Haptoglobin administration for hemolysis with autotransfusion of blood ultrafiltered after cardiopulmonary bypass

Ultrafiltration is well known as a useful method of hemoconcentration of the blood after cardiopulmonary bypass, but free hemoglobin increase is a problem in autotransfusion. The purpose of this study was to investigate the effect of haptoglobin administration for hemolysis with autotransfused blood ultrafiltered after cardiopulmonary bypass. By means of haptoglobin administration, autotransfusion of blood ultrafiltered with Hemocon (CD Medical Inc.) composed cellulose acetate membrane was performed in patients over a long period (max 313 min) of cardiopulmonary bypass, and with high serum free hemoglobin levels (max 128 mg/dl) at the end of the cardiopulmonary bypass. Comparing the prophylactic administration with the therapeutic administration of haptoglobin, both methods effectively prevented the increment of serum free hemoglobin level, but prophylactic administration (priming administration) was safer and more useful considering free hemoglobin level in ultrafiltered blood and changes of serum free haptoglobin, free hemoglobin and creatinine clearance during and after the operation.     

The meanings of the papaverine test

Intracavernous administration of papaverine is now commonly employed for diagnosis and therapy of impotence. To assess the pharmacokinetics of papaverine, we recorded its concentration in peripheral blood and also in cavernous blood after intravenous and intracavernous injection of 40 mg of papaverine. Peripheral blood was sampled serially after injection. Plasma was immediately extracted and then kept at at -40 degrees C until analysis. High pressure liquid chromatography was used to record the concentration of papaverine. The maximum serum concentration of papaverine measured after intracavernous injection was 7.7 ng/ml, which was considerably lower than the average serum concentration of 24.0 ng/ml after intravenous injection. Peak serum concentration was reached 1 min after intravenous injection and 10 min after intracavernous injection. It is clear that the corpus cavernosum constitutes a separate pharmacokinetic compartment. Therefore there was no significant difference between the papaverine concentration in peripheral blood of patients who showed full erection after intracavernous injection and that of patients who did not achieve erection. The concentration of papaverine in the intracavernous blood of a fully erected penis was only about 1 microgram/ml after 20 min. This concentration is similar to that in cavernous blood of those who showed excessively persistent erection. Our results imply that papaverine administered into the cavernous space relaxes smooth muscle, and is then washed out to general circulation, and the concentration in the cavernous space reaches a low level of about 1 microgram/ml. The low concentration level is maintained for several hours during erection. Therefore, we presume that papaverine acts on both the inflow system and smooth muscle of cavernous tissue in the phase of producing erections.(ABSTRACT TRUNCATED AT 250 WORDS)     

Inhibitory effects of kampo medicine on Epstein-Barr virus antigen induction by tumor promoter

We have investigated the possible interaction of Japanese Kampo medicine; Shosaiko-to with Epstein-Barr virus (EBV) induction by TPA (12-O-tetra-decanoyl-phorbol-13-acetate) in EBV-genome harboring cells. The effect of ether extract of Shosaiko-to was also studied on the induction of EBV by superinfection with EBV from P3HR-1 cells (P3H-EBV). Concomitant treatment of EBV-latently-infected cells (Raji and A2L/AH) with TPA and ether extract resulted in effective inhibition of EBV-antigen induction. However, in the experiments to test the influence of ether extract on EBV induction by superinfecting Raji cells with P3H-EBV, ether extract did not affect the percentage of EBV-antigen-positive cells. These data indicate that Shosaiko-to is effective to inhibit antigen synthesis induced by chemical promoters without affecting EBV-antigen induction after superinfection.     

Trial of isolation of a virus from sera of patients with Kawasaki disease

We tried to isolate pathogenic viruses from specimens of patients with Kawasaki disease. Blood clots and sera, spinal fluid, throat swabs, stool and urine from 24 patients with Kawasaki disease were studied. The specimens were inoculated into HEL cells and Vero cells. The cells were observed for one month, but no cytopathic effect (CPE) occurred. Blind passage was performed, but no degeneration of the second series of cells was observed. Fluorescent antibody indirect methods to determine viral antigens in cells inoculated with patients' specimens was also negative.     

Juvenile Crow-Fukase syndrome with response to bolus of methylprednisolone after failure of treatment by plasma exchange

A 20-year-old woman was hospitalized because of abdominal distention. She had developed facial edema about one year earlier, and recently amenorrhea and red verrucae on the chest and abdomen. Neurological examination disclosed hypesthesia, paresthesia, and diminished tendon reflexes in the arms and legs. The level of serum immunoglobulin A (IgA) was elevated and an M protein was detected. Examination of the bone marrow disclosed abnormal increase in plasma cells. Results of glucose tolerance test were mildly abnormal. The patient was diagnosed as Crow-Fukase syndrome. Plasma exchange was done four times and melphalan was given orally for two weeks, but the level of serum IgA increased further. Then one bolus injection of methylprednisolone decreased the serum IgA with improvement in other signs. The disorder is now controlled satisfactory with a low dose of prednisolone.     

Histological changes in the brain due to experimental obstructive jaundice

Histopathological changes and energy charge of the canine brain under the experimental obstructive jaundice were investigated. The common bile duct was ligated in group A (n = 25), and biliary decompression was carried out in group B after the duration of the obstructive jaundice, (n = 11). The results were as follows. 1) Simple atrophy, pyknosis, neuronophagia, and ghost cell were observed in nerve cells. 2) The changes of nerve cells appeared after 7 days of the obstructive jaundice at the basal ganglia, putamen and red nucleus. After 13 days of the obstructive jaundice, they spread widely to the thalamus, cerebral cortex and substantia nigra. 3) According to decreasing ratio of serum bilirubin concentration, B group was classified into 4 groups. Poorly decompressed groups III and IV showed severe histological changes than fairy decompressed groups I and II. 4) Energy charge of the substantia nigra after 7 days of the obstructive jaundice decreased to 0.65 comparing with 0.77 of control group. The results indicate that obstructive jaundice should be decompressed as early as possible.     

Development of sensitivity to maturation-inducing steroids and gonadotropins in the oocytes of the tobinumeri-dragonet, Repomucenus beniteguri, Callionymidae (Teleostei)

The effectiveness of steroids and gonadotropins (GtHs) in inducing final oocyte maturation was examined at different times of the day (0100, 0500, 0700, 0900, 1100, 1300, 1700, 2100 hr) in a daily spawning marine teleost, the tobinumeri-dragonet, Repomucenus beniteguri. The responsiveness of oocytes to GtHs and steroids was different at various times of day. The sensitivity of oocytes to hormones was apparent only during a certain period of the day (0100-0900 hr). Germinal vesicle breakdown (GVBD) could be induced by GtHs but not by steroids at 0100 hr. At 0500 hr, not only GtHs but also steroids at higher doses induced GVBD and ovulation. Oocytes underwent GVBD and ovulation at low doses of steroids at 0900 hr. GVBD and ovulation spontaneously occurred at 1100 and 1300 hr without any hormonal treatment. In addition, diameter and histological changes of ovarian oocytes were investigated. Ovarian oocytes were smaller than 420 microns, and only one oocyte group existed in distribution of oocyte frequency at 2100 and 0100 hr. With the increase in size of oocytes, two distinct groups appeared at 0500 hr. Larger oocytes completed GVBD at 1100 hr. Ovulation occurred between 1300 and 1700 hr and oviposition was completed between 1700 and 2100 hr daily. These results clearly show that the oocyte of the dragonet possesses a daily maturation rhythm. Responsiveness of oocytes to GtHs appeared earlier than responsiveness to steroids. This suggests that sensitivity to steroids is induced by GtH.     

Anti-nicotinic and anti-muscarinic actions of eperisone in the isolated canine atrium

The effects of eperisone, an antispastic agent, on the chronotropic and inotropic responses to acetylcholine, nicotine or stimulation of intracardiac autonomic nerves were evaluated in isolated, blood-perfused canine atrium. Eperisone (10-300 micrograms) injected into the sinus node artery of the isolated atrium produced dose-related negative chronotropic and inotropic effects, which were not affected by atropine. In the same doses, eperisone inhibited the negative chronotropic and inotropic responses to an injection of acetylcholine and intracardiac parasympathetic stimulation. Eperisone also suppressed the negative followed by positive cardiac responses to nicotine, but did not modify the positive responses to intracardiac sympathetic stimulation or norepinephrine. The inhibitory effect persisted much longer for the responses to nicotine or parasympathetic stimulation than for those to acetylcholine. These results suggest that eperisone at doses that induce direct cardiac depressant effects exerts its blocking action on nicotinic receptors at parasympathetic ganglia and sympathetic nerve terminals and on muscarinic receptors at the effector cells in the dog heart.     

Autonomic innervation of preretinal blood vessels of the rabbit

The preretinal blood vessels, that is, blood vessels lying on the inner surface of the retina, were observed by SEM examination using digestion methods, TEM examination and fluorescence histochemical examination using the Falck-Hillarp method. The nerve endings on the preretinal arterioles were distributed from the optic disc to the periphery. The longest nerve terminals from the optic disc to peripheral arterioles were about 9 mm. There were also a few nerve endings on the preretinal veins. These nerve endings had a series of axonal varicosities with diameters between 0.5 and 1.5 mu, which contained empty synaptic vesicles and cored synaptic vesicles. The number of nerve endings on these arterioles decreased with the shortening of the diameter of the retinal arterioles. Fluorescent nerve fibers with axonal varicosities were distributed on the wall of the preretinal blood vessels in the fluorescence histochemical study. These fluorescent nerve fibers were numerous near the optic disc, but there were only a few fluorescent nerve fibers on the peripheral blood vessels. The nerve endings on the preretinal blood vessels disappeared following superior cervical ganglionectomy. The present study shows that the preretinal blood vessels in rabbit eyes are innervated by the sympathetic nerve originating from the superior cervical ganglion.     

Comparative study between culture and PCR-RFLP analysis on identification of the causative agent of Tinea Unguium]

BACKGROUND: To identify the pathogenic fungi of dermatophytosis, restriction fragment length polymorphism (RFLP) analysis of PCR amplified ribosomal DNA including internal transcribed spacers (ITS) has been established in Japan. Our purpose was to evaluate the usability of PCR-RFLP analysis to identify the causative agent of tinea unguium directly from a nail sample. METHOD: Samples of tinea unguium from 100 nails were collected and cultured on Sabouraud's glucose agar and observed for 2 months. DNA was extracted from these samples, and the PCR product was digested with restriction enzymes Mva I and Hinf I. Weight of the samples was determined. RESULT: Sensitivity of PCR-RFLP analysis (73%) was higher than that of culture (20%) showing that PCR is more advantageous for identification of the causative agent of tinea unguium. Sensitivity of PCR-RFLP did not depend on weight of the nail sample.