Colocalization of Oestrogen Receptor lmmunoreactivity and Preproenkephalin mRNA Expression to Neurons in the Superficial Laminae of the Spinal and Medullary Dorsal Horn of Rats

A double-labelling procedure combining immunohistochemical staining with in situ hybridization using a radiolabelled cRNA probe was employed to demonstrate oestrogen receptor-like immunoreactivity and preproenkephalin-A mRNA in the medullary and spinal dorsal horn of female rats. Both markers labelled large numbers of neurons in the substantia gelatinosa and its trigeminal homologue. Many of these neurons were double-labelled, displaying both oestrogen receptor-like- immunoreactivity and preproenkephalin-A mRNA; cell counts showed that 40–60% of the of the oestrogen receptor-like-immunoreactive cells in the superficial laminae also were labelled for preproenkephalin-A mRNA, and that 60–70% of the preproenkephalin-A mRNA-labelled neurons in the same laminae displayed oestrogen receptor-like immunoreactivity. Previous studies have shown that oestrogen receptors can bind to the promoter region of the preproenkephalin-A gene, and studies on the hypothalamus have demonstrated that oestrogen regulates enkephalin expression in select neuronal populations. The present results demonstrate that enkephalinergic neurons in the superficial dorsal horn contain oestrogen receptors and suggest that oestrogen may play an important role in the modulation of sensory and nociceptive processing in the lower medulla and spinal cord.     

Neuromuscular diseases as models of cardiovascular regulation during exercise

This article reviews the research performed to date on the cardiovascular responses to exercise in patients with neuromuscular diseases and lesions affecting the transmission of afferent impulses from skeletal muscle. These studies have provided important information about the roles of central command and reflexes from skeletal muscle afferents in circulatory control. Few animal models of neuromuscular diseases are available. Studies of patients with specific defects in skeletal muscle energy metabolism are particularly valuable because the local metabolic state participates in both systemic and local cardiovascular regulation. In patients with certain muscle metabolic defects (e.g., McArdle's disease, carnitine deficiency) cardiac output is normal at rest but increases excessively in relation to oxygen uptake during exercise. The excessive increase in cardiac output during exercise can be totally or partially normalized by increasing the availability of substrate to exercising muscle. These studies provide unique insights into the specific metabolic factors which are involved in cardiovascular regulation.     

Measurement of growth rate of lung metastases in 21 patients with bone or soft-tissue sarcoma.

The volume doubling time (T2) of 52 lung metastases in 21 patients was calculated from measurements done on plain chest radiographs. Follow-up times ranged from 14 to 819 days. The measurements were fairly well reproducible in the majority of patients, although considerable discrepancies in T2 estimates made by two independent observers were found in a few patients. The median doubling time was 34.9 days (estimated 95% range 3.9 to 352 days). The variation of T2:s between patients was significantly (P = 0.0001) larger than that between T2: of multiple metastases in the same patients. The growth of the metastases seemed to be well described by a simple exponential function in all patients with more than two measurements, without evidence of Gompertzian growth. There seemed to be a linear correlation between the logarithm of T2 and log-survival time from diagnosis of metastatic disease, even if only one third of the variation of survival times between patients could be explained by differences in T2. T2 was not a significant factor for survival in Cox-analysis (P = 0.10).     

Autonomic dysfunction in women with mitral valve prolapse syndrome.

Autonomic cardiovascular regulation was evaluated in 35 women, 19 with mitral valve prolapse and 16 healthy controls. Heart rate responses to the diving reflex and to phenylephrine infusion were diminished in patients. Noninvasive measures of cardiac output, heart rate, blood pressure, forearm flow and leg volume during lower body negative pressure (LBNP) showed that patients had less lower extremity pooling of blood and had lower forearm conductance. Blood pressures during LBNP rose or remained unchanged despite decreases in cardiac output of 20--25%. These data indicate that mitral valve prolapse patients have an increased venous and arterial vasoconstrictor activity. Cardiac output at rest and echocardiographic indices of contractility were normal. Patients with a history of significant ventricular arrhythmias had higher heart rates and lower forward stroke volumes than the other patients or controls. The combined data demonstrate autonomic dysfunction in women with the mitral valve prolapse syndrome and suggest decreased parasympathetic, increased alpha- and normal beta-adrenergic tone and responsiveness.     

Substance P-like immunoreactivity in the lateral cervical nucleus of the owl monkey (Aotus trivirgatus): a comparison with the cat and rat

The location of substance P (SP) in the lateral cervical nucleus (LCN) of monkeys (Aotus trivirgatus), cats, and rats was investigated with immunohistochemical methods. Light microscopic analysis showed that SP-positive fibers and terminals are evenly distributed throughout the LCN of the monkey and rat, whereas the SP labeling in the LCN of the cat is concentrated in the medial part of the nucleus, with only very sparse labeling in the lateral part. Electron microscopic examination of the monkey LCN revealed the presence of SP-like immunoreactivity within terminal boutons and unmyelinated axons. The SP-positive boutons are in synaptic contact with dendrites and, occasionally, cell bodies; they contain densely packed, clear, round synaptic vesicles, as well as dense-core vesicles. The distribution of SP-like immunoreactivity in the LCN of monkeys, cats, and rats is similar to that of nociceptive-responsive neurons demonstrated in electrophysiological experiments. The possible role of the SP-containing fibers in the transmission of nociceptive information through the LCN is discussed.     

Tracing of neuronal connections with cholera toxin subunit B: light and electron microscopic immunohistochemistry using monoclonal antibodies

Subunit B of cholera toxin was used as a tracer substance in the central nervous system after being injected into various brain regions, mainly somatosensory relay structures. The tracer was localized with an immunoperoxidase technique, using monoclonal antibodies raised in mouse hybridomas. This method, which is applicable in both light and electron microscopic studies, is characterized by high contrast between specific labeling and unspecific background activity. It yields excellent retrograde labeling of the dendritic tree and is thus suitable for studying the neuronal cytoarchitecture and, on the ultrastructural level, the synaptic organization of identified projection neurons.     

Effect of increasing bronchodilatation on the single breath nitrogen test

To determine if and how changes of the slope of phase III of the N2 test reflect drug-induced bronchodilatation, we studied patients with moderate to severe reversible airflow limitation who inhaled increasing doses of salbutamol. The bronchodilating response on each dose level was monitored both by the N2 test and dynamic spirometry. The study shows that the slope of phase III is related to drug-induced bronchodilatation in a dose-dependent way. Furthermore, the decrease of the slope of phase III mirrors the concomitant increase of FEV1. These results are consistent with bronchomotor tone as a determinant of the slope of phase III. Alternatively, the decrease of the slope of phase III may be independent of bronchomotor tonus per se and be explained by a decrease in residual volume as reflected by the observed dose-dependent increase in vital capacity.     

The step technique for the reconstruction of lower lip defects after cancer resection. A follow-up study of 165 cases

One hundred and sixty-five patients with localized cancer of the lower lip were excised and reconstructed over a 25-year period using Bengt Johanson's step technique. Eight-eight percent of the tumors were less than 2 cm in size and 65% were of high histopathological differentiation. Fifty-six percent were reconstructed with bilateral step flaps. Nine local recurrences appeared in 5 patients, none of whom died of lip cancer. Eight patients later developed regional metastases and 3 of these patients died of lip cancer. The 5-year survival rate was 98%. The step technique is recommended for reconstruction of lip defects of up to 2/3 of the lower lip and may, in larger resections, be combined with either a fan flap or an Estlander flap. The outstanding functional results are due to the use of adjacent tissue for the reconstruction which preserves the normal arrangement of muscles, vessels and nerves.     

Hand function after replantation or revascularization of upper extremity injuries. A follow-up study of 21 cases operated on 1979-1985 in G?teborg

Twenty-one patients with revascularized/replanted amputated parts of the upper limb were studied for an evaluation of hand function. Two patients had been injured at the lower arm to wrist level, four between the wrist and MCP joint, three distal to the MCP joints in thumbs and/or fingers, and twelve in the thumb only. Hand function was measured as grip and pinch strength, range of movement (ROM), sensibility (two point discrimination), and Sollerman test score. Cold sensitivity as related to circulatory changes in the replanted limb was evaluated in six patients using the critical opening test (COP). Twelve of 17 initiated replantations (71%), and 11 of 12 revascularizations (92%), were successful. Hand function was restricted in patients with amputations at the lower arm to wrist level, fair in replanted midhands, good, but with wide variations after replantations at the MCP or distal II-V fingers, and best of all in replanted thumbs. Sensibility was poor in a majority of the patients. Three out of six of the patients who were COP-tested had significantly reduced blood pressure in the replanted part. The test results (grip, ROM, Sollerman score) in three patients with amputated thumbs were not found to differ greatly from those with replanted thumbs. These results raise the question of whether the Sollerman test underestimates the importance of the thumb or whether the thumb is overestimated in hand function.