A case of pheochromocytoma incorrectly diagnosed before and during surgery

In a patient with an adrenal tumor, although norepinephrine levels in the blood and urine were abnormally high, findings in CT and 131 I-MIBG scintigraphy denied pheochromocytoma. The preoperative diagnosis was metastatic adrenal tumor. The surgical manipulation of the tumor increased the blood pressure from 110/60 to 210/110 mmHg. However, intraoperative microscopic examination in frozen section excluded again possibility of pheochromocytoma. Later, findings in the permanent specimen confirmed that the tumor was pheochromocytoma. The problem of this case was that each specialist made judgment only on the subject of his own interest without considering of the patient's status as a whole. Anesthesiologist should have the ability to make preoperative assessment of a patient by using all available information with his unbiased mind.     

In vivo signal transduction of tetrodotoxin-sensitive nociceptive responses by substance P given into the planta of the mouse hind limb

Diarrhea, sudden death after short duration of diarrhea and sudden death without apparent signs were observed in a herd of breeder pigs. Five pigs that died suddenly with diarrhea (SDD pigs) and 6 pigs that died suddenly without signs (SD pigs) were examined. The average age of the pigs was about 28 days. Twelve pigs of age 10 to 14 days old showing diarrhea (D pigs) were also examined. Eleven of them recovered. Large numbers of Escherichia coli were detected in all organs of every SDD and SD pig and in feces of D pigs. All of the isolates were identified as enterotoxigenic E. coli (ETEC) by the polymerase chain reaction (PCR). Porcine reproductive and respiratory syndrome (PRRS) virus cDNA was also detected from the lung of every SD and SDD pig by the RT-PCR. High and low titers of antibodies to PRRS virus were found in 10-day-old and 1-month-old pigs, respectively. In an experiment, 3 ETEC were isolated from 9 healthy weaning pigs during the quiescent stage in the herd. These data showed that growth of the ETEC was not active in healthy weaning pigs; however, following infection with PRRS virus ETEC infection became systemic and caused peracute death in the weaning pigs. It suggested also that infection with PRRS virus in 10-day-old pigs were protected by the colostral antibodies, and fatal infection by ETEC did not occur as a result.     

A case of multiple muscular abscesses of the lower limbs by Staphylococcus aureus after chemotherapy for lung cancer

A 67-year-old male was admitted to our hospital because of lung cancer and interstitial pneumonia. Cisplatin, vindesie and mitomycin C were administered for treatment of lung cancer. The leucocyte-counts declined to 1700/microliter on the eighth day after the chemotherapy. Though granulocyte colony-stimulating factor was administered, pain in the right thigh and high grade fever developed. Because Staphylococcus aureus was isolated from the blood specimen, piperacillin was administered. But the high grade fever continued and the pain was expanded to the right hip, left hip, thigh and leg. Because a computed tomograph of the lower limbs showed low density areas in bilateral gluteus maximus muscle right adductor magnus muscle, left biceps femoris muscle and left soleus muscle and the culture of an aspirate from abscess of right leg detected S. aureus, multiple muscular abscesses of the lower limbs was confirmed. We changed the antibiotics from PIPC to imipenem/cilastatin and minocycline on nineteenth day after the chemotherapy. His symptoms improved after the change of antibacterial agents. But he died of acute exacerbation of interstitial pneumonia, after about two months of the chemotherapy. Muscular abscesses of the limbs are very rare in Japan. Only four cases with muscular abscess of the limbs were reported in Japan, since 1988. This case suggests that a muscular abscess must be considered in the differential diagnosis of fever in patients with neutropenia.     

The clinical efficacy of imipenem/cilastatin sodium in orthopedic infections and drug levels in the bone tissue]

We evaluated the clinical efficacy of imipenem/cilastatin sodium (IPM/CS--a carbapenem antibiotic) against orthopedic infections, and the drug levels of the bone tissues were determined. The clinical efficacies for 6 patients in the infection group were good in 3 cases, and fair in the other 3; giving an efficacy rate of 50%. Bacteriologically, 8 strains were isolated from patients with the infection and an eradication rate of 87.5% was obtained upon the treatment. In 39 patients that were given the drug prophylactically, no postoperative infections occurred. Mean IPM levels in the bone and the bone marrow at 1 hour after administration in 5 patients of the prophylactic group were 17.3 micrograms/ml and 5.9 micrograms/g, respectively. The ratio of concentrations the bone to those in the bone marrow was 34.6%. The results of this study suggest that IMP/CS reaches to the bone tissue providing sufficient concentrations and that the drug is efficacious for the prophylaxis and the treatment of orthopedic infections.     

Fluorine-18-FDG PET imaging is negative in bronchioloalveolar lung carcinoma

The goals of our study were to establish PET accuracy with 18F-fluorodeoxyglucose (FDG) in finding localized formations of bronchioloalveolar lung carcinoma (BAC) and to investigate the correlation between FDG uptake and the degree of cell differentiation in adenocarcinoma of the lung. MATERIALS: Twenty-nine patients with 30 adenocarcinomas of the lung (7 bronchioloalveolar lung carcinomas, 9 well differentiated, 2 well-moderately differentiated, 11 moderately differentiated and 1 poorly differentiated) were studied. All patients underwent thoracotomies within 4 wk after the FDG PET study. For qualitative analysis, the degree of FDG activity in the tumors was visually scored using a five-point grading system: 0 = same to background activity, 1 = less than mediastinal blood-pool activity, 2 = same to mediastinal blood-pool activity, 3 = slightly greater than mediastinal blood-pool activity and 4 = substantially greater than mediastinal blood-pool activity. Foci of activity with Grades 2-4 were considered tumors. For semiquantitative analysis, standardized uptake values (SUV) were calculated. RESULTS: In 7 BACs, 4 lesions (57%) showed negative results on FDG PET, while in 23 non-BACs, only 1 lesion (4%), which was a well-differentiated adenocarcinoma showed a negative result. BACs' mean visual score (1.43 +/- 1.27) was significantly lower than that of non-BACs (3.17 +/- 1.03) (p = 0.001). The BACs' mean SUV (1.36 +/- 0.821) was significantly lower than that of well-differentiated adenocarcinomas (2.92 +/- 1.28) (p = 0.014); the mean SUV of well-differentiated adenocarcinomas was significantly lower than that of moderately differentiated adenocarcinomas (4.63 +/- 1.86) (p = 0.031). No significant differences were apparent in average size among these three histologic types. CONCLUSION: A correlation was observed between FDG uptake and the degree of cell differentiation in adenocarcinoma of the lung. FDG PET may show negative results for BAC.     

A wild-type Japanese measles virus strain inducing predominant early down-regulation of CD46

Down-regulation of CD46 secondary to stimulation with measles virus (MV) was investigated using CD46-positive cell lines and Japanese wild-type MV strains. The cells used were simian cell lines B95a and Vero in which MV strains have been adapted to be amplified, and Chinese hamster ovary (CHO) cell transfectants expressing human CD46 with (CHO(tail+)) or without (CHO(tail-)) the cytoplasmic tail. Of four Vero-adapted and three B95a-adapted MV strains, one Vero-adapted strain named Khono (KO), down-regulated CD46 within 60 min (early down-regulation) in all cell lines examined except Vero. No strains other than Toyoshima (TY), which induced early down-regulation only in CHO(tail+) cells, induced early down-regulation of CD46 in any combination. On the other hand, conventional down-regulation of CD46 was observed 24 h post-MV inoculation (late down-regulation) when cell lines used were adapted to MV strains. Thus, we concluded that there are two modes of CD46 down-regulation by MV and the unique strain KO markedly induces early down-regulation. Also, the CD46 homologue of B95a, which fails to act as a MV receptor, is down-regulated concomitantly with MV replication (>24 h) in cells principally by competent virus strains.     

Excitatory effects of algesic compounds on neuronal processes in murine dorsal root ganglion cell culture

The effects of algesic compounds on the distal portion of the processes of cultured dorsal root ganglion cells (C-fiber) of mouse were studied by patch-clamp whole-cell recording at the cell soma (cell body). The processes of the cell were isolated from the cell body with a separator. Bradykinin (BK, 10 microM), prostaglandin E2 (PGE2, 20 microM), and capsaicin (CAP, 2 microM) were applied to the processes of a cell on the third day after seeding, each of which evoked action potentials in the cell body. No desensitization was seen by the repeated application of BK to the processes. No action potentials in the cell body were observed when BK (10 microM) was applied concomitantly with tetrodotoxin (6 microM). These results suggest that the stimuli of algesic compounds to the neuronal processes of the cultured dorsal root ganglion cells are useful for studying the neuronal mechanism involved in pain.     

Estrogen receptor expression in bovine and rat retinas

PURPOSE: To investigate the expression and distribution of estrogen receptor protein and mRNA in bovine and rat retinas. METHODS: Western blot analysis with an antiestrogen receptor monoclonal antibody (mAb) was used to detect estrogen receptor protein in the bovine retina. Immunohistochemistry with an antiestrogen receptor mAb and in situ hybridization with an oligodeoxynucleotide sequence coding for estrogen receptor were applied to study the cellular distribution of estrogen receptor protein and its mRNA in male bovine retina and rat retina of both sexes. RESULTS: Estrogen receptor protein was detected in bovine retina by Western blot analysis. Immunohistochemical staining with the antiestrogen receptor mAb was widespread throughout the neural retina. Specific staining showed extensive distribution localizing in the nerve fiber layer, the ganglion cell layer, the inner nuclear layer, and the outer plexiform layer. Retinal pigment epithelium and choroid were also stained with the antiestrogen receptor mAb. By in situ hybridization, the expression of estrogen receptor mRNA was predominantly observed in ganglion cell layer, the inner nuclear layer, and outer portion of the outer nuclear layer. No significant difference was found between male and female rats in the immunostaining of retinas with the antiestrogen receptor mAb. CONCLUSIONS: This study provides the first evidence for the presence of estrogen receptor in bovine and rat retinas. Expression of estrogen receptor throughout the retina suggests that estrogen may have important functions in the retina.     

A hydrolase enzyme inactivating endogenous ligands for cannabinoid receptors

Cannabinoids are psychoactive components of marijuana, and bind to specific G protein-coupled receptors in the brain and other mammalian tissues. Anandamide (arachidonoylethanolamide) was discovered as an endogenous agonist for the cannabinoid receptors. Hydrolysis of anandamide to arachidonic acid and ethanolamine results in the loss of its biological activities. The enzyme responsible for this hydrolysis was solubilized, partially purified from the microsomes of porcine brain, and referred to as anandamide amidohydrolase. In addition to the anandamide hydrolysis, the enzyme preparation catalyzed anandamide synthesis by the condensation of arachidonic acid with ethanolamine. Several lines of enzymological evidence suggested that a single enzyme catalyzes both the hydrolysis and synthesis of anandamide. This reversibility was confirmed by the use of a recombinant enzyme of rat liver overexpressed in COS-7 cells. However, in consideration of the high Km value for ethanolamine as a substrate for the anandamide synthesis, the enzyme was presumed to act as a hydrolase rather than a synthase under physiological conditions. The recombinant enzyme acted not only as an amidase hydrolyzing anandamide and other fatty acid amides but also as an esterase hydrolyzing methyl ester of arachidonic acid. 2-Arachidonoylglycerol, which was found recently to be another endogenous ligand, was also efficiently hydrolyzed by the esterase activity of the same enzyme. The anandamide hydrolase and synthase activities were detected in a variety of rat organs, and liver showed by far the highest activities. A high anandamide hydrolase activity was also detected in small intestine but only after the homogenate was precipitated with acetone to remove endogenous lipids inhibiting the enzyme activity. The distribution of mRNA of the enzyme was in agreement with that of the enzyme activity.     

Effect of pressure onTc in La2-xBaxCuO4 withx=0.125

The superconducting transition temperature,T _c , of La_2–x Ba _x CuO₄ has been measured under high pressure up to 8 GPa.T _c is found to change drastically at the pressure where the structural phase transition takes place. This finding clearly indicates that there exists an intimate relation between the crystal structure and superconductivity.