Adrenal surgery: Trends during the seventies

Surgical experience with adrenal disease from 1970 to 1979 was reviewed in 315 patients. The pathologic conditions that were encountered were hypercortisolism (74 patients), hyperaldosteronism (46 patients), adrenocortical carcinoma (35 patients), pheochromocytoma (77 patients), and nonfunctioning adenoma (47 patients). In addition, 5 patients with metastatic lesions, 14 with cysts, and 4 with myelolipoma were surgically treated. The accuracy of localizing adrenal lesions increased from about 50 percent to almost 100 percent during the decade studied. The increase was due mainly to the introduction of computerized tomography, the most important advance in the management of adrenal disease. The present study shows that adrenal surgery can be performed with low morbidity and mortality. Operative deaths were confined to patients with malignant disease or increased secretion of cortisol or catecholamines. Only patients with adrenocortical carcinoma (2 year survival probability, 34 percent) or hypercortisolism due to cortical hyperplasia (5 year survival probability, 76 percent) had significantly decreased survival.     

Connections of the bullfrog striatum: Efferent projections

Autoradiographic and degeneration techniques were used to describe striatal efferents in the bullfrog (Rana catesbeiana). Horseradish peroxidase (HRP) was then placed in the major terminal fields to reveal the striatal cells responsible for these projections. Except for the small ventral eminence of the lateral pallium immediately adjacent to the dorsal striatum, no pallial region receives a striatal projection. Most striatal efferents descend in the lateral forebrain bundle (LFB), passing through the anterior entopedun-cular nucleus, where one large fascicle decussates in the anterior commissure and innervates the contralateral anterior entopeduncular nucleus and caudal ventral striatum. A smaller fascicle exits the LFB to terminate in the ipsilateral lateral amygdala. The remaining efferents continue caudal in the LFB through the posterior entopeduncular nucleus, with sparse projections to the ventral thalamus, the adjacent preoptic areas, and the posterior tuberculum leaving the bundle at various points. At pretectal levels, some efferents leave the LFB to run dorsally, through the caudal pole of the central thalamic nucleus and into the posterior division of the lateral nucleus and the lateral portion of the posterior thalamic nucleus. Efferents also continue caudal, through the superficial tegmental cell groups (nucleus profundus mesencephali and superficial isthmal reticular nucleus) before turning dorsomedially into the ventral anterodorsal, lateral anteroventral, and rostral pole of the posterodorsal tegmental fields. A small superficial projection continues to isthmal levels but cannot be traced beyond. Tegmental HRP injections retrogradely fill cells in the dorsal and ventral striatum as well as nucleus accumbens and the anterior entopeduncular nucleus. Pretectal HRP injections fill cells only in the caudal ventral striatum and anterior entopeduncular nucleus. Anterior entopeduncular nucleus HRP injections fill numerous cells in all striatal divisions, but some of this filling may be due to interrupted fibers of passage. Thus the anuran striatum, which receives its major input from thalamic nuclei relaying tectal and toral input, can in turn influence the midbrain roof via several disynaptic pathways: through the anterior entopeduncular nucleus, pretectum, and tegmentum, all of which project directly to the tectum and torus (Wilczynski and Northcutt, ′77; Wilczynski, ′81). Additional trisynaptic routes through the anterior entopeduncular nucleus and its pretectal and tegmental connections parallel the striatal routes.     

Post renal transplant thrombotic microangiopathy: A single centre experience

SUMMARY: Thrombotic microangiopathy (TMA) is a rare complication of renal transplantation. This study is a review of our experience of seven cases of TMA occurring between 1986 and 1995, an incidence of 0.8%. One patient had a recurrence of TMA in her graft having an episode of haemolytic uraemic syndrome as the cause of her original kidney failure. the other six patients had a rejection episode either at the time of diagnosis of TMA or a mean of 12 days prior to the diagnosis of TMA. All patients were treated with plasma exchange and those on cyclosporin had their dose reduced. Two patients had graft loss while the remainder had successful outcomes with stable graft function 3–11 years post diagnosis of TMA. We conclude that, in our experience rejection played a prominent role in the disease pathogenesis and that cyclosporin could be continued successfully albeit at a reduced dosage.     

HPLC柱切换法测定血浆和尿样中头孢克肟浓度

用双泵HPLC柱切换系统直接进样测定血浆和尿样中头孢克肟(cefixime,CFIX)的浓度。血浆和尿样的回收率分别为99.1%和98.6%;最低检测浓度分别为0.05和0.2μg/ml;日内和日间的RSD小于5%;血浆和尿样浓度分别在0.1～3.2和1.0～32μg/ml范围内呈线性相关。此方法集样品净化、富集成分和色谱分析一次连续进行,操作简便、快速,可以进较大的样品量,灵敏度相对明显提高。     

Anti-immobility activity of different antidepressant drugs using the tail suspension test in normal or reserpinized mice

Summary— The tail suspension test is a screening procedure recently used in mice to detect antidepressant activity of drugs. The ability of amine re-uptake inhibitors to decrease immobility in non-reserpinized and in reserpinized mice was studied. Reserpine (4 mg/kg ip) was injected 4 h previously. Anti-depressants were administered ip, 60 min before tail suspension. Animal activity was recorded for 6 min. Preferential serotonin re-uptake blockers (fluoxetine, fluvoxamine, clomipramine) were poorly active in non-reserpinized mice and inactive in reserpine-treated mice. Noradrenergic drugs (desipramine, demexiptiline, viloxazine) were more efficient in reserpinized than in non-reserpinized mice. The mixed serotonin- noradrenaline re-uptake inhibitor (imipramine) shows an activity which should be considered between serotonin re-uptake inhibitors and noradrenaline re-uptake inhibitors. DA re-uptake inhibitors (amineptine, GBR 12909) exhibited the highest anti-immobility effect in non reserpinized animals but were of low efficacy after reserpine treatment. Amphetamine differed from dopamine re-uptake inhibitors by its better activity in reserpinized animals. Moreover, it was the only drug showing an equal anti-immobility effect in non reserpinized and reserpinized mice because the dose of 8 mg/kg of amphetamine reduced immobility in reserpinised mice with the same intensity as the dose of 4 mg/kg in non reserpinised mice whereas no other drugs tested in this study achieved the same effect. Comparison of anti-immobility activities of putative antidepressants in non-pre-treated and in reserpine-pre-treated mice, using the tail suspension test, may be useful to discriminate amphetamines from antidepressant drugs and to differentiate between categories of amine re-uptake blockers.