Experimental focal cerebral ischemia produced by embolization with silicone cylinder in normotensive (NTR) and spontaneously hypertensive rats (SHR): comparison of neurological and pathological findings

A focal cerebral ischemic model was produced by occlusion of the intracranial main cerebral artery with a silicone cylinder in normotensive (NTR) and spontaneously hypertensive rats (SHR). Main cerebral artery could be successfully occluded in approximately 90%. The most frequent embolized site was the distal part of the internal cerebral artery (ICb) and less frequently the horizontal segment of the anterior cerebral artery (Al). Mortality rate of NTR with ICb occlusion (NTR-ICb) was 43% at 72 hours after embolization and that of SHR with ICb occlusion (SHR-ICb) was 67% at 24 hours after embolization. NTR-ICb showed neurological signs (i.e. circling movement, hemiparesis, poor response to pain stimuli) and histologically, showed infarction in the deep cerebral structures (i.e. thalamus, hypothalamus, hippocampus, and internal capsule) accompanied with mild disruption of blood-brain barrier (BBB). SHR-ICb showed more serious neurological signs and more severe cerebral infarction in the deep cerebral structures with severe disruption of BBB. In SHR-ICb, ischemic cerebral edema was more prominent which may deteriorate symptoms and pathological findings compared to NTR-ICb. This embolization model is proposed to be useful for studying the pathophysiology of focal cerebral ischemia, especially, early ischemic edema.     

An immunohistochemical study of MAP2 and clathrin in gerbil hippocampus after cerebral ischemia

Changes in MAP2 and clathrin immunoreactivity were studied in gerbil hippocampus after transient cerebral ischemia. MAP2 immuno-reactivity decreased significantly by 1 h in the subiculum-CA1 and CA2 areas which correspond to reactive change, while no decrease was observed in CA1 until day 4. Before the initiation of delayed neuronal death, MAP2 immunoreactivity was not changed in CA1. On the other hand clathrin immunoreactivity increased in the pyramidal cell layer of CA1 by 3 h after ischemia and remained high for 2 days. Clathrin immunoreactivity in the pyramidal cell layer of CA1 diminished after delayed neuronal death. The transient change of clathrin was noted especially in CA1 in the period prior to delayed neuronal death. These results imply an abnormal change in clathrin turnover after ischemia, which may participate in the pathogenesis of delayed neuronal death.     

Dual effects of 5-hydroxytryptamine on the release of gamma-aminobutyric acid from myenteric neurones of the guinea-pig ileum.

The effects of 5-hydroxytryptamine (5-HT) on the release of gamma-aminobutyric acid (GABA) were examined in the longitudinal muscle-myenteric plexus (LM-MP) preparation of guinea-pig ileum. 5-HT increased the spontaneous release and inhibited the electrically-evoked release of [3H]-GABA. The 5-HT-evoked release was Ca2+-dependent and tetrodotoxin-sensitive, and was antagonized by (3 alpha-tropanyl)-1H-indole-3-carboxylic acid ester (ICS 205-930), but not by methysergide and ketanserin. The inhibitory effect of 5-HT was antagonized by methysergide, but not by ketanserin and ICS 205-930. 8-Hydroxy-2-(di-n-propylamino)tetralin mimicked the inhibitory effect of 5-HT. Thus, 5-HT may exert an excitatory effect on the enteric GABAergic neurone via the 5-HT3 receptor and an inhibitory effect via the 5-HT1A receptor.     

The usefulness of CEA as an indicator for early detection and a guide to the treatment of recurrent gastric cancer

The usefulness of carcinoembryonic antigen (CEA) as an indicator for recurrence and a guide to the treatment was evaluated from a retrospective analysis of 88 patients with recurrent gastric cancer. Sixty-two of these patients (70.5 per cent), 25 of whom had a preoperative positive assay, and 37 a negative assay, had elevated levels of CEA after disease progression. Averaged CEA level in patients with liver metastasis was significantly higher (872 ng/ml) than in those with peritoneal metastasis (68 ng/ml), with lymph node metastasis (103 ng/ml) or with local metastasis (93 ng/ml) (p<0.01). An elevation of CEA was found prior to the clinical manifestation of recurrence, and the average lead time was 4 months. In 25 patients with a lead time of more than 4 months, survival time after CEA elevation was 13.3 months, which was longer than the 6.5 months of 28 patients with less than 4 months. Thirty-seven of the 88 patients were treated after recurrence. The average survival period after the detection of recurrence was 9.4 months in patients with surgical treatments followed by chemotherapy, 5.9 months in those with chemotherapy alone and 3.8 months in those with surgery alone. The average survival period of 26 patients with positive CEA assays in recurrence was 5.1 months longer than of patients with negative assays. This fact suggested that early detection of recurrence followed by various treatments, in the elevated CEA group, contributes to favorable results.     

Symptoms of contruction workers exposed to whole body vibration and local vibration

Summary To study the effects of construction machinery operation on subjective symptoms, a questionnaire survey was caried out among construction machinery operators by a self-reporting method. Subjects were 184 power shovel operators, 127 bulldozer operators, 44 forklift operators as operator groups, and 44 office workers as a control. Their ages were in a range of 30–49 years. The questionnaire contained 20 symptoms referring to fatigue, digestive problems, and upper or lower limbs or back problems. The prevalence rate and symptom characteristics were examined. The dominant symptoms of the operator groups were stiff shoulder, low back pain, and stomack symptoms. The prevalence rate of low back pain was significantly different between forklift operators and controls. No significant differences were found in the symptoms of upper limbs and fingers between operator groups and controls. The prevalence of Raynaud's phenomenon was 0.5%–2.3% in the operator groups and 2.3% in the control group.     

Possible Role of Streptococcus Pyogenes in Mucocutaneous Lymph Node Syndrome. XII. Variable Responses of Platelets in MCLS Seem to Be Explainable by Streptococcal Pyrogenic Exotoxin

As a model system for mucocutaneous lymph node syndrome (MCLS), we have advocated and used mice which had been rendered tolerant to Streptococcus pyogenes-associated antigens by neonatal infection with group A fteta-hemolytic streptococci, because these mice have shown a variety of peculiar bioimmunological characteristics bearing a striking resemblance to those of MCLS patients. The results of our current investigations reaffirmed the reliability of the animal model by indicating that mice subjected to neonatal infection with 5. pyogenes , or inoculation with streptococcal pyrogenic exotoxin (SPE) in Freund's adjuvant, were perfect counterparts of patients with MCLS on account of their platelet activation and hyperaggregability in response to provocative treatment, which are familiar findings in this disease.     

Effect of extradural analgesia on the paradoxical arousal response of the electroencephalogram

Despite widespread recognition of the potential role of the processed electroencephalogram (pEEG) as a monitor of depth of anaesthesia, few studies have examined the effects of surgical stimuli on the intraoperative pEEG. Two groups of gynaecological patients (n = 10 in each group), with or without pre-incisional extradural analgesia, undergoing gynaecological laparotomy under nitrous oxide and isoflurane anaesthesia were monitored with routine haemodynamic observations and pEEG. Patients who received pre-incisional extradural analgesia showed no significant changes in pEEG variables during surgery (mean spectral edge frequency 95 percentile (SEF95) 13.3 (SD 1.4) Hz), whereas in all patients without pre-incisional extradural analgesia, a significant decrease in SEF95 was noted (6.5 (1.1) Hz after incision compared with a pre-incisional value of 12.5 (1.4) Hz) together with an increase in arterial pressure (paradoxical response). In the latter group, SEF95 and arterial pressure returned to pre-incisional values after extradural analgesia was established during operation. During emergence from anaesthesia, both groups showed a significant increase in SEF95 (25.7 (1.4) Hz). This study suggests that intraoperative pEEG arousal response was different from changes detected when anaesthesia was terminated at the end of surgery. Surgical stimuli in the absence of adequate analgesia induced a paradoxical arousal response.      

Three-dimensional surface display with 123I-IMP in corticobasal degeneration]

A 65-year-old right-handed woman was admitted due to gait disturbance. She had suffered from progressive motor clumsiness in the left-sided limbs for four years. On admission, she was mildly demented, but not aphasic. Neurological examination disclosed constructional disability, limb-kinetic apraxia on the left side, and parkinsonism. Brain CT and MRI showed no responsible lesion. Three-dimensional surface display with 123I-IMP demonstrated decreased cerebral blood flow mainly in the right angular gyrus, and mildly in the right central region. She was clinically diagnosed as having corticobasal degeneration. Hypoperfusion in the angular gyrus and central region may account for constructional disability and limb-kinetic apraxia, respectively. Three-dimensional surface display with 123I-IMP appears to be useful for detecting the cortical region.