs with MAC12 and MAC1, 30.9% with ART and 36.3% with FUKUDA. All four methods gave corresponding results in 65.4% of patients, 7.0% positive and 58.4% negative findings. FQRSD of MAC12, ART and FUKUDA was 110.2 +/- 18.1 msec, 105.2 +/- 20.4 msec and 125.8 +/- 22.8 msec respectively. Correlation coefficient (r value) in FQRSD was 0.90 between ART and MAC12, 0.74 between ART and FUKUDA, and 0.75 between FUKUDA and MAC12. RMSV of MAC12, ART and FUKUDA was 49.2 +/- 30.2 microV, 43.7 +/- 37.8 microV and 22.5 +/- 10.6 microV respectively. R value in RMSV was 0.59 between ART and MAC12, 0.38 between ART and FUKUDA and 0.43 between FUKUDA and MAC12. R value in high frequency low amplitude signals duration under 40 microV of LPs positive patients in MAC1 was 0.51 between ART and MAC 12, 0.18 between MAC12 and MAC1, and 0.32 between ART and MAC1. Most of the differences result from a different interpretation of the tracings. Especially LPs far from QRS offset could be registered with neither MAC12, ART nor FUKUDA.


[The effect of acebutolol and metoprolol on noninvasive ambulatory blood pressure monitoring system in essential hypertension].

We compared the antihypertensive effects of acebutolol and metoprolol during 2-4 weeks of treatment in patients with mild to moderate essential hypertension. Acebutolol (n = 12) significantly decreased conventionally measured blood pressure from 173/100 mmHg to 148/86 mmHg (p less than 0.005), and metoprolol (n = 11) decreased it from 164/106 mmHg to 138/87 mmHg (p less than 0.01). Based on data derived from automated 24-hour ambulatory blood pressure monitoring, both drugs significantly decreased the blood pressure in the early morning (5:00-10:00). Moreover, in the metoprolol group, there were significant falls in day-time blood pressure (7:30-19:30) and night-time blood pressure (23:00-7:00). In contrast, acebutolol showed significant antihypertensive effect on day-time blood pressure, but not effect on night-time blood pressure. The study confirmed the efficacy and character of metoprolol and acebutolol. We must choose an effective beta-blocker when using an automated 24-hour ambulatory blood pressure monitoring system to get adequate blood pressure reduction for the whole 24 hours.